Transcript Basic Vision Rehabilitation/Therapy Principles & Techniques

Basic Vision
Rehabilitation/Therapy
Principles & Techniques
Ashley S. Reddell, OD, FCOVD
HOACLS 2015
About Me
• From Haysville, KS
• Graduated from KU…..Rock Chalk!
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Worked as a vision therapist during undergrad
• Graduated from Southern College of Optometry
• Completed pediatric residency at SCO
• Joined a private practice in Leavenworth in 2010
• Now have 3 locations, 5 ODs, and ~28 staff
Housekeeping
• I have no financial interests in any of the products I may
mention during this presentation.
• If you have questions please email me….
[email protected]
Background Information on Vision
• Vision is the dominant sense
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Prism Demo
• 80% of what we learn comes through the visual system
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What happens if we have a faulty system?
Garbage In  Garbage Out
• The Myth of 20/20
What is it?
Visual Skills
• Eye Tracking (Oculomotor)
• Oculomotor Dysfunction
• Eye Teaming (Binocularity)
• Convergence disorders
• Divergence disorders
• Strabismus
• Eye Focusing (Accommodation)
• Accommodative Spasm
• Accommodative Insufficiency
Oculomotor Dysfunction
What if your eyes jumped
around like this?
Oculomotor Skills
• Pursuit Eye Movement
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The ability to smoothly follow a moving target
i.e. Following a ball or a pendulum
• Saccadic Eye Movement
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The ability to move eyes accurately and efficiently between two
stationary objects
i.e. Words on a page
• Link to gross motor skills
Symptoms of OMD
• Loses place while reading
• Skips words, skips lines while reading
• Difficulty copying from the chalkboard
• Uses finger or straightedge to read
Diagnosis of OMD
• NSUCO Tracking test
• Developmental Eye Movement Test (DEM)
• Visagraph
• Gross motor evaluation
• Vision & Learning Symptoms Survey
Treatment of OMD
• Eye Control
• Near-Far Hart Chart
• Hart Chart Saccades
• 4 Corner Saccades
Binocular Vision Dysfunction
Binocular Vision
• The ability to point both eyes together at the same
place and same time
• Necessary for 3D vision, good depth perception
• Poor with strabismus or amblyopia
• Convergence
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Refers to binocularity at near
• Divergence
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Refers to binocularity at distance
Symptoms of Binocular Vision Dysfunction
• Sees double when reading
• Words move/float on the page
• Closes/covers one eye when reading
• Avoids work involving reading or prolonged close-
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up activities
Falls asleep when reading
Poor depth perception
Diagnosis of Binocular Vision Dysfunction
• Stereo Vision Testing
• Cover Test
• Near Point of Convergence
• Vergences in the phoropter
• Worth-4-Dot
• Vision & Learning Screening Survey
Treatment of Binocular Vision Dysfunction
• Marsden Ball Games
• Brock String
• 3D computer programs
• Yoked prism activities
Accommodative Dysfunction
Accommodation
• The ability to change focus without blur at any
distance
• EXP: Looking from the chalkboard to their deskwork
• EXP: Looking from traffic to the dashboard
• Becoming more and more common with prolonged
near vision tasks (i.e. computer/iPad/phone use)
Symptoms of Accommodative Dysfunction
• Reports intermittent blur while reading
• Headaches while reading
• Must squint or blink when looking up from book
• May complain of blurred vision but still see 20/20 or
pass the school screening
• Eyes feel tired, dry
Diagnosis of Accommodative Dysfunction
• Refraction
• Accommodative amplitudes
• Accommodative facility
• Vision & Learning Screening Survey
Treatment of Accommodative Dysfunction
• Near-Far Hart Chart
• Accommodative Flippers
• Mental Minus
• Minus Lens Sorting
Autism Spectrum Disorders
• Imbalance of sensory information
• Use of Yoked Prism Lenses
• Toe walking
• Eye contact
• http://www.youtube.com/watch?v=OOS8q04kN-4
• http://www.youtube.com/watch?v=f-9N-mRRbMc
Traumatic Brain Injury
• Baseline concussion testing is an EYE MOVEMENT TEST!!!
• Many post-concussion symptoms are visual
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Blurred and/or Double Vision
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Focusing Dysfunctions
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No longer able to compensate for small prescription
Unable to change focus from distance to near and back
Visual Field (peripheral vision) Loss
Vision Fluctuations
Light Sensitivity
Balance Issues
Questions
• [email protected]