Vision is a unifying system that helps us interact with and make sense of our world.

Eighty percent of learning occurs through vision. Vision is more than just acuity or whether someone requires glasses or not. Vision is a complex set of systems that encompasses acuity, visual perceptual skills, visual motor integration skills and ocular motor skills. It also plays a big roll in balance in combination with the vestibular system. Convergence is a main skill that is, put simply, the ability of the eyes to work together as a team instead of opposing forces.

It is estimated that up to 10 million children ages 0-10 experience visual difficulties. Children and adults may have 20/20 vision and still have poor ocular motor control.

When Is a Learning Difficulty Due to a Vision Problem?
While learning occurs through a number of complex and interrelated processes, vision plays a key role.  Many signs, symptoms, and behaviors associated with learning disabilities are similar to those caused by vision problems.  This is why it is so important that a comprehensive vision examination be part of the interdisciplinary evaluation of all children who are failing to succeed in school.

Here are some signs and symptoms to look for that may indicate a vision problem.

Symptoms		Possible Vision Problems
-Complains of blurred vision -Rubs eyes frequently -Squints		Nearsightedness, Farsightedness, or Astigmatism inability to see clearly in the distance or up close
- Closes or covers one eye - Occasionally sees double - Rubs eyes frequently - Able to read for only a short time - Poor reading comprehension		Eye coordination problems inability to coordinate the eyes together effectively Pursuits         Saccades
- Holds things very close - Complains of blurred vision - Poor reading comprehension - Says eyes are tired - Able to read for only a short time - Has headaches when reading		Eye focusing problems inability to easily refocus eyes or maintain clear focus Convergence         Divergence
- Moves head excessively when reading - Frequently loses place, skips lines when reading - Uses finger to keep place - Poor reading comprehension - Short attention span		Eye tracking problems inadequate ability to smoothly and accurately move the eyes from one point to another Pursuits
- Mistakes words with similar beginnings - Difficulty recognizing letters, words, or simple shapes and forms - Can't distinguish the main idea from insignificant details - Trouble learning basic math concepts of size, magnitude, and position		Faulty visual form perception inability to discriminate differences in size, shape, or form
- Trouble visualizing what is read - Poor reading comprehension - Poor speller - Trouble with mathematical concepts - Poor recall of visually presented material		Faulty visual memory inability to remember and understand what is seen Simon Says
- Sloppy handwriting and drawing - Can't stay on lines - Poor copying skills - Can respond orally but not in writing		Faulty visual motor integration inability to process and reproduce visual mages by writing or drawing
- Trouble learning right and left - Reverses letters and words - Trouble writing and remembering letters and numbers		Difficulty with laterality and directionality Poor development of left/right awareness

Physical signs or symptoms

• Frequent headaches or eye strain
• Blurring of distance or near vision, particularly after reading or other close work
• Avoidance of close work or other visually demanding tasks
• Poor judgment of depth
• Turning of an eye in or out, up or down
• Tendency to cover or close one eye, or favor the vision in one eye
• Double vision
• Poor hand-eye coordination
• Difficulty following a moving target
• Dizziness or motion sickness

Performance problems

• Poor reading comprehension
• Difficulty copying from one place to another
• Loss of place, repetition, and/or omission of words while reading
• Difficulty changing focus from distance to near and back
• Poor posture when reading or writing
• Poor handwriting
• Can respond orally but can't get the same information down on paper
• Letter and word reversals
• Difficulty judging sizes and shapes

How to Identify a Vision Problem
Children should be referred for a comprehensive eye exam whenever visual symptoms are noticed or if they are not achieving their potential. Many of these vision problems will not be detected during a school vision screening or limited vision assessment as part of a school physical or routine pediatric health evaluation. 

Adults may also experience difficulty with their visual system. Often the most drastic changes are noted with traumatic brain injury, stroke, concussion but a variety of difficulties are seen without a major diagnosis present. Often times adults experience difficulty reading for prolonged periods, difficulty driving at night, double vision, frequent headaches, imbalance or vertigo type symptoms.

Memorial Hospital is pleased to offer a new Vision Rehabilitation program, complete with state of the art equipment. The program offers two trained Occupational Therapists that utilize both hand held and advanced technological equipment to improve muscle control and work to develop accurate pursuit, saccade and fixational skills. The end goal works on integrating visual and motor abilities for fine and gross motor tasks. We work closely with Dr. Becker, O.D., a neurodevelopmental optometrist with more than 25 years of experiencing in detecting and treating these difficulties. He offers hours on-site as well for evaluation.