The Importance Of Binocularity

Whenever Optometrists refers to ability of the brain to fuse two independent images,one from each eye, into one, they are talking about binocularity. Optimal binocularity, when both eyes are aimed singly at given point of distance, results in the merging (fusion) of both images into one three dimensional picture.

What Factors Inhibit Binocularity?

Inadequate vision development during childhood is a hefty factor in the lack of binocularity or eye teaming. Sometimes trauma including tumors, disease or injury can affect one’s binocularity and lead to poor fusion.

How Will Weak Binocularity Affect Vision?

Wherethere is a lack of eye muscle control, a person tends to compensate in ways that overtire or stress the visual system excessively. The extra exertion of the eye muscle tends to be the cause of headaches in those who suffer with problems in eye teaming.In severe cases the two pictures provided by each eye cannot be fused and double vision will occur. The brain sometimes attempts to alleviate these stressors by “ignoring” one of the images provided by the eyes, which is called suppression. In children it is possible that the child could develop visual impairment called amblyopia (lazy eye) where an eye is suppressed for too long by the brain becomes extremely weak.

How Are Binocular Problems Diagnosed?

There are many symptoms that imply an adult could be suffering from poor binocularity:
Double vision
Eye and body fatigue
Difficulty reading or concentrating
If a child is suffering from poor binocularity the following signs and symptoms may be present:
Covering one eye
Head Tilting
Skipping lines or losing their place while reading
Poor sports performance
Avoiding tasks that require close work
Tiring easily
If a child is suffering from poor binocularity the following signs and symptoms may be present:Covering one eyeHead TiltingSkipping lines or losing their place while readingPoor sports performanceAvoiding tasks that require close workTiring easily.

How Is Poor Binocularity And Other Vision Problems Treated?

This condition cannot be solved simply by utilizing prescription glasses or contact lens. Inadequate binocularity is generally treated with vision therapy along with specialized glasses. Vision therapy is a sequence of activities individually prescribed and monitored by a Neuro-Developmental Optometrist and administered by a Vision Therapist to develop efficient visual skills and processing. The professional staff at Sun Time Vision Specialist, Neuro-Developmental Optometry and Vision Therapy Services is ready to help you develop the most optimal vision possible and change your life.

How To Identify And Correct Double Vision

Sometimes when the eye,mind or body is exhausted, one can lose clarity in their vision; it can become blurred or even doubled. Some people suffer from (diplopial, Double image) double vision consistently in their lives; this condition is referred to as diplopia (Double image). Diplopia (Double image) can cause headaches and other common ailments, and it takes the help of a studied Optometrist to treat the condition of double vision. Mr. Stanley Tien is one such specialist, and is the main Neuro-developmental & Behavioral optometrist at SunTime Vision Specialist Neuro-Developmental Optometry and Vision Therapy Services. He believes that with some hard work, both children and adults can see tremendous results and a major life change. With offices in Kuala Lumpur, they strive to provide the best vision therapy treatments in the area. Mr Stanley has years of experience helping both children and adults to turn vision disorders into functional vision through therapy, and they would love to meet you and help you achieve a major life change.

How Does Double Vision Occur?

Double vision (double image, Diplopia) can come into play in two different ways. Strabismus (eye turn, squint eye) is the failure of both eyes to fuse images into one three dimensional picture to display for the mind. If one is plagued with strabismus (squint eye, eye turn) , their eyes do not point at one object at the same time, causing double vision (double image, diplopia) and the inability for the brain to digest one single picture. The second way that one can acquire the condition of double vision (double image, diplopia) is if they have a refractive error (power) that has not been corrected. When there is a refractive error (power) in one’s vision, they view of an object is split into two images due to error in the optical system; this can be caused by astigmatism, keratoconus and cataracts.

What Trials Does Double Vision Cause?

In the case of double vision (double image, diplopia) , the brain will block out one image that the mind is seeing in order to process the visual information that it receives. If this visual suppression occurs for a long period of time, especially in children, the visual system can become permanently impaired. When one eye becomes consistently suppressed it can become lazy, a common condition that is medically referred to as amblyopia (lazy eye). It can be difficult to treat the side effects of Strabismus (eye turn, squint eye) as they are a physiological result of the brain working to correct the ailment.

How Can Double Vision Be Treated?

Before attempting to treat double vision (double image, diplopia) , one must visit an Optometrist in order to find which condition is causing the vision to duplicate. If one suffers from Strabismus (eye turn , squint eye) they may have to undergo surgical straightening of the eye, practice eye exercises or go through a combination of both treatments. Neuro-Vision Therapy (Eye therapy) or exercises are practiced with the goal of straightening the strabismic (eye turn , squint eye) eye without surgery and in turn repair the visual pathway that is not properly connecting to the brain. If double vision (double image, diplopia) is related to astigmatism a patient will be prescribed corrective lenses to alleviate their duplicate vision. If cataracts are present in the optical system then a patient will possibly be referred to cataract surgery in order to repair the issue.

Whichever cause or treatment is necessary to repair double vision, the guidance of an experienced Behavioral & Neuro-developmental Optometrist is necessary. Regular visits to an optometrist from the age of six months are ideal for attaining optimal eye health. If a patient has been visiting an Optometrist or eye care professional for regular checkups, then it is less likely that they will have to take part in surgery to correct their double vision(double image, diplopia) problems.

The Eye’s Not Lazy Amblyopia Explained

The term “lazy eye” is a loosely used medical term that intones an older view of what is the most common cause of visual impairment in U.S. children, approximately five percent have it. The actual medical term is Amblyopia. It’s not an eye problem, it’s a problem where the brain ignores visual images from one eye due to a variety of vision disorders that cause double or blurred vision. The eye is not “lazy”, the brain is simply eliminating conflicting visual information by ignoring one of the images.

To look through a pair of amblyopic (lazy eye, blurred eye) eyes is challenging. Things are unclear. Shadows are hazy. Highlights and details are gone and colors are less vivid. One amblyopic patient describes looking at the world through her amblyopic eye is like holding her breath, or not scratching an itch, desperately wanting to open the stronger eye to let it take over.

Tracking while reading can be very difficult with an amblyopic (lazy eye, blurred eye) eye, as lines of type become wavy and even develop motion, causing the reader to lose track of progress. It also makes things go pretty slow, struggling to pay attention and interpret each and every word as it dances and fades.

When letters appear in a crowd, such as a word-find puzzle, people with amblyopia have difficulty seeing individual letters as opposed to one big mass of marks. Letters in the middle of the puzzle blur and blend into each other. Identifying letters becomes as difficult as counting grains of rice spilled on the floor from a standing position. Hard to determine which grains you’ve already counted, right?

There is a good amblyopia (lazy eye , blurred eye) simulation for those wanting to experience what an amblyopia (lazy eye, blurred eye) sufferer might experience. In a normally-lit room, put a patch on one eye, or just cover it with your hand, for two to five minutes. Then, either have someone turn the lights out, or move to a darkened room and uncover your eye. The covered eye has adjusted to the dark conditions, and will see pretty well, but the uncovered eye will not see very well, experiencing a disadvantage. That disadvantage of that uncovered eye moving from light into dark is similar to the disadvantage experienced with amblyopia. Try it and “see” for yourself.

Mr Stanley, Neuro-Developmental Optometrist would like to remind readers that there is help for those with vision disorders like amblyopia. His staff at Sun Time Vision Specialist ,Neuro-Developmental Optometry and Vision Therapy Services can work with you to develop a program that will have you seeing the world at its very best.

Blind People Had Good Vision? Ask Me How

Helen Keller Had Good Vision; Ask Me How!

Most of us are familiar with the true story of Helen Keller. She was born June 27, 1880 in Tuscumbia, Alabama. Although born with sight and hearing, Helen was rendered blind and deaf by an illness at 19 months of age. Because of her disabilities, Helen did not develop typical language skills and by the age of six only had a rudimentary “home based sign language” of about sixty words. Fortunately Helen’s parents pursued means to help her develop and were eventually introduced to Anne Sullivan who began a process of teaching Helen to communicate. Over time Helen not only learned to communicate but was able to develop an understanding of her environment and thrive in it. So how did Helen Keller have good vision?

Image removed.

Helen Keller

Vision is more than sight and acuity. It is the comprehensive ability to organize what is seen so that it can be understood. That understanding is then used to guide and direct one’s actions in an environment to achieve what is needed and/or wanted to survive and thrive. As Dr. Kaplan mentioned, “It is not just seeing clearly but obtaining meaning and understanding about what is seen.”
Vision is the brain’s ability to unify sensory information derived from our eyes, vestibular system (inner ear system responsible for balance and coordination), and proprioceptive system (sensory information from our skin, muscles and tendons). The sum total of the information creates a perceptual image of our environment that we use to visualize our intended movements and interactions. The visualization of our intended movements, interactions and activities in our environment precedes the action itself, even if we’re not necessarily aware of it. This is what Helen Keller was able to develop over time despite blindness.

Unfortunately not everyone fully develops their visual-perceptual abilities due to array of circumstances like neurological disease and injury, and vision related problems that stem from delayed or interrupted childhood development. The good news is that most of those whose vision did not develop optimally can be helped through developmental optometry and vision therapy. Neuro-Developmental Optometrist, like Mr Stanley, can expertly diagnose and treat vision related problems. Their professional staff and Vision Therapist have been changing lives through vision therapy.
Helen Keller’s personal struggle and eventual triumph can be analogous to the struggles of anyone who has suffered from vision related problems and has undergone vision therapy. In particularly anyone who’s ability to create a perceptual image of their environment was impaired or never properly developed. Many vision therapy patients work hard and struggle to obtain the gift so many others take for granted the gift of vision. Helen Keller once wrote “The best and most beautiful things in the world cannot be seen, nor touched … but are felt in the heart.” Or, it could be added, perceived in the mind.

This article been altered from Dr Tod Davis’s article

TV, Ipad Friend Or Enemy?

American Academy of Pediatrics says no TV is good for kids before the age of two. ” while certain television programs may be promoted to this age group, research on early brain development showes that babies and toddlers have a critical need for direct interactions with parents and other significant caregivers for healthy brain growht and development of appropriate social , emotional, and cognitive skills,” says American Academy of Pediatrics statement.

While there does not seem to be any present infrormation of actual physical harm to eye structures from television viewed at a proper distance after the age of two, it is important to consider function as well as structure. The TV camera probes for depth as a single eye might, focusing near and far as it pucks up the picture. When the picture is transmitted into your living room, it arrives on the television screen pre-focused. The only focusing the viewer needs to do is fro the distance to the screen. To see the TV screen/Ipad Screen  in focus, you must turn off the natural focusing of your eyes or the pciture would constantly blur.

Not only do you have to suspend normal focus but convergence (eye teaming, the abilty to point the eyes inward at the visual task) does not function either. If it did, you would point your eyes in towards your nose for the close-up shots, out toward a more nearly parallel position for the distance shots, and you would be in trouble. The television screen or Ipad screen  would “double” as well as blur. So how does the visual system cope with the television ? You learn to TURN off the convergence (eye teaming system).

If you already use your eyes well together, and don’t watch too much TV or Ipad , this is just another thing you learn to do with your eyes, and no harm is done. A problem arises, however when people with poor “eye teaming” or who are in the process of learning to see, watch a great deal of TV or Ipad.

No child should be allowed to watch hour after hour of television or Ipad, particualry without other everyday activities to help him learn to use his eyes in other ways. The child who spends too much time in his early years sitting in front of the television or Ipad may well be almost visually handicapped by the time he starts school. His eyes have learned to avoid communication between focusing and convergence. He has not practiced changing focus from far to near , or near to far, so copying from a chalkboard will be slow and tedious work for him. He has not learned to sustain a close-work task, so most of his desk work will be a strain, or low attention.

Children can and should benefit from television. If they are limited to programs that widen their knowledge of the world, television can contribute to their education. If it is never used as a babysitter, but rather as an addition to the family’s shared time to stimulate discussion and description , it can have real value.

Vision related challenges like convergence insufficiency; amblyopia and/or strabismus (the turning of an eye in or out) limit or prevent the eyes to aim at a specific point in space. Some studies suggest that this can affect twenty percent of children with learning related issues. Short and long term memory can also be affected by vision related disorders.

If you have questions or concerns about eye teaming ,focusing or any of the vision related issues noted in this article contact Mr Stanley,Neuro-Developmental Optometry, Board Certified in Vision Development & Vision Therapy. After a detailed screening and diagnosis they can design a vision therapy program specifically suited to develop the most optimal and efficient visual system for you or your child.

Does Tinted Lenses Overlay Help For Dyslexia?

The Use of Tinted Lenses and Colored Overlays for the Treatment of Dyslexia and Other Related Reading and Learning Disorders

Over the past two decades the use of tinted lenses and colored overlays to improve reading comfort and performance has been presented in both the popular media and professional literature. With increasing frequency, patients and parents consult optometrists about the value of colored overlays and tinted lenses. Meares1 and later Irlen2 described a syndrome of visual symptoms and distortion that can be alleviated with colored filters. This syndrome has been referred to as “scotopic sensitivity syndrome” or the Irlen Syndrome.3 Colored overlays and tinted lenses are purported to improve reading ability and visual perception, increase sustained reading time, and eliminate symptoms associated with reading such as light sensitivity, eyestrain, headaches, blurring of print, loss of place, and watery eyes.

A comprehensive review of the available scientific literature regarding the effectiveness of tinted lenses or filters revealed the following:

There is evidence that the underlying symptoms associated with the Irlen Syndrome are related to identifiable vision anomalies, e.g., accommodative, binocular, and ocular motor dysfunctions, in many patients seeking help from colored lenses.4-7 Furthermore, such conditions return to normal function when appropriately treated with lenses, prisms, or vision therapy. When patients exhibiting the Irlen Syndrome were treated with vision therapy, their symptoms were relieved. These patients were no longer classified as exhibiting this syndrome, and therefore did not demonstrate a need for the colored overlays or tinted lenses.4

Most investigators have not controlled for the presence of vision anomalies, e.g., accommodative, binocular, and ocular motor dysfunctions. In most cases, researchers have simply assumed that a history of a previous eye examination ruled out any significant vision problem.8-14 Others have developed a protocol to screen for vision problems but have not included an adequate battery of tests to eliminate common accommodative, binocular, and ocular motor dysfunctions.3, 15-19

The results of prospective, controlled research on the effectiveness of tinted lenses or colored overlays vary. One randomized, controlled trial demonstrated that children with reading difficulties, who were prescribed filters based on colored overlays, experienced reduced symptoms of asthenopia.15  While this study suggests the color may need to be individually and precisely prescribed, another study demonstrated significantly improved eye movements among reading disabled children when reading through blue filters.20  Other researchers failed to find improvement in comprehension scores in readers using tinted lenses.4

Results of testing utilized to determine the most appropriate color are not repeatable.21, 22 There are numerous variables within the individual and the environment (such as differences in lighting between the home and various classrooms) that can influence the effectiveness of assigned overlays. It has been reported that up to twenty-five percent of the time, children who receive tinted lenses need to have their tints adjusted within the first year.23

The effect of spectral filters and colored overlays is not solely a placebo.15 Colored overlays and tinted lenses are not cures for dyslexia, but may be useful reading aids for some individuals with reading difficulty.24

The underlying physiological mechanism for the Irlen Syndrome is still not known.  While some argue that a magnocellular deficit exists in these individuals,25-29 others suggest the problem is pattern glare.30, 31

There is lack of agreement about the best way to evaluate patients for the presence of the Irlen Syndrome. Some suggest the use of the Irlen 2-part evaluation system,32 while others promote the use of the Intuitive Colorimeter.33 Both systems require additional research.

Visual processing is a fundamental part of the reading process.34 Future research must address the issue of underlying vision anomalies, sub‑typing of reading disabilities and the differential response to different treatments. Controlled clinical research will allow reading and learning disabled individuals, their parents, and the professionals who work with them, to better evaluate the effectiveness of available treatments for each individual.

Therefore, it is the position of the American Optometric Association that:

1. Undetected vision problems may be a factor in individuals who exhibit the symptoms of the Irlen Syndrome.  A comprehensive vision examination (NDVE) with particular emphasis on accommodation, binocular vision, and ocular motor function is recommended for all individuals experiencing reading or learning difficulties, as well as those showing signs and symptoms of visual efficiency problems.

2. The American Optometric Association encourages further research to investigate the effect that specifically tinted lenses and colored overlays have on visual function related to reading performance.

3. Vision problems are a frequent factor in reading difficulities.  Ignoring the role of vision or inadequately evaluating the vision of individuals with reading problems is a disservice which may prevent the person from receiving appropriate care.
This publication was formulated by the American Optometric Association’s Binocular Vision Working Group. The following individuals are acknowledged for their contributions:

Gary J. Williams, O.D., Chair
Gregory Kitchener, O.D.
Leonard J. Press, O.D.
Mitchell M. Scheiman, O.D.
Glen T. Steele, O.D.

Approved by: American Optometric Association, April 2004


Meares O. Figure/ground, brightness contrast, and reading disabilities. Visible Language, 1980;14: 13-29.

Irlen H. Successful treatment of learning difficulties. in 91st Annual Convention of the American Psychological Association. August 1983. Anaheim, CA.

Evans BJ, et al., A preliminary investigation into the aetiology of Meares-Irlen syndrome. Ophthal Physiol Opt 1996;16:286-296.

Blaskey P, et al. The effectiveness of Irlen filters for improving reading performance: A pilot study. J Learning Dis 1990;23: 604-612.

Scheiman M., et al., Vision characteristics of individuals identified as Irlen Filter candidates. J Am Optom Assoc, 1990; 61:600-605.

Lopez R. et al. Comparison of Irlen scotopic sensitivity syndrome test results to academic and visual performance data. J Am Optom Assoc 1994; 65:705-714.

Hoyt  CS. Irlen lenses and reading difficulties. J Learning Dis 1990; 23:624-626.

Robinson GL, Foreman PJ. Scotopic sensitivity/Irlen syndrome and the use of coloured filters: A long-term placebo controlled and masked study of reading achievement and perception of ability. Percep Motor Skills 1999; 89: 83-113.

Robinson GL, Miles J. The use of overlays to improve visual processing-A preliminary report. Except Child 1987; 34:65-69.

Robinson GL, Conway RNF.  Irlen lenses and adults: a small-scale study of reading speed, accuracy, comprehension and self-image. Aust J Learn Disabil  2000; 5:4-12.

Whiting  PR. Improvement in reading and other skills using Irlen coloured lenses. Aust J Remed Educ 1988;20:13-15.

Clayton P. The Irlen lens: scotopic sensitivity. Optician, 1987. 194: p. 22-25.

Robinson GL, Conway RNF. The effects of Irlen colored lenses on students’ specific reading skills and their perception of ability: a 12-month validity study. J Learning Dis, 1990; 23: 621-626.

O’Connor PD, Sofo F, Kendal L.  Reading disabilities and the effects of colored filters. J Learning Dis 1990; 23:597-603.

Wilkins AJ,  et al.  Double-masked placebo-controlled trial of precision spectral filters in children who use coloured overlays. Ophthal Physiol Opt 1994;14:365-370.

Evans BJ, et al., Optometric correlates of Meares-Irlen Syndrome: a matched group study. Ophthal Physiol Opt  1995;15:481-487.

Scott L, et al..  Coloured overlays in schools: orthoptic and optometric findings. Ophthal Physiol Opt  2002; 22:156-165.

Evans BJ, Joseph F.  The effect of coloured filters on the rate of reading in an adult student population. Ophthal Physiol Opt 2002; 22:535-545.

Spafford CS, et al.. Contrast sensitivity differences between proficient and disabled readers using colored lenses. J Learning Dis, 1995;28:240-252.

Solan HA, et al..  Eye movement efficiency in normal and reading disabled elementary school children: effects of varying luminance and wavelength. J Am Optom Assoc 1998;. 69: 455-464.

Solan HA, Richman J.  Irlen Lenses: A critical appraisal. J Am Optom Assoc 1990; 61: 789-796.

Woerz M, Maples WC. Test-Retest Reliability of Colored Filter Testing. J Learn Disabil 1997; 30: 214-221.

Stone R.  The light barrier: understanding the mystery of Irlen syndrome and light-based reading difficulties.  New York: St. Martin’s Press, 2003.

Wilkins AJ.  Overlays for classroom and optometric use. Ophthal Physiol Opt 1993;14:  97-99.

Livingston MS, et al.  Physiological and anatomical evidence for a magnocellular defect in developmental dyslexia. Proc Natl Acad Sci USA, 1991; 88:7943-7947.

Solan HA, et al., Transient and sustained processing: effects of varying luminance and wavelength on reading comprehension. J Am Optom Assoc 1997;68:503-510.

Solan HA, et al., Coherent motion threshold measurements for M-cell deficit differ for above- and below-average readers. Optometry 2003; 74:727-734.

Williams MC, LeCluyse K.  Perceptual consequences of a temporal processing deficit in reading disabled children. J Am Optom Assoc 1990; 61:111-121.

Lehmkuhle S, et al.  A defective visual pathway in children with reading disability. N Engl J Med 1993; 328: 989-996.

Evans BJ, et al. Effect of pattern glare and colored overlays on a simulated-reading task in dyslexics and normal readers. Optom Vis Sci 1994; 71: 619-628.

Wilkins AJ, Milroy R, Nimmo-Smith, I. Preliminary observations concerning treatment of visual discomfort and associated perceptual distortion. Ophthal Physiol Opt 1992;12:257-263.

Irlen H. Reading by the Colors: Overcoming Dyslexia and Other Reading Disabilities by the Irlen Method.  New York: Avery, 1991.

Wilkins AJ, Nimmo-Smith I, Jansons JE.  Colorimeter for the intuitive manipulation for hue and saturation and its role in the study of perceptual distortion. Ophthal Physiol Opt 1992;12:381-385.

Garzia RP, Franzel AS.  Refractive status, binocular vision, and reading achievement.  In: RP Garzia, ed.  Vision and Reading.  Mosby: St. Louis, 1996.