How We Treat Lazy Eye?

Vision Therapy

Vision therapy is highly successful in remediating a lazy eye.  Much akin to other physical therapies, vision therapy stimulates and guides visual development, training the brain to perform visual functions that did not develop on their own.  Vision therapy is prescribed by Optometrists who specialize in children’s vision and who have received board certification in this area of care.

Vision therapy is highly successful in improving the function and performance of a lazy eye.   Therapy corrects not only the poor vision in the lazy eye, but it also corrects the underlying problem of the brain’s inability to align and use both eyes together, so the gains are permanent.  During therapy, the patient’s brain is trained to stop suppressing the lazy eye, the visual pathways from brain to eyes are improved so the patient can keep both eyes aligned, and finally the brain is taught to fuse the images coming in from both eyes for normal binocular (“two-eyed”) vision.  Research shows that vision therapy restores the visual system to normal in over 90% of cases.  Even in the remaining 10% of cases, those most severe instances of lazy eye complicated by additional circumstances, therapy can improve the  child’s vision to more functional levels.  And this can be done at any age.  (It should be noted, however, these statistics are for children who have never undergone surgery.  Scare tissue and nerve damage drops the success rate for a child who has already had one surgery to fifty percent, and the therapy prognosis for children who have had more than one surgery is poorer still.)

Like other interventions, vision therapy usually involves patching the clear eye to force the blurry eye to work, but for much shorter periods of time.  Rather than full time patching for up to twelve hours a day, a patient in vision therapy will usually be asked to patch for two hours. Much less patching time is necessary when the child’s visual system is also being trained how to use the weak eye properly. By the end of therapy, the child’s patching time has been eliminated altogether.

The gains achieved in vision therapy are permanent.  This is because once the child’s brain  learns binocularity, or how to fuse the images from both eyes, the child’s visual system is restored to normal.  Binocular fusion is the glue which permanently holds the vision system in place, simply because it’s easier to see correctly than to have each eye fighting each other to see separately.  Binocular fusion keeps the eyes from drifting out of alignment, and because there is no longer a need for the lazy eye to suppress, its improved acuity, or sharpness of vision, is not lost over time.

If you have questions or concerns about lazy eye 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.

We understand that you might have a number of questions; especially if this is the first time you are hearing that your child may have a vision problem. Please feel free to call our office with your questions. Phone 03- 2110 3967

Visual Hygiene

The visual process can be protected by simple precautions such as proper lenses, posture, lighting, ergonomics and working distance.  Some pointers are provided.
There is ample evidence that conditions which lead to muscle tension and place undue stress on the visual system will, over a period of time, lead to visual problems such as nearsightedness and astigmatism, and other disorders such as focusing and binocular coordination problems like strabismus.  Many authorities blame our culture’s emphasis, for both children and adults, upon prolonged near vision tasks (such as reading, computers and other hand-held devices) for an increase in visual problems.

We certainly cannot eliminate those tasks that need to be done, and may even be pleasurable.  They can be carried out in a manner that imposes minimal stress on the visual system.

These suggestions, if followed, may result in easier and more productive study and desk work and will have value in preventing or retarding the development of visual problems.

Proper lenses can make all the difference in the world.  Most doctors remain unaware of the importance of proper near lenses for people of all ages.  The proper lenses can reduce and prevent stress and keep the visual system in optimal working order throughout our lives.
It is important for reading, writing, and other near vision tasks that the object being viewed be kept adequately far from the eyes.  The working distance should be at least sixteen inches for adults and older children, and at least twelve to thirteen inches for younger children.  When the viewing distance is shorter, the demand upon the focusing and eye teaming systems becomes increased out of proportion to the few inches involved.  This increased demand can lead to severe stress and strain.  Therefore, maintaining an appropriate working distance is the foundation of good visual hygiene. Good balanced, relaxed posture and proper lighting are also important.  Reading and writing while lying down, reading in bed, and other inappropriate postures tend to result in shortened viewing distances.  Insufficient lighting also causes one to hold reading material inappropriately close in order to see it.
Desk work should be performed at an appropriately sized desk and on a surface inclined at an angle of 20o.  The chair should be of such size to allow the feet to rest comfortably on the floor.  The buttocks should be flat and tucked fully to the back of the seat.  Kitchen or dining room tables were not designed for studying or writing.  They are usually too high and inappropriate for use by a child.  It is desirable to read while seated erect in a comfortable chair.  Tilt the book up about 20o.  Read in bed only when sitting upright – if at all.
For proper lighting when reading in a chair, illuminate the entire area using overhead/full-room lighting.  Next, have another light on your book – one that avoids bright reflection on the task.
When performing any prolonged near work, take breaks if you begin to feel your neck, shoulder, or back muscles beginning to tighten.
Don’t get “locked in” when doing close work.  Read or study no longer than fifteen to thirty minutes without interruption.  Look up at a distant object as you turn each page, and try to get the distant object clear before beginning to read the next page.  Looking back and forth from distance to near while reading reduces the tendency of the focusing muscles to become cramped.
Be aware of your general surroundings while reading or viewing TV. Do not place desks against walls. Do not sit any closer to TV than is necessary.  A minimum viewing distance of six to eight feet is reasonable.
Active outdoor play is an essential part of normal and healthy development.  Play activities that require seeing beyond arm’s length should be encouraged.
When walking outdoors, sight a distant object close to eye level and try to be aware of the path, where things to either side, and between you and the object at which you are looking and beyond.
When riding in a car, look in the distance rather than close by.
When ill, try not to read or view TV for very long periods of time, especially if you have a fever.  Similarly, try to avoid close work when you are very tired.  Listen to the radio, or music instead, or some other non-visual activity.
The best prevention is regular, professional care.  We will indicate how frequently your eyes and vision should be rechecked.
Obtained from the Gesell Institute of Human Development, New Haven, CT.

Contact Mr. Stanley for more information about behavioral optometry, vision therapy or your own visual hygiene questions.

3-D Vision At Age 48


Mon, 07/20/2009 – 15:23 — billg

Neurobiologist Susan Barry finally found her 3-D vision at age 48 – with the help of vision therapy.

She’s just published a new book about her journey – 3 surgeries as a child fixed her cross eye – but not her vision – experts told her “that’s just the way it is” – adults can’t change their vision.

Susan Barry did – with Dr. Theresa Ruggiero, a developmental optometrist located in Northampton, MA.

Read the full article below as it appeared in the L.A. Times on June 22, 2009.  Or, listen to Susan’s story in an NPR Radio interview (click here).

Susan Barry’s New Book, Fixing My Gaze (see it at


A visual impairment that condemns children to see in only two dimensions can go unrecognized for years and be mistaken for stigmatized disorders.

By Susan R. Barry

June 22, 2009 I was 20 years old and a college student before I learned that I did not see the world like everyone else. I had been cross-eyed as a baby, but three childhood surgeries made my eyes look straight. Because my eyes looked normal, I assumed I saw normally too. But, in fact, I was stereoblind — unable to see in three dimensions.

That means I could not see the volumes of space between objects. Instead, things in depth appeared piled one on top of another, making me feel nervous and confused in cluttered environments. As a child, I didn’t understand why my friends were so entertained when they looked through a View-Master. I didn’t see Disney characters or Superman popping out at me. All I saw was a flat image.

When I got older, my gaze — particularly at a distance — was jittery, making it difficult to read signs while driving. I was always disoriented and easily lost.

The biggest effect of my vision was on my performance in school. I had trouble learning to read and did poorly on standardized tests. These problems were blamed not on my vision but on a lack of intelligence, and I was put in a class with other problem children.

That was in the early 1960s, but the situation hasn’t greatly improved today. Children are still not routinely tested for binocular vision deficits because the standard school vision exam (reading the eye chart with one eye at a time) doesn’t screen for defects in eye coordination or stereovision. As a result, many children with vision problems may be labeled learning disabled, or if they misbehave in frustration, diagnosed with attention-deficit hyperactivity disorder.

Despite my visual shortcomings, when my husband and I took our children to Disney World 16 years ago, I insisted that we see the 3-D movies. As my kids watched gigantic insects fly off the screen toward us, they screamed and retreated to the safety of my lap. They were thrilled, and so was I. Although the bugs did not pop off the screen at me, I knew that my children’s view of the world was much more stable and depth-filled than mine, and that they were less likely to encounter the problems that I had faced in school.

Then, at age 48, I consulted a developmental optometrist who prescribed a program of optometric vision therapy, which taught me how to coordinate my eyes and see in stereo. With my new stereovision, I learned to play tennis and could drive with confidence and without fatigue.

Most surprisingly, my view of the world changed in ways I couldn’t have imagined. Ordinary objects looked extraordinary. Sink faucets popped out at me; light fixtures appeared to float in midair. Tree limbs reached out toward me or grew upward, enclosing palpable volumes of space. Snowflakes no longer appeared to be falling in one plane slightly in front of me but were falling at different depths all around me in a beautiful, three-dimensional dance. I felt myself immersed in a three-dimensional world.

So it was with great anticipation that I recently attended a showing of “Up,” the new 3-D Disney/Pixar film. When I put on the Polaroid glasses at the theater last week, the film scenery bloomed into three dimensions. Balloons floated off the screen, and clouds receded far into the distance. Even the characters’ noses seemed solid and palpable.

Combined with feelings of joy at my new view of 3-D movies were feelings of anger. Why hadn’t anyone told me when I was a child that I lacked stereovision? Why had all my problems in school been blamed on my supposed lack of intelligence and not on my vision? Why hadn’t my parents been told about optometric vision therapy? Why do these issues persist today?

Perhaps 3-D movies have more to offer than pure entertainment. With the growing number of 3-D films for children, more parents may spot visual deficits in their kids. Detecting these problems early and then seeking proper treatment can improve a child’s vision and transform a child’s life.

Susan R. Barry is a professor of neurobiology in the department of biological sciences at Mount Holyoke College and the author of “Fixing My Gaze: A Scientist’s Journey Into Seeing in Three Dimensions.”

Source:  LA Times, June 22, 2009

3D Movie Seems To Cause Real Life Change

Can a movie ticket change your life? It would seem so, at least for one movie fan.

Dr. Bruce Bridgeman and his wife walked into a movie theatre, picked up their 3D glasses and found a seat in preparation to view the 3D film Hugo. Donning the 3D glasses, Bridgeman, afflicted with the inability to process depth perception, was prepared only to eliminate the confusion of viewing a 3D film without filtration. Instead, the event left him nothing short of euphoric.

The film sparked a level of depth perception in his viewing that he had never experienced, delivering a huge dose of stereo vision as trees, lamp posts, and cars jumped out at him for the first time. Even after exiting the theatre, Bridgeman continued to see in 3D, an effort that eluded him for nearly all of his life.
While readers should use caution in assuming a 3D film can fix the flat vision of a person lacking stereopsis, Bridgeman’s experience is proof of the elasticity of the neurological-visual systems in processing images. Some feel the highly exaggerated 3D film produced just the right stimulus to reawaken neuro-visual pathways, in effect jump-starting Bridgeman’s depth perception.

Bridgeman was also well into his adult life, adding to the impressive elasticity of the brain with regard to recharging visual pathways outside of the childhood window once thought to be the only effective time period for treatment.

Mr Stanley and the staff at SunTime Vision Specialist (Neuro-developmental Optometry and Vision Therapy Services) are eager to help patients develop their vision to see the world at its best. If you, or someone you love, is experiencing less than adequate vision, please contact us at 03- 2110 3967, or [email protected]

Article from Dr Tod Davis Vision Therapy

Would You Look At That! Fixation, Fixation, Fixation

Right now as you read these words your eyes are fixating (looking) at successive points along the screen. Visual fixation (looking) is the neuromuscular aiming of the eyes at a specific point in space. You can easily understand the need for fixation when you imagine someone involved in detailed work, like threading a needle, or sporting activities, such as throwing a baseball. According to many researchers fixation is determined by three basic factors; salience of the visual stimulus, memory or importance of the stimulus, and the nature of an activity we are engaged in.

Whether we fixate (look) on one thing or another can depend on the salience of the stimulus, or how prominent something is in the environment (like bright balloons). Color, illumination, contrast, and patterns determine how people perceive the prominence of something in their environment. Advertisers take advantage of this by presenting consumer products in a very particular way so that their product is prominently displayed with dramatic lighting and surrounding colors.

Have you ever stared at something unknowingly for a several seconds until you realized the thing that caught your attention had actually triggered a memory or sequence of memories? Before you know it, you’ve been staring at it for several minutes. Recognition, memory and familiarity are prominent aspects of fixation. How well we fixate on an object or scene is dependent on if the object or aspects of the scene are interesting, contrasting, or familiar to us in some way.

Clearly some tasks are more important than others; driving versus watching television for instance. Safe driving requires one’s full attention and will demand fixation on the road ahead or other cars nearby. This is why the use of electronic devices, like a phone or music player, while driving is so dangerous. Watching television can be a very passive activity and does not require we completely fixate on what’s happening. The nature of a particular task can override what we fixate on whether something in our environment has salience, prominence or is memorable or familiar to us. Task fixation is one example of how we control what we fixate on and why.

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 fixation or any of the vision related issues noted in this article contact a developmental optometrists, like 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.

This post is from Dr DavisVision Therapy centre

Headaches And Vision

A headache is a symptom of an underlying condition. There are many types of headache, ranging from a sensation of mild pressure to severe migraine. Most headaches are caused by a combination of triggers including stress, poor diet, muscle tension and eyestrain.

Q: What is a headache?
A: Headaches occur when tissues or structures in and around the brain such as blood vessels, nerve fibres and sinuses are irritated, compressed or inflamed. Headache can result from referred pain from tooth, neck or eye problem.

Q: What is the difference between migraines and other headaches?
A: A migraine often involves a long-lasting headache with other symptoms that do not seem to fit with a headache, such as:

• Nausea and vomiting
• Blurred vision or zigzag lights
• Sensitivity to smell, touch, lights, and sound.
Migraine is very common in women (20per cent of women experience migraine in their life) and there is often a family history of migraine.
The distinction between headache and migraine is not always obvious. Migraine frequently has a pattern of features and recurrence that helps to diagnose it and to warn sufferers of an impending attack.

Q: What should I do if I get headaches?

A: All severe or frequent headache should be investigated. It is not always easy to tell if your headaches are ‘severe’, as this depends very much on your tolerance to pain. If you experience headaches that make you bedridden or unable to attend work, medical advice should be sought.
For the majority of annoying, niggling headaches, you should still try to find a cause so that you can prevent their occurrence or reduce your dependence on painkillers.
Ruling out contributing health problems is an important step in headache management. Most people will have some idea of why they get headaches, or at least notice a pattern of triggers, for example, after eating certain foods, after stressful periods or with poor posture or a sore back.
Think about what you believe may be causing your headaches, then seek advice from an appropriate health professional. People who experience headaches after reading or using computer, or after work every day, or who feel pain around their eyes, often seek an eye examination by an optometrist. Many of the eye problems that cause headaches can be successfully treated with prescription spectacle or contact lenses. Sometimes practical advice about the height and position of computer monitors in relation to the eyes can help.

Q: Who should be investigated?

• Children
• Patients who wake with a headache.
• Patients whose headaches commence over the age of 50 years.
• Patients whose headaches are becoming worse in severity and frequency.
• Patients with no previous history of headaches or sudden onset

Q: How can eye problems cause headaches?

A: In some cases, the headache is caused by the person squinting and overworking the eye muscles in an attempt to better focus their vision or co-ordinate eye muscles. Even people with ‘perfect’ vision can have underlying eye problems that cause headaches. In other cases, problems of internal pressure and swelling within the brain can cause headaches and visual symptoms.

Q: Can refractive errors cause headaches?

A: In the eye, the cornea and the lens work together to focus images at the back of the eye. If either the cornea or the lens is not perfectly positioned or shaped, poor focus and attempts to compensate for the out-of-focus image may results, with common symptoms of tired and aching eyes, blurred vision and headache.
The main problems that cause eyestrain and associated headache include:
• Astigmatism- the cornea is distorted, which means that objects look blurry from certain angles. A person with astigmatism tends to squint and lean into their work to better focus their vision, which can contribute to headache.
• Long-sightedness- A person who is longsighted has to exert their eye muscles more than people who are normal-sighted, when viewing things up close.
• Presbyopia- the lens becomes harder and inflexible with age. The symptoms include blurriness at near, sore eyes and difficulty changing focus from near to distance.

The ability to see the letters on an eye chart is just one of 17 visual skills. Most eye care professional do not test all 17 visual skills. So even if you have been told you or your child’s vision is OK, there could still be a problem that cause headache and eyestrain.
• Poor binocular co-ordination- some people’s eyes may not work well together, causing strain on the external muscles of the eyes.
Most conditions can be help with prescription, Lens treatment and Vision Therapy.

Q: Can pressure in the eyes cause headaches?

A: Most people who have the disease glaucoma do not feel any discomfort but in some forms of glaucoma rapid increases in eye pressure may cause severe eye pain, which extends into the forehead as a severe headache. These episodes also cause blurred, foggy vision and can damage the optic nerve at the back of the eye and need to be dealt with promptly.
Pressure can also build up in and around the eyes when a tumor or haemorrhage is present. Such serious disorders are rare although they should be considered by your health professional. Optometrists can conduct visual field tests as a tumor or mass may affect your visual system and peripheral vision.

Q: How can my Neuro-Developmental & Behavioral optometrist help?

A: headache is a condition that is often difficult to diagnose and treat yet is widespread and debilitating. No-one should have to live with severe or frequent headaches or migraines. Getting to the bottom of what causes a person’s headaches may require tests by different practitioners.
Neuro-Developmental & Behavioral Optometrists like Mr Stanley, is a health professionals who are expertly trained in headache management. Please contact us @ 03-2110 3967 or [email protected]