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PADULA INSTITUTE OF VISION rehabilitation click here for a large print version

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	Behavioral Vision Services
	William V. Padula, O.D., FAAO, FNOR
		Vision is learned. From our earliest moments in life we develop our ability to use sight to match up information with our movement system and other senses to organize, confirm, develop experience. This is vision. The experience of vision should become the primary means by which the child or adult explores their environment. Vision also becomes a primary influence in higher functions such as attention and concentration. Behavioral Vision refers to the ability of the doctor to understand and analyze vision problems that are not only functional (problems with eye muscle coordination) but also visual processing problems that affect our ability to attend, concentrate, orient ourselves in our spatial world, and to organize movement. A Behavioral Vision Exam differs from a routine eye exam since the doctor will spend additional time analyzing behavior of vision to gain more information about visual imbalances.   Learning Difficulties and Vision Problems   Children often have vision problems that interfere with learning abilities in the classroom. Frequently the vision problems are not diagnosed even following normal eye examinations and vision screenings at school or doctors offices. Vision problems interfere and challenge the ability to attend and concentrate. When vision problems are severe they can affect perceptual abilities and even cause developmental delays. Functional and/or developmental vision problems can cause interference with teaming of the two eyes together. This can cause the child to have difficulty with maintaining their eyes in alignment particularly when reading and writing. Focusing problems can also interfere with a child's ability to sustain visual attention during reading and writing activities. Vision screenings in school systems often do not evaluate the functionally use their eyes for reading and writing activities. Most vision screenings in schools test the child's visual acuity at 20 feet. A child may have 20/20 acuity at distance but may have difficulty focusing and integrating their eyes to sustain looking at reading and writing material. Some children will even have double vision at close viewing distances but be able to pass the vision screening for distance vision. While it makes little sense to only screen visual acuity at distance and then to send the child back to the classroom to work for the next several hours performing reading and writing tasks, this is presently the standard that is being used across the United States in our schools. Doctors performing only eye examinations will frequently miss the functional vision problems affecting near vision. If only an eye examination is performed, the eye doctor will inform the parents that the child has healthy eyes and that the distance acuity is normal or 20/20. Unfortunately, the doctor will often not test for convergence or focusing the problems that will relate to the symptoms of eye strain, headaches, and cause learning difficulties. A vision examination should include a careful functional analysis of near vision skills including the ability to develop pursuit tracking, saccades (quick eye movements), and sustained focusing ability. Common symptoms of functional vision problems affecting children in the classroom are as follows: Eyestrain after reading a writing Headaches Double vision Blur of print Seeing words jumble or move on the page Color Color Losing place when reading Using a finger to keep the place when reading Daydreaming - Having to re-read a paragraph to understand Blurring of vision at distance after reading   These are some common symptoms of vision problems affecting learning ability. Children who have vision problems are frequently diagnosed with Learning Disabilities and/or Attention Deficit Disorder. It is important to understand that Learning Disabilities and Attention Deficit Disorder are a classification of symptoms and are not a cause in themselves. One of the main reasons for having LD or ADD can be vision problems that are on diagnosed and that cause the symptoms. Treatment: After a careful functional vision examination treatment options may include glasses that relax the visual process enabling improved focusing ability and eye teaming or integration. Glasses may be recommended to be used in school and for all reading and homework. Frequently parents and teachers as well as children will notice that reading and writing skills may improve from simply using these specially designed developmental lenses. Vision therapy: Another option that is sometimes considered it is vision therapy. This is a special approach to train the child to establish improved visual skills necessary to meet the visual demands of reading and writing in the classroom. In vision therapy the doctor will present special activities using instruments, lenses, and prisms, to establish visual skills in order to enhance performance of vision. Dr. Padula has been specially trained to diagnose and treatment vision problems affecting learning abilities of children. He has received the E.B Alexander Fellowship at the Gesell Institute of Child Development where he studied and treated developmental vision problems of children from infancy and older. Dr. Padula has written many publications concerning vision problems of children as well as lecturing extensively on the subject.

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