Why a Functional Vision Exam Matters

A basic vision screening is just that, basic. It takes a functional vision exam to really understand how well a person can use their eyes.

Children (and adults too) often get a routine vision screening at school or with their pediatrician. When you or your child passes with ’20/20 eyesight’ or gets a prescription for corrective lenses, it’s common to assume that that means their vision is fine. However, a child can pass a vision screening but still have serious functional vision problems that can seriously impede their ability to read or learn.

In fact, vision function covers far more than seeing letters on a chart!

Adults and children alike use their eyes to interpret and interact with the world around them, meaning any visual problem that can significantly affect their essential life skills. Visual processing skills refer to the ability of an individual to accurately read, distinguish objects, maintain balance and remember visual inputs correctly. Underlying problems with visual processing, such as eye-tracking, teaming, fixation and more can seriously impede someone’s ability to learn and succeed in life.

Only a functional vision exam, also called a vision therapy assessment, can diagnose the visual problems that can detrimentally affect learning and quality-of-life and ensure that all essential visual skills are working correctly. Reduced visual skills can result in conditions such as convergence insufficiency, amblyopia (lazy eye), strabismus (crossed-eyes), blurred vision, double vision and other problems that affect an individual’s neuro-visual processing.

Functional Vision Exam vs Standard Vision Exam

Standard eye exams check for visual acuity and for the presence of eye disease. However, if a patient suffered a concussion or an acquired brain injury, he or she may have excellent vision acuity, yet experience regular headaches, eye strain, vertigo, or light sensitivity (photophobia). These are all signs of functional vision issues.

Therefore, if your child is doing well developmentally and scholastically and you just want to check their eye health and vision acuity, a regular eye exam may be sufficient. However, if your child is experiencing developmental or learning difficulties, then a Functional Vision Exam is in order. Furthermore, if as an adult, your visual symptoms and struggles are not resolved with corrective glasses or contacts, consider undergoing a Functional Eye Exam as well.

Niwot Eyecare and Vision Therapy provides a comprehensive eye and functional vision examination that includes the assessment of visual information processing, binocular function and other essential visual skills.

Why Is a Functional Vision Exam Important?

All too often, it is an undiagnosed vision problem that causes problems with keeping focus at a distance (such as the board), or problems maintaining concentration. This can cause frustration and boredom and can often be responsible for an overlooked component of a child’s diagnosis with ADD/ADHD.

If your child is having difficulty with reading, homework, paying attention in class or is experiencing behavioral problems at school, it’s worth looking into. Contact Niwot Eyecare and Vision Therapy for a functional vision exam, and let Dr. Chang and Dr. Rachal get to the root of the issue.

What Is Included In a Functional Vision Exam?

A complete Functional Vision Exam can take anywhere from 45 to 60 minutes, or more. It begins with the review of the patient’s health and eye health history. This information will be used to tailor the Functional Vision Exam, which involves a series of tests on a wide range of visual skills, particularly learning-related vision issues. Other tests may be used for patients with developmental delays, brain injury and to examine sports vision.

A Functional Vision Exam Tests for Important Visual Skills

Functional vision is about much more than just seeing the object. It’s about how your entire visual system works with your eyes and brain to react to and interact with the objects around you in real-time.

To evaluate vision health, the functional exam will test for:

Eye Teaming/Convergence/ Depth Perception / Binocular Vision

This is when the eyes align to focus on the same point and work as a team in a coordinated fashion. If eye teaming is poor, it can cause double vision, poor 3D depth perception, eyestrain and fatigue, especially during reading and close work.

Furthermore, poor eye teaming skills (which occurs among 5-10% of children) can result in difficulties with convergence and issues with depth perception.

• Convergence insufficiency occurs when the eyes turn out while reading and doing close work. One needs to exercise immense effort to keep the eyes from drifting out, which, in turn, causes double vision and headaches.
• Convergence excess is when the eyes tend to turn inwards during reading and close work. The symptoms resemble those in convergence insufficiency.

Visual Acuity- Nearsightedness

Can the child see clearly at close distances? This is essential for reading, writing and doing other close work.

Focusing / Accommodation

Can the child maintain clear vision at varying distances? Quick eye focus adjustment is crucial to learning, reading, writing and sports.

For example: When a child moves his or her gaze from the board to his book, the eye muscles must contract or tighten, which causes the eye lens shape to change, allows the child to see clearly. To look back at the board, the child needs to relax the focusing muscle for clear distance vision.

Eye Tracking and Eye Movement

In those with healthy vision, eyes move accurately, smoothly and quickly from place to place. These movements rapidly and accurately scan the visual environment for information. For example, if a child switches its gaze from the board to their book and back, the eyes need to accurately jump from one target to the next. This is also the case in reading when jumping from one word to another, or for following moving objects in sports. In fact, eye-hand coordination in any activity begins with accurate eye movements.

For example: tracking allows you to understand the distance between you and a car, and the speed at which it’s driving. It also allows you to judge the distance and, if you’re going to honk, how loud the honk should be.

Poor eye movement and eye-tracking abilities can result in poor reading skills, speed, comprehension and concentration.

Letter Reversal

Does your child confuse or reverse letters or words (b, d; p, q; saw, was) past a certain age? After the age of seven, such reversals may indicate a visual perceptual dysfunction. The sooner you address letter reversals, the less ingrained the habit will be.

Color Perception

Accurate perception of color is crucial as many activities and occupations are based on being able to discern between various colors. Color is often used to emphasize a point or provide instructions. In daily living, color perception is needed to match outfits, obey traffic lights and work in certain professions, such as graphic design. Red-green color deficiency is the most common form of color-blindness, where red and green are both seen as a brown hue, this condition primarily affects males, with up to one in 8 (12%) experiencing color vision problems.

How Vision Therapy Helps Functional Vision

Vision therapy is an individually-tailored regimen of eye exercises made to improve visual functions and retrain the brain to interpret visual input more accurately. It is typically compared to [physical therapy], but for the visual system.

Children with functional vision problems struggle to learn simply because their visual system is not functioning as it should. The good news is that once he or she is provided with the right diagnosis, a personalized vision therapy program can result in significant lasting improvements within a relatively short period of time.

Does One Automatically Require Vision Therapy Following a Functional Vision Exam?

No. The functional vision exam determines whether you or your child has a vision problem. Though it’s not uncommon to find out that the only requirement is a change in prescription, the testing is necessary to get to the root of a suspected visual problem. If it is determined that vision therapy is necessary in order to correct or fix a visual issue, then you and your doctor can discuss further.

Good Vision Is So Much More Than 20/20

Pediatricians, school vision screenings or certain organizations may be able detect basic visual aberrations, such as myopia, through a vision screening, but the only way to absolutely ensure that all the essential visual skills are operating correctly is by conducting a functional vision exam.

Contact Niwot Eyecare and Vision Therapy today for a functional eye exam, or visit us with your concerns regarding your child’s vision, and we’ll be sure to find the best way to treat his or her visual problems.

Our practice serves patients from Niwot, Longmont, Boulder, and Erie, Colorado and surrounding communities.