Basic Vision RehabilitationTherapy Principles Techniques Ashley S Reddell

Basic Vision Rehabilitation/Therapy Principles & Techniques Ashley S. Reddell, OD, FCOVD HOACLS 2015

About Me • From Haysville, KS • Graduated from KU…. . Rock Chalk! • Worked as a vision therapist during undergrad • Graduated from Southern College of Optometry • Completed pediatric residency at SCO • Joined a private practice in Leavenworth in 2010 • Now have 3 locations, 5 ODs, and ~28 staff

Housekeeping • I have no financial interests in any of the products I may mention during this presentation. • If you have questions please email me…. areddell@Family. Eye. Care. Center. LV. com

Background Information on Vision • Vision is the dominant sense • Prism Demo • 80% of what we learn comes through the visual system • • What happens if we have a faulty system? Garbage In Garbage Out • The Myth of 20/20

What is it?

Visual Skills • Eye Tracking (Oculomotor) • Oculomotor Dysfunction • • • Convergence disorders • • Accommodative Spasm • Eye Teaming (Binocularity) Divergence disorders Strabismus • Eye Focusing (Accommodation) Accommodative Insufficiency

Oculomotor Dysfunction What if your eyes jumped around like this?

Oculomotor Skills • Pursuit Eye Movement • • The ability to smoothly follow a moving target i. e. Following a ball or a pendulum • Saccadic Eye Movement • The ability to move eyes accurately and efficiently between two stationary objects • i. e. Words on a page • Link to gross motor skills

Symptoms of OMD • Loses place while reading • Skips words, skips lines while reading • Difficulty copying from the chalkboard • Uses finger or straightedge to read

Diagnosis of OMD • NSUCO Tracking test • Developmental Eye Movement Test (DEM) • Visagraph • Gross motor evaluation • Vision & Learning Symptoms Survey

Treatment of OMD • Eye Control • Near-Far Hart Chart • Hart Chart Saccades • 4 Corner Saccades

Binocular Vision Dysfunction

Binocular Vision • The ability to point both eyes together at the same place and same time • Necessary for 3 D vision, good depth perception • Poor with strabismus or amblyopia • Convergence • Refers to binocularity at near • Divergence • Refers to binocularity at distance

Symptoms of Binocular Vision Dysfunction • Sees double when reading • Words move/float on the page • Closes/covers one eye when reading • Avoids work involving reading or prolonged close- • • up activities Falls asleep when reading Poor depth perception

Diagnosis of Binocular Vision Dysfunction • Stereo Vision Testing • Cover Test • Near Point of Convergence • Vergences in the phoropter • Worth-4 -Dot • Vision & Learning Screening Survey

Treatment of Binocular Vision Dysfunction • Marsden Ball Games • Brock String • 3 D computer programs • Yoked prism activities

Accommodative Dysfunction

Accommodation • The ability to change focus without blur at any distance • EXP: Looking from the chalkboard to their deskwork • EXP: Looking from traffic to the dashboard • Becoming more and more common with prolonged near vision tasks (i. e. computer/i. Pad/phone use)

Symptoms of Accommodative Dysfunction • Reports intermittent blur while reading • Headaches while reading • Must squint or blink when looking up from book • May complain of blurred vision but still see 20/20 or pass the school screening • Eyes feel tired, dry

Diagnosis of Accommodative Dysfunction • Refraction • Accommodative amplitudes • Accommodative facility • Vision & Learning Screening Survey

Treatment of Accommodative Dysfunction • Near-Far Hart Chart • Accommodative Flippers • Mental Minus • Minus Lens Sorting

Autism Spectrum Disorders • Imbalance of sensory information • Use of Yoked Prism Lenses • Toe walking • Eye contact • http: //www. youtube. com/watch? v=OOS 8 q 04 k. N-4 • http: //www. youtube. com/watch? v=f-9 N-m. RRb. Mc

Traumatic Brain Injury • Baseline concussion testing is an EYE MOVEMENT TEST!!! • Many post-concussion symptoms are visual • Blurred and/or Double Vision • • Focusing Dysfunctions • • • No longer able to compensate for small prescription Unable to change focus from distance to near and back Visual Field (peripheral vision) Loss Vision Fluctuations Light Sensitivity Balance Issues

Questions • areddell@Family. Eye. Care. Center. LV. com