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Vision Therapy: Conditions

Vision therapy is a specialized form of treatment that aims to improve visual function and performance. It involves a series of eye exercises, activities, and visual training techniques designed to address a wide range of vision-related issues. Unlike traditional eye care, which often focuses on correcting refractive errors with glasses or contact lenses, vision therapy takes a holistic approach to addressing the underlying causes of visual problems.

By targeting the root causes of these issues, vision therapy can help individuals achieve better visual function, improve their overall well-being, and enhance their ability to perform daily tasks with greater ease and efficiency.

 

Amblyopia

 

Amblyopia, commonly known as "lazy eye," is a common vision condition that affects approximately 2-3% of the population. It occurs when one eye develops reduced visual acuity due to the brain's inability to properly process information from that eye.

In many cases, amblyopia develops during childhood, often due to factors such as refractive errors, strabismus (misaligned eyes), or visual deprivation. If left untreated, amblyopia can lead to permanent vision loss in the affected eye, as the brain increasingly favors the stronger eye and the weaker eye's visual processing abilities deteriorate.

Vision therapy is a highly effective treatment for amblyopia, as it aims to retrain the brain to properly utilize the weaker eye. Through a series of specialized exercises and activities, vision therapy can strengthen the neural pathways between the brain and the affected eye, improving visual acuity and binocular vision.

The key to successful treatment lies in the brain's remarkable ability to adapt and change, known as neuroplasticity. By engaging in targeted vision therapy, individuals with amblyopia can stimulate this neuroplasticity, allowing the brain to reorganize and improve its processing of visual information from the weaker eye.

 

Strabismus

 

Strabismus, also known as crossed eyes or misaligned eyes, is a condition where the eyes do not properly align with each other. This can cause one eye to turn inward, outward, upward, or downward, resulting in a lack of binocular vision and depth perception.

Strabismus can have a significant impact on an individual's visual function, self-esteem, and overall quality of life. Left untreated, it can lead to the development of amblyopia (lazy eye) and other vision-related problems.

Vision therapy is a highly effective treatment for strabismus, as it focuses on retraining the brain and the eye muscles to work together in a coordinated manner. Through a series of specialized exercises and activities, vision therapy can help individuals with strabismus improve their eye alignment, binocular vision, and depth perception.

 

Binocular Vision Disorders

 

Binocular vision disorders are a group of conditions that affect the way the eyes work together as a team. These disorders can result in a range of visual problems, including difficulty with depth perception, eye strain, headaches, and difficulties with reading and other visual tasks.

Some common binocular vision disorders that can be effectively treated with vision therapy include:

  • Convergence Insufficiency: This condition is characterized by the inability of the eyes to properly converge, or come together, when focusing on a close object. This can lead to eye strain, headaches, and difficulties with reading and other near-work activities.

  • Accommodative Dysfunction: Accommodative dysfunction is a problem with the eye's ability to focus, or "accommodate," on near objects. This can cause blurred vision, eye strain, and difficulties with reading and other close-up tasks.

  • Vergence Dysfunction: Vergence dysfunction refers to a problem with the eye's ability to work together to maintain proper alignment and focus. This can lead to double vision, eye strain, and difficulties with depth perception.

Through vision therapy, individuals with binocular vision disorders can retrain their visual system to work more efficiently and effectively. The goal of vision therapy is to improve the coordination and synchronization of the eyes, ultimately leading to better visual performance and reduced visual symptoms.


Strabismus

Strabismus is a relatively common condition, affecting about 2-4% of the population worldwide. It is one of the most frequent eye disorders seen in children, though it can also develop in adults due to conditions like stroke or trauma. In the United States alone, it is estimated that around 12 million people are affected by strabismus, with varying degrees of severity. Early diagnosis and treatment are essential, as untreated strabismus in children can significantly impair visual development.

 

What is Strabismus?

 

Strabismus, commonly referred to as crossed eyes, is a condition in which the eyes do not properly align with each other when looking at an object. One eye may turn in, out, up, or down, while the other eye focuses correctly. This misalignment can be constant or intermittent and may affect one or both eyes. Strabismus occurs when the muscles controlling eye movement do not work together correctly, leading to difficulty in focusing both eyes on a single point. This condition can lead to visual issues such as double vision and, in some cases, can result in amblyopia (lazy eye) if left untreated.

How Does Strabismus Develop?

Strabismus develops when there is a disruption in the coordination of the muscles that control eye movement, leading to a misalignment of the eyes. This disruption can result from various causes, including genetic factors, neuromuscular conditions, or problems with the nerves that transmit signals to the eye muscles. In some cases, it may be present at birth, while in others, it can develop later in childhood or adulthood due to conditions such as cerebral palsy, Down syndrome, or even trauma to the eye or brain.

Signs and Symptoms of Strabismus

The primary symptom of strabismus is the visible misalignment of the eyes. However, there are other signs and symptoms that may indicate the presence of this condition:

  • Blurred or double vision

  • Headaches or eye strain

  • Difficulty with depth perception and spatial awareness

  • Reduced visual acuity in one eye

  • Frequent eye rubbing or squinting

  • Tilting or turning the head to compensate for the misalignment


Multifocal Contact Lenses

In the ever-evolving world of vision correction, multifocal contact lenses have emerged as a game-changer for individuals seeking a seamless solution to address their presbyopia. As you navigate through life's various stages, your eyes may undergo changes that can impact your ability to focus clearly on objects at different distances. Multifocal contact lenses offer a convenient and effective way to combat this challenge, providing you with a versatile and comfortable option for correcting your vision.

What Are Multifocal Contact Lenses?

Multifocal contact lenses are specialized lenses designed to correct presbyopia, a condition that typically occurs as you age, making it difficult to focus on near objects. Unlike traditional single-vision lenses that correct either near or distance vision, multifocal contact lenses incorporate multiple prescriptions into a single lens. This innovative design allows you to enjoy clear vision at various distances, eliminating the need for separate reading glasses or bifocals.
 

How Do Multifocal Contact Lenses Work?

Multifocal contact lenses employ advanced optical technologies to provide seamless vision correction. These lenses feature distinct zones or concentric rings that correspond to different prescriptions for near, intermediate, and distance vision. As your eyes move and focus on objects at varying distances, the appropriate zone of the lens comes into play, ensuring a clear and comfortable visual experience.

There are two main types of multifocal contact lens designs:

  • Simultaneous Vision Design: In this design, the lens incorporates multiple prescriptions simultaneously, allowing your eyes to utilize the appropriate zone based on the viewing distance. This design can take some time to adjust to, as your brain learns to interpret the different visual inputs.

  • Alternating Vision Design: Also known as "segmented" or "translating" lenses, these lenses have distinct zones for near and distance vision. As you move your eyes or shift your gaze, the appropriate zone is positioned in front of your pupil, providing the necessary correction.

 

Eye Conditions That Multifocal Contact Lenses Can Treat

Multifocal contact lenses are primarily designed to address the following vision-related conditions:

  • Presbyopia: As you age, the natural lenses in your eyes lose flexibility, making it challenging to focus on nearby objects. Multifocal contact lenses can correct this age-related farsightedness, allowing you to see clearly at all distances.

  • Myopia (Nearsightedness): If you struggle to see distant objects clearly, multifocal contact lenses can incorporate a prescription to correct myopia, while also providing near and intermediate vision correction.

  • Hyperopia (Farsightedness): For individuals with farsightedness, multifocal contact lenses can offer a solution by incorporating a prescription to improve distance vision, along with near and intermediate vision correction.

  • Astigmatism: Some multifocal contact lenses are designed to correct astigmatism, a condition caused by an irregularly shaped cornea or lens, resulting in blurred or distorted vision.


Cosmetic Services

We all want to look our best and in the last decade, we have seen a significant increase in the number of people seeking cosmetic services in order to enhance their appearance. With our eyes being our most distinguishing feature, we want to make the most of them. Thankfully there is now a range of cosmetic services that can help to rejuvenate our eyes and the area around them to keep them fresh, young and wrinkle-free. 

Let’s take a look at some of the services on offer.

Pigment removal

The brown pigment spots that appear on the face are often referred to as age spots and are a result of sun exposure. With age, the repeated exposure to UV rays causes melanin, a compound that is responsible for pigmentation and protecting the skin begins to clump together to form an area of hyperpigmentation. Whilst they aren’t any cause for concern, many people feel that they look unsightly. Luckily, there are a number of different treatments that you can get to remove them including topical creams, laser therapy, and chemical peels.

If you are suffering from darker pigmentation then we strongly recommend that you make an appointment with a qualified dermatologist who will recommend the best course of treatment for you, based on your specific needs.
 


LASIK Procedure

If you are one of the thousands of people considering LASIK laser eye surgery, then you will probably be gathering as much information as possible about the treatment. By this point, you are probably aware of the benefits that LASIK offers, such as a reduced or eliminated need for glasses or contact lenses and greater convenience in your day to day life. However, for many patients, despite the advantages of LASIK, the thought of surgery on their eyes is still a cause of anxiety and fear. One of the best ways to alleviate this concern is to find out more about what the procedure entails.

Your consultation

Before you can be approved for any form of laser vision correction, including LASIK, you will need to attend a consultation appointment with your surgeon. During the consultation, he will perform an examination of your eyes and use your medical and ocular history to determine if you are a good candidate for the procedure. He will also speak to you about the expected outcome from your surgery, making you aware that while LASIK will dramatically improve your eyesight, there is no guarantee that you will not need to wear glasses in some situations, such as while driving in the dark. 

How LASIK Works

LASIK uses a cool, ultraviolet beam of light to reshape the patient’s cornea. Doing so will more accurately focus the light that enters the eye on to the retina, thus improving the patient’s vision. The way in which the cornea needs to be reshaped will depend on the visual needs of the patient. For example, a patient who is far-sighted will need their cornea reshaping to be steeper to experience better eyesight. Alternatively, a patient who is near-sighted will require their cornea to be flattened in order to improve their vision. LASIK can also smooth an irregular cornea into a more standard shape, meaning that the procedure can also be used to correct astigmatism.

The LASIK procedure

The LASIK procedure is very fast and straightforward. Although you will probably be in the surgical suite for around half an hour, the actual process only takes a couple of minutes per eye. The rest of the time will be spent preparing and ensuring that you are comfortable. Anesthetic eye drops are given to patients before their procedure so that the entire process is pain-free. If you are particularly anxious, it may also be possible for you to be slightly sedated – this should be discussed with your doctor at your consultation appointment.

Once you are in position, we will use a femtosecond laser to cut a thin, circular flap into the outer cornea. This can then be pulled back to reveal the underlying corneal tissue, known as the stroma so that it can be reshaped using the laser. The exact path that the laser needs to take, known as the topography, will have been pre-programmed ahead of the procedure and can be followed with complete precision and accuracy.

Once the reshaping is complete, the flap is replaced back over the eye and the surgery is complete. There is no need for sutures or bandages as the cornea will start to heal immediately and without any medical intervention.
 


LASIK Co-Management

LASIK co-management is an integral part of vision correction surgery that often goes unnoticed. It involves a partnership between your primary eye care professional and your LASIK surgeon. This cooperative approach ensures that you're provided with the best possible care before, during, and after your procedure.
 

LASIK co-management is the collaborative effort of your eye care team to ensure your vision correction procedure is safe and successful. It's a team approach where everyone plays a significant role in your eye health journey.

The Evaluation Process

The evaluation process in LASIK co-management is thorough and meticulous. It begins with a comprehensive eye examination by your primary care optometrist. This examination is meant to ascertain your eye health status and determine if you're an appropriate candidate for the LASIK procedure.

The evaluation process underscores the collaborative nature of LASIK co-management. Every step is carefully coordinated to ensure your eye health is prioritized and that you're receiving the best possible care.

The Importance of Consultation in LASIK Co-management

Consultation is a crucial aspect of LASIK co-management. It allows for patient education, addressing concerns and questions, and establishing a clear understanding of the expected outcomes.

During the consultation phase, your optometrist will explain the results of your eye examination and how it relates to your suitability for LASIK surgery. They will also discuss the risks and benefits of the procedure, giving you a balanced perspective to make an informed decision.

The consultation with your LASIK surgeon will delve into the specifics of the operation, including the technology used, the surgical process, and the anticipated recovery timeline. Having the opportunity to consult with both your optometrist and your surgeon ensures that all your concerns are addressed, allowing you to proceed with confidence.

The Role of Communication

Effective communication is the backbone of successful LASIK co-management. It facilitates a seamless transition from your optometrist to your surgeon, creating a cohesive care plan that's centered around your specific needs.

This communication is not just between healthcare providers but also involves the patient. Regular updates on your progress, detailed explanations about each stage of the process, and addressing any concerns or questions you may have are all essential parts of the communication process.


Am I a candidate for LASIK?

If you already rely on wearing glasses or contact lenses to be able to see clearly, you may be frustrated with the effect that they have on your life. Regular vision tests, finding glasses to suit your face shape, having to remember to take eyeglasses with you wherever you go, prescription sunglasses, fiddly contact lenses… the list of inconveniences associated with conventional ocular solutions is extensive. 

LASIK is a modern, minimally-invasive procedure that can substantially reduce or eliminate your need to use eyeglasses or contact lenses, allowing you to enjoy life without limitations or inconvenience. The popularity and success of LASIK laser eye surgery have helped to make it the number one elective surgery across the globe. 
 

Candidacy for LASIK

LASIK has an extremely high success rate. According to the American Society of Cataract and Refractive Surgery, 96% of patients achieve 20/20 vision or better. However, it’s high success rate doesn’t make LASIK automatically the right solution for everyone.

Candidacy for LASIK is assessed by our doctors on a case by case basis so that you be certain that whatever treatment is recommended for you, it will give you the very best opportunity to improve your vision. During your consultation, our doctors will perform a thorough examination of your eyes and vision, ask you about your general health and talk you through both the procedure and aftercare.

The general guidelines for LASIK candidacy state that patients must:

  • be at least 18 years of age

  • have had stable vision with no prescription changes for a minimum of 12 months

  • have a current prescription for eyeglasses or contact lenses that falls between specified parameters (Our doctors will be aware of what these parameters are)

  • have no significant medical or eye-related problems such as glaucoma, macular degeneration or diabetic retinopathy

  • have no history of corneal disease

  • not be pregnant or nursing at the time of the procedure


iDesign Custom Lasik

If you thought that just laser eye surgery was impressive, then be prepared to be astounded by the arrival of iDesign custom Lasik. iDesign is the most advanced wavefront-guided laser treatment available. The system creates a uniquely accurate measurement of the entire optical system that can be relied upon completely without any guesswork. This is then used to create a highly detailed topography or map of your eye, making it easier for your surgeon to pinpoint the areas that need addressing with pinpoint precision. 

How accurate is iDesign?

iDesign is extremely accurate due to its diagnostic equipment that is able to determine 1,257 different micro eye prescriptions. Each one of these will measure the eye prescription to 0.01 of a dioptre strength – 25 times more than what a regular prescription for glasses or contact lens prescription is measured to. 

Who is iDesign suitable for?

While iDesign Custom Lasik can benefit almost any patient with refractive problems, it is particularly beneficial for people who have unusual corneas or have had eye surgery in the past. 

Is it painful?

Laser eye surgery is generally considered a pain-free procedure by the majority of patients. Anesthetic eye-drops are used to numb the outer area of the eye during the course of the surgery. Once these have worn off, some patients do experience some mild discomfort during the days following the procedure, but over the counter pain relief is usually sufficient to relieve this.
 


Limbal Relaxing Incisions

Astigmatism is a relatively common eye disorder that causes the vision to be blurred or distorted. It occurs when the lens part of the eye, known as the cornea, isn’t perfectly curved and instead resembles a football rather than a soccer ball. This means that the light entering the eye comes through at a distorted angle, making the object appear blurry and out of focus. There are several ways in which it is possible to treat astigmatism, including laser eye surgery and corrective lenses. However, another possibility is a solution referred to as limbal relaxing incisions.

What are limbal relaxing incisions?

Limbal relaxing incisions are microscopic cuts to an area in the eye known as the limbus. This helps to relax the curve in the cornea and improve its ability to focus light correctly. It can significantly improve your astigmatism and the overall quality of your vision.

Am I a good candidate for limbal relaxing incisions?

If you have astigmatism, are over 18, in good general health and have no major eye conditions, then chances are you are a good candidate for limbal relaxing incisions. Make an appointment with your eye doctor to discuss your candidacy further.


Refraction Test

A refraction test, also called a vision test, is usually performed as a part of a routine eye examination. The purpose of this test is to determine if a person has a refractive error which would then mean the patient would need glasses or contact lenses.

What Is The Normal Value for Refraction Test?

A value of 20/20 is normal (optimum) vision. This means that individuals who have 20/20 vision are able to read letters that are 3/8-inch (1 centimeter) tall from 20 feet (6 meters) away. The normal uncorrected vision (without glasses or contact lenses) refractive error is zero (plano). Individuals who don’t have 20/20 vision, have what is called a refractive error. A refractive error means that the light is not bending properly when it passes through the lens of the eye. The refraction test will tell the doctor what prescription lens should be used in order to have 20/20 vision.

For people over age 40 who have normal distance vision but difficulty with near vision, a refraction test with a small type size is used to determine normal near vision and the correct power of reading glasses.

How Is The Refraction Test Performed?

The test is performed by having the patient seated in a chair that has a special device (called a phoropter or refractor) attached to it. The patient looks through the device and focuses on an eye chart 20 feet (6 meters) away. The device contains lenses of different strengths that can be moved into the patient’s view. The test is performed one eye at a time. If the patient is wearing contact lenses, they should be removed before the test.

In case the final vision is less than 20/20 even with lenses, then there is probably another non-optical problem with the eye. The vision level achieved during the refraction test is called the best-corrected visual acuity (BCVA).
 

What Are The Causes of Abnormal Refraction Test Results?

  • Abnormal results may be due to:

  • Astigmatism (abnormally curved cornea causing blurred vision)

  • Hyperopia (farsightedness)

  • Myopia (nearsightedness)

  • Presbyopia (inability to focus on near objects that develop with age)
     

Other conditions under which the test may be performed:

  • Corneal ulcers and infections

  • Loss of sharp vision due to macular degeneration

  • Retinal detachment (separation of the light-sensitive membrane (retina) in the back of the eye from its supporting layers)

  • Retinal vessel occlusion (blockage in a small artery that carries blood to the retina)

  • Retinitis pigmentosa (an inherited disorder of the retina)
     

There is an art to refraction and the optometrist will always answer the patient’s questions and as well as discuss their findings. Based on the results of the refraction test, they can determine the amount of myopia, hyperopia or astigmatism.
 


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