The Spectrum of Vision Exams

Vision is, by far, the sensory system that has most neurological connections. This means that besides our ability to form an image that we “see,” other aspects of our perceptions (feelings) and cognition (thinking) are affected by vision. For example – try balancing on one foot with your eyes open vs. your eyes closed. Or try remembering a set of directions told to you without “visualizing” the movements or route you would have to take.

Did you know that over 50% of the brain’s cortex is involved in processing visual information?

At the Vision & Conceptual Development Center we treat the entire spectrum of functional vision, and we do so with a developmental approach. This means that we evaluate your visual skills from the earliest abilities we develop – how our eyes and our bodies work together to explore space – to higher-level, cognitive and abstract vision skills – such as visualizing, understanding, and remembering complex texts, being able to process and deliver audio-visual instructions with ease in real-time, and even being able imagine chiral molecules in 3D while rotating/transposing them to asses whether a particular reaction is feasible.

The developmental approach is NOT an exclusive service for children. What it is, is a holistic focus that ensures that we build the vision “house” from the bottom up – starting from the most foundational skills and helping you attain more advanced abilities once you are ready to work on them.

To this end, we do not offer “one-size-fits-all” exams. Instead, we tailor the evaluations to the patient’s difficulties and needs.

Below, you will see a breakdown of the categories of exams that we are accustomed to seeing and providing. Note that we do not offer the two lower levels at our clinic, since we only offer the most comprehensive care for our patients.

Starting with…

One of the most basic vision assessments we are familiar with are the school nurse’s vision screenings. While it is certainly a needed intervention for children who struggle with distance vision (think – can I see the board if I’m on the last row of seats), there are so many aspects of vision that get missed by this assessment. Often, this means that some parents rely on a false sense of security from a “PASS” result from these evaluations while their child continues to struggle with vision difficulties.

For instance, your child may be able to see clearly at the distance of the board, but may have an underlying health condition that – if not detected early – could pose a serious threat to their vision.

To this end, even if it is not at our practice, we encourage all (ages 6 and up) to receive a comprehensive eye exam at least once per year.

What is this “comprehensive eye exam” that we mentioned, you ask?

This evaluation is, generally, what most optometrists will perform on the typical patient. The assessment will now consider basic eye health (in case there is a need to refer to an ophthalmologist for disease concerns), some basic eye movement analysis, and a check to see if a glasses or contact lens prescription is recommended.

Generally, most people think of the “Comprehensive Eye Exam” when they think of an “eye doctor”. HOWEVER! This is not the full picture. At the Vision & Conceptual Development Center we treat more than “eyes” – we treat vision.

See below for the most basic vision evaluation we provide:

Even though we have two eyes, we only see one image in our mind. Things start going awry when one of the eyes (or both) have difficulties following the brain’s directions & intention. For that reason, we assess how well the eyes work – both, independently and as a team. This binocular vision assessment is key to understanding how eyes move together. A special mention goes to convergence – which is the motion towards the nose that our eyes do when looking at something close, such as a reading book.

Often times, we assume that our vision is “normal” because, why would we question how other people “see” the world? However, did you know that seeing double may appear to some as simply blurred vision. This is often the case when the teaming between both eyes is not quite in synch, but not sufficiently disrupted to be easily identified as a big problem. This is an example of a condition we generally term binocular vision dysfunction.

This condition is often worsened over time if not addressed – potentially leading to headaches, eye fatigue, and even difficulties with school or work due to reduced working capacity and low reading comprehension. Yes, you know, that feeling when you feel like you have just read a sentence but have to re-read it for the 5th time because you lost track of it? — It could be due to a difficulty with both eyes teaming together and your mind tapping out because it’s too effortful to focus on the “comprehension” portion of reading.

Thus, our binocular vision assessments – along with our binocular vision therapy programs – can help in bringing back the efficiency and effortlessness of vision back in your control. Do not forget: reading should be enjoyable, not a burden.

So yes, the binocular vision assessment is geared towards the mechanics of vision. But what about all of the other sensory, perceptual, and cognitive connections to the visual process we were talking about earlier?

Great question! We introduce you to our Developmental Visuo-Cognitive Examination:

As briefly discussed – the control of our bodies to move in space is one of the most basic aspects and roles of vision. Balance, coordination, and dexterity are just some of the aspects that we assess and help improve in patients with other vision challenges. We try to integrate other senses – such as hearing – into the mix. For instance, can you visualize a message that I speak to you? Can you remember and recall it later? And what about higher-level cognitive components? Our developmental approach incorporates Piagetian logic as some of the tasks that we can help our patients discover and hone.

These exams are also highly recommended for patients with developmental delays or those on the autism spectrum. We know that this patient population needs providers that are understanding and experienced in deriving clinical information from meaningful interactions rather than solely from measurements or tests. To this end, some of our staff are trained and certified in DIR-Floortime approaches that result in happier patients and more successful healthcare outcomes.

On the other hand, sometimes, patients have developed all of the appropriate vision skills but an injury or medical condition has affected their sensory or motor abilities. For these cases, we take a gentle approach to discovering the areas that have been damaged in pursuit of developing a rehabilitative program.

This is the scope of the Neuro-Optometric Evaluation:

The Spectrum of Vision Exams

Vision is, by far, the sensory system that has most neurological connections. This means that besides our ability to form an image that we “see,” other aspects of our perceptions (feelings) and cognition (thinking) are affected by vision. For example – try balancing on one foot with your eyes open vs. your eyes closed. Or try remembering a set of directions told to you without “visualizing” the movements or route you would have to take.

Did you know that over 50% of the brain’s cortex is involved in processing visual information?

At the Vision & Conceptual Development Center we treat the entire spectrum of functional vision, and we do so with a developmental approach. This means that we evaluate your visual skills from the earliest abilities we develop – how our eyes and our bodies work together to explore space – to higher-level, cognitive and abstract vision skills – such as visualizing, understanding, and remembering complex texts, being able to process and deliver audio-visual instructions with ease in real-time, and even being able imagine chiral molecules in 3D while rotating/transposing them to asses whether a particular reaction is feasible.

The developmental approach is NOT an exclusive service for children. What it is, is a holistic focus that ensures that we build the vision “house” from the bottom up – starting from the most foundational skills and helping you attain more advanced abilities once you are ready to work on them.

To this end, we do not offer “one-size-fits-all” exams. Instead, we tailor the evaluations to the patient’s difficulties and needs.

Below, you will see a breakdown of the categories of exams that we are accustomed to seeing and providing. Note that we do not offer the two lower levels at our clinic, since we only offer the most comprehensive care for our patients.

Starting with…

One of the most basic vision assessments we are familiar with are the school nurse’s vision screenings. While it is certainly a needed intervention for children who struggle with distance vision (think – can I see the board if I’m on the last row of seats), there are so many aspects of vision that get missed by this assessment. Often, this means that some parents rely on a false sense of security from a “PASS” result from these evaluations while their child continues to struggle with vision difficulties.

For instance, your child may be able to see clearly at the distance of the board, but may have an underlying health condition that – if not detected early – could pose a serious threat to their vision.

To this end, even if it is not at our practice, we encourage all (ages 6 and up) to receive a comprehensive eye exam at least once per year.

What is this “comprehensive eye exam” that we mentioned, you ask?

This evaluation is, generally, what most optometrists will perform on the typical patient. The assessment will now consider basic eye health (in case there is a need to refer to an ophthalmologist for disease concerns), some basic eye movement analysis, and a check to see if a glasses or contact lens prescription is recommended.

Generally, most people think of the “Comprehensive Eye Exam” when they think of an “eye doctor”. HOWEVER! This is not the full picture. At the Vision & Conceptual Development Center we treat more than “eyes” – we treat vision.

See below for the most basic vision evaluation we provide:

Even though we have two eyes, we only see one image in our mind. Things start going awry when one of  the eyes (or both) have difficulties following the brain’s directions & intention. For that reason, we assess how well the eyes work – both, independently and as a team. This binocular vision assessment is key to understanding how eyes move together. A special mention goes to convergence – which is the motion towards the nose that our eyes do when looking at something close, such as a reading book. 

Often times, we assume that our vision is “normal” because, why would we question how other people “see” the world? However, did you know that seeing double may appear to some as simply blurred vision. This is often the case when the teaming between both eyes is not quite in synch, but not sufficiently disrupted to be easily identified as a big problem.  This is an example of a condition we generally term binocular vision dysfunction.

This condition is often worsened over time if not addressed – potentially leading to headaches, eye fatigue, and even difficulties with school or work due to reduced working capacity and low reading comprehension. Yes, you know, that feeling when you feel like you have just read a sentence but have to re-read it for the 5th time because you lost track of it? — It could be due to a difficulty with both eyes teaming together and your mind tapping out because it’s too effortful to focus on the “comprehension” portion of reading.

Thus, our binocular vision assessments – along with our binocular vision therapy programs – can help in bringing back the efficiency and effortlessness of vision back in your control.  Do not forget: reading should be enjoyable, not a burden.

So yes, the binocular vision assessment is geared towards the mechanics of vision.  But what about all of the other sensory, perceptual, and cognitive connections to the visual process we were talking about earlier?

Great question! We introduce you to our Developmental Visuo-Cognitive Examination:

As briefly discussed – the control of our bodies to move in space is one of the most basic aspects and roles of vision. Balance, coordination, and dexterity are just some of the aspects that we assess and help improve in patients with other vision challenges. We try to integrate other senses – such as hearing – into the mix. For instance, can you visualize a message that I speak to you?  Can you remember and recall it later? And what about higher-level cognitive components? Our developmental approach incorporates Piagetian logic as some of the tasks that we can help our patients discover and hone. 

These exams are also highly recommended for patients with developmental delays or those on the autism spectrum. We know that this patient population needs providers that are understanding and experienced in deriving clinical information from meaningful interactions rather than solely from measurements or tests. To this end, some of our staff are trained and certified in DIR-Floortime approaches that result in happier patients and more successful healthcare outcomes.

On the other hand, sometimes, patients have developed all of the appropriate vision skills but an injury or medical condition has affected their sensory or motor abilities. For these cases, we take a gentle approach to discovering the areas that have been damaged in pursuit of developing a rehabilitative program.

This is the scope of the Neuro-Optometric Evaluation:

Many patients that have suffered a neurological insult (be it due to an accident or illness) contact us with similar descriptions of their symptoms: headaches, dizziness, nausea, brain fog, fatigue, light sensitivity, increased clumsiness… These symptoms often present in clusters that are hard to tackle by the series of specialists that have previously treated these patients – often a combination of physical, occupational, and/or vestibular therapy.

At the Vision & Conceptual Development Center, we know that no two neuro-optometric cases are the same. However, our trained doctors and therapists are adept at using our expert-level understanding of vision as part of a multi-sensory integrative model. This means that we approach your difficulties foundationally – from those that will be gentle enough to challenge you without making you symptomatic, burning you out, and leading to regressions.

What does this mean for you and your examination experience?

Depending on the symptoms and signs presented by the patient, our doctors, therapists, and technicians work within your comfort ranges to assess the functionality of your vision. Some metrics are objective, such as the Visually Evoked Potential – a measure of the speed of the neurological signal between the eye’s retina and the occipital lobe (the part of the brain associated with vision processing and relaying). Other measures are subjective – based on the unique experiences to various sensory stimuli or specific tasks.

In all cases, we take the time and care to ensure our patients have the evaluation they need and develop a goal-oriented treatment program that is individualized for you and make sure it integrates well with the additional medical care that you may be receiving from other specialists.

Whew! . . .

That was quite a bit of information to get across – we hope it was clear, concise, and (perhaps) slightly entertaining!

Based on this information, are you interested in scheduling a new patient evaluation?

Feel free to schedule a discovery call with our knowledgeable administrative staff today!

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