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vision and learning
 

There is controversy over the exact relationship between vision and learning. For example there is a negative correlation between distance refractive error and reading ability. Myopic or nearsighted children who cannot see clearly at a distance without glasses are more commonly good readers. Children who spend tremendous amounts of time reading become nearsighted. Before Alaska became a state myopia was rare. After becoming a state, more than 50 percent of the children in Alaska developed nearsightedness. Thus, correlation is such that nearsightedness or poor distance vision is highly correlated with success in reading. Restated another way, poor distance vision is associated with better reading abilities.  Farsighted children statistically are poorer readers than myopic children.

 

Some of the mechanical visual skills which are related to reading include focusing or accommodation, and eye teaming, or convergence. Fatigue of one or both of these systems may interfere with reading. There is also a relationship between eye movements such as saccades (whereby we change fixation from one target to the next) and smooth following movements known as pursuits and reading. Children who cannot make accurate eye movements are often found to skip lines and words while reading.

The visual system was originally designed so that the peripheral vision was responsive to motion detection (danger from the jungles) with a central portion for fine discrimination (to identify the source of danger; e.g., a lion.) In the school environment the child is expected to ignore the peripheral portion of their visual system and pay attention with the central portion. If the child can not ignore the peripheral portion, he/she becomes distracted.  Improvement in eye movement skills often results in less distraction and fewer errors of skipping words while reading.

loses place
 

Reading requires very accurate saccadics, which are fixations from one spot to another.  Children who have poor eye movements are easily distracted and lose their place.  Remember, the eye movement system was designed so that peripheral vision detects motion and danger.  Imagine what happens when the system works correctly in the class room.  As soon as there is peripheral movement, the eyes move toward the source of movement. This results in the complaint of inattention.  Thus, reflexive eye movement skills must be socialized so that they do not respond reflexively to peripheral information.  In addition, speed and accuracy must be trained so that one does not lose one’s place.

The skills are easily improvable with vision therapy.  Once the information is brought into the eyes, it must be sent back to the brain for appropriate processing. The information must be utilized and integrated with the sensory and motor areas of the brain. Defects in the perceptual (interpretation of visual system) and motor (the integration with output, e.g., hand-eye coordination) may interfere with the reading process. Perceptual motor skills are key in the early acquisition of reading skills. A deficit is important to identify very early on-- i.e., five to seven years of age. Remediation of the skills at a later date, such as age 12, will be less effective for reading. Thus, early identification and treatment is essential. It is evident that there is more to good vision than 20/20.

 

It has been presumed that children who reverse letters or words see them backwards.  This is false.  They have directional confusion.  In the real world direction has no meaning.  For example, a chair is a chair no matter which way it is placed.  Changing direction does not change interpretation.  In the world of language direction changes meaning.  Connect the bottom of a chair and it looks like a "b".  Turn it 180 degrees it becomes a "d", flip it upside down and it becomes a "q" and flip it again it becomes a "p".  Thus, direction changes meaning.  The difference between "was" and "saw" is direction.

 

As mentioned previously, we should correct all optical errors of the eyes (glasses); eliminate eye muscle problems; and create smooth accurate eye movements.  In addition, we should make sure that we properly interpret what we see and use it appropriately.  These are known collectively as perceptual skills and include form perception, size and shape recognition, visual memory, and visual motor integration (hand-eye coordination.)

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Ask Dr. Stewart Your Eye Care Questions

What can be expected during a contact lens fitting?

A patient can expect to have a different experience when having a contact lens fitting. In addition to the eyeglass exam, questions will be asked to determine which contact lens will work best for them. Will they want to leave the lenses in their eyes overnight or will they remove them every day? Will they wear them only occasionally or will they be for everyday use? Do they want a contact lens that they throw away every day or do they want a contact lens that they have to clean and disinfect? If the patient is over age 40 and has a compromised ability to see up close, how will they see up close with their contact lenses? Will they wear readers over their distant contacts, or will they wear multifocal contacts, or will they wear monovision?

Are some people more prone to having Dry Eyes than others?

Experiencing dry eye symptoms is more common as we grow older, particularly in people 50 years of age and older. Hormonal changes in women who are experiencing menopause or who are post-menopausal. Inflammation in our body can affect the tear gland's ability to produce tears. Eye or health conditions such as glaucoma, diabetes, lupus, rheumatoid arthritis, and Sjogren's Syndrome can be associated with Dry Eyes. Environmental conditions such as dry winter air, dry indoor heated air, working on the computer, and wearing contact lenses can cause Dry Eyes.

Are there advantages to single-use contact lenses? What are they?

Single-use daily wear contacts are convenient to the patient and a healthy recommendation from their eye doctor. At the end of the day, the patient only has to dispose of the contacts. There is no need to take the contacts out to clean and disinfect them. The patients time and money spent on solutions and caring for them are eliminated. Not to mention that the next time they wear a contact, they will be wearing a brand new contact! The single best recommendation your eye doctor can make is to recommend single-use daily wear contacts. They are the healthiest contact that can be worn. The contact lens pathology issues of wearing the same contact for two or four weeks such as neovascularization, microcystic edema, and bacterial infections are greatly reduced.

What is an eye infection?

Your eyes can get infections from bacteria, fungi, or viruses. Eye infections can occur in different parts of the eye and can affect just one eye or both. Two common eye infections are conjunctivitis (also known as pink eye) and lid styes which are swollen lid bumps that can also be painful. Common signs of an eye infection are pain, itching, or a sensation of a foreign body in the eye, photosensitivity, redness or small red lines in the white of the eye, discharge of yellow pus that may be crusty upon awaking, and tears.

What happens during a typical Diabetic Eye Exam?

Your Eye Doctor will evaluate the back of your eye called the Retina to check for leaking blood vessels. Diabetic retinopathy occurs when elevated blood sugars damage the walls of the blood vessels. The vessel walls may thicken, leak, develop clots, close off, or grow balloon-like defects called microaneurysms.

My eyes tear all the time. Why do you call it Dry Eyes?

Your eyes have extra tears because your eyes produce extra tears to combat irritation and dryness. A better way to describe Dry Eyes is tear film instability, which refers to the composition of your tears not being in the proper composition. Stopping eyes from producing extra tears is a goal in the treatment of Dry Eyes.

At what age should my child have his/her eyes examined?

If you ask 10 different Doctors you will get 10 different answers. Newborns have their eyes checked in the birthing ward for starters. From birth to age 5 their eyes are growing. At age 5 is a good time to schedule a regular eye examination, however, if any unusual eye behavior is observed under age 5 an eye exam should be scheduled at that time. Unusual eye behavior such as eye squinting, a head tilt, or having to get close to see.