Vision Therapy | Montenare Eye Care & Vision Therapy

VISUAL PERCEPTION

Visual-Perceptual Skills

Visual-perceptual skills are fundamental to learning! Without a proper foundation, simple tasks like letter formation, spelling, or visualizing a math problem become very challenging.

Unfortunately, it is estimated that 5 million children in the U.S. have visual disorders that cause them to struggle in school despite the best interventions.

Types of Skills

There are three categories of visual-perceptual skills:

Visual Analysis
Visual Spatial
Visual-Motor

Visual Analysis

Visual analysis skills refer to a group of skills required to identify and remember the salient features of a visual stimulus. In other words, it allows us to see a target, identify the target, remember the target, and manipulate the target in our visual minds.

These skills are further broken down into the categories:

Discrimination - the
Figure-Ground - the
Closure - th
Spatial Memory - the
Sequential Memory - the
Visualization
Form Constancy

In reading, we make a series of fixations and saccades. During a fixation (i.e., when the eyes are still), your visual system is processing what the word is. Once this is done, the eyes will make a saccade (i.e., a jump) to locate where the next word is in the sentence. This process repeats itself over and over. If this is done with accuracy and speed ("reading fluency"), then the language parts of the brain will "string together" these words to form a sentence. However, if the eyes do not move with accuracy and speed, reading fluency and comprehension will decline.

Signs of oculomotor dysfunction are:

Loses place often when reading
Skips words or lines frequently
Often uses a finger to keep place
Poor reading fluency ("choppy reading")
Poor reading comprehension
Prefers audio books

Difficulty following a moving target
Avoids sports (especially ones with balls)
Clumsy or often bumps into things
Inattentive or easily distracted
Possibly misdiagnosed with ADHD

Accommodation

Accommodation ("eye focusing") is the ability to alter the focusing structures of the eye to make a near target clear. In other words, as one shifts his or her attention from a distance target (such as the board in school) to a near target (such as a notebook), the eyes must alter their shape to bring the near target into focus.

In most people, accommodation is well developed. They are able to sustain focus on a near target for long periods of time without getting strained or fatigued. However, in some people, accommodation is very poor and doesn't work efficiently. This is called accommodative dysfunction and it can cause significant visual stress.

There are four types of accommodative dysfunction:

Accommodative insufficiency - the inability to make a near target clear due to under-focusing.
Accommodative excess - the inability to make a near target clear due to over-focusing.
Accommodative infacility - the inability to rapid change focus from near-to-far (and vice versa).
Ill-Sustained Accommodation - the inability to maintain focus on a target for extended periods of time.

Because reading is an "up close" activity, the visual system must use continuous accommodation to keep the words in focus.

Signs of accommodative dysfunction are:

Near vision blur
Eye strain when reading
Headaches during sustained near work (e.g., reading or homework)
Difficulty taking notes
Rubs eyes excessively
Poor reading fluency

Vergence

Vergence ("eye teaming") is the ability to keep the eyes in alignment when looking at a near or far target. It allows us to maintain single vision in three-dimensional (3D) space. When the eyes turn inward (as though you were looking at your nose), it is called convergence. When the eyes turn outward (as though you were looking away into the distance), it is called divergence.

In most people, vergence occurs automatically. However, in some people, the vergence system doesn't work properly and is inaccurate. This is called a vergence dysfunction and it can cause significant visual stress.

There are four types of vergence dysfunction:

Convergence insufficiency - when the eyes do not cross inward enough (an under-alignment)
Convergence excess - when the eyes cross inward too much (an over-alignment)
Vergence infacility - when the eyes get tired alternating between convergence and divergence
Fusional vergence dysfunction - when the eyes show a general instability in maintaining alignment

If the eyes go into misalignment during sustained near-activities (e.g., reading or computer work), it can cause the print to go blurry, double, or even "wiggle" on the page.

In some severe cases, the eyes may disassociate completely, causing one eye to either drift inward or outward. This is called a strabismus, which is further divided into esotropia and exotropia.

Esotropia = when the eye turns inward

Exotropia = when the eye turns outward

Signs of vergence dysfunction are:

Double vision
Sensation that words move on the page
Eye strain or headaches when reading
Closes one eye frequently
Bumps into things and/or lack of coordination (i.e. poor spatial sense)
Motion or car sickness

Visual Perception

Visual perception are mental skills required to analyze, discriminate, and sort out visual information. It also includes the ability to memorize and to understand directional relationships (e.g., left and right).

In most children, visual-perceptual skills develop naturally. They learn how to process what they see and interpret it for meaning and action. However, in some children, visual-perceptual skills are delayed and/or may not develop appropriately. This is called visual information processing dysfunction and it can cause significant difficulties in reading and learning.

There are three main types of visual-perception:

Visual analysis - the ability to analyze and remember visual information
Visual spatial - the ability to see and interpret directional relationships (e.g., left and right)
Visual-motor integration - the ability to coordinate the visual and motor systems (eye-hand coordination)

So much of our learning (80%) comes through our vision. That is why it is so important to ensure that your child is developing age-appropriate visual-perceptual skills. A delay in any of these areas will have a significant impact on your child's ability to read, learn, and play sports. This in turn will cause stress and low self-esteem.

Signs of a visual-perceptual deficit are:

Struggles with reading and learning
Trouble discriminating shapes or colors
Trouble finding similarities or differences
Difficulty learning letters, numbers, or words
Poor visual memory
Poor spelling (especially sight words)

Slow at processing new visual information
Difficulty "visualizing" a picture
Confuses left and right
Reverses letters, numbers, or words
Poor eye-hand coordination
Poor handwriting or fine motor control

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