The difference between sight and vision

Neurodevelopmental Optometry: What’s in a name?


            Neurodevelopmental optometrists (who, are also called behavioral or developmental optometrists) first look at the health of your eyes and your sight.  These specialists then examine your ability to process information visually.  This includes both binocular vision performance and visual perceptual abilities.  This is perhaps the most important area of application of vision care to you and your family.


            Because, vision drives learning.  If your brain is struggling to use your visual system, learning will necessarily be impaired by this distraction.  For certain, none of us has 100% efficient vision, so we all could do better in visually-demanding tasks.  A study about 20 years ago at Columbia University concluded that about 83% of what an adult knows has been acquired visually.  Even U.S. government estimates have long put the figure at 80%.

            It stands to reason that if you cannot see 100% efficiently, you cannot learn 100% of what you might otherwise.


            No. So-called “eye tests”, or Snellen chart screenings, are just that: screenings.  One study revealed that 51% of children who passed an eye chart screening still had vision problems that were affecting their ability to perform at their God-granted potentials in the classroom.   The student needs to be evaluated for a number of visual abilities that screenings or traditional eye exams don’t usually consider:

  1. Eye movement tests – reversals in reading and writing arise from scanning and tracking errors.  Words are miscalled, inserted from lines above and below, substituted, or whole lines are skipped.
  2. Eye teaming tests – words “moving on the page” and rapid eye fatigue, concentration, attentional problems, and reading comprehension problems can all stem from too narrow an eye teaming range or sampling problems between the two halves of the brain.
  3. Focus ability – miscalled words of similar appearance, letter substitutions and attentional deficits will arise from the child’s attempts to sustain focus on the print when it is too difficult — for that child.
  4. Perceptual tests – several studies by Rosner and Rosner in the mid-80’s support what neuro-developmental specialists have known for years: farsightedness and visual-motor perception problems are linked.  Children with this problem will pass eye chart tests with flying colors, but may have struggles with math and reading.  Integration of vision with all the other senses is also tested.
  5. Visual Suppression Tests – over 80% of poor readers in one ophthalmological study by Dr. Curtis Benton were found to have suppression of one eye, while the other did all the work.  Perceptual therapy in that experiment resulted in an 88% improvement rate in reading and suppression.


            As reported in the question above, therapy for visual processing helps because vision is actually developmentally learned and can therefore be trained or retrained.  Dr. Eugene Helveston, a highly noted pediatric ophthalmologist who has been a long-time critic of the role of vision and learning, actually discovered for himself what neurodevelopmental optometry has long said: school and visual-motor performances are linked.  He invented a test which was highly correlated with reading performance — he had children draw a two-wheeled bicycle, and he discovered that the higher the scores the children had, the higher their reading abilities, and the lower the scores, the more difficulty they were experiencing in reading. Unfortunately, he did not use that information in any productive way.

            Extensive research by Dr. Jerome Rosner at the University of Pittsburgh in the 60’s and 70’s showed that programmed therapies of visual-motor and auditory-motor skills transfer into real classroom changes.  The therapies were designed into a curriculum — but only one school district in Western Pennsylvania used it and  they have now stopped using it within the past ten years.

            Most families who are concerned about their student’s performance must seek out help privately.  Neurodevelopmental optometrists enhance visual learning abilities through visual and perceptual retraining.  Quite often, that’s just what it takes to get a smart child who does poorly in school performing and learning like they should.

[Note:  performance anxiety, self-esteem problems, acting-out behaviors, and “flat” emotions — or even mild depression — often overlay learning problems and are frequently (but not always) alleviated as the child is empowered and begins to perform more successfully.  Counseling may be an important part of the healing process if removal of the barriers is not sufficient to restore self-confidence, or if the affective problems have become embedded.]                                                                               


© 2011 - 2018 Merrill D. Bowan, O.D. All rights reserved


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