February Staff Pick: Vision and Learning...
This month I have decided to talk about a subject that I am very passionate about and one that I saw first hand with my own daughter.
My daughter Kaylin is now nine years old and lets just say she had a little bit of a rough journey as she entered this world. Weighing 9 lb 10onz, she ended up being a forceps delivery. Around the age of three years of age she started complaining about recurrent stomach pains that would last for a few days to weeks, but otherwise she was healthy and growing well. In the more recent years she started to complain about headaches at the same time that her stomach hurt, to the point she would miss some school now and then. All tests, blood work and imaging, were all normal....so life went on. Kaylin had regular eye exams each year throughout her life that revealed nothing abnormal. Once her headaches started to increase in frequency, her optometrist and myself decided it was time to use drops to relax her focusing system to see if there was any hidden farsightedness. At this time, it was discovered that she was moderately farsighted (which meant she was having to work hard to clear her vision compared to other kids). I was ecstatic, this was easy to fix! She was prescribed glasses which she wore daily and to my dismay they did not help with her headaches....now what?
Further vision testing showed that her ability to track a moving target was impaired as well, and again the glasses did not help with this. At this time, we were starting to notice increasing difficulty with reading. She was just barely meeting grade level requirements, but was making slow progress. Together, we worked on her tracking and eye teaming skills which improved greatly. But again, this did not help with the headaches or with her reading as would be expected. Then one day, I got a call from her school to come pick her up because she was not feeling well. Her appearance said everything. She was red in the face, glossy-eyed and lethargic looking...she had a headache and her stomach hurt. When asked, she also reported that she was dizzy and the room was shaking. I immediately checked her tracking system which was cleared and to my surprise had regressed back to having fixation losses and jerkiness. This dizziness bothered me as this was a new symptom, but then I remembered back to her delivery. She was delivered with forceps and the one forcep was over the left ear (I remember the bruising)... so now I wondering if there was something wrong with her vestibular system [this system is located in the inner ear and is used to tell your brain how your head is moving in space and helps stabilize your visual world during these head movements]. I booked an appointment with a physiotherapist specialized in vestibular testing and was surprised to find out the issue was not her eyes, it was not her vestibular system ... it was her NECK. Her C1 vertebrae was rotated out of place and limited her range of motion to the right and was causing the eye tracking issues and headaches. The physiotherapist was able to use gentle release to realign her neck and amazing her tracking issues immediately resolved as did her headaches and stomach pain. Yes, a solution!!!
Kaylin did physiotherapy to help with her neck strength and alignment over a course of six months, along with vision therapy to support her tracking and eye teaming. Kaylin is doing fantastic and has not had a headache in over nine months. Her reading is now at grade level and continuing to improve. More importantly she enjoys reading now. I no longer have to fight with her to do her reading or homework.
I shared this story for many reasons, as I learned a lot along this journey as well.
1) Eye and / or vision issues are not always obvious (and I work in this profession). Her farsightedness was not found until drops were used despite there being no clinical findings to support using the drops until the headaches started.
2) Proper vision does not mean 20/20 vision. This just means how clear are things, for example words on a page. If you can't track your eyes smoothly along a line of text then how can you read, even if the words are clear... this is something I am acutely aware of and try to educate all my patient's parents and teachers on.
3) Vision issues are not always JUST vision issues, sometimes there is a cause. In Kaylin's case her vision issues were actually the result of problems with her neck.
4) History is important. Forceps deliveries can cause complications with ocular structures, but I was not aware of other ways it could have affected the function of visual system indirectly.
5) Vision therapy works! Vision therapy is guided eye exercises that teaches eye teaming, focusing, and tracking skills (to keep it simple, but actually goes when beyond even these skills). It is like physiotherapy for the eyes. Vision therapy changes lives.
6) Vision therapy can be fun! We use a large, interactive, touch screen, balance boards, trampoline's, throwing games, etc. ... click on the following link to see a video demonstrating some vision therapy activities.
It is important for parents to take any child that is have learning difficulties for a functional vision assessment. This goes beyond a regular eye exam and not all optometrist specialize in this type of exam or the resulting management that may be required if a visual dysfunction is diagnosed. At, Bayside Eye Care we are fortunate to have two doctors specialized in this area of optometry and the space to provide in office vision therapy.