Conclusion: More to School than Meets the Eye

There is more to school than reading a book, writing a paragraph, or solving a math equation. What about all those sometimes forgotten skills that help us to be successful as we take notes, follow directions, play a game, take a test or interact with classmates? These abilities cannot be ignored no matter if the student is primarily an auditory, visual or kinesthetic learner. I have learned that since the eyes take in the information and the brain makes sense of what it sees, the visual system is of high importance. 


General School Difficulties

  • Having efficient speed/accuracy/ memory needed to copy from the board to their paper
  • Forgetting which way was right or left when playing games
  • Mixing up cardinal directions
  • Following multistep directions
  • General ability to process information and remember it
  • Wearing shoes on the wrong feet
  • Proper organization of school supplies/work
  • Needing to touch everything to know how it feels



Education and Vision Therapy

I am sad when I think of my students who lost confidence to do their work correctly and retreated into themselves. I also had students do the opposite, who acted out behaviorally because doing the work was so hard for them. Staying at either end of the spectrum for too long is not a place we want a child to be. Something that vision therapy offers is the chance to be in an environment where making mistakes is okay. During vison therapy we learn and grow in multiple ways at each session. While working on eye focusing skills we learn patience. We teach our eyes to work as a team, while being a part of a team that encourages each other to do our best. Our eye tracking abilities improve while we push ourselves. We gain spatial awareness and appreciate the body God gave us. A positive attitude helps foster and encourage our visual thinking skills. As a former classroom teacher and current vision therapist, I am blessed to continue my work of helping others learn more than classroom skills, but life skills as well. 

Part 4: Math is More than just Numbers

Math is usually one of those subjects you absolutely love or totally despise. Although math was never one of my favorite subjects when I was a student, as a teacher I grew to appreciate the various processes, tools, songs and hands-on ways to make learning more fun. Visually it can be cumbersome to understand how mathematical concepts work and are related. This doesn’t even include the act of reading, interpreting, and correctly writing the problem to find a solution which is a more advanced skill. Since the basic levels of math require number recognition, some students who struggle with math have difficulties starting at this level. Perhaps their difficulties begin when they have to use spatial awareness to write the numbers down in a certain way, or draw a visual representation of the mathematical work they are doing so that it makes sense. Math is a subject where you need to master one skill before moving onto the next level. In third grade this was made obvious as we progressed from mastering multi digit addition and subtraction, to learning how to multiply, to introducing division. 


Common Math Difficulties

  • Writing numerical answers in the correct order/place value (ex. Understanding 123 is very different from 321)
  • Recognizing patterns in numbers, counting
  • Skip counting
  • Lining up numbers correctly to solve problems
  • Following the appropriate steps to solve a problem
  • Clockwise/Counter clockwise
  • Symmetry of geometric shapes (ex. Drawing the rest of the picture so the sides match)
  • Memorizing math facts
  • Being able to read a word problem, understand what it is saying, and find a way to solve
  • Drawing a visual to solve a word problem 
  • Concepts of measurement such as weight/size/ distance/ length



Math and Vision Therapy

I have done several activities so far as a vision therapist that help promote visual awareness, memory, processing speed, seeing things from a different perspective, and patterns. Spatial awareness activities can include orientation, number order, and require a person to solve any problems that come up while working. One activity we use to promote visual logic is a version of tic-tac-toe where the patient cannot see the board and has to plan and visualize each move in their head, much like planning for how to solve a math problem. Working through these vision therapy exercises could promote mathematical growth as well as numerous other brain skills. While vision therapy doesn’t strive to teach math skills, it helps improve the child’s conceptual understanding of math through numerical literacy and visual thinking. It’s exciting to know so many areas of the brain can be enhanced at the same time. 

Part 3: Writing as Communication

Once learning has taken place, how do you show what you know? My students demonstrated their learning in the classroom through speaking, teaching another student, acting, drawing, using response cards and playing games. One method used daily in most subjects though was writing. The skill of writing is important on so many levels. It allows us to show what we know and communicate with the world. It’s been said that your brain remembers things better when you write it down. What if the physical and mental act of writing is less than fluid for the participant? We utilized writing for the common worksheet, writing notes, tests, learning cursive, and paragraph writing. Writing a math equation is not surprisingly very different from writing a 3 paragraph essay. In both cases though a student must use their brain to formulate an idea, remember how to form the letters/numbers correctly, how to set up and format the writing to be easily read and understood. 


Common Writing Difficulties

  • Frequently reversing some letters and numbers (ex. Writing b instead of d or 6 instead of 9, or similarly writing 51 instead of 15)
  • Mixing capital and lowercase letters within a word or starting every word with a capital letter
  • Disregarding spacing when writing a paragraph (ex. Writing all words on only 1 side of the page)
  • Writing words in an appropriate size based on the size of the line on the worksheet, lined writing paper, or free writing
  • Setting up the paper correctly with a heading or proper paragraph writing specifications, pencil grip, slanting the page, posture, forming the letters and numbers correctly
  • Brainstorming ideas in their head and being able to write them as sentences


Writing and Vision Therapy

Sometimes I would ask students if they could find which letters or numbers they wrote backwards…some students would notice and fix the mistake, others didn’t seem to think anything was wrong. This could indicate that the visual system has trouble processing and remembering what each letter and number means/how it should look. Many students did not use the space on a paper well. Some would write as if there was no line at all, some wrote on the line, but made their letters so large they would fill up the entire line space. This potential spatial awareness problem as well as others can be addressed with vision therapy.



A patient’s writing BEFORE starting Vision Therapy.

vision therapy writing

That same patient’s writing AFTER finishing Vision Therapy


Part 2: Why Reading is so Important

If there is one area of education that often concerns parents and teachers the most it is reading. We live in a world where being able to read the words on a page clearly and understand what we read is essential to our learning and our future. It’s undeniably a lifelong skill. As a teacher I remember being mystified at times by the few students I had over the years that continued to struggle with reading through the end of third grade. Some students could tell you every single detail about a story if it was read to them, yet couldn’t read on their own. Listening is a very valuable skill, yet so is reading.  We used to say that third grade was a pivotal year for students because they were transitioning from ‘learning to read’ to ‘reading to learn.’ This step in independence is not easy for some, especially if the student, teachers, and parents are putting in extra effort to make independent reading happen and something still isn’t clicking. Maybe these issues will go away on their own, but what if they don’t?


Common Reading Difficulties

  • Being able to listen to the story and answer questions about it accurately, but couldn’t read the print themselves
  • Often losing their place when reading, which led to losing their attention easily
  • Skipping words or entire sentences
  • Spending so long trying to read a sentence and make out the words that they had no idea what they just learned
  • Having the ability to make a picture in their head of what is happening in the story
  • Matching the letter or blend to its sound to say words fluently
  • Not being able to find the sentences on the page they volunteered to read aloud



Reading and Vision Therapy

If I had known about vision therapy I would have asked those students a few questions. 

  1. Do the words seem blurry or fuzzy to you? If yes this could be an accommodation problem. This means the eyes are having trouble maintaining clear focus. 
  2. Are the words moving or overlapping? This could be an eye teaming problem which has to do with the eyes working together to monitor spacing and depth. 
  3. Are you having difficulty keeping your place on the page? This may be an eye tracking problem where the eyes cannot maintain focus while moving to read along a page or following something that is moving. 
  4. Can you make a movie of the story in your head? If not, this may be a visual perception problem and this may impact comprehension and retention. 

What if this is how you saw things when attempting to read? Would you enjoy reading? It’s important to understand that a pair of glasses will NOT fix this issue.

 Vision therapy may be the answer.

Part 1: My Road to Vision Therapy

It is still a shock to me that if I had the knowledge I do now about the visual system and how the brain takes in information, I could have spared some of my students’ continuing struggles. Before 2 months ago I had never heard of the words “vision therapy,” nor even knew that vision was different from someone just needing eyeglasses. As a third grade teacher for 5 years, I figured that with the school screenings we had each year, reminding a student to actually wear the glasses they “forgot” in their backpack, or contacting a parent whose child said they couldn’t see well satisfied their eye needs and any further struggles they had were unrelated.

Now I see things differently, no pun intended. Every parent and teacher wants a child to use his/her God given gifts and abilities to reach full potential. Though everyone will struggle at some point in their lifetime, it is nice to have some extra help along the way, that’s where vision therapy comes in.  I left the classroom behind this summer and began my new journey as a vision therapist. I can say I wish I could check in with some of my past students. Perhaps some of them are doing very well now, others may still encounter the same challenges…I wonder if vision therapy could help.

This will be the first in a series of posts I make about some of the struggles I observed among students from this new perspective. I will go into more detail on some of the reading, writing, math and general challenges I witnessed as a teacher. 

What is Binocular Vision Dysfunction (BVD)?

Before discussing BVD, it is important to understand what binocular vision is. Bi- means both and -ocular means eyes, so binocular vision  means seeing with both eyes. In their post about binocular vision, Vivid Vision¹ discusses how the brain receives separate signals from both eyes, and combines them together in order to see. We can generally coordinate our eye movements when both eyes are well-functioning. Additionally, both eyes see slightly different visual fields, which is why we have depth perception. When the eyes are functioning well this all works seamlessly, but when the eyes do not properly align or team, a number of uncomfortable symptoms can occur. 


According to the Dizziness and Headache Optometry Center², binocular vision dysfunction is “…an ocular condition that occurs when the eyes don’t align properly with one another”. Symptoms of BVD result when our brain tries to correct or compensate for this misalignment, which can take a substantial amount of effort. 

Types of BVD³

  • Vertical Heterophoria
    • A vertical misalignment of the eyes
  • Esophoria or Exophoria
    • Tendency for the eyes to drift inward (eso) or outward (exo) during certain tasks
  • Convergence Insufficiency
    • The inability to turn the eyes inward and keep single vision at a near point
    • The #1 cause of eye strain
  • Convergence excess
  • Divergence excess
  • Divergence insufficiency


Signs and Symptoms of BVD

  • Double vision or blurred vision
  • Fatigue when reading or doing computer work
  • Poor balance or coordination
  • Nausea or motion sickness
  • Poor depth perception
  • Pain in the eyes, neck, back, or face
  • Head tilt
  • Headaches or migraines with near work
  • Anxiety in crowds or large spaces
  • Restless sleep
  • Difficulty with comprehension and attention


How Vision Therapy can help treat BVD

In his editorial piece “The Binocular Vision Dysfunction Pandemic”, Dominick M. Maino, OD, MEd, FAAO, FCOVD-A writes that “…Evidence based medicine has shown that the best and most efficacious treatment for convergence insufficiency (a type of binocular vision dysfunction) is office-based optometric vision therapy”. He describes how most other binocular vision dysfunction disorders would also benefit most from vision therapy.


Dr. Maino provided plenty of support for his findings through textbooks, case reports, studies, and other qualified individuals: “Dennis Levi, OD, PhD, Dean of the Optometry School at Berkeley, noted that perceptual learning (vision therapy) is a quite successful intervention if it is intensive, engaging and appropriately challenging”.


Those who have binocular vision issues due to brain injuries, autism, or other developmental, genetic, or intellectual disabilities can also greatly benefit from vision therapy. 


If you suspect you or your child may have Binocular Vision Dysfunction, contact our office to schedule an appointment at 




Vivid Vision

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The Binocular Vision Dysfunction Pandemic