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Vision Therapy

The Brooks Celebrate Life Event

As anyone who has experienced severe trauma knows – it can be devastating for the victim, friends, and family. Many activities that were previously taken for granted can be a frustrating challenge.

Recently, however, Dr. Beth and I were lucky enough to participate in a truly fun and magical event. The Brooks Celebrate Life event, organized by Brooks Rehabilitation and Regional Medical Photo by Connie GarcesCenter Bayonet Point and sponsored by Bioness, was in honor of Trauma Awareness Month.

The evening kicked off with hostess and Physical Therapist Connie Garces sharing information about Brooks Rehabilitation, both the main facility in Jacksonville, FL and the outpatient facility in Hudson, FL where she is Center Manager. She introduced the trauma survivors who were in the audience, signified with large red, white, and blue ribbons. Also recognized were their family members and the rehabilitation specialists who care for them.

Connie Garces is a passionate and wonderfully talented therapist, but the highlight of the event was one of her patients, Bronson. Dressed in a suit, he stood in front of the group and delivered an honest, funny, heartfelt account of his recovery from traumatic brain injury. Public speaking is intimidating for the average person. Bronson was courageous to deliver his talk and willing to get a little help from the audience when he needed it. With multiple notes in front of him, Bronson talked about his recovery, his care, and his young daughter.  It was one of the most heart-felt and moving things I have witnessed in a long time.

May 2015 is the 27th observance of Trauma Awareness Month. The American Trauma Society has declared this year’s theme “3D Trauma Prevention” and focuses on contributors to motor vehicle crashes – Drugs/Drinking, Distraction and Drowsiness.

Vision is a critical part of life and it can be an important part of rehabilitation for a survivor of traumatic brain injury. Dr. Beth and I work in conjunction with other professionals to provide visual rehabilitation. It is complex work and some of the rewarding care that we provide. You can learn more about visual rehabilitation here.

 -Dr. Nate

(Photo provided courtesy of Connie Garces, PT, DPT, CBIS)

 

“Foolproof” Eye Test for ADHD

We have known for years that there is a link between how the eyes work and attention. This is why there are so many children who have both Attention Deficit Hyperactivity Disorder (ADHD) and visual coordination problems. Pediatric optometrists see this in the exam room every day and it is our job to help sort out how much of a child’s difficulty is due to ADHD and how much is due to not being able to visual focus and move their eyes efficiently.

There is some new research about ADHD and eye movements that is very compelling. Researchers in Tel Aviv, Israel, led by Moshe Fried, MD, have found that by simply monitoring involuntary eye movements, ADHD can be diagnosed.

“This test is affordable and accessible, rendering it a practical and foolproof tool for medical professionals,” said Dr. Fried. “With other tests, you can slip up, make ‘mistakes’ — intentionally or not. But our test cannot be fooled. Eye movements tracked in this test are involuntary, so they constitute a sound physiological marker of ADHD.

The study also showed that Ritalin (methylphenidate) does work in improving ADHD as measured by eye movement control. What was not researched in this study is how much other treatments that also improve eye movement control influence ADHD. Optometric vision therapy is commonly used to help patients improve their voluntary and involuntary eye movements.

Clearly more research is needed to better understand the relationship between ADHD and eye control, but this new study is a step in the right direction.

DrNateSigMagnetCapture

 

An Infographic About Amblyopia

There is a lot of discussion lately about amblyopia (AKA lazy eye), largely due to the recent news reports of adaptations of Tetris and other video games as treatments for amblyopia. As I described in my previous post, these new binocular techniques are definitely better than old-school patching. However, in there essence, these techniques are not new. In fact, optometrists have known for a long time that treating two eyes is better than one. That is the basis of what we do in the vision therapy room to help patients with amblyopia – play games with both eyes at the same time.

I’m very happy to share with you an infographic on amblyopia treatment from the VisionHelp blog.

Amblyopia Infographic

You can read the full story behind the origin of this excellent infographic here. I think it is fantastic!

If you and your child are struggling with patching – you don’t have to be! Not only is binocular therapy more effective than patching – it is way more fun! If you have questions about amblyopia, vision’s therapy, or children’s vision in general, do not hesitate to give us at call at 813-792-0637 or email me at Doc@BrightEyesTampa.com.

And please  – share, pin, tweet or photocopy this infographic!

Dr. Nate

By Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
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Tetris therapy for amblyopia? Yes, please.

A new study, about amblyopia, has been published and it is really getting attention. From CBS news to Huffington Post to CNET, everyone is covering it, probably because they get to use the word “Tetris” in the title. Tetris, of course, is the hugely addictive block-stack game that, at least in my memory, was the first hand-held videogame blockbuster.

Amblyopia, known to many people as “lazy eye” is a visual adaptation to conditions that interfere with visual development. On a simple level, it means that even with the best glasses or contact lenses, the eye does not see and function as well as expected. It is not due to disease or injury, but rather a situation where the brain doesn’t communicate well with one eye and can’t use the eyes as a team.
Think of the brain being someone on the internet, and one eye is a friend with 14.4K dial up and the other has a 4G smart phone. Yes, you can communicate with both eyes, but you are going to prefer the 4G because it is faster and can do more things. Trying to use both eyes simultaneously as a team is hard because one is lagging behind and missing information.

I am extremely glad to see this study and I do have some thoughts on it:
First, do not get too excited about the Tetris part. While I really have no doubt that Tetris and similar games stimulate visual planning and cognitive development, I suspect that the main benefit of using Tetris in this study is that it is very engaging, requires attention to visual detail, and requires the  player to make decisions based on visual information. Basically this is true for most video games (and real world games, for that matter). So Tetris is not the magic here.

What IS a big deal about this study is the goggles – they required the eyes to work together to play the game. If you play, you can’t just shut off the amblyopic eye, or you’ll lose because you won’t see the falling blocks. And that isn’t motivating or good therapy.  It isn’t patching or covering the good eye because you won’t see the blocks on the bottom. You still won’t win. This is like conventional patching. You can stimulate the amblyopic eye (upgrading the modem), but that alone only helps somewhat.

What this study shows is that only when both eyes can see and are given the opportunity to work together to achieve a common visual goal is there significant improvement in the amblyopic eye. In my internet analogy, this is not only giving the amblyopic eye a 4G smartphone but making sure it is net savvy. Both eyes are now friends on Facebook and Twitter so they can work together in real time to solve visual-spatial problems efficiently. (Just to be clear: the eyes do not use Facebook, and they do not communicate directly – all that happens in the brain).

So why is this so exciting? Because this is exactly what we do in vision therapy every day. We “upgrade” the eyes to work well individually (4G) but also “network” them to work together (Facebook, Twitter). We don’t use Tetris, but we do use paper & pens, balls, special glasses, computer programs, 3D art, optical illusions and lots of other fun tools to make it fun and productive.

It is great to see more research on this on adults with amblyopia. For too many years, patients have been told that after early childhood there is no hope of improving the vision in the amblyopic eye. It simply is not true. I did a blog post awhile back on the science behind amblyopia. You can see that here. For a great look at binocular treatment of amblyopia, see this recent post on the VisionHelp blog.

Dr. Nate

By Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
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Congrats to our newest Vision Therapy grad!

The entire staff and I want to extend a special congratulations to DS, our newest vision therapy graduate!  She has worked very hard and has done extremely well. She should be quite proud of herself!

DS was referred by her excellent tutor who I have known for several years and is skilled at suspecting vision problems when they are interfering with learning activities like reading and writing. When DS came in our office,  she was struggling with words that appeared to run together while reading, skipping lines while reading and generally avoiding activities like homework. Her COVD Quality of Life Survey score was 39, indicating that visual problems were likely causing her symptoms. (A lower score is better, and anything over 20 is raises suspicion of a vision problem).

DS’s symptoms were explained by her convergence insufficiency (difficulty turning eyes inward when looking up close), accommodative insufficiency (difficulty focusing) and pursuit dysfunction (difficulty with tracking).

Now after completing vision therapy, all of that has changed! As her mom said, “It is like she’s a different child. She understands  more of her reading because of her eyes tracking better. Homework is not a struggle anymore. In fact, she has it done before she gets home most of the time. ”

And what I love to hear from parents:  “She is more excited about reading than ever before!”

Recently report cards came out, and her mom was so excited at the improvement that she emailed us a copy. There has been improvement not just in reading but improvement in many areas (especially in science) as you can see in this little section of the grade report:

I’m quite happy that through vision therapy, DS has overcome her visual problems, and this is reflected in her COVD Quality of Life score that dropped from 39 to 8! As DS lives quite a long distance from our office, I’m sure they will not miss the weekly drive. But we will miss seeing her in the office! We are very proud of her. If she works as hard at everything else as she has in VT, we have no doubt she will succeed beyond her wildest dreams!

Dr. Nate

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.
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August is National Children’s Vision & Learning Month

If you have tried to get an appointment recently, you may have noticed that August is a very busy month for us. And rightfully so. August is National Children’s Vision & Learning Month. I spend much of this month – and every month – helping children develop the visual skills they need to read and write. I routinely hear how after appropriate glasses and/or vision therapy, patients are reading better than ever, not fighting over homework, checking out books for fun, doing better in sports, and so many other achievements.

Here is one:

And you can find many more videos like this one at on YouTube.

If I’m not convincing enough, read these quotes from more well-known people and organizations.

  • “25% of students in grades K-6 have visual problems that are serious enough to impede learning.” – American Public Health Association
  • “When vision problems go undetected, children almost invariably have trouble reading and doing their schoolwork. They often display fatigue, fidgeting, and frustrations in the classroom—traits that can lead to a misdiagnosis of dyslexia or other learning disabilities.” – American Optometric Association
  • “It is estimated that 80% of children with a learning disability have an undiagnosed vision problem.” – Vision Council of America
  • “Early diagnosis and treatment of children’s vision problems is a necessary component to school readiness and academic learning; and that vision screening is not a substitute for a complete eye and vision evaluation by an eye doctor. Comprehensive eye and vision examinations … are important for all children first entering school and regularly throughout their school-aged years to ensure healthy eyes and adequate visual skills essential for successful academic achievement.” – National PTA Policy Statement 2005,
  • “Early testing for vision problems is key to preventing learning disabilities or, in some cases, significant visual impairment in children.” – Ned Calonge, MD, MPH, Task Force Chairman, Chief Medical Officer and State Epidemiologist at the Colorado Department of Public Health and Environment.
  • “A three year study of 540 children found that those children who had visual perceptual and eye movement difficulties did poorly on standardized tests.” – Dr. Lynn Hellerstein, FAAO, FCOVD,

You can find tons of information on vision and learning on COVD.org. I wholeheartedly encourage you to take part in Vision and Learning Month by  reading and sharing your success stories on COVD’s Facebook page! And, of course, if your kids haven’t had their back to school exam yet, schedule one here or call us at 813-792-0637.

Dr. Nate

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.
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Join COVD’s “Visions of Hope” Vision Therapy Video Contest.

At Bright Eyes Family Vision Care we love it when patients share their successes with us. Many times and they simply tell us when they come in. Sometimes they’ll write an amazing e-mail. One thing we really love is a good video!

Take for example this video of Kellan and his mom describing how vision therapy has helped him:

I’m excited to say that many other people are sharing their vision therapy success stories by video as well these days! Check out this very creative and timely one from Jillian, of Jillian’s Story. See also this very moving story of vision therapy and how much difference it made for Ann.

The College of Optometrists in Vision Development (COVD) is an organization dedicated to educating doctors and the general public about vision therapy.  This summer, in conjunction with Children’s Vision and Learning Month, COVD  is hosting an amazing vision therapy success story video competition called Visions of Hope video contest.

The goal of the competition is to see how many great vision therapy stories they can get on line to help share the positive impact vision therapy can have. It is exciting because the contest has already gotten lots of attention online. I can’t wait to see all the great videos that result from it!

Do you have a vision therapy success story that you want to share? Join the Vision of Hope contest! Read exactly how to submit your entry on the COVD Facebook Page. Submissions are due by August 10, so don’t dilly-dally! If you want to submit a video but have any questions or need help, do not hesitate to let me know!

Dr. Nate

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.
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New Sports Vision Video with NBA Star Tyreke Evans and VSP

This new video from VSP is great! Not only is it pretty fun and entertaining, but it also makes a great point about the importance of vision and activities like sports. I’ll be honest I don’t know who  Tyreke Evans is, because I don’t follow basketball, but I do know that vision is very important for sports! Not only do you need to see clearly, you and have to have  good peripheral vision and good visual reaction time; all of these things are necessary to win. The great thing is that if there are problems with any of these things, they can be fixed with corrective lenses or vision therapy!

This video shows that protecting your eyes on the court or on the field is very important. Regular glasses are not designed for sports and are actually less safe than sports glasses. And don ‘t worry,  the modern sports glasses are way cooler than the ones I had when I was a kid! Stop by Bright Eyes to check out some of the new models.

The VSP video also does a great job of highlighting the American Optometric Association’s recommendation that the  first eye exam should occur at six months, then three years, then before kindergarten, assuming nothing is wrong.

If you have any questions about your little one’s vision,  have concerns that vision may be interfering with sports, or whether or not they are protecting their eyes sufficiently during sports, ask us!

Dr. Nate

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.
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Vision Therapy Is Amazing!

We have had an amazing few weeks at Bright Eyes Family Vision Care in the Vision Therapy department and I just want to share! There have been several patients who have graduated with flying colors and it is so wonderful to see them so proud of their accomplishments  – and so happy with the results!

One young patient is very bright but has a variety of different problems including difficulty with eye movement control and visual attention. During the course of vision therapy not only has his visual skill improved but his parents have noted a dramatic difference in his awareness of the world around him. They say that he is better able to work with groups of people and get his behavior at school on has improved dramatically!

Another young patient had amblyopia (which means a lazy eye) as well as a few other related visual processing problems. Her therapy was primarily for the amblyopia to improve the vision in her eye and to improve the way the eyes work together. Then at one point a few weeks ago her mother reported that her reading had really taken off. She had her nose in a book almost all the time! Needless to say her mother is thrilled.

I am also excited because we have several new patients starting therapy program. One young man has had ongoing problems with double vision that have interfered with reading and school work. He is excited to get started and I am too because I know he is going to do very well. Another one is a typical case where the family came in with concerns about having to see blurry in the distance and only after we did the evaluation did we find out that there were focusing problems that may also be contributing to avoidance of homework and their close activities. Once I explained how and an underlying focusing problem can actually cause vision in the distance to be blurry, it made a lot of sense to them and they were excited to sign up.

Although vision therapy is the most time consuming and most complicated part of my career, it is also the most rewarding to being out the potential of these patients and their joy when they themselves realize it! If you have any questions about vision therapy and and whether or not you or someone else is a candidate, please feel free to give our office a call, e-mail us, or stop by.

Dr. Nate

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.
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AOA School Readiness Summit: Focus on Vision

The American Optometric Association recently held a School Readiness Summit: Focus on Vision in which doctors, nurses, educators and advocates for children’s health gathered to examine learning-related vision issues that are keeping children from achieving in the classroom. This summit was created to address the concerns that our current system is flawed and a policy shift is needed. The problem is that currently, the U.S. educational system and some health care providers rely heavily on vision screenings to discover the kids that need comprehensive exams. These screenings do catch some types of vision problems but they can miss about 75% of those children that have learning-related vision problems. Detecting these vision problems is very important as “studies show that much of what children learn comes though vision, and undetected and untreated eye and vision disorders in children, such as amblyopia and strabismus, can result in vision loss, additional costly treatments, delayed reading and poorer outcomes in school.”

The take-home statement that the summit produced is that comprehensive eye exams must serve as the foundation to determine school readiness in school-aged children. Another important point established at this meeting is the establishment of the link between healthy vision and classroom learning.

This historic summit is an important step in ensuring that children receive the proper detection and treatment of vision problems before they become detrimental to their learning. Here at Bright Eyes Family Vision Care, we are excited to see these changes being made, since it has been our goal from the beginning to not only catch vision problems at an early stage, evidenced by the InfantSEE program that we offer that provides free eye exams to infants between the age of 6 months and 1 year of age, but to also treat certain types of problems through our extensive one-on-one vision therapy program.

If you have any questions regarding the InfantSEE program, vision therapy program, or would like to schedule a comprehensive eye exam for your child before they start school, give our office a call or come in to schedule.

All the best,

Justin Schoonover, CPO

Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.
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