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We assess tracking, teaming and focusing ability

As a child progresses through the grades, the demand on visual skills and the need for more automatic visual skills increases.

Primary visual skills required for early readers are listed below but more complexity and integration increases with academic demands.

Tracking and saccades

This is the ability to point the eyes accurately at an object and to keep the eyes on target whether the object is moving or stationary. Without good tracking skills, you cannot clearly follow a moving object, such as a ball in flight. Without good saccades and fixation it is difficult to move your eyes smoothly across a line of text on a page. Scanning from letter to letter, word to word, looking ahead and predicting text, and moving from one line to the next are all complex skills related to eye movements and are necessary for skilled reading.

Eye teaming (binocular fusion and stereo depth perception)

This is the ability to co-ordinate and align the eyes precisely so that the brain can fuse the images from each eye into one. While we take this for granted, this is incredibly complex, and more complex on a page of print than in most other everyday tasks.  Even a slight misalignment causes difficulty with reduced attention and stamina for extended visual tasks, particularly reading. Misalignment of the eyes causes loss of concentration at the very least. If more serious, it can cause double vision, movement of the words or suppression of part of the vision of one eye.

Focusing skills

This includes the ability to accurately focus and maintain clarity (see each word clearly on the page) and the ability to rapidly change focus from one point to another (copying from the board to the book). Most children are capable of a large amount of change in focus, but fine, accurate control breaks down more easily under stress. Focusing and eye teaming (binocularity) are intimately integrated and a breakdown in focusing results in altered eye teaming as well, affecting concentration and often understanding of what we read.

Our assessment

An assessment of each of these visual functions is included in a thorough visual efficiency examination carried out on a child brought to our practice. Specific tests given will vary with each child’s individual needs. As well as the review of the child’s health history and an examination to confirm the eyes’ physical health, the vision examination by the optometrist includes:

  • Tests of the child’s ability to see sharply and clearly at near and far distances.
  • Tests to determine how we look (near-sightedness, far-sightedness and focusing problems).
  • Checks of the eye co-ordination to be certain the eyes work as a team at both distance and near.
  • Tests of the ability to change focus easily and accurately from near to far and vice versa.
  • Checks for any sign of crossed eyes or any indication that the child is not using one eye.
  • Tests of depth perception.