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The Vision Therapy Centre at Bolton Optometry

Off Highway 50 – Next to Arcadia Academy of Music

Vision Therapy in Bolton, Vaughan & Brampton

learning is visual
Over 25% Of School Aged Children Have Visual Issues That Affect Learning 

Vision is all about the way our brains and eyes interact. Whether it’s reading words on the board, catching a ball, or tying our shoelaces, we depend on our visual system to work properly in order to succeed at any of these tasks.

This is because vision isn’t just what we see, it’s how we interpret and interact with that information. In fact, you can have perfect visual acuity―able to rattle off all the symbols on the reading chart―but still struggle with dyslexia, poor focus, hand-eye coordination, or vision conditions like strabismus, amblyopia, or convergence insufficiency.

Vision Is More Than 20/20

Our Optometrists specialize in vision therapy, neuro-optometric rehabilitation and the treatment of learning-related vision problems. Optometrists that specialize in vision therapy and neuro-optometry are sometimes called behavioral optometrists or developmental optometrists.

Vision Training or Vision Therapy is an individualized program for the treatment of non-refractive vision problems. Vision is far more complex than 20/20. Our optometrists work with the entire visual system including the 17 skills used in reading and daily life such as the ability to smoothly move your eyes across a sentence or the ability for your eyes to work together.

Eye exercises and tasks are tailored to each patient according to the specific aspect of vision they need improvement. The therapy is performed in our office in Bolton by a certified vision therapist under the guidance of our vision therapy optometrists. Vision therapy is effective for children, adults, athletes, special needs, stroke patients and people that suffered a traumatic brain injury.

Our Optometrists have extensive experience providing vision therapy for children and adults in Vaughan, Brampton, and Richmond Hill, with incredible results. We are a proud member of:

COVT R logo

MEET OUR DR.'S

MEET OUR DR.'S

Dr. Virginia Donati FCOVD

Dr. Virginia Donati

FCOVD
President of the COVT&R

Dr. Michelle McKenzie FCOVD

Dr. Michelle McKenzie

FCOVD
Vice President of the COVT&R

Dr. Olivia Wiebe

Dr. Olivia Wiebe

COVD
Developmental and neuro-rehabilitative

MEET OUR DR.'S

MEET OUR DR.'S

Dr. Virginia Donati FCOVD

Dr. Virginia Donati

FCOVD
President of the COVT&R

Dr. Michelle McKenzie FCOVD

Dr. Michelle McKenzie

FCOVD
Vice President of the COVT&R

Dr. Olivia Wiebe

Dr. Olivia Wiebe

COVD
Developmental and neuro-rehabilitative

Over 80% Of Learning Is Visual: 3 In 4 Children With Reading Disabilities Have Underdeveloped Visual Skills

Vision & Learning

Vision problems in children, other than simple refractive errors such as nearsightedness, farsightedness, and astigmatism are not uncommon. These issues can cause significant behavioral and learning challenges for children.

Often, these challenges manifest in ways that are often confused with 

  • Dyslexia
  • ADD
  • ADHD
  • Reading Problems
  • Poor focus
  • Amblyopia (“lazy eye”)
  • Eye Alignment
  • Visual Perceptual Disorders

and can result in misdiagnosis, all requiring vision therapy. If children exhibiting these symptoms receive a negative diagnosis, left untreated, these non-refractive vision problems can cause learning problems, fatigue, eyestrain, and headaches. If you are concerned about your student or child, schedule a developmental eye exam with our optometrist and Vision Therapy doctor today! 

Vision Problems

Most people are familiar with vision problems that eyeglasses address; nearsightedness, farsightedness, and astigmatism. These are called refractive conditions.

A learning-related visual problem directly affects how we learn, read, or sustain close work. Because difficulties with reading and learning affect the child's ability to focus, vision-related learning problems are often misdiagnosed as ADHD or other behavioral issues.

Visual problems in any of the following areas can have a significant impact on learning:

  • eye tracking skills - eyes following a line of print
  • eye teaming skills - two eyes working together as a synchronized team
  • binocular vision - simultaneously blending the images from both eyes into one image
  • accommodation - eye focusing
  • visual-motor integration - eye-hand coordination
  • visual perception - visual memory, visual form perception, and visualization

Vision and learning are intimately connected.  Someone may have a learning problem that is caused by an underlying vision problem. A child with a vision problem can be misdiagnosed as having Learning Disabilities, ADHD, or Dyslexia. There are various reasons for this misdiagnosis. For example, children who have learning-related visual problems cannot sustain their close work at school or home and often show signs of Inattention or Hyperactivity. A child may be misdiagnosed with ADD or ADHD because children with ADHD also can't sustain attention on their work, and inattention and hyperactivity are the two of the three main symptoms for the diagnosis. Same behaviors with vastly different diagnoses.

Attention Deficit Disorder (ADD)

Attention Deficit Disorder (ADD) is a widespread problem. If a child has a short attention span, the common assumption is that the child has ADD and should be on medication. If a child has behavior problems, then the assumption is that they have ADHD, Attention Deficit Hyperactivity Disorder.

At times, an underlying vision problem further complicates matters. Addressing the vision problems reduces the symptoms of ADD and sometimes eliminates them entirely.

If a child has difficulty pointing their eyes in to read material (convergence), if they can’t physically focus (as you would focus a camera), or if they can’t sustain those activities, that makes it all the more difficult for the individual to maintain sustained attention. More energy is needed for the visual system and there is then less energy to concentrate on reading. This then leads to a short attention span. If someone can’t physically maintain concentrating for whatever reason, they may be then labeled ADD.

A child who cannot focus because of a vision problem will not be able to sit still and do as instructed. Furthermore, a child with these kinds of vision problems is not able to direct their eyes and focus within the amount of time allotted to complete assigned tasks and homework. In this case, medication will not be effective. As the child develops the visual ability to correctly physically focus their eyes, they are better able to attend and concentrate, maintaining their mental focus for longer periods. They are then able to complete their work.

Before a diagnosis of ADD/ADHD is made, (or even once it has been made) and medications prescribed, parents and teachers should first consider a comprehensive eye examination with our developmental optometrists for their children. Much is at stake in the event of a misdiagnosis.

For more information on ADD and the connection with Convergence Insufficiency please see https://www.ncbi.nlm.nih.gov/pubmed/16361187

What Is Dyslexia?

There is no consensus on the official definition of dyslexia. Often referred to as a “learning disorder”, dyslexia is typified with difficulty reading or interpreting symbols in the correct order or syntax despite the fact that the person with dyslexia has, at least, average intelligence. "Dys" means "not". "Lex" means "read". Dyslexia, therefore, literally means not being able to read.

A substantial number of individuals with dyslexia actually have other visual problems that make the problem greater. All too often, an undiagnosed vision problem is the reason the individual was diagnosed as having Dyslexia in the first place.  If a vision problem affects learning, it can sometimes be misidentified as dyslexia because there are striking similarities between the two.

Vision Therapy Treatment For Dyslexia

Behavioral and Developmental Optometrists at the Bolton Vision Therapy Centre in Bolton, Southern Ontario have the knowledge and experience to diagnose and treat vision disorders that masquerade as Dyslexia or contribute to the unique challenges presented by Dyslexia. However, Vision Therapy does not treat Dyslexia itself.

Vision & Special Needs

Special needs such as autism, cerebral palsy, down syndrome, and other conditions often mean a child struggles with hand-eye-coordination. Children with these challenges, or anything else requiring occupational therapy, is very likely to gain immensely from Vision Therapy. A regimen of customized focus and perception exercises will improve depth perception and fine motor skills.

  • 45% of patients with down syndrome have strabismus/cross-eye
  • As many as 40% of autistic people have strabismus/cross-eye
  • Estimates of the incidence of strabismus in children with cerebral palsy go as high as 88%, Vision Therapy has shown to be effective for children with cerebral palsy.
Autism & Developmental Disabilities

Vision problems are very common in individuals with developmental disabilities such as autism. These problems or stims include:

  • lack of eye contact
  • staring at spinning objects or light
  • fleeting peripheral glances
  • side viewing
  • difficulty at maintaining visual attention

People with autism and other developmental disabilities often have trouble efficiently and accurately processing visual information, often combined with difficulty coordinating between peripheral and central vision. Following an object (eye-tracking) is also a typical problem. There is usually a preference to scan or glance at objects from the side instead of looking at them straight on. Eye movement disorders and crossed eyes are common in the autistic spectrum.

Vision Therapy is effective at stimulating and improving proper visual responses, eye movements, and the central visual system. Vision Therapy is also effective in helping patients to better organize visual space and gain peripheral stability so that he or she can better attend to and appreciate central vision and gain more efficient eye coordination and visual information processing. Dr. Dr. Donati, Dr. McKenzie, and Dr. Wiebe is certified as a Fellow of the College of Optometrists in Vision Development (COVD) and is experienced in examining and treating individuals with developmental disabilities and autism, even those who are non-verbal.

Down Syndrome

Patients with Down Syndrome overwhelmingly require eye care, with 70% requiring glasses. 45% of people with down syndrome have strabismus, which is usually best treated by a Vision Therapy Optometrist. Furthermore, there are a variety of ocular diseases associated with Down Syndrome patients such as tear duct abnormalities that can lead to severe discomfort, keratoconus (misshapen cornea) and congenital cataracts. A patient with Down syndrome may also require specialized glasses made for their unique facial features.

Cerebral Palsy

Content...

Patients with Cerebral Palsy will most likely have visual conditions that require correction with glasses and in many cases Vision Therapy. Recent research on Vision Therapy for Cerebral Palsy is showing that it is extremely effective. Many patients with Cerebral Palsy will have Strabismus, or, “crossed eyes”, which is most effectively treated with a Vision Therapy program that is personalized to the patient.

Links to further research

https://www.aaopt.org/detail/knowledge-base-article/vision-therapy-effective-treating-visual-skills-patient-cerebral-palsy

http://www.ovpjournal.org/uploads/2/3/8/9/23898265/ovp3-5_article_kress_web.pdf

What Is Vision Therapy?

Vision Therapy helps patients improve their foundation for reading, learning and playing sports. It’s a series of custom and individualized activities and exercises which function as a form of neuro-optometric rehabilitation.

In other words, Vision Therapy retrains the brain to more effectively interact with the eyes and therefore improve vision functioning. The goal is to enhance eye tracking, focusing and eye teaming abilities as well as eye-hand coordination and visual processing speed.

The program is not only for children. Vision Therapy is effective for adults, especially if they are motivated to improve their visual abilities.

Your Bolton Developmental Optometrist can help with lazy eye (amblyopia), eye turns (strabismus), traumatic brain injury (concussion, whiplash) and special needs populations. Research has shown that 20% of children have a vision issue that affects their learning.

Amblyopia (Lazy Eye)

What is Amblyopia?

Amblyopia, commonly referred to as “lazy eye” is when there is a significant difference in power between the eyes. This is often, but not always, caused by an alignment or eye-teaming problem such as strabismus.

Some common symptoms and problems associated with lazy eye:

  • Poor depth perception
  • Head tilting
  • Social stigma
  • Slow reading*

*According to a study published on November 2015 by the Journal of the American Association for Pediatric Ophthalmology and Strabismus, children with amblyopia read slower 42 words per minute than children without amblyopia that read 81 words per minute.

Treatment for Amblyopia: It’s Not about the “Bad” Eye

Amblyopia or “lazy eye” is best treated by Vision Therapy.

First, the source of the amblyopia must be identified. When indicated, eyeglasses are prescribed. Many eye doctors, particularly Pediatric Ophthalmologists, begin treatment by patching the "bad" eye. However, numerous studies have indicated that patching has been proven to be ineffective! Likewise, some doctors recommend atropine eye drops. However, atropine eye drops merely address the symptoms and not the neuro-optometric cause itself.

The common approach treats the problem as a problem in that one eye. Treating one eye may improve the acuity (being able to see letters on a chart) for a while, but often reverts and regresses.

The developmental approach taken by Vision Therapists realizes that amblyopia is really not an eye problem, but rather a problem of not being able to use the two eyes together as a team (eye-teaming). This approach is therefore often much more successful. In the same way that it was difficult for a parent to identify if someone had the problem, to begin with, it is often difficult for them to know if an eye doctor's recommendation to patch the eye is really working. They, therefore, may be losing time with an ineffective and outdated treatment plan.

Amblyopia does not go away on its own, and it can significantly affect a child’s ability to both learn and thrive socially in school. Untreated amblyopia can lead to permanent visual problems and poor depth perception. To prevent this and to give your child the best vision possible, amblyopia should be treated early by vision therapy.

At What Age Can Vision Therapy Treat Amblyopia?

An old axiom that is still held by many eye doctors is that amblyopia must be detected and aggressively treated before the age of 8 or 9. In reality, treatment for amblyopia or lazy eye is effective for adults as well as children. A child’s visual system is more malleable at a younger age, making treatment quicker at a younger age. However, adults with amblyopia or “lazy eye” tend to be more motivated patients. Improved eye teaming is nearly always achievable.

Strabismus

What is Strabismus?

Strabismus, often referred to as “Crossed Eyes”, “Wandering Eyes”, or “Wall Eye” is a condition where the eyes fail to align properly. Beyond the social stigma, strabismus often results in other vision and visual processing problems such as diplopia (double-vision), amblyopia, and problems with depth perception. A major concern for developmental optometrists is that strabismus is not as simple to diagnose as a visual check. In fact, you can have strabismus without any obvious crossing or eye turn.

There are four kinds of strabismus, two horizontal and two vertical:

  • Esotropia: one eye may turn in relative to the other 
  • Exotropia: one eye turns out relative to the other
  • Hypertropia: one eye turns up relative to the other
  • Hypotropia: one eye turns down relative to the other

Treatment for Strabismus

All too often, parents are told not to worry about their child's Strabismus symptoms and that their child will 'grow out of it'. This is a mistake. In many cases, the symptoms of the problem do not improve as the child grows, and meanwhile, strabismus causes significant difficulties with reading and learning. Treatment varies depending on the cause of the eye-turning, and may include:

  • Eyeglasses
  • Vision Therapy
  • Prism
  • Eye muscle surgery

Eye muscle surgery can sometimes make the eye appear to others as if it is straight, but it rarely aligns with the other eye, and the symptoms associated with Strabismus continue.  A program of Vision Therapy for children or adults is usually required in order to restore visual function and the ability to properly use the two eyes together as a team.

Convergence Insufficiency

Convergence Insufficiency is a neuro-visual condition where the eyes fail to come together (to converge) enough to enable proper visual perception. The condition is particularly related to near-vision or near-center and visually demanding activities. This can result in:

  • Poor school performance and behavioral problems
  • Eyestrain
  • Blurred vision
  • Diplopia (double-vision)
  • Asthenopia (eye strain and fatigue)
  • Difficulty making eye contact
  • Fatigue
  • Headaches and migraines
  • Difficulty reading and concentrating
  • Avoidance of “near” work
  • Poor sports performance
  • Dizziness or motion sickness

A study of almost 700 5th and 6th graders indicated that convergence insufficiency is much more common than many assumed with 13% of students having convergence insufficiency. Also, the children who showed three signs of convergence insufficiency, 79% were classified as being accommodative insufficient as well.

 

Treatment for Convergence Insufficiency

Eye coordination problems such as convergence insufficiency and convergence excess generally cannot be improved with eyeglasses or surgery. Likewise, research demonstrates that the traditional focus exercise often called "pencil pushups" are ineffective. The only consistently effective treatment for convergence insufficiency is office-based Vision Therapy, which will improve eye coordination abilities and reduce symptoms and discomfort when doing close work.

Binocular Vision

According to research performed by The AAO 32% of university students had Binocular Vision Issues. The conclusion of this study is:

"Because these dysfunctions have a negative effect on performance, appropriate vision evaluation for this population is extremely important.

In this study, 31% of the students needed Vision Therapy for symptoms such as eye strain, double vision, and headaches.

strugguking-at-school

Vision Therapy Can Help With Vision Problems From Concussions, Brain Injury, and Stroke

What Is Neuro Optometry?

Neuro Optometry involves the rehabilitation of visual skills that were degraded due to a traumatic brain injury, stroke or other neurological issues. These visual issues affect how someone is able to function on a daily basis. Addressing these vision conditions is crucial to the recovery process. In fact, patients typically gain more from neuro-developmental vision therapy than they do from other therapies, such as occupational therapy, physical therapy, or cognitive therapy, etc. Vision issues such as the ones listed below are all too often the main obstacle in achieving a full recovery.

When someone has a Traumatic Brain Injury (for example a car crash or a bad fall) or an Acquired Brain Injury (stroke or brain tumor), it is common to then develop problems associated with vision.  Making sense of what you see is one of the most basic and important brain functions. Your Bolton Neuro-Optometrists help individuals solve the vision problems brought about by that brain injury. Addressing the vision problem often facilitates improvement with other therapies. Neuro-Optometrists diagnose and treat the vision problems in order to maximize the patient's outcome, with the ultimate goal of these services to improve the patient's quality of life.

Neuro-Optometric Rehabilitation at our vision therapy center serving Bolton,Vaughan,Brampton ,and Mississauga treats patients with a specialized Vision Therapy program for those who have suffered a brain injury, that effectively treats visual problems including:

  • Diplopia (double vision)
  • Eye-tracking problems
  • Binocular Vision Dysfunctions (the ability to coordinate the two eyes to work together)
  • Reduced visual acuity at far (how clear the letters are at distance)
  • Reduced visual acuity at near (how clear the letters are at reading distance)
  • Accommodative Disorders (physically focusing the eyes)
  • Difficulties in visual perception (are objects where I think they are?)
  • Visual Field loss (not being able to see on the right side of the right eye, for  example)
  • Deficits in visual motor (eye movement problems)
  • Ocular Motility disorders integration (putting together eye movement with body movement)
  • Visual Information Processing (making sense of what you see)
  • Strabismus (eye turns)
  • Mental visual focus
  • Physical eye focus
Acquired Brain Injuries

A brain injury such as a concussion will often disrupt the visual process that interferes with how information is taken in and processed. Vision can be also be compromised as a result of a neurological disorder such as a stroke, a brain tumor or Multiple Sclerosis. These are termed Acquired Brain Injuries.

Compete At A Higher Level With Sports Vision Therapy

What Is Sport Vision Therapy?

2020 eyesight and good hand-eye coordination are not enough to maintain peak performance for sports. We tend to underestimate the complexity and challenge posed to our visual system when we try to hit a ball moving at 65-80 miles per hour. Sports Vision Training uses the principals of vision therapy in research-backed therapy that improves sports performance through improving skills such as:

  • Better hand-eye coordination
  • Improved depth perception and estimation
  • Faster reaction times
  • Vision and balance
  • Precise eye movement and tracking

Our optometrist,  provides cutting-edge sports vision training to athletes from Bolton, Vaughan, Brampton , Mississauga.

Sport Vision For Kids (Video)

Sport Vision For Athlets (Video)

Questions And Answers
Is there an age limit to vision therapy?

No. There is no age limit because of the brain’s neuroplasticity. Our brains are dynamic and flexible. Just like a muscle or playing an instrument, the more we practice and hone our ability and memory, the more skillful we become. Children's brains are more malleable than adults, and for this reason, it is assumed that children will have better results with Vision Therapy. While true, adults possess a strong motivation to make the treatment plan a success, and we successfully treat patients of all ages.

What Are Symptoms To Look Out For?

Teachers, parents, and adults should learn to be on the lookout for the symptoms listed below as they may indicate a vision issue. 

  • Lazy Eye, cross eye, double vision 
  • Difficulty Reading 
  • Poor Classroom Performance 
  • Difficulty staying focused 
  • Strabismus
  • Poor hand-eye coordination
  • Constant squinting/head tilting
  • Uses fingers to read
  • Favors one eye over the other 
  • Poor handwriting
  • Difficulties with geometric shapes
  • Headaches after reading or computer work 
  • Feeling of fatigue after reading or using the computer
Can you eliminate glasses with Vision Therapy?

Vision therapy is NOT the same as self-help programs that claim to reduce refractive errors and the need for glasses. There is no scientific evidence that these "throw away your glasses" programs work, and most eye care specialists agree they are a hoax.

In contrast, vision therapy is approved by the Ontario Association of Optometrists (OAO) for the treatment of non-refractive vision problems, and there are many studies that demonstrate its effectiveness. 

However, Not every vision problem can be helped with vision therapy. Children that can be helped must adhere to the established vision program.  The degree of success with vision therapy is determined by a number of factors.  The patient’s age and his level of motivation are key factors.  As important is the patient's performance of all eye exercises and visual tasks correctly.  Furthermore, the type and severity of the vision problem are taken into account when evaluating the level of improvement with vision therapy.

We See Patients From

Bolton | Vaughan | Brampton | Mississauga | and Ontario