What do you do in the Visual Evaluation and how is what you do different than other eye doctors?

The Purpose - or Why do I do the Exam? The clarity of your sight is only one of our many concerns. The visual evaluation will also reveal how well your eyes work together as a team. Evaluations of depth perception, eye movement skills, ability to focus easily from near to far and back again, focus endurance for near-centered tasks, color vision, and visual fields are among the many tests of visual performance which we implement. During the visual evaluation, we carefully evaluate the health of your eyes, inside and out, for such problems as cataracts, glaucoma, circulatory problems, hypertension, diabetes, etc. We are part of a wide network of health professionals and will direct any patient in need to the most appropriate source as quickly as possible should we detect any abnormality. However, additional special testing of visual performance is available right here in our office. Contrast sensitivity testing for those subtle visual defects, which can so profoundly affect visual performance, and electro-diagnostic analysis, to rule out neurological problems as a causative factor in eye turns or lazy eye conditions, can be done without leaving the office. Our modern world demands more from our vision than ever before. In fact, 80 percent of all school learning tasks require close-up vision. Adults in our technological society constantly use their near vision at work and at home. Computers especially strain our visual systems, and both adults and children are using them more and more. A thorough vision evaluation and follow-up care on a regular basis are very important for early detection and treatment of eye health problems and for prevention of vision problems created or aggravated by today's academic and vocational demands. Your vision should be evaluated EVERY YEAR or more frequently if symptoms of vision problems occur. Children should have a complete behavioral screening at the ages of six months and three years. They should then have complete visual evaluation on a yearly basis with the first evaluation occurring the summer prior to entry into kindergarten. The Mechanics of the Exam/Evaluation The initial visual evaluation is an exciting time for me. It is a real thrill to meet so many different people who have the need for my services. Many have seen others who have failed to help make a difference. Many have been down several different avenues searching for help and ended up making little or no progress. I love playing the role of Sherlock Holmes and discovering the mystery before me and coming up with alternatives of care to help you alter the path your life is on. Most of you will see me for a full 90 minutes the first time we are together. Generally that time is broken up in the following way. I will spend 15-20 minutes getting to know you and to find out what unmet needs you have that I might be able to help you with. These may vary from not being able to sustain attention on near-centered tasks, to getting headaches when reading or working on computers, to seeing double or seeing the words move on a page of print, to simply wanting to be better at sports or to recover basic skills of daily living following a stroke or head injury. Patients are often struck by my down-to-earth fun-loving spirit. A comprehensive visual evaluation should be fun, in spite of being put through many challenges that will help me see how various aspects of your visual process is working. After the case history we shift to the examination chair. We rapidly will move through a series of tests with lights and a moving steel ball, and lenses, and charts, and Polaroids and color charts and many other things. After as many years as I have been doing this it feels choreographed and you may marvel at how quickly we move from one thing to another. During this part I get a good sense of how you track moving objects and how you move from one place to another while shifting visual attention. I also get a sense of how accurate you are at pointing each of your eyes at precise locations in space. Many people have never learned how to be very accurate with the placement of both eyes at the same time and this can cause all kinds of loss of efficiency as the brain attempts to decide which channel to trust, rather than having the benefit of a well-merged dual view of the world. I then move in a testing device called a phoropter, which has many different lenses and allows me to analyze the optics of your eyes precisely while also giving me the chance to put your visual process through a series of visually stressful probes to find the range and ease that you can extend the use of your two eyes through. Once this is done we typically move over to a table top where I will do several performance tests. It is one thing to look at the optics of the system and to see the ranges through which you can keep both eyes aligned for example, but it is another thing entirely to see how quickly you can call off numbers from a paper or follow intertwined lines in a maze. I may have you read or copy text or write some spelling words, to see how you use your visual system in the real world. For some the final test uses infra-red technology to record your eye movements to a computer system so I can analyze the data and understand the mechanics of how you use your eyes to read. All of the testing usually can be completed in 50-60 minutes. The balance of our time is spent in me explaining to you and those who have come with you to your appointment, in terms you can understand, what my understanding is of your visual process. We will discuss the various potential etiologies that brought you to this point of your life and then I will give you the three alternatives of vision care and help you understand the potential outcomes of each of these alternatives. Many times problems can be addressed by using lenses alone. If so, this is great as it means we may not need to engage in vision therapy. However, some problems can only be overcome by vision therapy and if you have one of them I'll come right out and let you know that this is your best option. With your permission I will make a digital recording of our conversation and I will make it available to you and to whomever you wish to share it with via the internet later that same day or the very next day. Many people have found this refreshing that they will be able to go back through our dialogue later and not feel so overwhelmed with all the new information that is so important to learn. My goal is to find a path that helps you improve your visual abilities so that you can meet the demands that life throws your way. I look forward to meeting you and those whom you bring with you to the office.