For many presbyopes, bifocal lenses are a necessity. But it can be difficult to adjust to the harsh line that is found in many bifocal lenses. Fortunately, there are no-line lenses, which are also called progressive lenses. No more lines! Just a change in focusing power which allows you to comfortably focus on any distance. Just as with lined bifocals, distant objects are viewed through the top portion of the lenses, and near objects are viewed through the bottom portion of the lenses.

If you need bifocals but cannot stand wearing glasses, you may need bifocal contact lenses. Now you can have all of the benefits of bifocal lenses in the convenience of contact lenses. Talk with your doctor about bifocal contacts today.

For some of our emerging presbyopes we offer another option to glasses. Monovision is a method of fitting your dominant eye for distance vision and your non-dominant eye for near vision. Contacts are available in disposable, extended wear, and even daily disposable lenses to fit your lifestyle. Most patients require 2-4 weeks to make the adjustment from binocular vision to monovision.

Children with uncorrected vision conditions or eye health problems face many barriers in life, academically, socially, and athletically. High-quality eye care can break down these barriers and help enable your children to reach their highest potential. As a parent, make sure you are giving your children the eye care they need. Presented are guidelines from the American Optometric Association.

Your baby has a whole lifetime to see and learn. But did you know your baby also has to learn to see? As a parent, there are many things that you can do to help your baby’s vision develop.

When your baby is about six months, you should take him to your doctor of optometry for his first thorough eye examination. Things that the optometrist will test for include excessive or unequal amounts of nearsightedness, farsightedness, astigmatism, lack of eye movement ability, as well as other eye health problems. These problems are not common, but it is important to identify children who have them at this stage. Vision development and eye health problems can be more easily corrected if treatment is begun early.

Unless you notice a need, or your doctor of optometry advises you otherwise, your child’s next eye exam should be around age three, and then again before he or she enters school.

During the first four months of life, your baby should begin to follow moving objects with the eyes and to reach for things, first by chance and later more accurately, as hand-eye coordination and depth perception begin to develop.

To help, use a nightlight or other dim lamp in your baby’s room; change the crib’s position frequently and your child’s position in it; keep reach-and-touch toys within your baby’s focus, about eight to twelve inches from his eyes; talk to your baby as you walk around the room; alternate right and left sides with each feeding; and hang a mobile above and outside the crib.

Between four and eight months, your baby should begin to turn from side to side and use her arms and legs. Eye movement and eye/body coordination skills should develop further and both eyes should focus equally.

Enable your baby to explore different shapes and textures with his or her fingers; give your baby the freedom to crawl and explore; hang objects across the crib; and play “patty cake” and “peek-a-boo” with your baby.

From eight to twelve months, your baby should become mobile, crawling and pulling himself or herself up. He or she will begin to use both eyes together to judge distances and grasp and throw objects with greater precision. To support development do not encourage early walking – crawling is important in developing eye-hand-foot-body coordination; give your baby stacking and take-apart toys; and provide objects your baby can touch, hold and see at the same time.

From one to two years, your child’s eye-hand coordination and depth perception will continue to develop and he or she will begin to understand abstract terms. Things you can do are to encourage walking; to provide building blocks, simple puzzles and balls; and to provide opportunities to climb and explore indoors and out.

There are many other affectionate and loving ways in which you can aid your baby’s vision development. Use your creativity and imagination. Ask your doctor of optometry to suggest other specific activities.

During the infant and toddler years, your child has been developing many vision skills and has been learning how to see. In the preschool years, this process continues as your child develops visually guided eye-hand-body coordination, fine motor skills, and the visual motor skills necessary to learn to read.

As a parent, you should watch for signs that may indicate a vision development problem, including a short attention span for the child’s age; difficulty with eye-hand-body coordination in ball play and bike riding; avoidance of coloring and puzzles and other detailed activities.

There are everyday things that you can do at home to help your preschooler’s vision develop as it should.

These activities include reading aloud to your child and letting him or her see what you are reading; providing a chalkboard, finger paints and different shaped blocks and showing your child how to use them in imaginative play; providing safe opportunities to use playground equipment such as a jungle gym and balance beam; and allowing time for interacting with other children and for playing independently.

By age three, your child should have a thorough optometric eye examination to make sure your preschooler’s vision is developing properly and there is no evidence of eye disease. If needed, your doctor can prescribe treatment including glasses and/or vision therapy to correct a vision development problem.

Here are several tips to make your child’s optometric examination a positive experience:

1. Make an appointment early in the day. Allow about one hour.
2. Talk about the examination in advance and encourage your child’s questions.
3. Explain the examination in your child’s terms, comparing the E chart to a puzzle and the instruments to tiny flashlights and a kaleidoscope.

Unless recommended otherwise, your child’s next eye examination should be at age five. By comparing test results of the two examinations, your optometrist can tell how well your child’s vision is developing for the next major step. . .the school years.

A good education for your child means good schools, good teachers and good vision. Your child’s eyes are constantly in use in the classroom and at play. So when his or her vision is not functioning properly, learning and participation in recreational activities will suffer.

The basic vision skills needed for school use are:

• Near Vision. The ability to see clearly and comfortably at 10-13 inches.
• Distance Vision. The ability to see clearly and comfortably beyond arm’s reach.
• Binocular coordination. The ability to use both eyes together.
• Eye movement skills. The ability to aim the eyes accurately, move them smoothly across a page and shift them quickly and accurately from one object to another.
• Focusing skills. The ability to keep both eyes accurately focused at the proper distance to see clearly and the ability to change focus quickly.
• Peripheral awareness. The ability to be aware of things located to the side while looking straight ahead.
• Eye/hand coordination. The ability to use the eyes and hands together.

If any vision skills are lacking, your child will have to work harder. This can lead to headaches, fatigue, and other eyestrain problems. As a parent, be alert for symptoms that may indicate your child has a vision or visual processing problem. Be sure to tell your optometrist if your child frequently:

• Loses his place while reading.
• Avoids close work.
• Holds reading material closer than normal.
• Tends to rub his eyes.
• Has headaches.
• Turns or tilts head to use one eye only.
• Makes frequent reversals when reading or writing.
• Uses finger to maintain place when reading.
• Omits or confuses small words when reading.
• Consistently performs below potential.

Since vision changes can occur without you or your child noticing them, your child should visit the optometrist at least every two years, or more frequently if specific problems or risk factors exist. If needed, the doctor can prescribe treatment including eyeglasses, contact lenses, or vision therapy.

Remember, a school vision or pediatrician’s screening is not a substitute for a thorough eye examination.

Never overlook the importance of safety eyewear when playing sports. Every year, hundreds of men, women, and children are injured while playing sports. To help prevent sports-related eye injuries, athletes should use protective athletic eyewear whether or not prescription eyewear is needed. One choice is a sports frame with prescription or non-prescription polycarbonate lenses. Baseball or softball players who are hit in or near the eye, or suffer a blow to the head, should seek immediate care at a hospital emergency room or from an eye care professional.

The important thing to remember for parents of children who wear contact lenses is that contacts are prescribed medical devices. Contact lenses are not a cosmetic accessory. While the wearer may be happy about his or her new look, it is extremely important that the lenses be properly cleaned and worn according to the instructions of the optometrist.

• My Child Is Near-Sighted. Will Glasses Correct His/Her Learning Problem?
• What Is the Relationship between Eye Muscle Problems and Learning?
• My Child Loses His/Her Place. Is That Related to the Eyes?
• My Child Reverses Letters and Words. Does He See Backwards?
• What Are the Other Visual Components Necessary for Academic Achievement?

There is controversy over the exact relationship between vision and learning. For example there is a negative correlation between distance refractive error and reading ability. Myopic or nearsighted children who cannot see clearly at a distance without glasses are more commonly good readers. Children who spend tremendous amounts of time reading become nearsighted. Before Alaska became a state myopia was rare. After becoming a state, more than 50 percent of the children in Alaska developed nearsightedness. Thus, correlation is such that nearsightedness or poor distance vision is highly correlated with success in reading. Restated another way, poor distance vision is associated with better reading abilities.  Farsighted children statistically are poorer readers than myopic children.

Some of the mechanical visual skills which are related to reading include focusing or accommodation, and eye teaming, or convergence. Fatigue of one or both of these systems may interfere with reading. There is also a relationship between eye movements such as saccades (whereby we change fixation from one target to the next) and smooth following movements known as pursuits and reading. Children who cannot make accurate eye movements are often found to skip lines and words while reading.

The visual system was originally designed so that the peripheral vision was responsive to motion detection (danger from the jungles) with a central portion for fine discrimination (to identify the source of danger; e.g., a lion.) In the school environment the child is expected to ignore the peripheral portion of their visual system and pay attention with the central portion. If the child can not ignore the peripheral portion, he/she becomes distracted.  Improvement in eye movement skills often results in less distraction and fewer errors of skipping words while reading.

Reading requires very accurate saccadics, which are fixations from one spot to another.  Children who have poor eye movements are easily distracted and lose their place.  Remember, the eye movement system was designed so that peripheral vision detects motion and danger.  Imagine what happens when the system works correctly in the class room.  As soon as there is peripheral movement, the eyes move toward the source of movement. This results in the complaint of inattention.  Thus, reflexive eye movement skills must be socialized so that they do not respond reflexively to peripheral information.  In addition, speed and accuracy must be trained so that one does not lose one’s place.

The skills are easily improvable with vision therapy.  Once the information is brought into the eyes, it must be sent back to the brain for appropriate processing. The information must be utilized and integrated with the sensory and motor areas of the brain. Defects in the perceptual (interpretation of visual system) and motor (the integration with output, e.g., hand-eye coordination) may interfere with the reading process. Perceptual motor skills are key in the early acquisition of reading skills. A deficit is important to identify very early on-- i.e., five to seven years of age. Remediation of the skills at a later date, such as age 12, will be less effective for reading. Thus, early identification and treatment is essential. It is evident that there is more to good vision than 20/20.

It has been presumed that children who reverse letters or words see them backwards.  This is false.  They have directional confusion.  In the real world direction has no meaning.  For example, a chair is a chair no matter which way it is placed.  Changing direction does not change interpretation.  In the world of language direction changes meaning.  Connect the bottom of a chair and it looks like a "b".  Turn it 180 degrees it becomes a "d", flip it upside down and it becomes a "q" and flip it again it becomes a "p".  Thus, direction changes meaning.  The difference between "was" and "saw" is direction.

As mentioned previously, we should correct all optical errors of the eyes (glasses); eliminate eye muscle problems; and create smooth accurate eye movements.  In addition, we should make sure that we properly interpret what we see and use it appropriately.  These are known collectively as perceptual skills and include form perception, size and shape recognition, visual memory, and visual motor integration (hand-eye coordination.)