Frequently Asked Questions
"My child passed the vision screening test at school and at the
pediatrician's office, doesn't that mean their vision is fine?"
Many children successfully pass school eye screenings that may still have vision
problems because most screening tests only check a child's distance vision.
Only children who are nearsighted (myopic) or who have a severe 'lazy eye' (amblyopia,
strabismus) will fail this screening. Children who are farsighted (hyperopic),
have astigmatism, or who have much more subtle, and often more debilitating
problems with eye movements, perceptual skills and control of their ocular focusing
system may pass these test with flying colors.
For more information visit What is Vision?
"At what age should my child have an eye exam and who/where should I schedule
According to the American Optometry Association (AOA), your child's vision
should first be evaluated at 6 months of age. This is when the structures of
the eye are fully developed. If all is well, your child should be examined again
at age 3, then again before beginning school. Once you child has started attending
school, they should get examined every 2 years unless your doctor advises otherwise
(Adults should be examined every 2 years, too!).
Remember, it is good to get a clean bill of health from your eye doctor. Eye
exams should be though of as wellness exams. Just like seeing the dentist, you
should visit your eye doctor before something is wrong.
For very young children, up to age seven, a pediatric optometrist would be
recommended. They often have more specialized equipment to test young children
who don't yet know their letters or numbers and who cannot yet follow some of
the standard tests used on most adults. Optometrists who specialize in pediatrics
often note this speciality in their business listing. Doctors who list an association
with the American Optometry Association (AOA), College of Optometrists in Vision
Development (COVD), or specialize in the areas of vision training, vision therapy,
or sports vision are also good resources.
For further information on these organizations see Recommended
"What is the difference between an optometrist and an ophthalmologist?"
Both ophthalmologists and optometrist are highly trained eye doctors with different
areas of specialty.
An optometrist has spent four years beyond an undergraduate program in a professional
school earning a doctor of optometry degree studying the body and how it works,
but really specializing in how the eyes works and the fundamentals of visual
Their training primarily consists of the following: learning how to test for
refractive error, prescribe glasses and contacts, how to test visual skills
and treat problems when detected, treating eye diseases and conditions, managing
disease with pharmaceuticals, and co-managing eye surgeries.
Ophthalmologists also spends four years in a graduate program in medicine or
osteopathy. Then they spend four years of residency specializing mostly in eye
surgery, but also in how to manage and treat eye diseases and conditions. Some
ophthalmologists also prescribe glasses and contacts, but very few gain training
in the function of the entire visual process.
"If the optometrist recommends vision therapy for my child will insurance
pay for it?"
Many plans now cover some vision therapy (VT) sessions, but every insurance
plan is different. Some plans will cover it without a referral. Others require
a referral from an ophthalmologist or primary care provider. Some plans require
certain diagnoses in order for them to approve coverage. Then there are the
insurance companies that consider VT preventative or homeopathic care and will
not cover it.
Most optometry offices handle a large number of insurance plans and often know
if your particular plan is accepted and many are often willing to call for you
to verify your benefits as they know the proper steps to find this information.
When in doubt, ask your eye doctor that provides vision therapy. If they can't
answer your questions, they can tell you what you need to ask your insurance
company in order to get a good answer.
"Is vision therapy only useful for children?"
Vision therapy (VT) can be useful for people of all ages but undoubtedly the plasticity so apparent
in children is not seen to nearly the same degree in adults. Adults can be set
in their ways and be less resistant to change, but it all depends on patient
motivation. Who says you can't teach old dogs new tricks?
VT can work for adults, but the rates of progress and therapy strategies
may be different. Another aspect to consider is the type of dysfunction being
treated; different problems respond more readily to VT (but this also applies
An ever growing and more specialized area of VT is treating people who have
suffered traumatic brain injuries (head injuries, strokes, etc.). 85% of our
brain is involved in vision and brain injuries can really affect visual skills.
The people who are affected come in all ages and sizes.
For more information on traumatic brain injury, you may want to visit the Neuro-Optometric
Rehabilitation Association International (NORA) site to learn more.
"I am over 40 and need bifocals. Will VT help me?"
VT cannot remove the need for reading glasses or bifocals as our vision ages
(presbyopia), however it has been shown that doing VT exercises prior to the
onset of presbyopia may delay the need for reading glasses or bifocals and the
power needed may be reduced as compared to cohorts.
Unfortunately, presbyopia happens to everyone. As you age, from your late teens
on, you slowly lose your focusing ability (accommodation) due to the lens that
focuses the light getting bigger, less flexible and the way it pushes against
the muscles that flex it. All these things eventually make it too difficult
for you to change how the light comes into the eye to make things clear.
"Can taking vitamins improve my vision?"
Vitamins, particularly the antioxidants with lutein, are showing great promise
in delaying changes associated with certain eye diseases, such as those associated
with age-related changes. However, there is much controversy surrounding the
use of vitamins because of the difficulty to study the affects of JUST vitamins
without other factors such as age, sex, race, environment, current health, heredity
and so forth. Some professionals need definitive proof, while others are satisfied
enough with the studies out there to recommend vitamins.
Vitamins do not seem to affect refractive error, however, so vitamins will
not lessen your need for wearing glasses or prevent you from ever needing them.
"Why is this refractive vision problem (nearsighted/farsighted/astigmatism)
showing up now?"
Vision difficulties can "show up" at any time, however some definite trends
have been noted. Studies have shown distinct trends toward myopia (nearsighted
vision) in certain age groups, primarily ages 8-11 years old.
During this same time frame, usually around third grade, we find that the size
of text gets smaller and the classroom demands get more intense. Not only are
students asked to read smaller words on a page, but they are reading more words
than ever before AND now have to add reading comprehension! This change in reading
demand can will impact kids with fragile visual systems.
Some kids are just not caught earlier on because they have vision problems
that are not as easy to spot by parents and educators. For example, a child
that is farsighted can often "hide" or cover up their farsightedness (involuntarily)
by putting their focusing system into overdrive. Eventually due to constant
stress the system breaks down and the child cannot compensate any longer. Third
grade is a good time for this.
Care by the doctor should be taken when prescribing lenses by taking into
considering their patient's age, visual skills performance, overall development
and environmental demands.
"Will wearing glasses or contacts make my vision worse?"
If glasses or contacts are worn appropriately this should not create any problems.
Glasses for hyperopia are generally worn at all times and a prescription with
extra power is sometimes needed for near work. Prescriptions correcting large
amounts of astigmatism should also be worn full time and at all distances. Myopic
corrections for most people should be worn to see clearly in the distance and
taken off to do near work (homework, computer work, reading, desk top work).
There are cases where this is not possible, such as myopes with high prescriptions
and people with certain types of visual dysfunction. Many times, one pair of
glasses is not the ideal wearing regiment. A second pair of lower powered lenses
or a bifocal may be needed up close (even over contact lenses) for optimal visual
Contact your doctor to see what wearing schedule you should be on so your prescription
is worn appropriately.
"Will I become dependent on my glasses or contacts?"
People sometimes feel they have become dependent on their glasses when the
more likely case is that they have grown used to enjoying seeing things clearly
and when the glasses are removed the world is not as sharp and crisp in appearance.
Now that you have a basis of comparision, it feels like your eyes are getting
worse, but in fact, your level of tolerance has changed.
Some people can make their vision worse by wearing their glasses or contacts
inappropriately. See your doctor if you are unsure of your wearing schedule,
or if you want more information about different pairs of glasses for different
types of activities that may be more appropriate than the one pair you may have.
"Will wearing glasses or contacts, improve my vision?"
Most of the time glasses and contacts will not improve your vision, but only
compensate for the refractive error you have. They are an aid, not a cure for
your refractive error.
There are doctors, however, that may use glasses or contacts as part of their
vision therapy regiment that CAN make long term improvements to their patient's
For more information on vision therapy, click here.
"Can refractive surgery correct my vision problems?"
Laser refractive procedures are becoming more common everyday. Just as the
procedure says, refractive surgery is intended to correct REFRACTIVE problems
that include myopia, hyperopia and astigmatism. This will help you see clearly,
but problems related to visual dysfunction WILL NOT be corrected by these procedures.
People with fluctuating prescriptions are not candidates for these procedures.
Most surgeons will not touch children or adolescents, either.
Patients who are nearing 40 years of age or older should be aware that correcting
their distance vision will not eliminate the need for near reading glasses.
An exception to this statement is the patient who has successfully functioned
in a state of monovision, (one eye corrected to see in the distance and the
other eye corrected to see up close). These people may have the option to have
the refractive procedure done correcting the eyes in a state of monovision.
Monovision works very well for many patients, but it does affect binocularity
and glasses worn during driving, to re-establish binocular vision, should be
Refractive procedures will not prevent the development of cataracts that come
with age; cataracts can cause refractive error to change and involve an additional
surgery to be removed. The good news is, cataracts are generally not a problem
for most people until they near 70 years of age or more; a thirty year old patient
having a laser refractive procedure could reap the benefits for decades before
these issues arise.
If you are seriously considering a refractive procedure, you should discuss
whether you are a good candidate and surrounding issues with your eye doctor;
educate yourself. Most institutes performing these procedures have free seminars
to discuss risks and benefits. If you attend a seminar, go prepared with questions.
Ask questions like...How many procedures has this doctor done? How many surgeries
of the particular procedure you need has this doctor done? What is their success
rate? What does the procedure entail?
"If I wear glasses/contacts and/or had learning difficulties as a child,
will my child have the same problem?"
There is a chance that your child's chances of having similar problems that
you experience are increased if a parent has refractive problems. The same is
true with learning difficulties and visual dysfunctions. This can happen for
a number of reasons, including heredity, similar environment, and similarly
learned behaviors and adaptations.
If the parent has/had any of these issues, regular and thorough vision exams
are strongly recommended for their children. Remember detecting problems early
increases your child's rate of success and can possibly prevent or better manage
vision changes that may occur.
For more information on risk factors, click here.