Visual Skills for Learning

Vision is More than 20/20

Most eye exams and screening tests are built around the measurement or obtainment of 20/20 visual acuity. While important, visual acuity is only a small part of what “good” vision entails and does not measure how effectively or efficiently a person is using their vision. Deficiencies in the visual skills listed below are more often associated with learning problems and/or other functional vision problems and can be treated with vision therapy.

Vision Screening Questionnaire​​​​​​​


  • Eye Movement Skills- Ability to accurately track and follow with our eyes. Inaccurate tracking skills can cause loss of place when reading, skipping over words/lines, poor reading fluency, “careless” errors and difficulty with eye-hand activities including sports.

  • Eye Focusing Skills- When we look far away, the focusing muscles in each eye relax, when we look up-close they constrict. The accurate and efficient use of these muscles allows us to focus on near-print for a sustained period of time and easily switch our focus from near to far and back again. Inefficient focusing skills may cause blurred vision, visual fatigue, trouble copying from the board, reduced reading comprehension and avoidance of near-point activities.

  • Eye Teaming Skills- Ability of the eyes to work together as an efficient, coordinated team to create a clear and single picture when looking near or far. Small eye teaming problems cannot readily be detected by the untrained observer; however, they do significantly interfere with the ability to efficiently process visual information, especially at near when reading and writing. Deficiencies in eye teaming skills can cause numerous symptoms and adaptations including eyestrain, headaches, blurred or double vision, words running together when reading, difficulty with handwriting/spacing, covering or closing of an eye, decreased reading comprehension and most commonly in children, difficulty keeping attention on reading and writing tasks.

  • Eye Alignment/Strabismus/Depth Perception- A more severe eye teaming problem can create difficulty with depth perception and understanding where we are in relation to other objects. Sometimes this is caused by a severe misalignment of the eyes that can easily be observed by a lay person or in photographs. Over time, these severe eye teaming problems can cause undesirable adaptations such as head turns/tilts, suppression of visual information from the turned eye or an amblyopia/lazy eye. While these adaptations reduce the confusion, poor eye alignment interferes with the ability to judge distances for driving and sports, creates difficulty with eye hand coordination, reduces depth perception and creates an overall inefficient visual system.

  • Peripheral/Spatial Awareness- When eye movement, focusing or teaming skills are under-developed, it is often causes difficultly with understanding where we are in our visual space. The signals we get from our vestibular (inner ear), proprioceptive (our joints and muscles) and visual systems must be integrated in order for us to function well and have balance, and coordination. Vision is particularly important because it also answers the question of where we are in relation to the objects around us. It is very common for people with poor visual skills to “tunnel” their vision and have difficulty with peripheral awareness. This makes eye teaming and tracking more difficult. Vision therapy improves both the visual skills and spatial awareness, leading to better coordination and improved sensory integration.

Visual Information Processing

Often children who are struggling with learning will also have difficulty with vision information processing or perception. Visual information processing delays are commonly found along with poor visual skills and can also be treated with vision therapy.

Below are some the visual perceptual areas we test with their associated symptoms:

  • Laterality/Directionality Right/Left knowledge & Letter Reversals

  • Visual Discrimination- Ability to notice small differences in objects/words.

  • Visual Figure Ground- Ability to separate out relevant details/information. Difficulty can also lead to poor planning/organization.

  • Visual Closure- Ability to complete the whole. Difficulty can cause confusion of similar objects/words, and make it slow to complete tasks.

  • Visual Memory/Visualization- Ability to recall or create a visual picture. Difficulties lead to poor spelling, poor recall of information, difficulty with remembering a sequence of directions, poor reading comprehension and difficulty with writing.

  • Visual Motor Integration- Relates to eye-hand coordination and handwriting. Difficulties cause poor organization on written page, poor copying/spacing, and increased effort to complete written tasks.

  • Auditory-Visual Integration- Ability to integrate what we hear with what we see. Relates to understanding phonics, and reading music.

Vision Therapy (or Vision Training)

Vision Therapy is often referred to as physical therapy for the eyes. It is a progressive, individualized program designed to remediate and enhance visual skills and visual information processing.

Vision Therapy sessions include procedures designed to enhance the brain's ability to control:

  • eye alignment

  • eye tracking and eye teaming

  • eye focusing abilities

  • eye movements

  • peripheral and spatial awareness

  • depth perception

  • eye-hand coordination/visual-motor skills

  • visual memory/visualization

  • visual processing of information

Visual-motor skills and endurance are developed through the use of specialized optical devices, including therapeutic lenses, prisms, and filters. During the final stages of therapy, the patient's newly acquired visual skills are reinforced and made automatic through repetition and by integration with motor and cognitive skills. Vision Therapy should not be confused with any “self-help” vision program and should only be done under the supervision of a qualified developmental optometrist.

​​​​​​​Other Services

Therapeutic and Performance Lens Prescribing

Patients with eye teaming, tracking, or focusing problems can see immediate benefits from prescription glasses designed to help the visual system perform more efficiently. These glasses are not solely based on eyesight or visual acuity, but instead help place the visual system back into balance. Therapeutic lenses often involve specialized prisms to help improve peripheral awareness. Most eye doctors are not trained in therapeutic lens prescribing and how they can affect visual performance. Therapeutic lenses can be prescribed separately or as part of a complete vision therapy program.

Therapeutic Lenses can help:

  • Decrease headaches, eye strain, and dizziness with reading and writing tasks

  • Increase peripheral/spatial awareness in patients with AD(H)D, autism, or brain injury.

  • Improve eye-hand coordination

  • Improve posture, including decreasing head tilts/turns, improving center of balance, and decrease perceived shifts in the midline.