and
To improve independence and quality of life!
About Adrienne Broadfoot, M.S., OTR/L, SCLV
Vision Therapy
Vision Therapy Reference List
Development Testing
Specialized Visual Occupational Therapy for Pediatrics
Pediatric Low Vision Rehabilitation
Facts About Low Vision
Causes of Low Vision
Symptoms of Low Vision
Common Issues of Adults with Low Vision
Low Vision Rebabilitation
Adrienne Broadfoot, M.S., OTR/L, SCLV is a registered occupational therapist with a specialty certification in low vision and specialty training in vision therapy/orthoptics. She has over four years of experience in this specialized area of rehabilitation.
Adrienne graduated with her Bachelors in Science from the University of Alabama and her Masters of Science/Occupational Therapy from the University of Alabama at Birmingham (UAB). She also earned her specialty Graduate Certificate in Low Vision Rehabilitation from UAB and Specialty Certification in Low Vision from the American Occupational Therapy Association. Before relocating to Valdosta, she worked at UAB Eye Care and the UAB Center for Low Vision Rehabilitation in Birmingham, Alabama. Also, she served as a vision therapist on a multi-center National Eye Institute research study for convergence insufficiency in children.
Rehabilitation Services Provided:
• Vision Related Developmental Testing
• Specialized Visual Occupational Therapy for Pediatrics
• Specialized Occupational Therapy for Low Vision related to age-related diseases and stroke/brain injury
Vision Therapy (Orthoptics) is a combination of in-office and home based exercises designed to retrain the accommodative (focusing), vergence (eye teaming), and ocular motor (tracking) visual systems. It is a systematic series of exercises using lenses, prisms, computer software, polarized filters, and other equipment to improve innervational signals to ocular muscles.
Common Diagnoses:
• Reduced near focusing power (accommodation).
• Patients with AI must work very hard to keep near text clear while reading.
• Accommodative Infacility:
• The accommodative system is sluggish when making focusing changes back and forth from distance to near, which is very important to complete board work.
• Ocular Motor Dysfunction:
• Difficulty making accurate, coordinated eye movements, which is necessary for reading.
• Convergence Insufficiency:
• A reduced ability to converge both eyes in toward the nose, which is necessary for accurate eye alignment while reading.
• Patients with CI must work very hard to keep the text single.
• Fusional Vergence Dysfunction:
• General difficulty converging and diverging the eyes.
• A general lack of stability of the eye teaming system.
• Divergence Excess:
• An outward eye turn (exotropia) when looking at distance.
• Patients with DE may have difficulty with sports and have poor depth perception.
• Amblyopia:
• Reduced vision, usually in one eye, not correctable by glasses or contact lenses and is not due to any eye disease.
• Along with patching or atropine treatment from an optometrist or ophthalmologist, vision therapy can help correct/prevent suppression and improve accommodation and eye teaming.
Symptoms:
• Headaches
• Eyestrain/Fatigue
• Fatigue or sleepiness
• Squinting or rubbing eyes
• Poor reading comprehension
• Avoidance of reading
• Slow to complete board work
• Frequent loss of place
• Slow reading speed
• Poor reading comprehension
• Difficulty copying from the board
• Covering an eye while reading
Extensive literature exists supporting the validity and efficacy of vision therapy. Below is brief listing of relevant literature.
• Kulp MT, Schmidt PP. Effect of oculomotor and other visual skills on reading performance; a literature review. Optom Vis Sci. 1996 Apr; 73(4):283-92.
• Duckman R. Management of binocular anomalies: efficacy of vision therapy exotropia. Am J Optom Physiol Opt. 1987 Jun;64(6):421-429
• Daum KM. Convergence Insufficiency. Am J Optom Physiol Opt. 1984 Jan;61(1):16-22.
• Ciuffreda K. The scientific basis for and efficacy of optometric vision therapy in nonstrabismic accommodative and vergence disorders. Optometry. 2002 Dec;73(12):735-762.
• Scheiman M, Mitchell L, Cotter S, Cooper J, Kulp M, Rouse M, Borsting E, London R. Wensveen J, CITT Study Group. A randomized clinical trial of treatments for convergence insufficiency in children. Arch Ophthalmol. 2005 Jan;125:14-24.
• Barnhardt C, Borsting E, Deland P, Pham N, Vu T. Relationship between visual motor integration and spatial organization of written language and math. Optom Vis Sci. 2005 Feb;82(2):138-143.
Helpful Websites for Parents:
www.pavevision.org
www.visiontherapy.org
www.childrensvision.com
www.vision-therapy.com
This testing battery is given to patients who have already had a comprehensive eye examination but exhibit difficulties in school. The testing may include the following:
• Visual Motor Integration Test (VMI—Beery)
• The Developmental Eye Movement Test
• Jordan Right/Left Reversal Test
• The Dyslexia Screener
Vision Therapy addresses difficulty with:
• Handwriting
• Letter/word reversals
• Balance/equilibrium
• Developmental Delays
• Visual Perceptual Deficits
• Visual-Motor Deficits
Symptoms that may indicate a need for occupational therapy:
• Delayed Gross Coordination, such as difficulty jumping, hopping, walking on tip toe or standing on one foot.
• Delayed Fine Motor Coordination, such as difficulty cutting with scissors, holding a pencil/crayon, coloring, or tying shoes.
• Poor handwriting, such as incorrect letter or number formation, illegible handwriting, letter/number reversals.
• Delays in school performance
• Developmental Delay, such as difficulty achieving independence in age appropriate activities.
• Difficulty understanding relationships between people, objects, time, and space.
• Deficits in problem solving skills
• Clumsiness
• Easily Distractible
Therapy addresses difficulty secondary to:
• Ocular Impairments
• Oculomotor Impairments
• Visual Field Losses
• Other Diagnoses
Common issues of children/babies with low vision:
• Poor development of fine motor abilities and ability to manipulate toys
• Difficulty with spatial awareness and exploration of the environment
• Difficulty with age appropriate self-care skills, such as feeding, toileting, and dressing
• Resistive to textured foods
• Resistive to hair washing and teeth brushing
• Difficulty engaging in play and self-directing play
• Difficulty recognizing face of parent/caregiver
• Poor socialization skills and afraid of being around other children
• Poor communication skills
• Presence of self-stimulatory behaviors, such as rocking, eye poking or excessive eye rubbing
• Poor localization of sound
• Excessive fussiness
• Resistive to change or new environments
• Visual impairment is included among the 10 most prevalent causes of disability in the U.S. (National Eye Institute, 2004).
• It is a condition that affects persons of all ages and backgrounds.
• Macular Degeneration
• Diabetic Retinopathy
• Glaucoma
• Stroke or Brain Injury
If you notice any of these visual changes, make an appointment with your ophthalmologist or optometrist.
• Difficulty recognizing familiar faces
• Straight lines, such as sentences on a page, telephone poles, and the sides of buildings, appear wavy
• A dark or empty area (blind spot) appears in the center of vision
• Rapid loss of central vision - vision necessary for driving, reading, recognizing faces, and performing close up work
• Blurred or narrowed field of vision
• Severe pain in the eye(s)
• Halos (which may appear as rainbows) around lights
People living with low vision may experience:
• Writing
• Grooming
• Meal preparation
• Financial management
• Driving
• Grocery shopping
• Accurately monitoring and identifying medications
• Dialing emergency telephone numbers
• Identifying daily hazards, such as water spilled on floors or sidewalk curbs
• Participating in leisure activities, such as watching television or sports or playing games
• Social isolation
Specialized Occupational Therapy
Training to safely and independently complete important, daily activities that are difficult due to vision loss by:
• Learning to use vision enhancement equipment effectively.
• Learning compensatory techniques.
• Making environmental adaptations to maximize your vision.
