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A B C
D E F G
H I J K L M
N O P Q R
S T U V W X
Y Z
20/20
-the expression for normal eyesight (or 6/6 in countries where metric
measurements are used). This notation is expressed as a fraction. The numerator
(1st number) refers to the distance you were from the test chart, which is
usually 20 feet (6 meters). The denominator (2nd number) denotes the
distance at which a person with normal eyesight could read the line with the
smallest letters that you could correctly read. For example, if your
visual acuity is 20/100 that means that the line you correctly read at 20 feet
could be read by a person with normal vision at 100 feet. The Snellen chart,
which consists of letters, numbers, or symbols, is used to test visual acuity
(sharpness of eyesight). A refraction test is used to determine the amount of
correction needed for a prescription when treating refractive error such as
astigmatism, myopia, or hyperopia. See "Refraction Test".
AC/A Ratio-
accommodative
convergence / accommodative (measured in prism diopters/diopters). The
convergence response of an individual (amount the eyes turn inward) in relation
to the amount of stimulus of accommodation (eye focusing). The normal ratio is
4:1.
Accommodation-
(eye focusing)
the eye's ability to adjust its focus by the action of the ciliary muscle,
which increases the lens focusing power. When this accommodation skill is
working properly, the eye can focus and refocus quickly and effortlessly, which
is similar to an automatic focus feature on a camera. The ciliary muscles must
contract to adjust for near vision, which causes the eye's crystalline lens,
which is flexible, to be squashed. For distant vision, the ciliary muscle must
relax and the eye's crystalline lens is stretched out. The ability of the
eye to accommodate does decrease with age due to the crystalline lens becoming
less flexible causing a condition called presbyopia. (See
"Presbyopia").
Accommodative
Fatigue-
This clinical condition is also called Ill-Sustained Accommodation. It
is the inability of the eye to adequately sustain sufficient focusing over an
extended time period.
The most common sign or symptom is blurred vision after prolonged near work
such as reading and using a computer. In addition, such patients often have
asthenopia (eyestrain), general fatigue, headaches and nausea, excess tearing,
and an unusual sensitivity to light. Clinical signs include: normal amplitude
of accommodation, decreased PRA, and the patient generally fails the +/-2.00 D
flipper test. Plus lenses (glasses or contacts) and vision therapy are
effective in treating this condition.
Accommodative
Esotropia-
(clinical condition)
when an individual is focusing on a near object and his or her eyes are turning
inward too much. It is
caused by either
uncorrected hyperopic refractive error and/or a high accommodative
convergence/accommodation (AC/A) ratio. The average age of onset is 2 1/2
years. It is most noticeable when the child is tired or sick.
This is treated with plus lenses (glasses or contacts) to help straighten the
eyes. In some cases, vision therapy and corrective lenses are prescribed.
(Please note that Accommodative Esophoria is a condition similar to
accommodative esotropia but lesser in extent.)
Accommodative
Excess (AE)-
This clinical condition is also called accommodative spasm. It is an
over focusing, over stimulation of the focusing action of the crystalline lens
causing an inability to relax the focusing system which may result in blurry
vision when focusing at distance objects. Other symptoms include holding near
work closer than normal, headaches with near work (such as reading or using a
computer), eyestrain associated with near work, and possible double vision.
Clinical signs include: patient accepts more minus on accommodative rock but
blurs with plus lenses, lower NRA than PRA, dynamic retinoscopy findings
indication of over accommodation and/or slow relaxation of accommodation, and
reduced or erratic distance visual acuity.
Treatment includes a low plus lens and/or vision therapy.
(See "Pseudomyopia")
Accommodative
Infacility-
a clinical condition in which the individual has difficulty changing eye focus
from distance to near. Symptoms include eyestrain associated with near work
(such as reading or using a computer), periodic blurring of distance vision
especially following sustained near visual work, tendency to hold near work
closer than expected, headaches with near work, and possible double vision.
Clinical signs include: patient will have difficulty with both the plus and the
minus lens (fails +/- 2.00 D flipper test), low PRA and NRA, and poor
recoveries on Bell Retinoscopy.
Vision therapy is an effective treatment option.
Accommodative
Insufficiency (AI)-
This clinical condition is also called non-presbyopic accommodative
insufficiency. It is an under focusing, a lack of focusing ability at a
near distance. Symptoms include eyestrain, blurred vision, occasional or
constant when doing near work (such as reading or using a computer), occasional
unusual sensitivity to light,
excess tearing, headaches,
and general fatigue. Clinical signs include: patient will have difficulty with
a minus lens, low amplitude
of accommodation, low PRA and higher NRA.
Vision therapy is an
effective treatment option.
Accommodative
Vergence- a
convergence response
(to turn the eyes inward) which occurs as a direct result of accommodation (eye
focusing). (See "Vergence")
Acuity-
clearness of eyesight. Depends on the sharpness of images and the sensitivity
of nerve elements in the retina. (See "Near Acuity" and "Distance Acuity")
Add-
prescription
strength of a plus lens which is used for near vision. A plus lens can be added
to another lens such as a minus lens for distance vision. (See "Bifocal
Glasses" and "Presbyopia")
After-image-
the eye's ability to still see an image during eye blinks and even after the
viewed object is no longer present. The most common example is seeing light
after the flash of a camera.
Albinism
- pigmentation is deficient or absent. May occur in skin, hair, and eyes.
Ocular albinism is a pigmentation deficiency occurring mainly in the eyes.
Individuals with albinism including ocular albinism commonly have decreased
visual acuity (20/70 -20/200), strabismus, photophobia, and nystagmus. There is
no known treatment. Individuals may benefit from low-vision aids. Treatment
options for strabismus and nystagmus does apply to these individuals.
(See "Strabismus" and "Nystagmus")
Alignment-
proper fusing (uniting) of images to each eye.
Amblyopia-
(clinical
condition) reduced
visual acuity (poorer than 20/20) which is not correctable by glasses or
contacts and is not caused by structural or pathological anomalies. This
condition is often called "lazy eye" because it is typically the result of
disuse. It is usually marked by blurred vision in one eye and favoring one eye
over the other. About two percent of the population is affected.
Types of functional (reversible)
amblyopia:
-
refractive- anisometropia
(the two eyes have
different refractive powers), or other amblyopiogenic
refractive errors (hyperopia, myopia, or astigmatism)
-
strabismic-
misalignment of the two eyes in which they point in different directions
-
form deprivation (may also be
referred to as amblyopia ex anopsia)-
caused by conditions that prevent light from entering the eye. These may
include congenital ptosis (droopy eyelid), corneal opacity, or cataract.
Treatment options for functional
amblyopia are eye patching, prescription lenses, prisms, and vision therapy.
Ametropia-
any optical error such as
hyperopia, myopia, or astigmatism. Also called refractive error.
Amplitude
of Accommodation (AA)-
a measurement of the eye's ability to focus clearly on objects at near
distances. This eye focusing range for a child is usually about 2-3 inches. For
a young adult, it is 4-6 inches. The focus range for a 45-year-old adult is
about 20 inches. For an 80-year-old adult, it is 60 inches.
Aniseikonia-
a difference
in the size or shape of two visual images
when the images should be
the same size and/or shape.
Anisometropia-
the condition in which the two eyes have different refractive powers.
Anomalous Retinal Correspondence
(ARC)- a
type of retinal projection, occurring frequently in strabismus, in which the
foveae (center of the retina that produces the sharpest eyesight) of the two
eyes do not facilitate a common visual direction; the fovea of one eye has the
same functional direction with an extrafoveal (non-fovea) area of the other
eye.
Aperture Rule-
a
stick-like instrument used in vision therapy to develop convergence and
divergence (eye teaming) skills.
Associate
of the College of Optometrists in Vision Development-
individual
who is licensed optometrist for at least two years and provides developmental
and behavioral vision care services including vision therapy. Associate members
must obtain at least 10 hours of continuing education annually in functional /
developmental/ behavioral / rehabilitation vision care.
The optometrist has not sat for his/her certification exams, therefore is not
Board Certified in
Vision Development and Therapy.
(See "Fellow of the College of Optometrists in Vision Development (FCOVD)")
Asthenopia-
eyestrain, symptoms include excessive tearing, itching, burning, visual
fatigue, and headache. It can be caused from an uncorrected refractive
error, accommodation (eye focusing) disorder, binocularity (eye teaming)
disorder, or by extended, intense use of the eyes.
Astigmatism-
light rays entering the eye do not all meet at the same point (similar to a
frayed string), which results in blurred or distorted vision. An abnormally
shaped cornea typically causes this condition. Occasionally
astigmatism exists in the lens of the eye.
This condition is corrected by a cylindrical (toric) eyeglass or contact lens.
Automated
refractor
- also called auto refractor. This
method determines the eye's refractive error and the best corrective lenses to
be prescribed by using a
computerized device that varies its optical power
mechanically and prints out the results.
Axis-
the
alignment of the len's cylindrical part; used for correcting astigmatism. This
measurement is given in degrees. The values are typically from 90 degrees to
180 degrees.
Base-Down
(BD) Prism-
a wedge-shaped lens which is thicker on one edge than the other. The thicker
edge (base) is turned down. Prisms bend light (opposite direction from its
thicker end) so the base-down prism turns the light upward thus causing the eye
to also move up. This prism is used to measure an eye misalignment and/or treat
a binocular dysfunction (eye teaming problem). Prisms are sometimes added to
glasses to help improve eyesight due to a misalignment or
visual field loss.
Base-In
(BI) Prism-
a wedge-shaped lens which is thicker on one edge than the other. The thicker
edge (base) is turned inward, closest to the nose. Prisms bend light (opposite
direction from its thicker end) so the base-in prism turns the light outward
(toward the ear) thus causing the eye to also move outward. This prism is used
to measure an eye misalignment and/or treat a binocular dysfunction (eye
teaming problem). Prisms are sometimes added to glasses to help improve
eyesight due to a misalignment or visual field loss.
Base-Out
(BO) Prism-
a wedge-shaped lens which is thicker on one edge than the other. The thicker
edge (base) is turned outward, closest to the ear. Prisms bend light (opposite
direction from its thicker end) so the base-out prism turns the light inward
(toward the nose) thus causing the eye to also move inward. This prism is used
to measure an eye misalignment and/or treat a binocular dysfunction (eye
teaming problem). Prisms are sometimes added to glasses to help improve
eyesight due to a misalignment or
visual field loss.
Base-Up
(BU) Prism-
a wedge-shaped lens which is thicker on one edge than the other. The thicker
edge (base) is turned up. Prisms bend light (opposite direction from its
thicker end (base)) so the base-up prism turns the light downward thus causing
the eye to also move down. This prism is used to measure an eye misalignment
and/or treat a binocular dysfunction (eye teaming problem). Prisms are
sometimes added to glasses to help improve eyesight due to a misalignment or
visual field loss.
Behavioral
Optometrist-
also called Functional Optometrist or Developmental Optometrist.
An optometrist who specializes in all aspects of vision as it is related to an
individual's development and to the role of vision in
relation to reading, computer monitor use, and sports. The
optometrist may use prescription lenses and/or vision therapy to improve an
individual's visual function and performance. Behavioral
optometry had its origins in orthoptics, which is a non-surgical treatment for
strabismus, and in case analysis systems which were developed to resolve
eyestrain symptoms that
include excessive tearing, itching, burning, visual fatigue, and headache
in nonstrabismic individuals. Behavioral
optometry's emphasize of visual care is in prevention, remediation,
rehabilitation, and enhancement. (See "Fellow
of the College of Optometrists in Vision Development (FCOVD)")
Bifocal
Glasses-
used to correct vision at two distances, composed of two ophthalmic lenses such
as a plus lens for near vision and a minus lens for distance vision.
Bi-lateral
Integration/ Gross Motor Coordination-
visual guidance of body movements and the coordination between both sides of
the body.
Binocular
Fusion Dysfunction-
a clinical
condition in which the eyes are not working as a team. Vision
therapy is an effective treatment option. (See
"General Binocular Vision Disorder")
Binocular
Vision-
the simultaneous use of the two eyes.
Binocularity-
the ability to use both eyes as a team and to be able to fuse (unite) two
visual images into one,
three-dimensional image (See "Convergence" and
"Divergence").
Bi - Ocularity-
using both eyes, but not together as a team.
Blurred Vision-
lack of visual clarity or acuity.
Botulinum Toxin
Type A (Oculinum, Botox®)-
an injection of this poison has been used as an alternative to conventional
surgery in selected strabismic patients. It causes a temporary paralysis of an
extraocular muscle that leads to a change in eye position. This change has been
reported to result in long-lasting and permanent alteration in eye alignment.
Although one injection is often sufficient to produce positive results,
one-third to one-half of patients may require additional injections. This
technique has been most successful when used in adults with small-angle
misalignments. It is not commonly used in children. This treatment is also used
in patients who have blepharospam (an uncontrollable eye lid spasm).
Break Point-
the point at which a person can no longer fuse (unite) two images into
one. A blur point will occur before the this point.
Brewster
Stereoscope
- an instrument used in orthoptics/vision therapy to improve eye teaming skills
and near focusing skills. It consists of two parallel viewing tubes with a
+5.00 D lens. The distance from the target can be adjusted as well as the
pupillary distance. The Bernell-O-Scope and Keystone Ophthalmic Telebinocular
are designed essentially the same.
Cataract-
a condition of the crystalline lens, in which the normally clear lens becomes
clouded or yellowed, causing blurred or foggy vision. Cataracts may be caused
by aging, eye injuries, disease, heredity, or birth defects. Surgery is a
treatment option. The affected lens is removed and is replaced with a
substitute (implant) lens or with a special type of contact lens. Generally the
success rate of cataract surgery is over 90%, if the eye is otherwise
healthy.
Cheiroscope-
an instrument used in orthoptics/vision therapy to train binocular skills and
accommodation skills. The Keystone Correct-Eye Scope is an example of a
Cheiroscope.
Ciliary Body -
a structure
directly behind the iris of the eye and contains the ciliary muscle.
Ciliary Muscle-
a band of muscle and fibers that are attached to the lens that controls the
shape of the lens and allows the lens to accommodate (change
focus).
Color
Perception Test-
a test that measures the ability to identify and distinguish colors.
Color Vision
Deficiency-
also known as Colorblindness. It is the absence of or defect in the
perception of colors. Color vision is based on perception of red, green, and
blue. If there is a defect in the perception of one of these colors, a color
will be perceived as if it were composed only of the other two colors. Based on
the color or colors for which there is defective perception, a person may
suffer from red, green, or blue blindness. Color blindness in which all colors
are perceived as gray is termed monochromasia. For people with the common,
inherited, types of color deficiency there is no cure.
Comitant Strabismus-
a condition in which the magnitude of deviation remains essentially the same in
all positions of gaze and with either eye fixating.
Computer Vision
Syndrome (CVS)-
the complex of eye and vision problems related to near work that are
experienced during or related to computer use. Its symptoms include eyestrain,
dry or burning eyes, blurred vision, headaches, double vision, distorted color
vision, and neck and backaches. The condition is caused by various internal and
external factors. Treatment options may include prescription glasses and/or
vision therapy.
Cone -
a receptor cell
which is sensitive to light and is located in the retina of the eye. It is
responsible for color vision.
Conjunctivitis-
an inflammation of the conjunctiva, the transparent layer covering the inner
eyelid and the white portion (sclera) of the eyeball. Conjunctivitis can be
caused by a virus, bacteria, or fungus (infectious conjunctivitis, or "pink
eye", may be contagious); by allergies to pollen, fabrics, animals, or
cosmetics (allergic conjunctivitis); or by air pollution or noxious fumes such
as swimming pool chorine (chemical conjunctivitis). Symptoms include red or
watery eyes, blurred vision, inflamed inner eyelids, scratchiness in the eyes,
or (with infectious conjunctivitis) a puss like or watery discharge and matted
eyelids. Conjunctivitis is usually treated with antibiotic eye drops and/or
ointment.
Convergence-
the ability to
use both eyes as a team and to be able to turn the eyes inward to maintain
single vision up close.
Convergence
Excess (CE)-
a clinical condition in which the eyes have a tendency to turn excessively
inward when viewing an object at a near distance. Symptoms may include visual
fatigue while reading or using a computer, occasional blurred or double vision,
and inability to comprehend or concentrate while reading. Clinical signs
include: greater esophoria at near than distance, high AC/A ratio, and a high
lag of accommodation.
Can be improved with vision therapy and/or glasses. (See "Esophoria")
Convergence
Insufficiency (CI)-
(clinical condition) the inability of the eyes to turn inward and/or sustain an
inward turn. Symptoms include eye strain with reading and using a computer,
headaches, loss of comprehension, difficulty concentrating, blurred or double
vision, and eye fatigue. Clinical signs include: near point of convergence of
greater than 4 inches (10 cm), greater exophoria at near than at distance, and
low AC/A ratio. Vision
therapy is an effective treatment option.
(See "Exophoria")
Cornea-
the transparent, blood-free tissue covering the central front of the eye (over
the pupil, iris, and aqueous humor) that initially refracts or bends light rays
as light enters the eye. Contact lenses are fitted over the cornea.
Cover Test-
a test of eyeball alignment in which each eye is covered with an occluder (eye
cover) and then uncovered to observe eye movements.
COVTT-
Certified Optometric Vision Therapy Technician. To be certified an
individual must be employed by a Fellow (FCOVD), provide documentation of 2000
hours or 2 years of direct clinical experience in vision therapy; or 1000 hours
of clinical experience if the individual holds an AA degree or higher with
emphasis in the behavioral sciences. Submit written answers to a series of Open
Book Questions dealing with various aspects of vision function, testing and
therapy. Pass an extensive written and oral examination evaluating the
candidate's knowledge and clinical abilities in behavioral vision, vision
development and vision therapy. COVTTs must obtain at least 6 hours of
continuing education annually in functional / developmental / behavioral vision
care.
Crystalline
Lens-
transparent disc located behind the iris which changes shape to focus on
objects at different distances from the eye.
Cycloplegic
Refraction-
one method available to eye doctors
to determine the
eye's refractive error and the best corrective lenses to be prescribed
if needed. The eye is dilated with the muscles of accommodation (eye focusing
muscles) being temporarily paralyzed with specialized eye drops or spray (Atropine,
Homatropine, Cyclogyl, or Mydriacyl). This is a good method for non-responsive
or non-communicative patients such as young children.
The technique of retinoscopy is used with this method. (See "Retinoscopy")
Cylinder Lens-
an ophthalmic lens that has at least one non-spherical surface. Used to correct
astigmatism. The values are typically from -0.75 to -1.25. The cylinder
measurement is given with a "-" sign. (Please note that the sign for myopia
(nearsightedness) is also "-".)
Depth
Perception-
the ability to judge relative distances of objects. (See "Stereopsis")
Depth
Perception Test-
a test to measure the ability of the vision system to discern the relative
distances of various objects. (Also called a "Stereopsis Test")
Developmental
Disorder- when
a delay in an individual's normal development has occurred.
Developmental
Vision Analysis-
more comprehensive than a routine eye exam, examination will evaluate all of
the patient's visual abilities such as visual acuity, eye focusing skills, eye
teaming skills, eye tracking skills, visual motor skills, and visual perceptual
skills.
Diopter (D)-
a measurement of the refractive (light bending) power of a lens or a prism
(pd). The strength of prescription glasses and contacts are measured
in these units. For example a lens that is 0.50 diopter (D) is very weak, where
as a lens that is 10.0 diopter (D) is very strong.
Diplopia-
a single object is perceived as two rather than one; double vision.
Direct
Occlusion-
covering the non-amblyopic eye. (See "Inverse Occlusion" and "Occlusion")
Directionality/Laterality-
directionality relates to the awareness of the relationship of one object in
space to another / laterality relates to the internal awareness of the two
sides of the body. Directionality/Laterality can also be called spatial
relations.
Directionality/Laterality
Disorder- a condition in which an individual has poor development of
left/right awareness. Symptoms of this disorder include confusion of right and
left direction and letters and/or numbers reversals. Vision therapy is a
helpful treatment option.
Distance
Acuity-
the eye's ability to distinguish an object's shape and details at a far
distance such as 20 feet (6 meters).
Divergence-
the ability to use both
eyes as a team and be able to turn the eyes out toward a far object.
Divergence
Excess (DE)-
(clinical condition) the eye's tendency to drift out relative to the direction
of a distant object being viewed.
Symptoms include: double vision at distance, headaches, eyestrain, nausea,
dizziness, and blurred vision. Clinical signs include: exophoria greater at
distance than near, high AC/A ratio, and reduced positive fusional vergence at
distance. Can be
improved with vision therapy.
Divergence
Insufficiency (DI)-
(clinical condition) the eye's tendency to turn more inward than necessary when
viewing a distant object. Symptoms include:
double vision, headaches, eyestrain, nausea, dizziness, and blurred vision.
Clinical signs: esophoria greater at distance than near, low AC/A ratio, and
reduced negative fusional vergence at distance. Treated with corrective lenses
and vision therapy.
Dominant Eye-
the eye that "leads" it partner during eye movements. Humans also have dominant
hand, foot, eye, and side of the brain (not necessarily all on the same
side).
Duction Test-
a test of the eye's ability to turn inward or outward while maintaining single,
binocular vision with the gradual introduction of progressively stronger
base-in or base-out prisms.
Dysphoneidesia-
inability to "sound out" words and poor sight recognition of words.
Dysphoneidesia is a subtype of dyslexia. Its characteristics are a combination
of the other two forms of dyslexia: Dysphonesia and Dyseidetic.
Dysphonesia-
inability to "sound out" words. Dysphonesia is a subtype of dyslexia. Children
with this form of dyslexia have difficulty sequentially analyzing and
remembering what and where the sounds are in words. The resulting phonemic
processing problems make it difficult to sound out new words, learn phonics,
and make them dependent on their sight vocabulary. When they come to an unknown
word they will often substitute a word using context clues. For example, "pony"
for "horse", even though the substituted word doesn't look or sound anything
like the original word. When spelling unknown words it is often difficult
to determine what the original word is. For example, they may write "fmlue" for
"familiar" or "lap" for "lamp". They cannot learn phonics because they cannot
process where the sounds are. Their short term sequential auditory memory can
be poor and result in repeating "8167" as "8671", or remember to go to their
room but forgetting to get the item requested.
Dyseidetic- poor sight recognition of words. Dyseidetic is a subtype of
dyslexia. Children with this form of dyslexia have trouble analyzing and
remembering written symbols. They continue to confuse the orientation. For
example, they will write numbers and letters backwards long after other
children have mastered these skills. They often confuse letter sequences in
reading, and in spelling often get all the letters but in the wrong sequence
(spelling "dose" for "does", "on " for "no", etc.). Their visual memory
for words is poor, and after learning a new word they may fail to recognize
that same new word later in the sentence. They have trouble learning to read
and spell phonetically irregular words. For example, they may read " laugh" as
"log" and spell it as "laff", both of which are phonetically consistent. Their
spelling will have many mistakes, but will be phonetically consistent and one
can usually tell what the word was they were trying to spell. When they are
attempting to read an unknown word they will usually attempt to sound it out
and do so very slowly.
Dyslexia - a
specific language-based
disorder.
The individual has difficulty with letter or word recognition, spelling,
reading, writing, and sometimes naming pictures of objects.
Dyslexia varies in degree from mild to very sever.
It is caused by an inability of the brain's language centers to decode print or
phonetically make the connection between the word's written symbols and their
appropriate sounds. Dyslexia is not caused by a vision disorder. Children often
are of normal or above normal intelligence. Dyslexia cannot be cured and will
never be outgrown. Appropriate teaching methods can be taught to help those
with dyslexia overcome their weakness.
The Dyslexia Determination test which is used by many optometrists who
specialize in vision related vision problems investigates if the patient has
one of the three forms of dyslexia:
Dyseidetic - poor sight recognition of words, Dysphonesia- inability to
"sound out" words, and Dysphoneidesia - a combination of characteristics from
both types. Vision therapy is NOT considered a direct treatment for dyslexia.
Eccentric Fixation-
the deviating eye does not use the central foveal (center of the retina
that produces the sharpest
eyesight) area for fixation. Commonly, individuals with amblyopia and some
individuals with strabismus will have this visual adaptation. In esotropia, the
eccentrically located retinal point used for fixation is usually in the nasal
retina. In exotropia, the eccentrically located retinal point used for fixation
is usually in the temporal retina.
Vision therapy is a treatment option for those with amblyopia and/or
strabismus. It is not a treatment option for an individual with a fovea
that has been destroyed.
Emmetropia-
normal vision, no correction needed.
Esophoria
(Eso)- (clinical
condition) a
tendency of the eyes to want to turn more inward than necessary when an
individual is viewing an object at near or at distance, which may cause the
individual to experience eyestrain and other symptoms. Symptoms of basic
esophoria include: eyestrain, headaches, blurred or double vision, apparent
movement of print, and difficulty concentrating on and comprehending reading
material. Clinical signs of basic esophoria include: AC/A ratio is normal,
equal esophoria at distance and near, and normal near point of convergence.
Sometimes esophoria is caused by a refractive error such as hyperopia
(farsightedness), and glasses or contacts can correct the problem alone.
However, sometimes vision therapy is needed to to help re-train the eyes to
function more appropriately. (See "Convergence
Excess" and "Divergence Insufficiency")
Esotropia (ET)-
(clinical condition)
a condition in which an eye is
turned either constantly or intermittently inward toward the nose. Esotropia is
a type of strabismus. It is caused by a reduction in visual acuity, reduced
visual function, high refractive error, traumatic brain injury, oculomotor
nerve lesion, or eye muscle injury. Treatment options may include one or more
of the following: glasses or contacts, bi-focal lenses, prisms, vision therapy,
surgery, or Botulinum Toxin Type A (Oculinum, Botox®) injections. In
some cases, esotropia is caused by a refractive error such as hyperopia
(farsightedness), and glasses or contacts alone may allow the eyes to
straighten. Vision therapy is most appropriate when there are small degrees of
misalignment. Surgery, to re-position or shorten the eye muscles, may be
required for high degrees of misalignment. If surgery is required, a
combination of surgery and vision therapy often yields the best results.
(See "Strabismus")
Exophoria (Exo)-
(clinical condition)
a tendency of the eyes to want
to turn more outward than necessary when an individual is viewing an object at
near or at distance, which may cause the individual to experience eyestrain and
other symptoms. Symptoms of basic exophoria include: eyestrain, headaches,
blurred or double vision, apparent movement of print, and difficulty
concentrating on and comprehending reading material. Clinical signs of basic
exophoria include: normal AC/A ratio, equal exophoria at distance and near, and
decreased near point of convergence. Vision therapy is an effective treatment
option. (See "Convergence
Insufficiency" and "Divergence Excess")
Exotropia (XT)-
(clinical condition)
a condition in which an eye is
either constantly or intermittently turned outward toward the
ear. Exotropia is a type of strabismus. It may also be called divergent
strabismus, wandering eye, or wall eye(s). It is caused by a reduction in
visual acuity, reduced visual function, high refractive error, traumatic brain
injury, oculomotor nerve lesion, or eye muscle injury. Treatment options may
include one or more of the following: glasses or contacts, bi-focal lenses,
prisms, vision therapy, surgery, or Botulinum Toxin Type A (Oculinum, Botox®)
injections. Vision therapy is most appropriate when there are small degrees of
misalignment. If surgery is required, a combination of surgery and vision
therapy often yields the best results.
Extraocular
Muscles- the
muscles attached to the outside of the eyeball which control eye movement. Each
eye has six muscles (lateral rectus, medial rectus, superior oblique, inferior
oblique, superior rectus, and inferior rectus) that are coordinated by the
brain.
Eye
Hand Coordination-
the ability of our eyes
to guide our hands, also called visual
motor integration.
Eye Trac-
(equipment) an electronic testing and recording system of eye movements as in
reading.
Eye Tracking-
the ability of the eyes to smoothly and effortlessly follow a moving target.
Facility
of Accommodation-
a measure of the ease and speed of the eye(s) to change focus.
Fellow of the
College of Optometrists in Vision Development (FCOVD)-
individual who is a
licensed optometrist for a minimum of three years and directly involved in
vision therapy for a minimum of 2 years, has completed a guided study program,
submitted evidence of 100 hours of continuing education in functional vision
(and vision therapy), and passed rigorous written, oral, and clinical
examinations. Fellows are Board Certified in Vision Development and Therapy and
must obtain at least 15 hours of continuing education annually in functional /
developmental / behavioral / rehabilitation vision care.
Figure-Ground-
the ability to recognize distinct shapes from their background, such as objects
in a picture, or letters on a chalkboard.
Fine Motor Skills-
the ability to coordinate hand and finger movements.
Fixation-
the ability to direct and maintain steady visual attention on a target.
Fixations are a form of pursuits.
Fixation
Disparity (FD)-
over-convergence or under-convergence, or vertical misalignment of the eyes
under binocular (both eyes) viewing conditions small enough in magnitude so
that fusion is present.
Floaters-
also known as spots, are usually clouded or semi-opaque specks or
particles within the eye that are seen in the field of vision. The
eyes are filled with fluid which maintains the shape of the eye, supplies it
with nutrition and aids in the focusing of light. Often, particles of protein
or other natural materials are left floating or suspended in this fluid when
the eye is formed before birth. If the particles are large or close together,
they cast shadows which make them visible. This is particularly true when
nearsightedness occurs or becomes more severe. In most cases this is normal but
floaters can also be caused by certain injuries, eye disease or deterioration
of eye fluid or its surrounding structures.
Form
Constancy-
the ability to recognize two objects that have the same shape but different
size or position. This ability is needed to tell the difference between "b" and
"d", "p" and "q", "m" and "w".
Fovea-
center of the retina that can produce the sharpest eyesight and contains the
most cones.
Fusional
Vergence-
a convergence response
which serves to maintain (fusion)
the union of images from each eye into a single image. The eyes will turn with
a slow smooth tonic movement or a fast jumping movement called phasic.
Fusional
Vergence Dysfunction-
see "General Binocular Vision Disorder".
Fusion-
the union of images from each eye into a single image. There are three
degrees of fusion. 1st degree fusion is the superimposition of two
dissimilar targets. 2nd degree fusion is flat fusion with a
two-dimensional target. 3rd degree fusion is depth perception
(stereopsis) with a three-dimensional target.
Fusion Test-
determines the eyes ability to unite the images from each eye into a single
image.
General
Binocular Vision Disorder-
inability to efficiently utilize and/or sustain binocular vision. Symptoms
include eyestrain, headaches, decreased comprehension, inability to concentrate
while reading, excessive tearing, and blurred vision. A patient will have
difficulty with both base-in and base-out prisms. Vision therapy is an
effective treatment option.Heterophoria-
tendency of the eyes to deviate from their normal position for visual
alignment. This condition may be observed when one eye is covered.
Heterotropia-
the eyes are abnormally
turned.
HTS
Computerized Binocular Home Vision Therapy System
- a computer program which is prescribed by an eye doctor. The computer program
is for improving eye tracking, eye teaming, and/or eye focusing.
Hyperopia-
farsightedness, an individual will have difficulty seeing clearly up close.
Light entering the eye focuses behind the retina when the eye is at rest and is
corrected with a plus lens.
Vision therapy is not prescribed for hyperopia. Children, up to about the age
of 8 years, are often farsighted.
Hyperphoria-
a condition in which one eye has a tendency to point higher than the other eye,
causing eyestrain. Sometimes improved by prisms in glasses.
Hypertropia-
strabismus, one eye
turned in an upward direction.
Hypophoria-
a condition in which one eye has a tendency to point lower than the other eye.
This condition may be observed when one eye is covered.
Hypotropia-
strabismus, one eye turned in a downward direction.
Hysterical
Amblyopia- a
non specific visual loss with an unknown cause.
Upon examination the doctor is unable to find corroborating objective evidence
of this abnormality. The most common symptom is an isolated visual acuity
impairment, followed by combined visual acuity impairment and visual field
constriction, and whereas an isolated visual field constriction occurred most
infrequently. This vision loss may be due to anxiety or emotional
repression. (See "Streff Syndrome")
Ill-Sustained
Accommodation-
this clinical
condition is also called Accommodative
Fatigue. It is
the inability of the eye to adequately sustain sufficient focusing over an
extended time period.
The most common sign or symptom is blurred vision after prolonged near work
such as reading and using a computer. In addition, such patients often have
asthenopia (eyestrain). Clinical signs include: normal amplitude of
accommodation, decreased PRA, and the patient generally fails the +/-2.00 D
flipper test. Plus lenses
(glasses or contacts)
and vision therapy are effective in treating this condition.
Incomitant
Strabismus - a condition also known as Noncomitant Strabismus. It
occurs when the magnitude of deviation is not the same in the different
positions of gaze or with either eye fixating. There is an abnormal
restriction to movement or an over-action of one or more of the extraocular
muscles. Generally, the magnitude must change by at least 5 PD to be incomitant
(nonconcomitant).
Inverse
Occlusion- covering
the amblyopic eye. (See "Direct Occlusion" and "Occlusion")
Iris-
the colored part of the eye located between the lens and cornea; it regulates
the entrance of light.
Kinesthesia-
the sensation of bodily position, presence, or movement resulting chiefly from
stimulation of sensory nerve ending in muscles, tendons, and joints.
Lag
of Accommodation-
a measure of the eye's ability to focus accurately on a given target. The
dioptric difference between the eye's focusing response and the stimulus to
focus.
Latent
Hyperopia-
hyperopia (farsightedness) is compensated by accommodation and the tonicity
(tension) of the ciliary muscle; identified by cycloplegic refraction. In mild
cases of hyperopia (farsightedness), the eyes are able to compensate without
corrective lenses; otherwise a plus lens (glasses or contacts) is
prescribed. Vision
therapy is not prescribed. (See "Hyperopia")
Learning
Disability (LD)-
a disorder that affects people's ability to either interpret what they see and
hear or to link information from different parts of the brain. Learning
disabilities can be divided into five broad categories: speech and language
disorders, reading disorder, arithmetic disorder, writing disorder, and
attention disorders. The term learning disability does not include children who
have learning problems that are primarily the result of visual, hearing, or
motor disorders.
Lensometer-
also called Verometer, is a device used to measure the refractive power
of eyeglasses and contact lenses.
Macula-
the most sensitive part of the retina that is about the size of a pinhead and
is where our most detailed vision occurs.
Macular
Degeneration -
a
deterioration of the central portion of the retina known as the macula.
Malingering-
a voluntary or intentional reduction in visual acuity or other examination
data.
Microstrabimus
- also called microtropia, monofixation syndrome, and small angle
strabismus. A small angle deviation (inward or outward, commonly
inward) that is less than five degrees with some amount of stereopsis (depth
perception) and anomalous
retinal correspondence
(ARC). Possible mild amblyopia, eccentric fixation, and/or anisometropia may
also be present. It frequently results from the treatment of a larger-angle
deviation (esotropia or exotropia) by optical correction, vision therapy,
pharmacological agents, and/or extraocular muscle surgery. Treatment for
microstrabimus consists mostly of correcting significant refractive errors and
any coexisting amblyopia. The use of vision therapy and prisms to establish
bifoveal fusion has been successful in selected cases.
Minus (-) Lens-
concave lens, stimulates
focusing and diverges light. The lens is thinner in the center than the edges.
It is used in glasses or contact lenses for people who are nearsighted
(myopia).
Monocular
Vision-
only one eye having useful vision.
Myopia-
nearsightedness, an individual will have difficulty seeing clearly at distance.
Light entering the eye focuses in front of the retina when the eye is at rest
and is corrected with a minus lens. A condition known as high myopia occurs
when myopia is greater than 6 diopters.
Typically, vision therapy is not prescribed for myopia.
Near
Acuity-
the eye's ability to distinguish an object's shape and details at a near
distance such as 16 inches (40 cm).
Near Point of Convergence (NPC)- the closest point at which the two eyes
can maintain a single united image.
Near Point of
Convergence Test-
measures the patient's ability to point the eyes at an approaching object and
to keep them fixed on the object as it reaches the patient's nose. Normal
range is 0 to 4 inches away from the nose.
Negative
Relative Accommodation (NRA)-
a measure of the maximum ability to relax accommodation while maintaining
clear, single binocular vision.
Normal Retinal Correspondence
(NRC)- the
foveas of the two eyes are corresponding neural points in the visual cortex and
binocular vision can occur.
Nystagmus- rhythmic
oscillations or tremors of the eyes which occur independent of the normal eye
movements. Generally nystagmus is not curable, but it is manageable. Treatments
include prescription glasses or contact lenses, prisms, and vision therapy.
Occlusion-
to block out light. An eye can be completely or partially blocked. This
procedure is used to promote the use of one eye or both eyes. This therapy
procedure may be used for people with amblyopia, strabismus, or closed head
trauma. It may also be used in a vision therapy program for someone with
amblyopia, eye focusing (accommodation) disorder, or poor eye tracking
(oculomotor) skill. An eye patch, black contact, or another device may be
used to block out light from an eye. (See "Direct Occlusion" and "Inverse
Occlusion")
Ocular
Motility- pertaining
to binocular alignment and eye muscle movement. (See "Binocularity",
"Strabismus")
Ocular Motor
(OM)- general
eye movement ability, which include pursuits (to visually track and/or follow
moving objects) and saccades (to direct and coordinate eye movement as the eye
quickly and voluntarily
shift from one target to another).
Ocular Motor
Dysfunction-
poor eye movement skills. Vision therapy is an effective treatment
option.
(See "Pursuits Dysfunction" and "Saccades Dysfunction")
Oculomotor
Skills-
the ability to quickly and accurately move our eyes. These are sensory motor
skills that allow us to move our eyes so we can fixate on objects (fixation),
move our eyes smoothly from point to point as in reading (saccades), and to
track a moving object (pursuits). (See "Fixation", "Pursuits" and "Saccades")
Oculus Dexter
(OD)- right
eye.
Oculus Sinister
(OS)- left
eye.
Oculus Uterque
(OU)- both
eyes.
Ophthalmologist
-
a physician (doctor of medicine (M.D.) or doctor of
osteopathy (D.O.) who specializes in the comprehensive care of the eyes and
visual system in the prevention of eye disease and injury. The ophthalmologist
has completed four or more years of college premedical education, four or more
years of medical school, one year of internship, and three or more years of
specialized medical and surgical training and experience in eye care. The
ophthalmologist is a physician who is qualified by lengthy medical education,
training and experience to diagnose, treat and manage all eye and visual system
problems, and is licensed by a state regulatory board to practice medicine and
surgery. The ophthalmologist is the medically trained specialist who can
deliver total eye care: primary, secondary and tertiary care services (i.e.,
vision services, contact lenses, eye examinations, medical eye care and
surgical eye care), and diagnose general diseases of the body. An
ophthalmologist is not trained to provide visual therapy.
Ophthalmoscope-
a device used to illuminate the inside of the eye and enlarge the image for
examining the retina, optic nerve entrance, arteries, and veins.
Optic Nerve-
is a bundle of nerve fiber that connects each eye to the brain and transmits
images from the retina to the brain.
Optician-
is a professional in the field of designing,
finishing, fitting and dispensing of eyeglasses , based on an eye doctor's
prescription. Many opticians have undergraduate education and are licensed in
the field of opticianry.
Optometric
Vision Therapy (VT)-
as defined by the American Optometric Association: Optometric vision therapy is
a treatment plan used to correct or improve specific dysfunctions of the vision
system. It includes, but is not limited to, the treatment of strabismus (turned
eye), other dysfunctions of binocularity (eye teaming), amblyopia (lazy eye),
accommodation (eye focusing), ocular motor function (general eye movement
ability), and visual-perception-motor abilities.
Optometric
vision therapy is based upon a medically necessary plan of treatment which is
designed to improve specific vision dysfunctions determined by standardized
diagnostic criteria. Treatment plans encompass lenses, prisms, occlusion (eye
patching), and other appropriate materials, modalities, and equipment. (Vision
therapy can also be called visual or vision training, orthoptics, eye training,
or eye exercises.)
Please note
that the definition above describes Optometric Vision Therapy, which has been
clinically shown to improve certain eye disorders, which are described above.
However Optometric Vision Therapy is NOT the same as the Bates Method, vision
therapy using Bates, integrated vision therapy, or natural eye exercises. These
holistic programs use some form of eye exercises associated with relaxation
techniques, which claim to improve nearsightedness, farsightedness,
astigmatism, decreasing vision with age, and other disorders. There is
virtually no statistical studies/results indicating the success of these
methods.
Optometrist
- a physician
(doctor of optometry (O.D.) who specializes in comprehensive eye health and
vision examinations; diagnosis and treatment of eye disease and vision
disorders; the detection of general health problems; the prescribing of
glasses, contact lenses, low vision rehabilitation, vision therapy, and
medications; and the counseling of patients regarding their surgical
alternatives and vision needs as related to their occupations, avocations and
lifestyle. The optometrist has completed four or more years of undergraduate
education in a college or university and four years of professional education
at a college of optometry. The optometrist is licensed by a state regulatory
board.
Some optometrists complete a residency.
Organic
Amblyopia-
gradual or sudden loss of central vision (partial loss) affecting visual acuity
with no treatment options.
Types of organic (irreversible)
amblyopia:
-
nutritional
amblyopia- vision loss caused by
low levels of vitamin B12 due to poor nutrition and poor absorption associated
with drinking alcohol.
-
tobacco-alcohol
amblyopia- clinical
evidence exists that a nutritional deficiency is the underlying cause of this
vision loss; however, many still believe that the toxic effects of alcohol
and/or tobacco are contributing factors.
-
toxic
amblyopia- caused by
exposure to toxins such as ethambutol, methyl alcohol (moonshine), ethylene
glycol (antifreeze), cyanide, lead, and carbon monoxide.
Orthophoria
(ortho)- the
absence of either esophoria or exophoria. The eyes do not have a tendency to
want to turn more inward than necessary or want to turn more outward than
necessary when pointed on an object.
Orthoptics-
the science of correcting defects in binocular vision. The technique of eye
exercises to correct strabismus (esotropia or exotropia), convergence
insufficiency (exophoria), or convergence excess (esophoria), amblyopia, and
ocular motility disorders. Orthoptics was pioneered by French
ophthalmologist Javal in the mid to late 1800's. Today ophthalmologists use
specialty-trained healthcare professionals called orthoptists to evaluate
patients and treat them with orthoptics. In America, the non-surgical technique
of orthoptics is less commonly used by ophthalmologists compared to other
countries. Orthoptics is a limited form of optometric vision therapy.
Paresis-
a paralysis that when occurring in ocular muscles causes double vision when
looking in some directions.
Penalization-
to prevent sight out of the
good eye and force the weaker, amblyopic eye, to function. A filter, eye patch,
or eye drops such as atropin or miotics are used on the good eye.
Perceptual
Skills-
includes the identification, discrimination, spatial awareness, and
visual-sensory integration. These are visual cognitive skills used to processes
visual information to the brain to be organized and interpreted. (See "Visual
Perceptual Disorder")
PTS
Computerized Perceptual Home Vision Therapy System-
a home-based computerized perceptual therapy program, which was designed to
enhance visual information processing. The therapy procedures address
simultaneous processing, sequential processing and/or speed of information
processing. This computer program contains 6 activities that are specifically
for the following problems: a weakness with visual information processing
skills such as figure-ground, form constancy, spatial relations, visual
closure, visual discrimination, visual memory, and visualization skills, slow
speed of information processing, and acquired brain injury with
perceptual-cognitive deficits. This program is available only from a licensed
eye care practitioner.
Perimetry-
the measurement of a visual field function (the total area that can be seen
while looking straight ahead) using targets of different sizes and brightness
(light levels). The visual field is measured in degrees. In a normal eye the
peripheral field of vision is about 180 degrees. An instrument called a
perimeter is used for mapping
all areas of a person's eyesight, including peripheral (side) vision.
Visual field testing can
help detect certain patterns of visual loss, indicating specific types of eye
diseases or vision conditions. It is the single best test for diagnosing
glaucoma.
Peripheral
Vision-
the ability to see or be aware of what is surrounding us, our side
vision. (See "Visual Field".)
Phasic-
fast, jump movement. (See "Fusional Vergence")
Photophobia-
unusual sensitivity to light.
Physiological
Diplopia- a
normal diplopia (double vision) that occurs when an individual is not pointing
his/her eyes on a certain object.
Plano Lens-
a lens that has no
prescription. No variance between the curvature of the front and back lens
surfaces. It is a flat lens.
Pleoptics-
a method of eye exercises created to stimulate and train an amblyopic eye. The
goal is to have eyesight which is produced by the fovea. (See "Eccentric
Fixation")
Plus (+) Lens-
convex lens (thicker in the
middle) relaxes focusing and converges light. It is typically used in glasses
or contact lenses for people who are farsighted (hyperopic). Although it may
also be prescribed for other visual conditions as well.
Polaroid Lens-
a lens used in sunglasses
and sometimes 3D glasses which consists of two glass or plastic surfaces with a
plastic lamination between the two surfaces, and designed to reduce reflected
glare. In optometric vision therapy, these lens are used with 3D pictures
such as vectograms and stereograms, which are also polarized.
Positive
Relative Accommodation (PRA)-
a measure of the maximum ability to stimulate accommodation while maintaining
clear, single binocular vision.
Presbyopia-
sometimes called the fourth refractive error, is not truly a refractive error.
It is the natural process of the eye losing the ability to accommodate or
change the shape of the natural crystalline lens inside the eye to see
comfortably at near. This vision defect occurs with the advancement of age; the
onset usually occurs between the ages of 40 to 45. Unlike the rest of the body,
which stops growing by the age of twenty, the lens of the eye continues to grow
throughout life. As the lens ages and grows, it becomes harder in consistency,
loses its elasticity, and therefore is resistant to changes in shape. The
result is a gradual reduction in accommodation (near eye focus), and a more
dependence on reading glasses. A plus lens or multi-focal lens (such as a
bifocal lens) is prescribed in the form of glasses or contact lenses. Vision
therapy is not a treatment option.
Prism-
a wedge-shaped lens
which is thicker on one edge than the other. This plastic or glass lens bends
light (opposite direction from its thicker end). Prisms can be used to measure
an eye misalignment and/or treat a binocular dysfunction (eye teaming problem).
A prism is sometimes added to glasses to help improve eyesight due to an eye
misalignment or visual field loss.
(See "Base-Down Prism", "Base-In Prism", "Base-Out Prism",
"Base-Up Prism", "Yoked Prism")
Prismatic
Effect By Lens-
when light goes through a wedge shaped lens which is called a prism, it bends.
Light is also bent when it does not go through the center of a lens. This is an
undesirable effect that can occur in glasses. It commonly occurs when the
pupillary distance (PD) is not measured or made correctly.
Proximal
Vergence- a
convergence response attributed to the awareness of, or the impression of
nearness of an object of
regard. (See
"Vergence")
Pseudomyopia-
the condition Accommodative Excess/Spasm causes an individual to
experience blurry distance vision after prolonged near work such as reading or
using a computer. The individual may appear to be nearsighted (myopia).
Treatment options may include
prescription lenses and/or vision therapy.
Ptosis-
droopy upper eyelid, causing the eye to remain partially closed.
Pupil-
the opening at the center of the iris of the eye. It contracts (dilates) in the
dark and when the eye is focused on a distant object.
Pupillary
Distance (PD)-
the distances between the pupils of the eyes, in millimeters -- a necessary
measurement for proper lens prescription.
Pupillary
Reflex- the
automatic contraction or enlargement of the pupil when confronted with the
presence or absence of light, accommodation, or emotional change.
Pupillometer-
a device used to measure the distance between the pupils of the eyes, in
millimeters, which is a necessary measurement for proper lens prescription. It
also measures the diameter of the pupil.
Pursuit
Dysfunction-
a condition in which the individual's ability to follow a moving target is
inadequate. Vision therapy is an effective treatment option.
(See "Ocular Motor
Dysfunction")
Pursuit Test-
measures the eyes ability to follow a moving target.
Pursuits-
the eye's ability to smoothly follow a moving target.
Reading-
requires the use of good visual skills, which are distance and near acuity,
accommodation skills, binocularity
skills (convergence), oculomotor skills (saccadic),
peripheral vision,
figure-ground, form constancy, spatial relations, visual closure, visual
discrimination, visual memory, and visualization.
Refraction Test-
determines the eye's refractive error and the best corrective lenses to be
prescribed. There are several methods of performing refraction: Retinoscopy,
Automated Refractor, and Subjective Refraction.
Refractive
Error-
defects in vision caused by the eye's inability to bend, or refract light and
focus it clearly on the retina. Astigmatism, hyperopia, and myopia are common
conditions of refractive error, also called ametropia.
Refractive
Power- a
lens' ability to bend parallel light rays into focus, as measured by power
diopters. In general, the greater the curvature of a lens and the greater the
difference between center thickness and edge thickness, the higher the index of
refraction and the greater its refractive power. Refractive power can also
refer the strength of a person's contact lenses or glasses.
Refractive
Media- the
parts of the eye that light travels through before being focused on the retina
includes the cornea, crystalline lens, aqueous, and vitreous.
Relative
Amblyopia-
functional amblyopia can co-exit with a pathology abnormality. Treatment is
possible.
Retina-
the innermost layer of the eye, a neurological tissue, which receives light
rays focused on it by the lens. This tissue contains receptor cells (rods and
cones) that send electrical impulses to the brain via the optic nerve when the
light rays are present.
Retinoscopy-
this technique determines the eye's refractive error and the best corrective
lenses to be prescribed. An instrument called a retinoscope which consists of a
light, lens, mirror, and handle, is used to shine light into a patient's eye.
There are two types of retinoscope: streak and spot retinoscope. When light is
shone into patient's eye, the light is reflected back ("reflex"). If the
reflection is in the same direction ("with movement") of the retinoscope then
the refractive error is hyperopia (farsightedness) and a plus lens is
prescribed. If the reflection is in the opposite direction ("against movement")
of the retinoscope then the refractive error is myopia (nearsightedness)
and a minus lens is prescribed. The strength of the prescription is determined
when the pupil is suddenly filled with light ("neutralized") with the
appropriate lens powers (strength).
Rod-
a receptor cell
which is sensitive to light and is located in the retina of the eye. It is
responsible for night vision (non-color vision in low level light).
Saccades-
the eye's ability to
direct and coordinate movement as it quickly and voluntarily
shift from one target to another.
Saccades
Dysfunction-
a condition in which the individual's ability to scan along a printed page and
move his eyes from point to point is inadequate. Symptoms include frequent loss
of place while reading, skip or transpose words, and have difficulty
comprehending because of an inaccurate eye movement. Vision therapy is an
effective treatment option.
(See "Ocular
Motor Dysfunction")
Saccadic Test-
measures the eyes ability to move quickly and precisely from point to
point.
Sclera-
the white protective covering of the eye.
Slit
Lamp (Biomicroscope)
- this instrument can examine ocular tissue from the
front of the cornea to the back of the lens. A narrow "slit"
beam of very bright light produced by a lamp. This beam is focused on to the
eye which is then viewed under magnification with a microscope. A
joystick control is employed to enable instrument to be moved left-right and
up-down. A chin rest, head rest and fixation target is also required. Some slit
lamps have a tilting mechanism to enable the lamp to be directed from different
angles.
Spatial
Relation- the
ability to judge the relative position of one object to another and the
internal awareness of the two sides of the body.
These skills allow the individual to develop the concepts of right, left,
front, back, up, and down. This ability is needed in reading and math. (See "Directionality/Laterality")
Sphere-
an ophthalmic lens with no
cylindrical power or addition. It has the same power in all parts of the
lens.
Squint-
to be unable to direct both eyes simultaneously toward a point. Also known as
strabismus (turned eye).
For more information, see "Strabismus".
Stereopsis-
the ability to perceive a
three dimensional depth which requires adequate fusion (union) of the images
from each eye.
Stereopsis
Test- measures
depth perception that is dependent on the accuracy of eye teaming.
Strabismus-
(clinical condition)
turned eye (s), the eyes are
misaligned. It is caused by a reduction in visual acuity, reduced visual
function, high refractive error, traumatic brain injury, oculomotor nerve
lesion, or eye muscle injury. In strabismus, the eyes send conflicting images
to the brain, and the brain cannot combine these images as it would in normal
vision. The brain compensates by ignoring one image in favor of the other,
causing a loss of depth perception. Strabismus in more common in children, and
affects four percent of all children (although it may also appear later in
life).
It is
characterized by using the following categories:
Strabismus is
also known as squint. It may also be referred to as cross-eyes (convergent-
turning inward) or wall eyes (divergent- turning outward). Treatment options
may include one or more of the following: optical lenses, bi-focal lenses,
prisms, surgery, vision therapy, or Botulinum Toxin Type A (Oculinum, Botox®)
injections.
(See "Esotropia", "Exotropia",
"Hypertropia", and "Hypotropia")
Streff Syndrome-
named after the optometrist who originally described it, Dr. John Streff. This
functional vision loss is also known as Non-Malingering Syndrome. Signs include
reduced visual acuity in both eyes at distance and near. The visual acuity at
near is more reduced than the distance acuity. Frequently patients will have
reduced stereopsis, large accommodative lag on dynamic retinoscopy, and a
reduced visual field (tubular or spiral field). The syndrome is associated with
a visual or emotional stress occurring in the child's life. It is more
prominent in girls (ages 7-13) than boys. Treatment includes a low plus lens
and/or vision therapy. This condition is sometimes incorrectly diagnosed by
doctors as hysterical amblyopia.
Subconjunctival
Hemorrhage -
a blood spot on the eye. It occurs when a small blood vessel under the
conjunctiva (the transparent coating that covers the inner eyelid and the white
of the eye) breaks and bleeds. A common condition caused spontaneously from
coughing, heavy lifting, or vomiting. In some cases, it may develop following
eye surgery or trauma. It tends to be more common among those with diabetes,
hypertension, and taking blood thinners (including aspirin). A subconjunctival
hemorrhage is essentially harmless. The blood naturally absorbs within one to
three weeks and no treatment is required. If a mild irritation is present,
artificial tear drops can be used. You can speed up the healing process by
applying cool compresses for the first two days and then warm compresses in the
following days.
Subjective
Refraction -
the procedure in which the patient is asked to report on which lens combination
provides the clearest vision. While this is the method of choice for
determining prescription in those able to understand the task and respond to
the examiner, it is less reliable in children.
Suppression of
Binocular Vision-
when the brain ignores the image that is seen by one eye. It is the result of
weak eye teaming skills (binocularity).
Suppression
Test- determines
if there is any tendency for the visual processing center of the brain to
ignore or suppress visual data from one eye.
Tactile-
pertaining to the sense of touch.
Tonic-
slow, smooth tension. (See "Fusional Vergence")
Tonic Vergence-
convergence due to the basic tonicity (tension) of the extraocular muscles,
which are responsible, in part, for the distance phoria.
Deficient tonic vergence
would result in exophoria and excessive tonic vergence results in esophoria.
(See "Vergence")
Tonometry-
an instrument that measures
the pressure within the eye, which is known as intraocular pressure (IOP).
Tranaglyph-
red/green targets used with
red/green glasses to develop eye teaming skills.
Tunnel Vision-
a constriction of the visual field that is commonly caused by chronic glaucoma,
retinal degeneration, a tumor, or a brain disorder that interferes with the
fibers that connect the optic nerve to the brain. (Please note that a visual
stress, emotional stress, or emotional trauma can also cause a
constriction of the visual field.) (See "Streff Syndrome".)
Vectogram-
a three-dimensional
picture that is used to strengthen the binocularity system. Available in fixed
and variable styles to provide base-in and/or base-out training. 3D glasses are
used to view the picture.
Vergence-
to turn the eyes horizontally (convergence- inward or divergence- outward). Accommodative
vergence, fusional vergence,
proximal vergence, and tonic vergence are needed to maintain
single vision.
Vergence
Facility- a
measure of the ease and speed of the eyes to change
from a converging to diverging position.
Vertigo-
a disordered state in which the individual is dizzy or feels that the
surrounding environment is whirling.
Visagraph
Eye-Movement Recording System - records and measures eye movements while
an individual reads. The system also measures reading efficiency. Specially
created goggles and a computer program are used.
Vision-
the ability to take in information through our eyes and process the information
so that it has meaning.
Vision Therapy
(VT) - see
"Optometric Vision Therapy"
Vision Therapy
Technician- one
who works under the supervision of an optometrist in evaluating clients and in
planning and implementing vision therapy programs. (See "COVTT")
Vision
Therapist-
Optometrist or an optometric vision therapy technician who develops and
administers vision therapy programs. (Typically this term is referring to
a vision therapy technician rather than an optometrist.)
Please note
that there are some individuals that call themselves vision therapists, but
they are not optometrists or vision therapy technicians.
Visual
Acuity-
sharpness or clearness of eyesight. (See "Near Acuity" and "Distance
Acuity", "20/20")
Visual
Analysis-
refers to figure-ground,
form constancy, spatial relation, visual closure, visual discrimination, visual
memory, and visualization.
Visual Closure-
the ability to identify or recognize a symbol or object when the entire object
is not visible.
Visual
Discrimination-
the ability to discriminate between visible likeness and differences in size,
shape, pattern, form, position, and color. Such as the ability to distinguish
between similar words like "ran" and "run".
Visual Field-
the total area that can be seen while looking straight ahead. (See "Tunnel
Vision".) (Note: Perimetry is the method of testing an eye's field of vision.
For more information, please see "Perimetry".)
Visual Form
Dysfunction-
difficulty with figure-ground,
form constancy, visual closure, and visual discrimination.
Symptoms include confusion with similar objects, words, or colors. Vision
therapy is a treatment option.
Visual Memory-
the ability to recall and use visual information from the past. (See
"Visual Sequential Memory")
Visual Memory
Dysfunction-
difficulty with retention, recall, or recognition of things seen. Symptoms can
include poor spelling and poor recall of visual information. Vision therapy is
a treatment option.
Visual-Motor
Dysfunction-
the inability to process and reproduce visual images by writing or drawing.
Symptoms can include poor pencil grip/writing, poor organization on written
page, poor copying/spacing, and excessive erasing. Vision therapy is a
treatment option.
Visual-Motor Integration (VMI)-
after
visual data is gathered, it is processed and combined in the brain with
information from movement (eye hand coordination).
Visual-Motor
Skills-
the ability of our eyes to guide our hands (eye hand coordination, visual-motor
integration).
Visual Pathway-
route of the nerve impulses
from the retina along the optic nerve, and optic nerve radiations to the
brain's sensory cortex that is located at the base of the skull.
Visual
Perceptual Disorders-
information processing dysfunctions of the visual system. These dysfunctions
can be a directionality/laterality disorder, visual form dysfunction, visual
memory dysfunction, and visual-motor dysfunction. Vision therapy is a treatment
option. (Also see "Perceptual Skills")
Visual Perceptual Skills-
the ability to
organize and interpret information that is seen and give it meaning. These
information-processing skills include figure-ground, form constancy, spatial
relations, visual closure, visual discrimination, visual memory, and
visualization.
Visual-Sensory
Integration-
after visual data is gathered, it is processed and combined in the brain with
information from hearing (auditory-visual integration), balance
(gross-motor/bilateral integration), posture, and movement (visual-motor
integration).
Visual Sequential Memory-
ability to recall a sequence of numbers, letters or objects in the order they
were originally given.
Visual Skills-
are accommodation (eye
focusing), binocularity (eye teaming), and oculomotor skills (eye movement),
which are neuro-muscular abilities that are controlled
by muscles inside and outside of the eye and are networked with the brain.
Visualization-
the ability to crate and
manipulate mental pictures of an object or concept on the basis of past visual
experience and memory. Essential in reading and playing sports.
Wandering
Eye(s)- see
"Exotropia".
Wheatstone
Stereoscope
-an instrument designed to present separate images to each eye. Each eye can
see independently. Two plane mirrors are joined at one edge at a 90-degree
angle and two target holders, one opposite one mirror and the other, mounted on
a screw base which, when turned, synchronously moves the targets toward or away
from each other. The
Amblyoscope, Troposcope, Synoptophore, and the Bernell Mirror Stereoscope are
examples of this design.
Yoked
Prisms-
a wedge-shaped lens which
is thicker on one edge than the other. The prism bases
(thicker end) are in the same direction for both eyes (up, down, left, or
right). Yoked prisms are used to train or compensate for a binocular
dysfunction (eye teaming problem) or a visual field loss. Sometimes used in
optometric vision therapy programs.
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