Frequently Asked Questions

About Vision Therapy at 4D Vision Gym

Dr. Juanita Collier is a Behavioral Optometrist (or Developmental Optometrist). She evaluates visual problems and specializes in vision-related learning issues that may cause patients to struggle to learn efficiently. In the section below, Dr. Collier answers questions about vision therapy and shares relevant medical facts.

What can you expect at your exam?

The vision therapy process begins with a comprehensive behavioral examination, called a functional vision evaluation, which includes testing for eye movement control, focusing, eye teaming, visual motor ability, visual perception, and visual development.
Dr. Collier and her Optometric Vision Therapy Team can then identify specific issues with focusing, eye teaming, and tracking that may cause you to lose your place when reading, skip over lines or words when reading, get headaches or strain your eyes. They then tailor a vision therapy treatment program geared toward correcting the issue and helping you use your eyes more efficiently.

The treatment program starts with simple tasks that gradually become more complex and is tailored to each individual patient.

What does a Functional Vision Evaluation include?
This comprehensive examination begins with a very detailed case history. For a child, it starts from pregnancy through childhood. It includes a detailed assessment of focus, eye tracking, and eye teaming. Additionally, a behavioral evaluation discusses performance at work, home and school.

A Functional Vision Evaluation includes the following vision checks and tests:

— Measure your distance vision
— Evaluate how easily your eyes shift focus
— See how smoothly your eyes follow a target
— Measure the teamwork between your brain and eyes
— Notice how your eyes move from point to point
— Determine your eye function at close range
— Screen for medical conditions
Learn more about our functional vision evaluation here: Eye Exam

What is a Behavioral Optometrist (or Developmental Optometrist)?
A Behavioral Optometrist (or Development Optometrist) is concerned with how your eyes and visual system function and is interested in how your behavior affects vision or how your vision influences your behavior.
As a Behavioral Optometrist, Dr. Collier believes that your vision is a result of how you use your eyes and that your visual skills can be enhanced with vision therapy, including activities and training. She can provide a program of training to improve your overall visual skills.

Of course, Dr. Collier can prescribe corrective lenses, and she will ask questions about your visual difficulties at work, school and home, and she will explore how vision therapy and/or eye glasses may help improve your comfort and performance, while preventing future vision issues.

What is Vision Therapy?
Vision therapy, sometimes referred to as physical therapy for your brain and eyes, is a series of exercises that are designed to improve the efficiency and function of your visual system. It includes rehabilitation and training of your eye-brain connections.

Here are some issues that can be treated with vision therapy:

Binocular issues – this is eye teaming.
Oculomotor problems – this is tracking.
Accommodative issues – this is focusing and refocusing, near and far.
–Strabismus – this is when one or both of your eyes turns out, in, up or down.
This can be intermittent, constant or alternate between your two eyes.
–Amblyopia – this is a condition called lazy eye where vision is not 20/20,
even with the best correction. The earlier you begin treatment, the better.
How long does treatment take?
A typical vision therapy program lasts a few months and includes weekly office visits coupled with daily exercises at home.

Individual factors such as the age of the patient and complexity of the condition may vary the duration of treatment.

How do I know if vision therapy is the right treatment option for me?
After the comprehensive functional vision evaluation, your doctor will discuss treatment options with you and recommend the most effective treatment.

Should my child have a near-point vision screening?
Dr. Collier says children who struggle in school may have a learning difficulty that is due to a vision problem that goes undetected by standard vision tests. A developmental visual issue may be causing them to underperform or work harder with minimal results.

Dr. Collier recommends that school children be given a near-point vision screening, in addition to the standard distance vision screening, in order to reveal any visual issues that may exist. This type of screening is very different from the typical eye chart children are asked to read.

How can eye problems be differentiated from behavioral problems?
When a child has difficulty with his vision, he may act out in order to avoid having to endure the stress of trying to interpret incorrect, incomplete, or confusing information from the eyes. How he navigates through space, his understanding of his environment, and how he is learning are all impacted by what he perceives. One of the ways we judge a child’s attention or behavior is their ability to sustain attention to near tasks. It is not always easy to discern between behavior and visual issues; and the only way to know for sure is to eliminate the visual barriers and examine the remaining behavioral problems. By undergoing Vision Therapy to help correct these difficulties, a child’s behavior may be modified with the increasing ability of his visual and visual perceptual systems.

How are the eyes impacted by differing activities, i.e. math, writing, reading, etc. versus computer use?
Activities at near, such as reading and writing, on normal surfaces, such as paper and books, cause the eyes to have to increase their focusing power in order to be able to see clearly. For example, when a child has Accommodative Insufficiency, he has trouble maintaining that clear focus over time. That child’s diagnosis of Convergence Excess means that his eyes tend to over-cross at near, which contributes to this problem. He may also have difficulty with the flexibility of his focusing system, which makes looking up close at his notes and far away to the board (and vice versa) difficult. A computer screen, however, involves the viewer’s focusing power, eye movements, and all of the same visual challenges of reading on paper, but adds in elements of contrast, flicker, and glare; which cause increased strain on the muscles of the eyes. Incorporating breaks, such as the 20/20/20 rule, help reduce this strain. The 20/20/20 rule is a recommendation from the American Optometric Association to look away at a target at least 20 feet away every 20 minutes for 20 seconds.

What other services does Dr. Collier offer at 4D Vision Gym?
While 4D Vision Gym specializes in Vision Therapy, it is also an eye care center, offering eye exams, emergency eye care, diagnosis and management of ocular diseases, treatment of eye infections, injuries, dry eye, and contact lens fittings.

4D accepts Visa, Master Card, American Express, and Discover Card.

Is this covered by health insurance?
Our staff can help in determining your insurance coverage.

At this time, 4D participates with Anthem, Aetna, United Health Care, Oxford, Medicare, and Connecticare insurances. We are out-of-network with Cigna.

Learn more about our functional vision evaluation here: Eye Exam

Please note: In-office therapy under the direction of a behavioral optometrist using prisms, filters and lenses, as used with our patients, is far more effective than home-based therapy.