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734 Caledonia Ave
Victoria, BC V8T 1E5

1-250-590-7384

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205-1825 Bowen Road
Nanaimo, BC V9S 1H1

1-250-591-0270
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Progressive lenses

progressive lenses

Why Can't I Get Used To Progressive Lenses?

Can't get used to your progressive lenses? It may not be the reason why you or your optometrist think! Progressive lenses can be a frustrating thing for many people to try to get used to.  They can cause dizziness, headaches, depth perception problems and more. Most of the time you're told to 'just get used to it' (that's what many eye doctors are taught in school). If you struggle with them, sometimes it's suggested that you just need to buy a more expensive lens.It wasn't until several years after graduation from optometry that my engineering brain caught up with me, and I started to realize the main reasons why people can't get used to progressives.

Most of this stems from the fact that glasses do more than just make you see clearly.  Most people, including many eye doctors, don't realize that the prescription you're given can change more than just your clarity.
Your glasses can also change:

  • How your eyes work together
  • How you perceive depth/space
  • How your inner ear and vision work together

1. The prescription could be causing the problems.  

Most prescriptions are given to make you see clearly but can have unintended consequences.  The same prescription that makes things clear, may actually be causing headaches, migraines, dizziness, light sensitivity or other problems. Giving a glasses prescription isn't as simple as measuring a shoe size.  The prescription should take into account what makes things clear for you, and then be altered and adjusted based on how your eyes and your brain work together. You may have even had a second opinion on your prescription, and still, be frustrated.  The problem is that optometrists and ophthalmologists are still taught only to prescribe based on clarity.  Our education seems to overlook how the lens can change so much more (for better or worse).

THE FIX:  Find an optometrist who specializes in neuro-optometry and is familiar with using prism for depth perception, not just muscle weaknesses (this is not always the best way to use prism).

2. How the glasses are made could be causing the problem. 

So you've sat there and had the conversation about good, better, and best lens designs. You've been given options to choose from with your lenses.  When was the last time this happened with a drug prescription?  In order for the glasses to be considered 'the prescription', it only needs to match the prescription for clarity.  Many lens manufacturers make other adjustments to the prescription such as adding prism (which can change how your brain processes depth and space).  Even the pupillary distance (PD) measurement, or where the heights of your lenses are set can change the actual prescription.

I can still remember a patient who came to me with the complaint that she was dizzy and often falling forward off of her horse.  Her prescription was great for clearness, but the lens design had prism in it that caused her to always be off-balance leaning forward.  A simple change, using prism in the correct fashion, and she no longer was dizzy or falling off her horse.

THE FIX:  Make sure that the glasses are made exactly as prescribed by the optometrist in Victoria or Nanaimo who understands how they will impact how your eyes and brain work together. Ensure that where-ever you have your glasses made, they will guarantee that you will be satisfied with your glasses (often a 100% refund policy for 2 months).

3. Your progressives may have been prescribed for the wrong reasons or overpromised.

Progressive lenses allow a person to be able to see at both distance and near.  Think of your glasses like shoes, the shoes that multi-task for you (a water-resistant runner for example), is not as good in the rain as a boot and not as comfortable to run in as a good runner.  Progressive lenses are the same. The place this causes the most problems is at the computer. Remember, the top of your glasses is set for distance (think 10 ft and further), and the bottom is for reading. 

When you use your progressives at the computer, one of two things will happen:

  • You will begin to tilt your head back.  Your brain has learned to tilt your head back to get better focus on your screen.  You will start to adopt a posture with your head tilted back.  This is a great thing if you'd like to pay for your physiotherapist or chiropractor's new car.
  • Your eyes will use the wrong area of the lens. You feel like you can see the computer ok, so what could be the problem?  Migraines, headaches, and screen sensitivity are caused because the eyes will start to strain and your brain has to expend extra energy trying to use them together.  Often this is incorrectly attributed to 'blue light' as the culprit.  Please see the other blog article on this because spoiler alert; it's not!   Caution! Even 'task glasses' or the way that most computer glasses are calculated are very generic prescription modifications that can be causing you problems.

THE FIX: Now that you've found the optometrist who specializes in neuro-optometry or vision therapy, be sure to be specific about how you will need to be using your glasses. Measure your distance to the computer screen at your work station.  Use glasses that are specially designed for your desk setup, and ensure that they are prescribed specifically for you and your setup, not just a generic 'computer' or 'task' lens-based off your distance prescription.

Photophobia and light sensitivity

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What could be causing my light sensitivity and what can I do about it?

Photophobia, or light sensitivity can have multiple causes, and many companies have filters, tints, or special glasses claiming to help. It’s important you know how to find the route cause of your photophobia, and how to treat it.

Causes:

Uveitis, Iritis, or inflammatory conditions.

The most obvious causes for photophobia (light sensitivity) are physically problems with the eye that cause the light to scatter as it passes through the eye. One of the most common is termed iritis and refers to inflammation inside the eye. If this is the cause of your light sensitivity it will be easily detected. It is most often treated with steroids, and/or treating any underlying systemic conditions. For the short term sunglasses or dark lenses can be worn, as the light sensitivity in these cases usually resolves within days to a week.

Concussion or head injury

Photophobia (light sensitivity) is common after concussion and head injury. Unless there is physical damage to the eye (causing iritis or uveitis), the light sensitivity is most often linked to problems with how the eyes and the brain work together. This could be because the eyes are not working together properly, sometimes called binocular dysfunction or binocular vision disorder, or because the brain is having trouble processing the light. Treatment options range from specialty glasses prescriptions including prism, light filters such as FL41 or blue tints, and vision therapy. It is important to see a neuro-optometrist, who specializes in testing and treating how the eyes and the brain work together.

General Photophobia

Photophobia that isn’t well explained by uveitis can often be caused by problems with how the eyes work together. It can sometimes have been there for the majority of a person’s life, slowly getting worse. Other times it can seem to onset after years of working at a computer, which sometimes gets referred to as computer vision syndrome. Most often this type of photophobia presents with headaches, dizziness, screen sensitivity or with what people assume is sensitivity to blue light. Often this type of photophobia is due to problems with how the eyes are working together, and the strain that is often put on the visual system. An examination with a neuro-optometrist who specializes in this area of treatment (including prisms, filters, and vision therapy), should be able to uncover the reason why and provide solutions. Treatment often involves specialty glasses that improve efficiency (and reduce symptoms), filters (such as Fl41) and vision therapy (to improve how the eyes and the brain work together).

Treat the reason it’s happening

In any case of photophobia or light sensitivity, the most important part is treating the underlying condition that is causing the photophobia. Cases of inflammation like uveitis should be seen by your optometrist or ophthalmologist in order to diagnose via slit-lamp examination and treat with steroids or other medication. If this has been ruled out, it is important to see a neuro-optometrist who specializes in vision therapy, specialty glasses prescriptions (including Fl41 and other tints), and tinted lenses. This way you can get to the root of the problem and see improvements.

Nighttime Driving Tips Against Glaring Headlights

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It's the time of year when it's hard to escape driving in the dark. Glare from new LED or HID headlights, water on the road, rain, snow and more all gets worse when it's dark out.  Often it gets to the point when people have to stop driving at night all together.  Here are some of the main causes for problems driving at night.

  1. Certain eye health conditions can cause trouble with night driving.  The common causes are cataracts and macular degeneration.  Both are easily diagnosed and cataracts are easily treated.  Have your optometrist check you for cataracts and macular degeneration.
  2. If your prescription is out of date the unfocused images can cause more glare than there would otherwise be.  Be sure that you're working with a recent prescription that has been accurately made.
  3. Your prescription may be up to date, but it may still be a problem.  Sometimes the most up to date prescription for 'seeing clearly' can fail to solve problems driving at night.  In fact, your prescription may even be part of the problem.  This is because it's harder for your eyes to work together at night.  See an optometrist who specializes in neuro-optometry so that the prescription will take into account how your eyes work together during night time driving.
  4. If your eyes don't work together properly it can cause trouble with everything from double vision when driving at night, to complaints about the brightness of new car headlights.  Problems with how your eyes work together can sometimes slowly get worse over time, or it may come up suddenly after a concussion, head injury, whiplash, or vestibular neuritis. Have our Victoria  or Nanaimo neuro-optometrist check how your eyes are working together, and how it will affect your night time driving.

Dynamic Duo Podcast

 

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Cameron McCrodan gave a Ted Talk about the unknown or often overlooked parts of the visual system. Having over 36,000 views on Youtube, his speech has caught the eye of many adults, parents, students, and professionals, including Dr. Stull and Dr. Edwards. We welcome him on this month’s podcast!

Things you will learn in this episode:

  • Unlike a disease, it is difficult to show people what is happening or understand what the patient can see. This is why it can be overlooked or not treated if the doctor or patient are uneducated on this topic.
  • To a certain extent, people aren’t just “stuck” with their vision; because it is “such a learned process, you can make it more accurate”
  • Although studies can be helpful, it is important to “dig deeper” and fully understand the logistics behind the numbers and conclusion.
  • Approximately “12%-18% may have binocular issues”; however, many go undetected or do not interfere with everyday life.
  • Understanding what a patient wants to get from an exam can help tailor it and connect more with the patient.
  • Going through VT can improve so much more than just vision. Children and adults can see a change in behavior, self esteem, or schoolwork/work.
  • Cameron compares a child with a vision issue like a day at work with your computer down. You are still expected to do the same tasks but it is frustrating and focused your energy away from your responsibilities.

Listen to the podcast here.

Beyond Blindness Podcast

Listen to the podcast here:

On this episode you will learn three things:

What is Dyslexia? Diagnosing Dyslexia with an optometrist Understanding how the visual system works. 00:01 About doctor Cameron McCrodan

01:24 Why is Dr. Cameron McCrodan’s message important for you.

02:37 How did Dr Cameron McCrodan transitioned from being a regular optometrist to a doctor that focuses on the way that be I functions properly.

05:10 What is visual development

06:01 How visual development affects older people

08:15 What sets you apart from other optometrists?

10:33 What is dyslexia?

13:06 How to assess dyslexia?

15:53 Creating dyslexia awareness

18:24 Dyslexia and visual tracking

22:10 How to treat dyslexia.

26:00 How long does it take to treat dyslexia?

26:39 Delimitations to treat dyslexia online

30:25 Advice Dr. Cameron McCrodan to anybody who has dyslexia

35:58 Three things Dr. Cameron McCrodan does to stay on top of his game.

40:00 Section “On the way I see it

Back to School Time & Your Child’s Vision

It’s back-to-school time, and your child could be struggling because of one of four vision problems that eye exams often don’t pick up.

1. Eye tracking: If the eyes don’t track properly through text, how would you expect somebody to read well? Take a look at the video on this page, at 0:21. The reader on the left – as you can see here, eyes don’t track properly through the text. She skips lines, loses her place, and mixes up the information. Her reading fluency sounds terrible, while the reader on the right is your average reader. Notice the difference?

2. How the eyes actually work together: On the video at 0:41, you can see here that the two eyes actually do the same thing while they’re tracking. On this one, the two eyes don’t work together at all. No wonder there’s problems! At 0:52 the is an example of a grade-10 girl when she was a C-student, and you can note the eyes not working together. At 0:57, when she’s an A-student, you can see that they do work together.

3. Eye focusing: If the eyes don’t shift their focus accurately, sustaining attention is much harder and it’s even hard to copy off the board.

4. How the brain makes sense of visual information: This has everything to do with the visual memory required for spelling or understanding the difference between the hand motions I make in the video at 1:19, which is at the heart of a lot of letter reversals. So, if your child is struggling in school, even though they may have had an eye exam, please make sure to have their eye tracking, teaming, focusing and the visual processing tested. Find a developmental or neurological optometrist near you. Browse our site for more information.

Happy learning!

Testing for ADHD? Don’t overlook this!

It’s back to school, and back to paying attention. It’s also often the time of year it’s suggested to parents that they have their child assessed by a psychologist for attention deficit hyperactivity disorder (ADHD), or attention deficit disorder (ADD).

This generally comes up because a child is having difficulty maintaining their focus in class. It’s often hard for them to stay on task when reading, writing or similar. Sometimes the idea for psych ed testing comes up because that child is struggling with reading, writing, or other areas of learning. But there are a few things that are commonly overlooked during the testing process, and could leave your kid struggling or mis-diagnosed.

7 of the 9 symptoms of AD(H)D can be caused by problems with how the eyes work together. It makes sense, doesn’t it? If your eyes cannot focus or track efficiently, it will be much more difficult to do the task, and you don’t be able to do it for as long. See the TEDx talk here to dive deeper. Imagine if your child was riding a bicycle. If the tires were flat, and the wheels slightly bent, would you expect them to be able to perform properly, or to ride their bike for as long as the other kids? Of course not! The same goes with their eyes. On top of that, they need to use their eyes for all psych ed testing.

80% of struggling readers have problems with how their eyes work. Problems with eye tracking, focusing, or binocularity (how the eyes work together) have to be specially tested. Many eye exams with the optometrist or ophthalmologist only test visual acuity (clarity), and the physical health of the eyes. This means that children commonly get told that their vision is ok, when there are still problems with how it functions. If the eyes cannot move properly through the text, how could you expect a child to learn well? This makes it even harder to stay focused!

Have your child tested for binocular vision dysfunction, eye tracking problems, and more. Make sure that you see a developmental or neuro optometrist who can test all the areas of how your child’s vision works. Ask them to test tracking (often with special goggles), accommodation (focusing), and binocularity (convergence and eye teaming). If it is a problem with how vision works, it can be very treatable. Treatment may involve specially prescribed glasses and/or vision therapy. If applicable, treatment success rates are greater than 95%.

Psych ed testing and ADHD testing is important and has its place within our system. Children can also have ADHD as well as vision problems, making their symptoms even worse. For these reasons, any parent looking at doing a psych ed assessment for their child should make sure that the eye tracking and teaming is fully tested.

We offer advanced testing in Victoria and Nanaimo that can determine if vision causing problems with attention and focus. If it’s part of the problem, our advanced treatment methods can help get your young learner back on track Testimonials.

Visual Migraines and Vertigo

Suffering from vertigo, feeling dizzy, or have a feeling of unsteadiness? Does it get worse with visual stimulus like grocery stores, busy places, flashing lights, patterns, blinds, or watching motion? It could be related to how your eyes and brain work together. In many of these cases, but not always, people may also experience migraines with aura or visual/ocular migraines.

70% of the brain’s incoming sensory information is visual and more of your brain is dedicated to processing vision than any other sense. This means that you depend on accurate visual processing to make sense of where things are around you. This includes using your vision to make sense of where you are in space, and where things are around you. This is one of the reasons why people feel sea-sick, when their vision is not matching their other senses. Many people with vertigo or dizziness describe it as though they feel like they are walking on water, or on a boat (unsteady).

Vision is your brains dominant sense and when your vision doesn’t match with other systems your brain will often choose to pay attention to vision. This can cause problems if your brain can’t process vision properly. This is where it can tie into ocular or visual migraines.

Visual migraines, or Ocular Migraines are often caused by the brain having trouble processing visual information. This is why they can be brought on by things like fluorescent lights, busy stores, computer time, reading, flickering lights or more. When treated, visual migraines will reduce in frequency. Treatment for visual migraines often involves a special glasses prescription, as well as vision therapy to re-train how the eyes and the brain work together.

Visual migraines and vertigo are often related because each can be caused by problems with how the eyes and the brain work together. If the brain has trouble processing vision, then it can lead to visual migraines, vertigo, dizziness, and more. The easy way to tell if vision is part of the problem is to pay attention to any visual triggers. Do fluorescent lights, computer screens, busy places, watching moving objects, high contrast patterns, or other visual stimulus cause symptoms? If so, it’s almost certain vision is part of the problem. You can also Children Vision Assessmentto see if you’re affected.

If you suffer from vertigo, visual migraines, or even vestibular migraines, it’s important to be assessed by a neuro-optometrist. You need to have your neuro-optometrist look at how your eyes and your brain are working together. This includes visual-vestibular mismatch, eye tracking problems, convergence problems, and more. Many other neuro or eye examinations may not test these areas, so your problem could potentially be overlooked. If the above are addressed, they should be able to offer treatment in the form of specific exercises to re-calibrate and rehabilitate the function, as well as specialty glasses that will hugely help the process. The rehabilitation process can take a lot of time and effort, but if properly diagnosed and treated, it can often fully treat the vertigo, dizziness, and visual migraines.

My daughter was diagnosed with Dyslexia. We had her eyes tested and they said it’s fine. Could tracking be a problem?

“My daughter was diagnosed with Dyslexia. We had her eyes tested and they said it’s fine. Could tracking be a problem?”

This mom writes in with a really common question. Can vision be part of the dyslexia puzzle? Well, the answer is yes… and no. Probably not what you want to hear, is it? As we break down how vision and dyslexia are related, you’ll understand just what I mean.

Vision

First, a reminder of vision. Unfortunately many professionals still consider vision just as seeing clearly, a glasses prescription and the health of the eye. What is now understood by the leaders in the field is that vision is much more than that. It’s about how well the eyes and the brain work together. The TedX talk here: https://youtu.be/L0pljgXZ_GA covers a lot of this.

This involves:

  • Tracking
  • Eye teaming (binocularity)
  • Focusing (accommodation)
  • Visual processing (visualization for spelling etc)
  • Visual-motor integration (writing and fine motor coordination)
  • Visual-vestibular integration (how the eyes and inner ear talk to each other.

Dyslexia

The International Dyslexia Association defines dyslexia as:

“Dyslexia is a specific learning disability that is neurobiological in origin. It is characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities. These difficulties typically result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction. Secondary consequences may include problems in reading comprehension and reduced reading experience that can impede growth of vocabulary and background knowledge.”

So how does vision relate to dyslexia?

Picture yourself listening to an audiobook on headphones, and the CD or track was skipping and jumping around. Understandably you would have difficulty recognizing the words, and making sense of what was said. So the language areas in your brain would not be given accurate input to work with. Of course you would show difficulties.

Now imagine if you were reading a paragraph of text. While reading, the letters all split in random ways, and then floated around to reorganize themselves every couple of seconds. You would be able to see the page, but the language centers would not be getting accurate input about what was actually on the page. This is like the skipping CD, expect you may not even know it’s skipping, and nobody around you would know either.

If a child’s eyes do not track accurately, their eyes can often jump to the wrong place when reading, or jump forwards then backwards without them understanding this is what happened. The eyes can also deviate from each other so that each eye is actually pointing at a different part of a word, confusing the information that is ‘seen’.

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Normal Reader

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Reader with ‘Dyslexia’ and problems with eye movement.

How could you expect someone to recognize a word, or decode a phoneme (part of a word), if it looks different every time they see it? This is often why vision problems can mean that you will teach your child a word on one line, and three lines later they won’t recognize the same word. Because to them, it looks like an entirely new word!

If a child was struggling while listening to an audiobook, you would want to check to make sure they are getting the proper input in their headphones. Vision is the same thing. Problems with eye tracking and teaming can mess up the input like the skipping CD.

Dyslexia Diagnosis

When diagnosing dyslexia, the DSM-V clearly states:

The individual’s difficulties must not be better explained by developmental, neurological, sensory (vision or hearing), or motor disorders… “

Ironically, vision is developed, neurological in origin, sensory, and vision is an important part of motor ability (coordination requires coordinates). So this means that all areas of vision should technically be ruled out before dyslexia testing is done or a diagnosis is made. This is now the standard in the UK.The reason for this, as you can imagine, is that most of the testing done requires vision, or visualization in order to do the testing.

Dyslexia and Vision confusion

The confusing part about the DSM-V statement on dyslexia is that many people understand it to mean that dyslexia has nothing to do with vision. This is 100% true, if vision (including tracking, binocularity, and processing) was completely ruled out before the dyslexia was diagnosed. Unfortunately, most dyslexia diagnoses are made when only seeing clearly and eye health have been checked. This means that most children who are tested for, and diagnosed with dyslexia, have not had had the visual functions properly tested and ruled out. This means that if they have vision problems (80% do), these problems will have interfered with the testing.

What can you do?

If your child or someone you love is struggling with reading, suspected of dyslexia, or has a dyslexia diagnosis, it’s is important to have their full visual function evaluated. Find a neurological or developmental optometrist who will test: binocular function, accommodative function, tracking, visual processing, and often more. Make sure the optometrist is experienced in this area, as most optometry and ophthalmology schools still teach the old understanding of vision. Many routine eye exams, or even exams with the best surgeons, will not test the actual tracking function. So don’t stop until you find someone who will.

The exam may rule out vision entirely, and then you know that it’s not part of the problem. Or it may find that vision is part of the issue, or with treatment you may find that vision was the entire part of the problem. Either way, it’s an 80% chance that vision is involved in the struggle, so the odds are in favour of an exam.

How long should vision therapy be?

Why will one doctor recommend 10 weeks of vision therapy, and another recommend 25, 30, or 40? As a person evaluating your options for treatment, it may be difficult to understand why the difference.

Most of the time it comes down to your neuro-optometrist’s understanding of vision. There are a variety of different approaches, and at the risk of over-simplifying, we will boil it down to 2.

Convergence, accommodation, and saccades (tracking)

There is a school of thought in optometry that areas of vision are essentially separate. There may be a problem with convergence (how the two eyes come together), accommodation (how they focus), and/or saccadic function. Treatment is aimed at doing the thing that caused the person to fail that particular test, and only that thing. Particular skills are worked on for about 6-10 weeks, and then re-evaluated to see if they can now pass the test, showing that the condition was treated. Treatment is often extended for another 6-10 weeks to work on the same things. There may also be extensive testing to see if there are visual-processing deficits, looking at areas such as visual memory, sequential memory and more.

Vision as an integrated system

The other popular view is that vision is more of an integrated system where things like convergence, accommodation, and saccadic function are inter-related. For example, before the eyes can make an accurate movement (saccade), the brain needs to accurately calculate where they need to move. The eyes also need to be able to coordinate that movement together, or they end up in slightly different spots. If the accommodation is off target, it also effects how the eyes move together as the brain tries to compensate.This theory also looks at how the visual and vestibular systems work together, how depth and space are processed and more. The belief is that areas of vision do not function as separate silo’s, and when treating, it is essential to properly integrate everything together so that it continues to work that way. There are often dozens of exercises that need to be completed and treatment algorithms to be followed to achieve proper integration.This method of treating can take as little as 10 weeks, but most often the optometrist is able to give an estimate of a time-frame based on findings, that may range from 16-50 weeks time, with progress checks along the way. T Even though the official progress checks are often 10 weeks apart, each particular exercise has built in expectations so your optometrist will know each week if you’re on track.

Which is better?

I have practiced in both methods, so I’ve had a very good idea of the pros and cons of each. The ‘try 10 weeks’ approach is fantastic for creating a low barrier to entry. After all, 10 weeks doesn’t seem so bad. What I found though, was that it was possible to teach you to beat a test, without actually getting the full transfer to daily life (that is what gives true symptom improvement). It’s like teaching you to read a paragraph of Italian, so you could fluently read that paragraph, and then pass the test. But how would you do if you were plunked down in Italy? You learned to beat the test, but the skill transfer would be minimal. You failed the test because you didn’t know Italian, not because the paragraph itself was the problem. The same goes with vision. Often the test that is failed is the surface manifestation of an underlying problem. A great example of this is convergence.Often it’s thought that if you can’t follow your finger to your nose with both eyes, that you need to just practice more convergence. In reality, part of the problem is that there is a fundamental lack of spatial/depth processing, so your brain doesn’t truly understand where the finger is and what needs to be done to get the eyes to point at it. Simply doing more convergence exercises may mean that you can beat the test, and show some symptom improvement, but nowhere near the level of addressing the root cause.

The engineering brain in me screams that because of how fantastically integrated our vision is, it needs to all be calibrated to work together, so that it stays that way. Understanding this was a game-changer for the improvements seen by our patients. Based on our in-clinic research and trials, it has allowed us to develop models that can accurately (95-98%) predict within +-2 weeks how long will be needed for treatment. The models have become so strong that we can back it up with free treatment extensions for up to 3 months if needed, and a money-back guarantee on achieving our outcomes.

This approach has its’ downsides. Because we can estimate the time-frame, our patients are faced with a larger commitment that can seem daunting. For some people it’s too much, but from a clinical perspective it means that I know we are being set up for success.

So the try 10 weeks approach is great for getting a lot of people into vision therapy, but I found it severely lacked in actually getting the outcomes that mattered. The more integrated model means that people know what they are in for up-front (and may mean that some get scared off), and that results can be guaranteed.

When you’re evaluating your vision therapy options, ask your optometrist about their approach, their outcome measures, and how they stand by their recommendations.