Eye examinations

We provide full scope Optometry including eye examinations (eye health checks, diabetes and glaucoma monitoring, cataract assessment, computerised visual field testing, colour vision and stereopsis testing etc) as well as specialised services in vision related educational difficulties of children and visual perceptual testing (Behavioural Optometry).

We work closely with numerous schools, educational psychologists, occupational therapists and audiologists to undertake visual and perceptual testing of children whose educational performance does not reach expected levels or whose concentration levels are below average.

New technology: Digital imaging

We are delighted to have two new pieces of diagnostic equipment to further improve the eye health care we can provide.

The first is a retinal camera that allows us to photograph the back of the eye for a permanent record of the retinal appearance. This is extremely useful for watching the health of the eyes in diabetics, glaucoma sufferers, highly short sighted patients and people with many other conditions. We can show you the results of this test on the spot on a high resolution monitor.

We also have installed a corneal topographer which is a digitial imaging machine that maps the shape of the front surface of the eye and is used for contact lens fitting, corneal problem assessment, astigmatism measurement and many other condiitons. Again we can show you the results at the time of the examination.

Both procedures can be undertaken in a matter of minutes and in the majority of cases do not require the use of any drops in the eyes. Please note that Medicare does not cover the cost of these imaging procedures and there is a small charge associated with them.

Visual Perceptual Assessments

What is visual perception?

Visual perception is more than sight. Sight is simply seeing what is there. Perception takes what is seen and gives it meaning.

Think about a child who is learning to read - if they have sight they will see the letters and words on the page. Visual perception or Visual processing allows them to recognise the letters, and eventually words, and give derive meaning. The letters need to be recognised and remembered (visual analysis, visual memory), read from left to right to avoid reversals (visual spatial ability). Letters and words should be read in the order that appears on the page (visual sequential memory), and multiple letters (and ultimately words) need to be seen in one quick look (visual digit span). This enables reading to flow fluently rather than letter - by - letter, one - word - at - a - time. Efficient eye movements also facilitate reading fluency. Visualisation or using the mind's eye facilitates fluency and assists with comprehension of what is read. When reading aloud, the child needs to be able to quickly recognise and say what is seen (rapid automatic naming).

At Russo and Associates Optometry we commonly assess visual perceptual skills in children who are struggling with aspects of classroom performance. A range of age appropriate testing protocols are used to probe skills such as

• Visual analysis
• Visual spatial ability
• Visual motor integration
• Visual sequential memory
• Visual closure
• Visual digit span
• Efficiency of eye movements
• Rapid automatic naming
• Visualisation

The assessment commonly takes around 30-40 minutes to complete. It can be challenging for a small child to concentrate for this stretch of time; as such it is best if these assessments are performed in the morning when the child is alert. If the child has glasses, these should be worn during the assessment. Once the testing is completed, results are compared to normative data, and the child's visual perceptual ability can be expressed as either age appropriate, or above/below the expected level for age.

Outcomes of a Visual Perceptual Assessment

• Sometimes the results of the assessment may indicate a need for visual perceptual therapy.
• In some instances further assessment with other specialists (eg audiologists, educational psychologists, occupational therapists, speech pathologists) can be indicated
• Observations about a child's processing style (quick and impulsive/ slow and reflective/ low confidence/poor attention) can also be made during a perceptual assessment. These concerns can then be addressed.
• The optometrist provides a report detailing the results of the child's perceptual assessment.

Perceptual vision training

Visual perceptual skills develop through touch, movement and play. A therapy program is designed to follow a similar developmental sequence to the natural developmental sequence but in a more condensed time frame. The perceptual motor program (PMP) that is run in many schools is an example of the precursor developmental sequence to the development of efficient visual processing. Early therapy activities involve plenty of coordinated movement, promoting awareness of body position, orientation, sidedness, and right/left coordination. Skills such as sequencing, memory, analysis, etc are practiced through movement initially. Further into the program the processing skills are  guided more through visualisation. This improved awareness and control facilitates the use of visual cues and ultimately symbols on pages.

Perceptual vision training takes time. It is not an overnight cure, but a developmental process designed to modify the child's learned perceptual behaviour. With commitment and dedication from both parent and child it can produce excellent results.

Summary

Visual perceptual assessment can sometimes reveal inadequate development or poor integration of visual processing or visual motor integration.

Therapy to resolve these problems can be of assistance with the development of efficient learning styles, and a more integrated, confident, coordinated person.