Hopefully all children irrespective of whether they are having reading difficulties have had an NHS eye test with their family Optometrist. However it is surprising how many have not had a basic eye screen, so if you or the patient have not had a basic eye test you are advised to have one.
Before an assessment takes place we will ask you to fill out one of our questionnaires (link) about the difficulties. We always send one out in advance for the parent regarding the history and one for the teacher. We are interested not only in the child's current problems, be they reading difficulties or concentration problems. We also need to know what has happened in the past and what has been done so far to help, be it through school or at home. What has led up to the current situation? what was the developmental history like, walking, talking or has there been a need for occupational therapy?
Any family history of dyslexia, migraines, headaches is also important. the teacher will tell us; how the child is progressing at school, how is their reading, writing and spelling?
This information is important to have so that we can have the full picture before the assessment takes place.
During the assessment we are making observations about their 'laterality', simply, can the child identify their right hand, my right hand, their parents or carers right hand? Why? Well so that when I ask them to cover their right eye they will get it right! But more importantly children with a poor sense of laterality often do 'b' and 'd', 'p' and 'q' the wrong way round!
We look at the child ability to move their eyes. Can they jump from target to target called pursuit and saccadic movements. People who are good at ball sports are noted to have particularly smooth and accurate pursuit movements whilst we have noticed that people with poor saccadic eye movements often have problems with reading, missing out words, getting lost adding in extra words and skipping or repeating lines.
We check colour vision and stereopsis. Stereopsis or 3D vision is a measure of the level of teaming of the eyes. Not so much how well they work together but how much extra information the brain receives when they are teamed together properly. In a situation where the two eyes are poorly teamed it does not matter if one of the eyes drifts a little, but a good team of properly coordinated eyes, if there is tension in the team can pull the whole visions train off the rails. A person with a squint has no teaming and the eyes will alternate control, one eye will be the master and the other just be there for the ride.
The eye has to do so much for it to be able to read accurately. All this is to happen automatically with very little thought process from the person who meantime has to process what the text is all about. It is a complicated process. We think of it as a sport that needs just as much practice and training as any other sport to be good at it. people who don't read much don't learn the skills and so find reading tedious and boring. Those who master the skills find the process of reading easy and so are able to relax and enjoy the text.
What we do during an assessment is try and breakdown all these visual skills and examine them one by one. if we find one or more are weak then the obvious thing is to build up the skill level in that area. We pride ourselves on our successes with a variety of children and adults who often see what we do as a last resort.
What to expect & what to bring:
*Glasses if already wearing them.
*Reports from the school or any other professional(s) you have seen such as an educational psychologist,
occupational therapist, speech therapist or other optometrist.
*Examples of handwriting or other work that is an issue.
*Plan on arriving 10 minutes before the appointment to allow time for filling out information, settling down and going to the toilet. (Many children have travelled a long way and/or may be a little nervous). To get the most value from your time with the optometrist, please:
*Turn off your mobile phone during the assessment.
*Have other children minded outside of the test room.
What will happen
we will want you to:
*Sit in a big comfortable chair
*Read some letters - if you don't know your letters that's OK; just tell them and they will use pictures instead.
*Try some puzzles
*Draw some shapes or copy some pictures
*Look through some interesting machines and tell them when letters or pictures are clear or blurry and when you see one thing or two.
*Look at a light while they look into your eyes so that they can see how healthy they are.
If you don't know an answer or find some things a bit tricky that's OK - just say so. As long as you have a try, the optometrist will be happy.
* Very occasionally the optometrist will need to put drops in the eyes to get a better look. The drops sting a little for about 15-20 seconds. This is the only part of the examination that may be uncomfortable and is not needed for most patients.