Im­prov­ing qual­ity of life at Rose Eye Clinic

The Sentinel-Record - HER - Hot Springs - - Contents - Story by Lindsey Wells, pho­tog­ra­phy by Richard Ras­mussen

The num­ber of chil­dren with sen­sory in­te­gra­tion and vis­ual pro­cess­ing prob­lems is sky­rock­et­ing and chil­dren are be­ing di­ag­nosed with At­ten­tion Deficit Hy­per­ac­tiv­ity Dis­or­der or dys­lexia when that might not ac­tu­ally be the is­sue.

Sen­sory in­te­gra­tion is de­fined as the process by which we re­ceive in­for­ma­tion through our senses, or­ga­nize this in­for­ma­tion and use it to par­tic­i­pate in every day ac­tiv­i­ties. An in­di­vid­ual with a vis­ual pro­cess­ing dis­or­der has a hin­dered abil­ity to make sense of in­for­ma­tion taken in through the eyes. This is not to be con­fused with prob­lems in­volv­ing sight or sharp­ness of vi­sion; dif­fi­cul­ties with vis­ual pro­cess­ing af­fect how vis­ual in­for­ma­tion is in­ter­preted or pro­cessed by the brain.

These dis­or­ders can cause chil­dren to be­come eas­ily frus­trated, have dou­ble or blurry vi­sion, have trou­ble fo­cus­ing when read­ing, get dis­tracted eas­ily, be un­co­or­di­nated or have trou­ble fol­low­ing di­rec­tions.

Though no one re­ally knows why more and more chil­dren are hav­ing these prob­lems, help is avail­able.

Dr. Angela Rose with Rose Eye Clinic in Hot Springs can de­velop an in­di­vid­u­al­ized vi­sion ther­apy pro­gram for pa­tients suf­fer­ing with the above prob­lems, and she’s one of only 10-12 doc­tors in Arkansas who of­fer these ser­vices.

Typ­i­cally, the pa­tient will have a 45-minute ses­sion once a week for a min­i­mum of 12 ses­sions, though Rose said many chil­dren need more ses­sions than that depend­ing on the sever­ity of the prob­lem and how long it’s been go­ing on, so it’s not un­com­mon for a child to need 24 ses­sions.

An exam will be done dur­ing the first ses­sion in which the doc­tor will test a num­ber of things, in­clud­ing the pa­tient’s acu­ity, de­ter­mine if they need glasses just to see clearly, test their abil­ity to fo­cus up close and ex­am­ine their depth per­cep­tion and how their eyes move. Then, a sec­ond type of test­ing will be done called de­vel­op­men­tal test­ing. This test takes ap­prox­i­mately an hour and the pa­tient will re­ceive a six-page re­port to take with them to school.

The de­vel­op­men­tal test­ing will de­ter­mine the pa­tient’s strengths and weak­nesses, al­low­ing the doc­tor to de­velop a unique pro­gram, and the weekly ses­sions will com­mence af­ter that.

“It’s not just kids sit­ting at a desk do­ing ex­er­cises. That is what we do, but it’s a lit­tle more. We try to bring in sen­sory in­te­gra­tion tech­nique,” said Rose. “Kids get so much screen time any­way; there are a few things that are nice to do on a com­puter but most of it is out here. You know, vis­ual au­di­tory things: jump­ing on the tram­po­line, call­ing out dif­fer­ent

things. We’ll work on their vestibu­lar sen­sory spin board and spin them around.”

Rose said her of­fice has been get­ting a lot of re­fer­rals from oc­cu­pa­tional ther­a­pists, as they’re find­ing that the prob­lems they’re see­ing in their pa­tients have a vis­ual com­po­nent and its af­fect­ing their bal­ance and at­ten­tion. For those pa­tients, they’ll con­tinue their oc­cu­pa­tional ther- apy and do ther­a­peu­tic classes at Rose’s clinic.

Though Rose’s pro­grams are de­signed for chil­dren, she said there are places in the coun­try that work with adults too.

“We see kids — some­times it’s an ob­vi­ous prob­lem where they have a crossed eye, but some­times it’s not. Most of the time it’s more sub­tle. In­ef­fi­cient eye move­ments where they’re skip­ping words or lines when they read and it’s af­fect­ing their read­ing com­pre­hen­sion, grades, be­hav­ior,” she added.

Con­ver­gence in­suf­fi­ciency is an­other prob­lem Rose has seen and it can also mimic other things and be dif­fi­cult to di­ag­nose.

“If you can’t turn your eyes in a lit­tle bit when you’re fo­cus­ing up close you will get blurry, you will go dou­ble, and that’s con­ver­gence in­suf­fi­ciency. Well, if you can imag­ine a child who has that but has not been di­ag­nosed, be­cause it’s kind of sub­tle — you have to be look­ing for it — then you can see that they might be read­ing, go dou­ble, get blurry, they get dis­tracted, lose their place; that’s a child that can eas­ily be la­beled ADD. That’s just one ex­am­ple,” she said.

“We’re see­ing more and more of it now and no­body re­ally knows why. The occu- pa­tional ther­a­pists are see­ing lots more kids with sen­sory in­te­gra­tion prob­lems, we’re see­ing kids with vis­ual pro­cess­ing prob­lems. It’s neu­ro­log­i­cally- based, that we know. It’s not as sim­ple as ‘Oh, this mus­cle is too strong so it’s pulling the eye in.’ That’s old school stuff. Now we know it’s much more com­pli­cated than that,” Rose added.

The goal at the end of vi­sion ther­apy is for the pa­tient to have good vis­ual acu­ity, good binoc­u­lar­ity and 20/20 vi­sion with or with­out glasses, Rose said, adding that some­times chil­dren will come in and, even with glasses, can’t see 20/20 be­cause their vis­ual pro­cess­ing sys­tem is work­ing so slow.

Many chil­dren don’t need glasses at all once they grad­u­ate the pro­gram. Some have no depth per­cep­tion when they be­gin and Rose said that’s a big prob­lem, adding that most of the chil­dren are on the A/B honor roll at school when they fin­ish the pro­gram. If they aren’t, Rose said she doesn’t con­sider them ready to grad­u­ate be­cause some­times there are other is­sues that need to be looked at. At the end of the pro­gram, the pa­tient should have bet­ter com­pre­hen­sion and bet­ter be­hav­ior.

Vi­sion ther­apy is only about 20 per­cent of the prac­tice at Rose Eye Clinic; the clinic also sees adults and chil­dren who just need reg­u­lar eye ex­ams.

“It’s just so nice to see a kid just turn their whole world around,” Rose said. “The changes can be so dra­matic and when we’re get­ting ready to grad­u­ate them the mom cries, I cry, and the kids a lot of times don’t want to leave. We try to make it re­ally fun and they be­come kind of part of the prac­tice fam­ily. It is very re­ward­ing.

“There could be a child who’s never been able to play sports be­cause of poor bal­ance and co­or­di­na­tion and it opens up a whole new world for them af­ter that. We live in a vis­ual world so when par­ents come in and say ‘Well, they’re giv­ing lit­tle Johnny his test orally be­cause he’s an au­di­tory learner,’ on the one hand it’s great that they are work­ing with you on that but we live in a vis­ual world and even­tu­ally, hope­fully, he will go to col­lege and/ or get a job and they’re not go­ing to cater to him like that. They’ve got to be able to func­tion in a vis­ual world,” said Rose.

“It’s just so nice to see a kid just turn their whole world around. The changes can be so dra­matic and when we’re get­ting ready to grad­u­ate them the mom cries, I cry, and the kids a lot of times don’t want to leave.” - Dr. Angela Rose

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