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Medical Info January 1, 2011  RSS feed

Double vision is a common problem that affects school-aged children

By Dr. S Moshe Roth

The popular TV show “The Doctors” recently aired a feature on double vision.The optometrist being interviewed, Dr. Elise Brisco, FCOVD, described some of the common vision problems that affect school-aged children and prevent them from succeeding in school.They demonstrated a picture of what someone might see if they have double vision, and what reading can look like to a child who has difficulty using their two eyes together as a team. Children who see double assume that everyone sees this way and therefore rarely complain. Log onto http://www.thedoctorstv.com/videolib/ init/3086 to watch the video.

It is common to think that eyeglasses should solve these problems. Sometimes they do, but at times, these problems go undetected because a child may pass the eye chart test, which is obviously done at distance. However, the child may actually have a problem at near. They may have a problem using the two eyes together as a team, and eyeglasses do not solve that type of problem. Further, many people confuse a vision screening at the pediatrician’s office or by the school nurse as being the same as an eye examination. The doctor interviewed on the show describes lazy eye, when one eye turns in or out, and therefore the child sees double. Unless it is severe, an eye turn many not be obvious to parents. During a true examination, a doctor can make it easier for the parent to see for themselves that there actually is an eye turn that they may have never noticed.This only occurs if the doctor tests for these types of problems. Not all eye doctors do. Some might test each eye individually, but not test how the two work together as a team.

Dr.Travis Stork, the emergency room physician who was the master of ceremonies for the show, put on a special pair of glasses that simulated the double vision that someone may experience if they have an eye coordination problem. Dr. Stork is a good athlete, but when wearing the special glasses he had difficulty catching a ball. He explained to the audience that he had to use the sense of touch to compensate for the poor vision.

If someone has strabismus, an eye turn, then they see double all of the time, unless they suppress, (turn off, ignore) the image from one eye inside their brain. If they do that, then they see flat, and do not see in 3D at all.Vision actually occurs in the brain, and not in the eye. Double vision can occur if there is distortion within the eye due to astigmatism, cataract or keratoconus, or it could be due to the eye muscles not lining up the two eyes together. Sometimes the fact that someone might be having a vision problem may become more apparent when they can’t see the 3D effects in a 3D movie; they might get a headache afterward.

The problem can be developmental, meaning that the brain never learned to coordinate the two eyes together, or it can be due to a neurological problem, when someone has double vision that doesn’t go away. It could be from drinking alcohol, or from something as serious as a brain tumor, stroke or aneurism.

The ability to see is learned.You are not born with it. Children do not know what normal vision is, and assume that they see the same way that everyone else does.Your child may be compensating for poor vision by using the sense of touch.You wouldn’t know it and you might think that your child is just a little clumsy. He may be using touch to compensate in catching a ball, or by holding his finger on the page so as not to lose his place while reading.

Some people need a special type of physical therapy, called vision therapy, where they can work on eye muscle control and coordination, and train the brain to use the eyes to work together as a team. Once learned, this skill will stay with the child in the same way someone owns the skill of riding a bike or driving a car.

Dr. S. Moshe Roth, optometric physician, practices at Family Eye Care in Old Bridge. He is board certified in vision development and therapy. Lic. No. 4635, OM No. 27OM0005600. For more information, call 732-679-2020.