He had a relatively common visual dysfunction of eye teaming, tracking and focusing. His problem wasn’t with his eyes (per se) or his eyesight. Indeed it was no surprise that my examination concurred with his referring doctor. Both of his parents attended my exam and where noticeably concerned and frustrated by his struggles with reading and battle with homework.
His referring optometrist had tried reading glasses, but they didn’t seem to make any significant difference in the boy’s symptoms and didn’t improve his reading. He was a bright boy who did well when presented with oral learning but got exhausted when trying to read and learn. He complained of headaches, eye strain, words overlapping when reading and poor attention for reading. He had no refractive error, 20/20 visual acuity at distance and near and normal healthy eyes. Recently I saw a 9-year-old boy in 4th grade, who was referred to me by his primary care optometrist with a condition of accommodation-vergence dysfunction involving convergence excess and oculomotor dysfunction. Problems in eye tracking are known as an oculomotor dysfunction. Eye “tracking” is another way of saying our eyes need to fixate visually (to look at), follow in a smooth pursuit (follow) and saccade (move spot to spot). When a child has trouble with eye focusing, they may have either accommodative insufficiency or accommodative infacility. The eye focusing system helps us focus on objects and see images clearly.
The eye teaming system must also work together with the eye “focusing” system, otherwise known as accommodation. When an individual has poor eye teaming skills, they may have one of two conditions, convergence insufficiency or convergence excess. When consulting parents about developmental vision and eye coordination problems, I find it far better to keep the dialog “parent-friendly.” That is to say instead of referring to their child’s condition as poor binocular vergence, oculomotor dysfunction and/or accommodation insufficiency, I refer to these important visual skills as problems in their eye “teaming, tracking, and focusing.” These three eye coordination abilities essential for reading fluency, but what do they mean?Įye “teaming” or vergence is another way of saying we have two eyes and they must work together as a team.
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