Vision Performance Centre

Vitalizing Your Vision and Performance

For adults, it is never too late to seek solutions for amblyopia (lazy eye), strabismus (turned-eye) or to enhance your visual-thinking performance.

Vision and Life

It is never too late to seek solutions for amblyopia (lazy eye), strabismus (turned-eye) or any eye teaming challenges. Enhancement of visual-thinking performance is always an advantage.

Seeing is our dominant sense. About 80% of what we learn channels through our eyes and is processed to make sense of what we see (visual information processing or VIP skills).

Vision problems can contribute to poor performance which may not be detected during a basic eye exam. A patient may have 20/20 vision clarity yet still have visual interferences limiting performance.

Binocular Vision and Visual Performance

Binocular vision occurs when both eyes track as a team. Performance is enhanced when the two eyes, together, deliver the full complement of visual information. The brain receives this visual information and then analyzes, catalogues, stores and retrieves the visual concepts – essentially making sense from what is seen.

For some, the effortless process of making sense of what is seen is challenged and not robust; one or more visual sub-skills may be fragile and fail during stress, or a demanding visual task. For others, just a single visual skill may not have reached the appropriate skill-level causing performance challenges.

What to look for:

  • eyes that do not look straight (strabismus, tropia)
    • one eye turned in or out
  • one eye blurred vision (lazy eye or amblyopia)
  • when reading, writing, or doing computer work
    • burning or tearing eyes
    • eye strain
    • eye rubbing
    • tired eyes
    • double-vision (covers one eye)
  • holds near-work close
  • loses place when reading
  • uses ruler, guide or finger when reading
  • poor attention, headaches, loss of concentration
  • poor reading comprehension
  • letter (or number) reversals
  • difficulty spelling
  • difficulty completing a written or reading task in a reasonable amount of time

Vision and Concussions

VISION PERFORMANCE CENTRE AND CONCUSSION
Vitalizing Vision and Performance – Love your eyes at any age

A CONCUSSION IS A FORM OF MILD TRAUMATIC BRAIN INJURY.
Concussions are a result from a direct blow to the head or, indirectly from something such as whiplash.
The impact causes the brain to hit against the inside of the skull causing brain bruising. It is estimated that nearly ½ a million (~500,000) concussions occur yearly in the Canada.

CONCUSSION SYMPTOMS CAN PERSIST.
10-20% of concussions result in symptoms that can last weeks, months, or more. When these symptoms persist, a condition known as Post-Concussion Syndrome (PCS) occurs.

GENERAL SYMPTOMS
CONCUSSIONS HAVE THESE TYPICAL SYMPTOMS. * Vision related

  • Confusion
  • Headache*
  • Disorientation
  • Vomiting and/or Nausea
  • Unsteadiness*
  • Light sensitivity*
  • Blurred Vision*
  • Double vision*
  • Loss of place when reading*
  • Post-traumatic amnesia
  • Dizziness*

THE MISSING LINK
UP TO 1/2 OF SYMPTOMS ARE VISUAL, MEANING VISION IS OFTEN THE MISSING LINK.

Recent research suggests that over 50% of patients with concussion or post-concussion syndrome (PCS) have visual problems that may cause headaches,, double vision, eye strain or blurred vision.
Seeing is our dominant sense and about 80% of all the information processed is channeled through our eyes. Post-Concussion Syndrome (PCS) may interfere with the efficiency and effectiveness of how we make sense of what is seen or read, or make you to work twice as hard for your current performance.
For some patients with PCS, the effortless process of making sense of what is seen is altered. One or more visual sub-skills may be fragile and lose their auto-pilot mode and result in interference with performance.

OVERCOMING CONCUSSION-RELATED VISION PROBLEMS
Optometrists have a great understanding of the visual system. They have the opportunity to retrain the visual sub-skills through a program of vision therapy or neuro-optometric rehabilitation. This helps eliminate the visual symptoms most commonly associated with post-concussion syndrome (PSC) and vitalize vision and performance.

GETTING TREATMENT
YOU WILL WANT AN OPTOMETRIST DEDICATED TO NEURO-OPTOMETRIC REHABILITATION (VISION THERAPY)

Neuro-Optometric Rehabilitation represents a specific area of optometry, which addresses deficits in eye-teaming, focusing, visual tracking, visual processing problems, and related visual problems. These problems are common with patients who have concussion and other forms of acquired brain injury. Treatment may involve spectacle lens prescriptions, prisms, filters, special tints and vision therapy which can provide symptomatic relief.
Vision therapy entails a variety of non-surgical therapeutic procedures designed to vitalize visual function. Vision therapy involves a series of treatments during which carefully planned activities are carried out by the patient under professional supervision. The targeted treatments are determined by the nature and severity of the diagnosed condition. Vision therapy is done to vitalize visual sub-skills to boost performance – not simply strengthen eye muscles.

Patients with vision problems show their struggles in different ways. With the symptoms listed above, there may be significant visual challenges, particularly in areas of reading, computer work, spreadsheets or hand-eye coordination tasks.

There is great success at overcoming visual challenges.

We have 4 steps to vitalize vision and performance.

1. A Complete Digital Retinal Eye Exam is the first step. If an eye exam has been completed within 12 months then it does not need to be repeated. The OHIP benefit eye-exam covers the vast majority of the investment for patients up to 19  and over 65 years of age, while the remainder is the patient’s responsibility. Typically, dilating eye drops are used to make certain the best optical prescription is prescribed.                                                                                                                                               

2. Determine candidacy for the Performance Vision Centre – Vitalizing Vision and Performance, by completing a 2-hour Initial Assessment. This testing, which is completed on a Tuesday, is a critical appraisal of 12 visual sub-skills that goes far beyond the basic eye exam and 20/20 vision clarity; it assesses visual efficiency (eye focusing and teaming), reading eye-movements and visual information processing (VIP) skills.                                                                                                                                    

3. Initiate vision therapy if two or more of the 12 visual sub-skills tested are significantly below normal.  Depending on the number visual sub-skills below normal, vision therapy is scheduled over 2 or more Blocks (each Block is 6 weeks long). Patients interact with a vision therapist one or two-times per week (Monday and/or Wednesday) for 45-minutes per session. End-of-Block Evaluations are compared to the Initial Assessment findings to target the treatment for success. 

4. Support activities are essential for success. These supportive activities use specific software programs and custom eye-exercises. They are completed 5 times per week for 30 minutes.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  

Dr. Gall is an optometrist who cares for patients and is excited when they reach their potential and achieve success. From the beginning, Dr. Gall has offered vision therapy as an option for success. In 1993, Dr. Gall received his Doctorate in Optometry, and then in 1995, he received his Master of Vision Science in the area of binocular vision after which he started his practice. In 1999, he received his Fellowship from the American Academy of Optometry (FAAO). In the fall of 2010, he moved his practice to a larger facility and opened the Oakville Centre for Vision – Vision is the Difference with its four centres of excellence. Upon studying for two years, in 2015 Dr. Gall was awarded the Diplomate in Binocular Vision Perception & Pediatric Optometry (Diplomate BVPPO), and in 2018 Dr. Gall earned his Fellowship from the College of Optometrists in Vision Development (FCOVD), which all clearly demonstrates his desire for lifelong learning to provide advanced vision therapy and best patient care.

Dr. Gall’s Vision Therapist Team, led by Heather Dillon, play a vital role in caring for patients and motivating them to achieve success. Heather has a Bachelor of Arts degree, two designations of certified vision therapist (PVTAP, COVT) and over 10 years of experience with vision therapy. The Vision Therapy Team works closely with Dr. Gall while providing personalized vision therapy.

The philosophy of the Vision Performance Centre – Enhancing Vision and Its Connections, is based on the work of Drs. Mitchell Scheiman and Bruce Wick (Clinical Management of Binocular Vision, 4th Ed. 2014), Drs. Sidney Groffman and Harold Solan (Developmental & Perceptual Assessment: theoretical concepts and diagnostic testing. 1994) and Drs. Elizabeth Caloroso and Michael Rouse (Clinical Management of Strabismus. 1993) which are guiding references for any practice offering vision therapy.