Advance Vision Therapy of Regina (Located inside Advance Eye Care Center)

At Advance Vision Therapy Regina, Dr Myles Bokinac has a special interest in developmental optometry. In our office he offers in-depth vision assessments (also known as Developmental Optometry Assessments, Binocular Vision Assessments). These assessments are designed for children who are having difficulties in school or who are struggling with learning. This may specifically be difficulties with reading, math, memory, attention, learning, visual versus verbal performance, reversals of letters/numbers, etc….

Dr. Bokinac will also work closely with Educators, Educational Psychologists, Resource Teachers, Occupational Therapists and Speech Pathologists to provide inter-disciplinary co-operation in the diagnosis and treatment services for those with Vision-Related Learning Problems.

It is often assumed that a routine eye examination, will always detect any and all vision and eye conditions that may be present. This assumption is mistaken. Learning is 80% visual. Vision problems often contribute either directly or indirectly to difficulties learning in school. Proper diagnosis and treatment of these vision problems will often resolve or improve the learning problem. Many common visual deficiencies that may interfere with learning will not be detected during a routine eye examination. In these cases where an underlying vision problem is suspected, an in-depth visual assessment should be performed. In-depth visual assessments include thorough assessment of Visual Efficiency and Visual Information Processing layers of the Visual Pyramid, in addition to the Visual Integrity testing.

visualpyramidVisual Integrity

Visual Integrity includes factors impacting clear sight, eye health, refraction and visual acuity. It is the foundation of the Visual Pyramid and also the foundation of vision and the routine eye examination. For residents up to age 18 years, Medicare in Saskatchewan pays for what is known as a ‘Refraction’ and ‘eye health assessment’, which essentially tests Visual Integrity. A typical routine eye exam tests only the Visual Integrity level of the Visual Pyramid, including treatment and referral when required.

Visual Efficiency

Visual efficiency involves how the eyes move and interact with one another as a team. It includes Accommodation (or focusing), Ocular Motility (or eye tracking) and Binocular Vision (or eye teaming). This component often requires specialized investigation and treatment. With few exceptions, Medicare in Saskatchewan does NOT pay for thorough Visual Efficiency assessment or treatment. A typical routine eye examination does NOT generally include comprehensive non-refractive assessment of Visual Efficiency.

Visual Information Processing

Visual Information Processing involves visual perception which can be defined as the capacity to interpret or give meaning to what the eyes see. The definition includes recognition, insight, and interpretation at the higher levels of the central nervous system of what is seen by the eye. In other words, is what is seen by the eye being properly interpreted by the vision centres in the brain? This vast functional area can be further subdivided into various subsets such as Visual Spatial, Visual Motor Integration and Visual Analysis. Visual Information Processing also requires specialized investigation and treatment. In most cases, Medicare in Saskatchewan does NOT pay for Visual Information Processing assessment and treatment. Similarly, a typical routine eye examination does NOT generally include comprehensive non-refractive assessment of Visual Information Processing.

The point of these distinctions is very important because Visual Efficiency and Visual Information Processing deficiencies are present in about 15% of the population and can have a significant impact on reading and school performance. This is why detecting and treating these deficiencies is critical in young people during the period when they are learning to read. This does not understate the value of Visual Integrity Examination. After all, it is the foundation of the Visual Pyramid. However, it illustrates how easily some eye problems can be overlooked in a Visual Integrity Examination. This explains how an eye problem can be suspected by a parent or teacher BUT the vision report from the provider says ‘their eyes are fine’. A more accurate description would be ‘their Visual Integrity was fine’. If thorough Visual Efficiency and Visual Information Processing tests were not performed, these problems, of course, will not be detected. Reading and learning problems often involve healthy eyes but will show issues in the Non-Refractive components of the Visual Pyramid―Visual Efficiency and Visual Information Processing.

These assessments generally take 60-90 minutes

Visual Information Processing

Visual Information Processing involves visual perception which can be defined as the capacity to interpret or give meaning to what the eyes see. The definition includes recognition, insight, and interpretation at the higher levels of the central nervous system of what is seen by the eye. In other words, is what is seen by the eye being properly interpreted by the vision centres in the brain? This vast functional area can be further subdivided into various subsets such as Visual Spatial, Visual Motor Integration and Visual Analysis. Visual Information Processing also requires specialized investigation and treatment. In most cases, Medicare in Saskatchewan does NOT pay for Visual Information Processing assessment and treatment. Similarly, a typical routine eye examination does NOT generally include comprehensive non-refractive assessment of Visual Information Processing.

The point of these distinctions is very important because Visual Efficiency and Visual Information Processing deficiencies are present in about 15% of the population and can have a significant impact on reading and school performance. This is why detecting and treating these deficiencies is critical in young people during the period when they are learning to read. This does not understate the value of Visual Integrity Examination. After all, it is the foundation of the Visual Pyramid. However, it illustrates how easily some eye problems can be overlooked in a Visual Integrity Examination. This explains how an eye problem can be suspected by a parent or teacher BUT the vision report from the provider says ‘their eyes are fine’. A more accurate description would be ‘their Visual Integrity was fine’. If thorough Visual Efficiency and Visual Information Processing tests were not performed, these problems, of course, will not be detected. Reading and learning problems often involve healthy eyes but will show issues in the Non-Refractive components of the Visual Pyramid―Visual Efficiency and Visual Information Processing.

These assessments generally take 60-90 minutes

Vision Therapy

Advance Vision Therapy Regina uses the In-Depth Visual Assessment as a tool to diagnose your child’s visual concerns and then can determine the best course of Vision Therapy to treat these problems. Vision therapy can take on many forms from home therapy to in-office therapy or a combination of both. Vision therapy may be aimed at improving eye-muscle function such as eye-tracking, eye-focusing or convergence or maybe aimed at Visual Information Processing deficiencies such as issues with visual sequential processing, visual processing speed, subitizing, visual memory and more…

A new therapy available at Advance Vision Therapy Regina is called Syntonics. Some patients who struggle with learning have a reduced “functional” visual field. This is the awareness of what the eyes see in the peripheral vision – this is different than the pathological visual field that affected by eye disease. Syntonics is application of a specific wavelength of light to the eyes to expand awareness of the peripheral “functional” visual fields. This expansion in the visual fields helps make vision better for learning and makes the eyes more responsive to other conventional vision therapy. Syntonic therapy has been shown beneficial for many other conditions as well including Autism, ADHD, amblyopia and Traumatic Brain Injury.