Comprehensive Visual Evaluation

HOW LONG (MINUTES, HOURS) SHOULD A COMPREHENSIVE , LEARNING – RELATED VISUAL EVALUATION TAKE? WHAT VISUAL AREAS ARE BEING EVALUATED?

A. This type of evaluation will take at least one hour, usually closer to two hours long.

B. The visual areas that are evaluated include:

1. Visual acuity at far: The ability to see clearly at 20 feet.
   
   
2. Visual acuity at near: The ability to see clearly at the child’s reading distance. This distance varies from 7 inches to 16 inches, depending upon the length of the child’s forearm.
   
   
3. Ocular health: The internal and external health of the eyes. The eyes are routinely dilated to rule out any eye disease.
   
   
4. 21-Point Analytical Examination: This is a 20 – 25 minute “stress test” done on the visual system to determine whether or not the system can handle visual stress. It is analogous to the treadmill test that cardiologists use to evaluate heart function. Except we are evaluating visual function under a controlled amount of visual stress. (The task of reading is one example of visual stress.) In the Analytical Examination, we do not ask the child to read, but the child is asked to “run a marathon” with his visual system.
   
   
5. Eye movement control: there are 3 types that are evaluated.
   
   a. Steady fixation: The ability to aim the eyes accurately.
   
   b. Pursuits: The ability to follow a moving target with the eyes.
   
   c. Saccades: The ability to shift the eyes from one place to another.
   
   
6. Eye focusing test: The ability to adjust the focus of the eyes at different distances.
   
   
7. Eye coordination tests: The ability to use the two eyes together.
   
   
8. Keystone Visual Skills Test: This is a series of 9 visual slides that evaluates eye coordination (e.g., lateral posture, vertical posture, fusion, suppressions, and depth perception).
   
   
9. Developmental Eye Movement Test (DEM): This is a saccadic eye movement test that is done on a desk. It mimics the reading task.
   
   
10. Dyslexia Determination Test (DDT): This is a screening test for dyslexia. It screens for decoding skills deficits and spelling skills deficits.
    
    
11. Randot Stereopsis Test: A test for depth perception.
    
    
12. Monocular Estimate Method (MEM) Retinoscopy: This is a test used to determine a near point (reading lens) prescription
    
    
13. Children’s Vision and Learning Questionnaire (7 pages): This questionnaire gives us important information about the difficulties that the child is experiencing, prior treatments attempted, previous vision care, other professionals involved, etc. This questionnaire contains a visual symptoms checklist that helps Dr. Gushiken assemble all of the stated and unstated potential needs of the child and/or parents.
    
    
14. Parent Conference: After all of the above data are collected, our office will schedule a parent conference to go over the results and recommendations. This conference is usually scheduled a week after the evaluation.