March 21, 2019
March 21, 2019

Binocular What?

WORDS: Dr. Paige G. Laudicina

Kids spend much of their time in school, so I wanted to put out a reminder on the importance of eye exams. I want to introduce and discuss a topic that I believe to be both undervalued and under-examined – binocular vision.

Binocular vision means using the two eyes together to create a single, clear, and comfortable image for the viewer. It is very important for a child (and an adult!) to have adequate binocular vision, in order to be efficient in their school work. It is also important to mention that binocular vision is not assessed during vision screenings and can only be measured through a comprehensive eye exam.  

One of the first components of a patient’s binocular vision we examine, is the ability to converge the eyes. Convergence is the act of bringing the two eyes together while looking at something up close (think “crossing your eyes”.) It’s crucial the eyes do this well, for someone to read or do homework for an extended period of time.

Without adequate convergence, someone might get very tired while reading, experience a headache, or may even experience double vision, or the perception that words and letters are moving around on the page. How distracting! Once diagnosed, certain glasses and/or vision therapy exercises can help improve and sustain convergence.

Another element to assess in binocular vision is a patient’s ability to accommodate, or “focus” their eyes. When we look to the distance, our eyes should be relaxed, but when we look at things close to us, it requires eye muscles to engage. It’s important these muscles work efficiently and rather effortlessly to provide clear and comfortable vision for the individual. Accommodative insufficiency is a term that describes weak focusing muscles and is commonly treated with reading glasses.

Lastly, it’s important to examine what we call a phoria, or the eye’s natural resting position. In an ideal world, a person’s two eyes would point in exactly the same direction and move fluidly together, as we view the world around us. However, it’s quite common for the eyes to turn inwards or outwards, slightly. In small amounts, this is normal and easily compensated for, and the viewer will have no symptoms.

In other cases, one eye can drift too far in or out, and the viewer may experience uncomfortable vision, and possibly double vision. To improve this, we sometimes prescribe glasses with prism. Prism reduces the amount of effort the eyes must expend, to maintain a single, clear, and comfortable image.

It’s also important to evaluate a phoria to prevent a condition called amblyopia, more commonly referred to as “lazy eye”. If an eye develops a tendency to turn inward or outward too often, one eye may become visually impaired due to lack of use. It’s imperative to diagnose and treat amblyopia while a child is still young, as it gets significantly more difficult, and perhaps impossible, to correct after the visual system is fully developed, around age eight or nine.

This may seem like a lot of information to digest, but fear not. At Eye Center, Inc., your child will receive a very thorough eye exam. We assess the possible need for glasses or contact lenses, evaluate the binocular system, and examine the health of the ocular anatomy. We will make absolutely certain your child has the best vision possible to succeed in this school year, and those to follow.

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