For our Optometric & Ophthalmologic Colleagues

Here are some common visual findings to be on alert for that support a referral to Vision & OpticNeuro Care:

Oculomotor dysfunction

  • Inaccurate fixation, pursuits and/or saccades
  • Symptom provocation during fixation, pursuit and/or saccade testing
  • Resistance to supraduction or mild asthenopia in certain fields of gaze
  • Subtle (or not so subtle) extra-ocular muscle incomitancies

Binocular dysfunction

  • Excessive blinking or symptom provocation during Cover Test—especially when the phoric posture appears to be small
  • Vertical heterophoria, or inconsistent small vertical heterophoria measurements
  • Reduced stereopsis
  • Unstable or poor fixation disparity
  • Convergence insufficiency
    • Reduced or effortful NPC, especially on repeated trials, and/or reduced NPC recoveries
    • Asthenopia or rejection observed during NPC testing
  • Convergence excess, divergence insufficiency, or divergence excess
  • Acute onset strabismus
  • Positive response to sectoral binasal occlusion
  • More exophoria suggested in phoropter than in free space (e.g. during Cover Test)
  • Asthenopia or rejection observed during NPC testing
  • Asthenopia or rejection observed during NPC testing

Accommodative dysfunction

  • Reduced amplitudes, BCC/PRA/NRA, and/or accommodative facility (monocular or binocular)

Other neurological signs

  • Visual motion hypersensitivity
  • Failed or symptom-provocation during vestibular-ocular reflex testing
  • Visual midline shift (or egocentric spatial localization shift)
  • Subtle physiological anisocoria
  • Observed head turn or tilt
  • Excessive light and/or sound sensitivity
  • Comes in wearing sunglasses, ball cap, earplugs and/or walking sticks

Prescribing difficulties

  • Visual symptoms remain (or even worsen) despite correcting for the ametropia and/or prescribing plus at near
  • Difficult adapting to multifocal lenses or monovision

For a greater understanding of what we do from the personal  experiences of our patients follow the link below: