• Sight / Vision: what does this mean?

    Parents often ask what the difference is between Sight and Vision:


    Sight makes up a very small percentage of a person’s Visual system, approximately 8 – 10 %. The majority of Optometrists test one’s ability to see, this is referred to as your Visual Acuity which is measured as 6/6 or 20/20 acuity. South Africa uses the metric system therefore: at a 6 meter distance from your eyes, a specific size target (there are various types of targets that Optometrists use e.g. letter/number/picture, will have a specific size which is referred to as a size 6. As such 6 divided by 6 (6/6) equals 100%. Therefore one see’s 100% at distance. The same format is used for near targets. This would then refer to near sight.

    Michele and Donovan are Behavioural and Developmental Optometrists, therefore: they test a person’s Sight as well as a person’s Visual Skills. Visual Skills make up 80 – 82 % of the Visual System. This is why patients (of all ages) are referred to this practice for a Binocular and Visual Evaluation.

    The majority of children evaluated in this practice have a 100% sight ability, but there Visual Skills have not developed sufficiently for the close related work or activities they are expected to be doing for their age group (due to Developmental delays), OR: they started working on near range activities that result in: too much, too close to their eyes and for too long at too young an age. E.G. Computers, Tablet, I-Pad, cellular phones.

    Visual Skills:

    These are the basic mechanical skills of the visual system which makes up the 80 – 82 % of the working visual system.

    Visual skills refer to: Eye movement ability, Eye teaming ability, Focus ability.

    Deficiencies or difficulties with Visual skills are more often associated with learning problems, concentration difficulties, excessive blinking, copying incorrectly from a board, tiredness in or around the eyes especially when reading, writing, studying, doing art’s and crafts or working with technology. Complaints or awareness of blurring when ‘looking’ at something.

    Eye movement difficulties are most often noticed as: Skipping or re-reading words, numbers or letters. A child may use their finger to guide their eyes when reading. Losing one’s place often when reading, reads the large words but misses the short words. Moving one’s head in order to read and if asked to keep the head still, the reading becomes jerky.

    Eye teaming difficulties become obvious when a person complains of seeing blurred or double. When writing,reading or drawing, one eye is covered or the person lies down on one arm – effectively compensating by only using one eye when working. One eye is noted to turn inwards, outwards, up or down. The person tilts or turns their head to one side. They may complain of words ‘swimming’ ‘jumping around’ on a page when reading or writing.


    Vision is the dominant sense.  80% of what is learned throughout life occurs through the Visual system. The remaining 20% is made up of the other senses: Movement and Balance, Auditory, Taste, Smell and Touch. In order to have Vision, one would have to have good visual skills and be able to see well. Only then will we be able to process the visual information, understand what we are looking at, thereafter will our brain direct movement/read/write/catch a ball/play sport etc: as triggered by light that was originally received in the eye.

    The human brain is a masterpiece. Our brain directs our body in that we see, speak, taste, feel, hear and smell via our brain. Therefore: Your children and family members are all masterpieces so teach them well they are all precious.

    Frequently asked questions:

    • Would reduced visual skills cause school problems?     Yes, but if your brain has suspended one eye (a compensation mechanism to stop blur or double vision) you might be coping very well with your school work or after school studies and work. At some stage, symptoms will appear which will result in a deterioration of your abilities.
    • Could young adults also have reduced visual skills? Yes: especially when the person makes excessive use of technology. Eye teaming becomes fatigued, headaches, blur of near range work, distance areas are blurred when suddenly looking up. Tired eyes and/or red eyes.
    • What can one do to resolve the unstable visual skills? Visual therapy is the only way to establish a flexible and sustainable visual system. In some cases when a visual system was previously stable but due to various reasons [such as: head injury following an accident (motor vehicle or motor bike)(falling from a high area)(Stroke)(Parkinson’s)(Any form of closed head injury which we refer to as a Traumatic Brain Injury)] has now become unstable, visual therapy will be required to re-establish visual skills.
    • Can difficulties with Visual skills be corrected by using spectacles instead of working through a visual therapy program?                                                   Unfortunately not. I will use the following analogy: When you first rode a bicycle, you fell off on numerous occasions, until: your brain, Vestibular system in the inner ear for balance and movement, and your visual system was able to guide your eyes to maintain direction, had all worked together as a team before you could ride without falling off and hurting yourself. That took many months of training.                                           The visual system is no different, it takes time to learn to see and learn to become a stable binocular system being able to sustain any activity expected of the visual system for any length of time. Therefore: if for whatever reason the visual system is not stable, the only way to get it right is to teach it what to do, therefore spectacles are no better than crutches. We might loan or hire them out to you for the purpose of visual therapy, but only 5% of cases that have been seen in my practice will end up with Spectacles. I would like to see the human body working as it is designed to function without ‘crutches’ (spectacles).
    • Does an unbalanced visual system or difficulties with visual skills happen in a family?                                        Yes, I have seen this in very many cases over the years. In the past, pupils and students did not like to read, they preferred outdoor activities. A good percentage of those youngsters were labelled as Juvenile Delinquents, Dyslexic, Minimal Brain Dysfunction and in recent years labels such as ADD or ADHD have appeared. Please don’t misunderstand that which I am referring to: I am not saying there are not such cases, and I am not referring inaccurate diagnoses, but in the majority of cases that Donovan and I have seen over very many years: once we established or re-established good visual skills in our patients, there school work, concentration and behaviour in a class room, substantially improved. They could then continue with Occupational therapy to re-balance the entire body and remedial therapy to teach the areas they had missed in order to continue (in the future) without difficulty.
    • I have worked through a visual therapy program before, but I seem to have problems again. I don’t want to have to go through another 3 months of therapy, what now?                                                                  Your current difficulties may well be due to excessive near range activities which causes difficulties with the focus mechanism. Also: in many cases, during puberty we see an imbalance in the visual system.   Lastly if there has been excessive use of near range technology over a period, this would also cause an imbalance.                                               These difficulties are easily rectified, depending on where they are in the visual system, which usually takes between 2-3 weeks of top up therapy to be resolved. Compare the top up therapy to Physiotherapy, quick (2-3 weeks) treatment.
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