Times Chronicle
June 20, 1990
Louis De Vicaris peers through a lens as he tries to make out letters and numbers on a swinging ball as technician Susan Maskin assists.
Some children, unfairly characterized as “unintelligent,” could be suffering from complex visual problems, two optometrists say. Glasses alone might not help. But vision therapy could.
Brendan was only in first grade when scholastic problems surfaced. By second grade he had fallen far behind in reading and no one could understand why. A standard eye examination had revealed a mild case of farsightedness, and he wore glasses to correct the condition. Still, he reversed letters and numbers, became frustrated and angry during reading group, and made no improvement with a reading tutor. The school psychologist determined that he was suffering from an “incipient learning disability.”
Brendan’s case is not unique, according to Dr. Arthur S. Seiderman, who cited the case in the book “20/20 Is Not Enough,” which he co-authored with Dr. Steven E. Marcus.
“My partner and I believe that good sight is not enough. A person must be able to make full use of his vision,” said Seiderman, who with Marcus has primary offices in Elkins Park and Valley Forge. The Doctors also work with other physicians in offices in Souderton, Pottstown, Frankford and Oxford Valley.
‘This country is 50 years behind the times in vision care,” said Seiderman. ‘The impact on society is enormous.” Visual problems are often ignored, he said, or labelled as learning disabilities, as in Brendan’s case. “Many people have the idea that certain learning problems can’t be helped, or will be outgrown,” said Seiderman, who holds a master’s degree in child psychology in addition to his doctor of optometry status. ‘The fact is that 73 percent of all kids with reading disorders have vision disorders. Many people think that if a child can pass the eye chart test, his vision must be fine,”
Not so, say Seiderman and Marcus, who is also a doctor of optometry and a sports vision consultant of the U.S. Olympic team. The doctors believe the standard eye chart is hopelessly outdated, putting the focus on sight, rather than vision. The difference between sight and vision is crucial, they put forth in their book, with sight a function of the eyes alone, and vision the interplay between the eyes and the brain. And since sight is our dominant sense, the importance of that interplay is magnified.
‘When children enter school good vision is crucial,” said Seiderman. “If they begin to fall behind because their eyes can’t properly focus together or their perceptual development is lagging, it can effect the rest of their lives.” Many such children will develop what Seiderman calls the “I can’t do it” syndrome, where a child becomes accustomed to failure, and thinks of himself as unable to learn. “A visual problem can lead to a learning problem, which in turn can lead to a psychological problem,” he said. Even as adults, many have made adjustments because of their visual deficiencies, such as choosing a profession that dosen’t require close work, or not driving at night.
Since children entering school must have a full dental exam, Dr. Seiderman is outraged that the eyes, which provide most of a child’s sensory perception, are tested by charts that haven’t been updated since the Civil War days.
But help is available, and Seiderman believes so strongly in vision therapy that he has set up an 800 number to refer patients from out of the Philadelphia area to the relatively few other doctors nationwide who are experts in the field. “Many parents are frustrated because they know their children are bright and no one can tell them why these children are doing poorly in school or being labeled unnecessarily,” said Seiderman. “It doesn’t have to be that way.”
As in Brendan’s case where Seiderman discovered that Brendan, like many other children, was unable to make his eyes work as a team–he couldn’t form the two pictures his eyes saw into a single image.
Seiderman and Marcus began Brendan on a course of vision therapy that consisted of 30 office sessions, plus home exercises. By the time he began third grade, his vision was normal and he was reading at grade level.
The vision therapy created by these two doctors, who between them have close to 50 years of experience in the field, consists of training the brain to send the right messages to the eyes until the process becomes second nature. Through the use of specially-designed lenses and prisms, a patient is presented with various visual situations that allow him to practice the correct responses.
After an initial visit costing $135, which includes testing, a report and consultation with either Seiderman or Marcus, a patient with visual deficiencies begins a course of treatment that usually lasts about six months, said Seiderman. Treatment is covered, he said, by most third-party insurance plans, except HMO. ‘We see an improvement in about 95 percent of our patients,” he said, “and a total cure is close to 80 percent. But it’s difficult to put a number on the psychological improvement that occurs in conjunction with visual improvement.”
And according to Drs. Seiderman and Marcus, the field of vision therapy is here to stay. Perhaps the underlying message of their book is that man is now asking his eyes to perform functions for which they were not designed, necessarily causing problems that will have to be addressed. “Until very recently in the history of man, we used our eyes mainly for long-distance sight, as in hunting. Now, within the past few decades, adults and children alike spend much of our time in front of computer terminals, concentrating on a small screen a foot in front of us.” And yet vision is almost ignored when compared to sight, he said.
In a country where every child entering school must have a complete dental exam, Seiderman is outraged that the eyes, which provide most of the child’s sensory perception, are tested by a chart that hasn’t been updated since the Civil War.
‘To the best of my knowledge, no learning occurs throughout school through a person’s molars.”
