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Eye Focusing & Movement Problems

Home » Eye Care Services » Pediatric Eye Exams in Hartsdale » Accommodative Dysfunction – Eye Focusing Problems

You may have difficulty focusing.
Vision Therapy can help by using a customized training program that teaches the brain and eyes to work together.


Weak accommodative facility refers to difficulty with visual focus. In a typical vision exam, a child may have clear 20/20 eyesight, but the exam usually does not require the child to sustain focus for an extended period of time or to shift focus quickly from far to near and back to far again.

The student may see the board clearly and see his paper clearly, but looking up and down, back and forth, from the board to the paper could be where the difficulty comes into play. If the focus mechanism in a child’s visual system is weak or not fully developed, the adjustment period as he looks from one point of sight to another will be slower than average, which can be challenging and frustrating.

What are saccadic eye movements?

Saccades are the earliest vision element to develop, and is used in reading to scan. It is the ability to quickly skip from one eye position to another. Saccadic deficiencies primarily effect the ability to read, causing slow reading, frustration from loosing place, and ultimately affects reading comprehension. Saccadic deficiencies are treated with vision therapy and have a great track record for success.

What are Pursuits?

Pursuits is the ability for the eye to track a fast moving object such as a fast moving ball. Our optometrist will assess the patients ability to track pursuits and recommend a vision therapy treatment program that will reteach this ability.


Having 20/20 vision may not be enough to properly see the board. Vision is a dynamic function and in order to see clearly we have to change the focus of our eyes every time we look from one object to another. Most people are not even aware that they have to focus their eyes. This is because in most people the focusing system operates so well that objects always instantaneously appear in focus. However, in reality a focusing adjustment is made every time we look from one object to another. This adjustment is made through the ciliary muscle or “focusing” muscle. For instance, when a child looks from the board to his desk, he must expand or contract this muscle, which changes the shape of the lens in the eye and allows the child to see the print in his book clearly. When the child looks back at the board he must now relax the focusing muscle which permits clear vision at a distance. A focusing problem occurs when the child is unable to quickly and accurately constrict or relax the muscle, or if he is unable to sustain this contraction/relaxation for adequate periods of time.


Four types of focusing problems can occur in children and young adults. A common problem occurs when an individual loses the ability to contract the focusing muscle for adequate periods of time. This is called accommodative insufficiency. A second problem occurs when the focusing muscle actually goes into a muscle spasm and is unable to relax. This is referred to as accommodative spasm. A third problem occurs when the focusing muscle over contracts when looking up close, also known as an accommodative excess. A final type of focusing disorder occurs when the child has difficulty with both contraction and relaxation of the muscle. This is referred to as focusing or accommodative in facility.


child having headache, Eye Doctor in Hartsdale, NY

People with that have focusing problems may complain of the following:

  • Eyestrain after reading for a short period of time
  • Headaches after reading for a short period of time
  • Inability to concentrate when reading
  • Short attention span
  • Rubbing or closing an eye
  • Words moving or swimming on the page
  • Good decoding skills, but poor comprehension
  • Blurry vision after reading or near work

Focusing problems which result in above mentioned symptoms have a significant impact on learning.

Unfortunately, most school vision screenings are only designed to detect vision problems which cause a lack of clarity. Very few school screenings test for focusing disorders.


There are currently two prime methods that are used to treat focusing problems. Sometimes eyeglasses alone can be prescribed to provide relief from the visual complaints associated with focusing problems. These glasses are usually prescribed for near visual tasks.

Often eyeglasses alone are insufficient to completely relieve focusing problems. Although glasses may provide some relief, the underlying problem and symptoms persist.

Vision therapy is a treatment approach that involves weekly office visits. During these visits the patient is given carefully selected and sequenced activities. The treatment is specifically designed to help the child reach efficient visual skills and eliminate visual complaints associated with the focusing problems.


Vision therapy is a specialized treatment program that works in a very similar way to physical therapy. A custom tailored training program is created to train the eyes and the brain to work together. Therapy is conducted both at home and at the practice using a variety of training tools such as lenses, computer programs, and special games. As the patient progresses the vision therapist will adapt the training to continuosly improve vision. Unlike glasses which fix a refractive error in the eye, vision therapy deals less with the eye and more with the interaction between the eye and the brain

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