Often parents will bring their children in for a comprehensive eye exam because they are concerned about the reading development of their child. They rightfully want to know if a visual problem is interfering with development of proper reading.

When evaluating an adult or child who has concerns about reading ability, there are several visual skills that I evaluate. These including clarity of sight, eye teaming, eye focusing, and eye movements. I have several ways to evaluate eye movements. Some of these tests rely on observation of eye movements; some tests involve timing the accuracy of read material.

I now have an additional method that I am very excited about. The Visagraph III™ is a computer-based system for measuring eye movements while reading. Through the use of infrared sensors, an individual’s eye movements are recorded while he or she silently reads an appropriate text selection while wearing special goggles. Following the reading, a brief series of questions determines whether or not the subject reads with reasonable comprehension.

In addition to analysis of specific types of eye movements, I look at the overall path the the eyes take when the patient reads.

For example, a good reader will have a nice, even “stair-step” pattern from left to right with a smooth return to the left that is symmetrical for the right and left eye. The image below is from a real patient who reads well above grade-level:

But a person who has poor eye movement skills when reading will show lots of uneven movements both left and right as they go back to re-read certain words. They will also have irregular movements when the eye movements are not symmetrical.  This could occur due to eyestrain, focus problems, or problems using the eyes as a team. The image below is from a patient that reads well below grade-level.

This test is important to perform both during the initial evaluation and again at the end of therapy, if any has been provided. That way, I have a comparison to determine the level of progress that has been achieved and how much this mirrors the improvement that patients and parents report in reading skill.

If you or your child appears to have reading skill that is well below what you think it should be, a complete visual evaluation is in order. There may not be a vision issue impacting reading performance, but if there is, it should be corrected as early as possible.

Be Well!

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

You may have heard the rumors, and they are true!

We are excited to announce our newest offering of luxurious and exclusive eyewear, Tiffany & Co. These sunglasses and                 ophthalmic frames are beautiful to view and fun to wear. Most frames are adorned with Swarovski crystals or sterling silver  Tiffany & Co. logos, that truly make them stand out. All Tiffany & Co. frames come with a signature little blue box, an authentic Tiffany & Co. case, and a cleaning cloth. As with all of our frames, they come with a two-year unconditional breakage warranty, which includes the crystals.

Many of our patients want eyeglasses that are beautiful and unique – after all, what other necessary “accessory” do you wear every day? This is the first time that Tiffany & Co. has produced eyewear, and we are happy to be among the first to offer these frames to our patients. If you would like to try on something special, please stop by. No appointment is needed.

The evidence continues to support what optometrists have known for years: it is possible to improve amblyopia (lazy eye) beyond childhood years. It is faster and easier to treat at younger ages, but can be treated at any age.

If you’d like to read about this latest study on adult amblyopia treatment, click here.

If you are an adult with amblyopia and have been told that it is too late to be treated, call us for an appointment and, after evaluation, we can discuss what type of benefit you might receive from treatment.

Be Well!

Nathan Bonilla-Warford, OD

Bright Eyes Family Vision Care

Located in the Westchase area of Tampa.

In the spirit of making Bright Eyes News and Updates a two-way means of communication, I have created a new category called Ask Dr. Nate. This is your chance to ask any questions you may have about eye disease, vision, infant & child vision, contacts, or other eye-related questions. You can either submit them as comments to this site or them to askDrNate@brighteyestampa.com. I’ll do my best to answer in a timely manner.

Please be aware that on this site, I will not be able to make any diagnoses or recommend specific treatment. What I can do is provide general information that pertains to the question and provide links and information that I hope will be useful.

So now I’ll just sit back and wait while the questions flood in…. ;^)

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

In 2003 I completed my contact lens externship. It was a chance to see how contact lenses helped a variety of patients in different settings. The majority of these patient encounters were relatively routine in that I was determining the contact lens that provided the patient with clear vision. Some people simply needed a modification of their current contact lens prescription, some were having difficulty with their contacts for astigmatism, and others were experiencing multi-focal contact lenses for the first time.

But there were also some special patients that were trying something that at the time was new and exciting: Precise Corneal Reshaping (PCR). Although it goes by many names, including orthokeratology, PCR is the wearing of a reshaping lens (similar to rigid gas permeable contact lens) during sleeping hours to mold the cornea and eliminate the need for daytime glasses and contacts.

When orthokeratology was first created in 1962, it was rather crude and unpredictable. The process was refined over time but it has only been in the last 5 years that we have seen a tremenedous increase in both scientific studies and utilization of PCR. In 2002, Corneal Refractive Therapy ™ (CRT) by Paragon was the first modern system to receive FDA approval. In those days there were very few practitioners doing CRT and I was lucky enough to have this expereince early on.

In the last year I have been asked several times if I am still providing this service. Well, after some work and investment in equipment, I am happy to announce that Bright Eyes Family Vision care is now offering PCR for eligible candidates! We are the only eye care office in Westchase and one of the few in Tampa to offer this service.

Who is an eligible candidate? Well, the procedure can correct myopia (nearsightedness) with or without some astigmatism. It is approved for all ages and is reversible, so it can be prescribed for kids and teens as well as adults. Since PCR changes the shape of the cornea, candidates must have healthy eyes and corneas that will respond to the treatment. Through a series of tests, such as computerized corneal topography, I can determine whether or not a patient will be a good candidate. Because not everyone is a candidate, we are offering the PCR Pre-Evaluation at no charge. This also gives patients (and parents) a chance to ask questions before deciding on the procedure.

PCR will be a great vision correction option for active adults – no worries about contacts while swimming, biking, playing sports, etc. It will be great for kids and teens – no worries about breaking glasses or losing contacts, since the reshaping lenses stay at home and are only worn at night.

In time, I will write about some of the latest research about PCR slowing the progression of myopia, but if you have any questions, you can always call the office for a patient information packet. You can also attend one of the seminars that I will be offering on November 8th, and 15th. Call 813-792-0637 for more information.

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.