Optometric Extension Program Foundation, Inc.
1921 East Carnegie Avenue, Suite 3-L
Santa Ana, CA 92705

(714) 250-8070
(714) 250-8157 - FAX

 June 20, 1998

Mr. and Mrs. Peter Elliott

18 Daws Hill Lane

High Wycombe. Bucks. HP11 1PW

GREAT BRITAIN

Dear Mr. and Mrs. Elliott:

RE: David Elliott
DOB: 14/04/85

The following are observation made during the optometric visual screening performed in London 6/3/98. Only a complete developmental optometric work up can rule out pathology, determine refractive error, AND evaluate visual performance skills, such as eye focusing, teaming, pointing and following, and vision perception. A list of behavioral optometrists specialising in vision development is included in this report to aid you in finding a professional who can perform this comprehensive examination.

1. David's vision and medical history were noted, with good health at this time, and esotropia infrequently with fatigue. The glasses he wears for far sightedness help him maintain fusion. Parents have no concerns. David is developmentally at the third grade level.
2. External eye health appears normal, with epicanthal folds and Brushfield spots noted.
3. Internal health insofar as could be viewed without dilation appears normal.
4. Pupils were reactive to light and focusing.
5. David appears to have moderate hyperopia (farsightedness), with astigmatism, about equal in the two eyes.
6. Light House Cards revealed acuities of: Right 20/20 (20/10 at 10 ft.) Left 20/30 (20/15 at 10 ft.)
7. David's eyes did follow the movement of a target of interest with both eyes and head over a short distance. He grasped the target with a pincher grip.
8. David could maintain fusion while a target was brought to his nose. He maintained fusion, using both eyes on the target at all times in all fields.
9. Targets brought from the periphery caught his attention within the normal range for age and condition. While the demonstrated range seems smaller than normal, my observation is that this is due to a delay in changing visual attention, not a retinal defect/ other observations.
10. Formal measurements of stereopsis (depth perception) yielded 100 seconds of arc.
11. Form Puzzles were performed visually (vs. tactilely). a higher level of development.

As I explained to you, Mr. and Mrs. Elliott, basic visual skills needed for efficient information gathering and processing can be developed and improved through optometric vision therapy making David more available to the classroom teacher. The reduced acuity and loss of eye alignment can also be very successfully treated with vision therapy. Surgery is always a very last resort.

David is a delightful child, bright and alert I highly recommend finding a behavioral optometrist who will work with you in guiding his visual development. When an appointment is made, the office should be notified of his special needs. Then the optometrist can be prepared to spend extra time, (even an extra visit, if necessary), to establish rapport and get the needed findings.

Please do not allow atropine to be used in your child's eyes. If you should have any questions, please feel free to call me at the number above.

Warm regards,

Anne R. Barber, O.D.

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