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Our Developmental/Functional Vision Checklist

It is always important to ask the right questions.  Understanding a person’s visual history is the first step to providing the help they need.  This checklist helps people begin to see how the visual process is involved in the problems they are having.  People are often unaware of the role that the visual process plays in how they perform certain tasks.  When these connections can be made, it is easier for people to understand the benefits of behavioral optometry.  The conditions on this checklist are usually amenable to treatment with therapeutic lenses and/or vision therapy.

Yes No
Frequent headaches b1 b1
Eyes frequently red b1 b1
Double vision b1 b1
Closing or covering one eye b1 b1
Eyes tire easily or hurt b1 b1
Holding reading close b1 b1
Tilting head while reading b1 b1
Losing place while reading b1 b1
Pointing to keep place on page b1 b1
Words moving on page b1 b1
Poor reading comprehension b1 b1
Focus changes while reading b1 b1
Getting drowsy while reading b1 b1
Purposely avoiding reading b1 b1
Difficulty completing work on time n1 n1
Reversing letters/numbers n1 b1
Difficulty with spelling b1 b1
Poor handwriting skills b1 b1
Short attention span b1 b1
Blurry vision-  far away b1 b1
Blurry vision-close up b1 b1
Focusing is slow from near to far (or far to near) b1 b1
Discomfort during or after computer work b1 b1
Poor general coordination b10 b10
Motion sickness b10 b9
Sensitivity to light b8 b7
Color vision problems b6 b5
Wearing an eye patch b4 b3
Visual therapy b2 b1

Contact Dr. Gallop for more information about behavioral optometry, vision therapy or how you did on this checklist.

To find a behavioral optometrist near you go to OEPF.org