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Grace Wee provides remediation guidance for Lily    Photo: ACBO

Behavioural optometrist Grace Wee is guiding Lily to improve her vision. Lily is one of 11 patients who are undergoing vision therapy with funding from the Susan Larter Vision Trust.


By Grace Wee


Lily was a lively four-year-old when she had her first eye examination in December 2013 at Grbevski and Associates Optometrists in Rockdale, New South Wales. She had failed the vision screening at her preschool and this prompted her mother to bring her in for a full vision examination.

Prior to the examination, the only sign her mother had noticed was that Lily was always rubbing her eyes.

Lily was found to have moderate latent hyperopia and mild bilateral amblyopia, and her best corrected visual acuity in each eye was 6/15, borderline at 6/12 with the LEA shape chart.

She also had problems with tracking, prominent lag in accommodation and remote near point accommodation, making it hard for her to sustain her attention at close distance activities for long periods. Her Randot stereopsis was 100 seconds of arc. A starting prescription of +2.00 DS was given as her first pair of spectacles to correct the hyperopia.

Along with spectacles, patching and home vision activities were also given to improve Lily’s vision. When she returned for a review, her visual acuity had improved to 6/9. Her mother found it difficult to get Lily to consistently keep up with the home activities.

When her vision started regressing to 6/12, I recommended that Lily commence the in-office vision training program so I could closely provide remediation guidance. The program comprised four weeks of home therapy and 10 weeks of in-office vision therapy.

Lily also had esenophilic oesophegitis which routinely required medical attention and treatment. This made it difficult for Lily’s mother to afford the full training program.

With the financial assistance of the Susan Larter Vision Trust, Lily commenced her comprehensive vision therapy program in September 2014.

Comprehensive testing also showed reduced functional fields, which measure how much of the world each eye can visually attend to at once, as opposed to a pathological field loss.

After two weeks of home therapy, Lily’s functional fields expanded and her visual acuity dramatically improved to 6/7.

We are now half-way through her in-office program and she is making further progress in her ocular motilities, accommodation and stereopsis. Her eye movements and fixations are more accurate, and improvement in her stereoacuity shows that both eyes are switched on and teaming well. It will be exciting to see the results when the program has finished.

Grace Wee is a member of Optometry NSW/ACT and the Australasian College of Behavioural Optometrists.

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