Functional Vision Evaluation


A Functional / Developmental Vision Evaluation is an essential part of a comprehensive multidisciplinary approach to a child's developmental or academic struggles. Our doctors collaborate with other professionals in providing this important visual component. After an evaluation, therapeutic activities are prescribed. Many of these activities can be integrated within existing therapies or school programs, with progress monitored via Internet systems and occasional office visits.

Our doctors make extensive use of internet-based software, and at-a-distance coaching systems offering students / families effective therapeutic practice at home, which saves considerable time and resources over more traditional office-based programs (office-based therapy is available too).


A functional vision evaluation is different than an ordinary eye exam. A child that is struggling developmentally or academically, or a child that is receiving physical, occupational, or speech therapy should have a functional vision evaluation to assess vision issues that could be present. A functional vision evaluation looks at issues such as:

  • Two eye coordination / Binocular Skills / Lazy Eye
  • Focusing Skills Near and Far
  • Eye Tracking / Eye Hand / Vision & Vestibular / Visual Motor Skills
  • Integration of vision with other sensory and motor skills
  • Visual Perception / Visual Information Processing / Cognitive & Thinking Skills
  • Visual Attention / Vigilance / Comfort & Efficiency with near activities
  • Visual Emotional / Awareness of Social Cues / Perceptual Anxieties / Behavioral Issues

Interdisciplinary Collaboration

A Functional-Vision-Evaluation begins with a survey of your child's functional/developmental profile. That is, what are your child's current struggles, developmental & medical history, as well as abilities and strengths. The survey also explores existing therapies and professionals involved in your child's care. The survey is not about vision specifically, but about all aspects of your child's development and learning. Vision issues might relate to some of your child's struggles without the connection being obvious. Our doctors knowledge and experience can identify connections between possible visual issues and your child's struggles. This survey may also help identify non-visual issues that may need support from other professionals.

A Functional-Vision-Evaluation gathers vision testing data that can lead to a profile of visual skills deficits and/or diagnoses as well as visual strengths. It is a much more extensive battery of tests than a routine eye exam. A Functional-Vision-Evaluation looks in detail at binocular two-eye coordination, eye tracking, and focus flexibility skills. It usually also involves visual perceptual processing tests. It may involve technologies such as eye-tracking goggles or stereoscopic instruments. It may involve observations of your child in a therapy room performing visual-motor activities while wearing various combinations of lenses or prisms. It may involve observations while your child is receiving other therapies such as occupational, speech, or physical therapy. It may involve more than one visit to complete.

The most important part of the Functional-Vision-Evaluation is the presentation of the findings and assistance in making decision for next steps. Our doctors perform tests that provide useful information on what can be done next to improve your child's visual skills and overcome deficits. Now he will discuss the findings and provide you with a variety of treatment options. Options for treatment can include one or more of the following:

  • Integration of visual development goals and activities into your child's current therapies and collaboration with your current therapists (such as occupational, speech, or physical therapy)
  • Individualized vision therapy appointments in-clinic.
  • Home-based vision therapy assignments and activities monitored via the Internet.
  • Specialized Visual Skills or Vision-in-Reading home-based curriculum programs.
  • No treatment needed. Return to your regular eye doctor for routine eye examinations.


Q: What is the difference between a Functional-Vision-Evaluation and the eye exam at my regular eye doctor?

A: Regular eye exams usually look at eye optics (need for eyeglasses) and eye health (disease) and usually only screen for the presence of functional issues. Time with the eye doctor averages about 15 to 30 minutes. The exam is usually billed to vision insurance. If the doctor finds functional issues they often refer the patient to a Functional/Developmental Optometrist. Our doctors specialize in the area of the Functional-Vision-Evaluations. A Functional-Vision-Evaluations may include checks of eye optics and eye health, but includes all of the details described previously. The evaluation may take two to three hours of the doctor's time involved in testing, consultation with parents, writing reports, and communicating with other professionals. Functional-Vision-Evaluations are usually billed to major medical insurance. Patients seeing one of our doctors for functional vision issues will usually continue to see their regular eye doctor for regular eye health checkups.

Q:Who should have a Functional-Vision-Evaluation rather than a regular eye exam?

A:Regular eye exams are important to make sure no eye disease or eye optics issues are present, however, a child may "pass" their regular eye exam, with healthy eyes, 20/20 vision, and no need for eyeglasses, but still have serious functional vision issues impacting development, life functions and learning. Therefore, if your child is doing well developmentally and academically and you only want to know if they need eyeglasses and have healthy eyes then schedule a regular eye exam with your family eye doctor. On the other hand, if your child is struggling developmentally and/or academically, or if your child is involved with other therapies or tutoring, or has an IEP at school, then a Functional-Vision-Evaluation is recommended.

Q: My child just had a regular eye exam, can he/she still receive a Functional-Vision-Evaluation?

A: In most cases, yes. The Functional-Vision-Evaluation is billed to major medical insurance, not vision insurance. But you may need a referral from your Primary Care Physician depending upon your insurance plan. Contact your insurance plan to be sure.

Q: Will the Functional-Vision-Evaluation determine if my child needs eyeglasses?

A: YES. Eyeglass prescriptions are common for functional vision issues. Eyeglasses are not always prescribed just for sharp vision, but may also be prescribed to help with eye coordination, focusing, or other visual skills. Eyeglasses may also be used therapeutically with periodic lens changes over the course of therapy. Our doctors will write the appropriate eyeglass prescription but do not have an optical lab and frame shop. You can return to your regular eye doctor to purchase your eyeglasses.


Vision is much more than 20/20. A 20/20 "vision report card" does not mean your child has no functional vision issues, in fact, most children with functional vision issues have 20/20 visual acuity.

Visual skills are essential for child development and learning. 80% of what we learn comes through vision.

The majority of children in therapy programs such as physical, occupational, or speech therapy have at least mild, if not more serious functional vision issues.

Vision Screenings at school do not screen for or identify any functional vision concerns. Eye exams by an eye doctor are recommended by the American Optometric Association at 6 months, 2-3 years, and yearly starting at Kindergarten. A Functional Vision Evaluation should be considered if there are any developmental or academic concerns affecting your child.

Functional Vision Evaluations are usually billable to Major Medical Insurance, not vision care insurance.

You can still go to your regular eye doc tor for basic eyeglasses exams and eye health checks. Even if your child just had a regular eye exam, a Functional Vision Evaluation can still be completed and will look at different issues and answer different questions.

When visual issues are found, treatment can take place integrated within physical, occupational, or speech therapy. Homework programs are also available. If more serious issues are found, specialized clinic based vision therapy is available.

For more information about Vision Evaluations, or to make an appointment, please call (800) 410-1356.