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The Eye Exam: More than 20/20!
20/20 vision is important. Seeing 20/20 means that the person can clearly see a standard-sized letter on the eye chart. But there's so much more to healthy vision than having 20/20 vision. 20/20 is just the starting point!
Our comprehensive vision exam goes beyond 20/20 to evaluate many important visual skills with specific vision tests:
· Complete ocular health evaluation - We examine the eyes inside and out to make sure that they are completely healthy. Eye drops to dilate the pupils are used ensure a thorough evlauation for such problems as cataracts, glaucoma, hypertension, diabetes, tumors, etc.
· Visual Acuity at Near - Is vision clear and single at close distances? Clear sight at short distances is critical to reading, writing, close work, computer use, etc.
· Eye Teaming Skills - Do the two eyes aim, move, and work as a coordinated team? If not, numerous difficulties, including convergence insufficiency and poor depth perception can result. A Binocular Visual Evaluation may be necessary to determine the underlying problem.
· Eye Focusing Skills - Do the eyes maintain clear vision at all distances? Rapid, automatic eye focus adjustment is critical to learning, reading, writing, sports, etc. Deficiencies can cause visual fatigue, reduced reading comprehension, and/or avoidance of close work or other activities. A Binocular Visual Evaluation may be necessary to determine the underlying problem.
· Eye Movement Skills - Do eye movements show adequate muscle control, tracking, fixation, etc.? In the classroom, normal eye movements allow rapid and accurate shifting of the eyes along a line of print or from book to desk to board, etc. In sports, efficient eye movements contribute to eye-hand coordination, visual reaction time, and accurate tracking.A Binocular Visual Evaluation may be necessary to determine the underlying problem.
Specialized Visual Evaluations
The binocular vision evaluation - This in-depth evaluation will determine how efficiently the patient uses their eyes. Eye tracking, eye focusing, eye movement testing, and how well the eyes work together are all carefully evaluated and this information will indicate what type of treatment is necessary. This evaluation usually takes an hour and includes Visagraph III testing
The visual information processing evaluation - This specialized evaluation uses standardized pencil and paper type tests to determine how well the patient makes sense of what the eyes see. Several processing skills that are used for reading are evaluated. This usually takes an hour and is scheduled the same day as the binocular vision evaluation.
The strabismus evaluation - This evaluation will determine how often and how much the eye turns and what impact this eye turn has on daily life. This evaluation usually takes an hour.
The consult - After a binocular vision evaluation or a visual information processing evaluation a detailed report of the findings and recommendation will be written. A time will be set aside to discuss this report and ensure that the patient or parent has full understanding of the recommendations and any questions can be answered. This evaluation usually takes between 30 minutes and an hour.
Vision Therapy
Vision Therapy is an individualized one on one program of therapeutic activities designed to correct visual efficiency and/or visual perceptual deficiencies. Vision Therapy sessions include procedures designed to enhance the brain's ability to control eye alignment, eye teaming, eye focusing, eye movements, and/or visual processing.
Visual-motor skills and endurance are developed through the use of specialized computer and optical devices, including therapeutic lenses, prisms, and filters. During the final stages of therapy, the patient's newly acquired visual skills are reinforced and made automatic through repetition and by integration with motor and cognitive skills.
Although children most commonly undergo vision therapy, it may help adults with visual challenges as well. Vision therapy can help with:
· Poor Binocular Coordination - Vision Therapy helps individuals develop normal coordination and teamwork of the two eyes (binocular vision). When the two eyes fail to work together as an effective team, performance in many areas can suffer (reading, sports, depth perception, eye contact, etc.).
· Learning-related Vision Problems - Vision Therapy can help those individuals who lack the necessary visual skills for effective reading, writing, and learning (i.e., eye movement and focusing skills, convergence, eye-hand activity, visual memory skills, etc.).
· Strabismus and Amblyopia - Vision Therapy programs offer much higher cure rates for turned eyes and/or lazy eye when compared to eye surgery, glasses, and/or patching, without therapy. The earlier the patient receives Vision Therapy the better, however, recent research has shown that patients can be treated well into adulthood.
· Stress-induced Visual Difficulties - 21st century lifestyles demand more from our vision than ever before. Children and adults in our technological society constantly use their near vision at work and at home. C.V.S. (Computer Vision Syndrome) is one of the fastest growing health concerns in the workplace today. Environmental stresses on the visual system (including excessive computer use or close work) can induce eyestrain, headaches, and/or visual difficulties that can be effectively treated with corrective lenses and/or Vision Therapy.
· Visual Rehabilitation for Special Populations - Vision can be compromised as a result of neurological disorders or trauma to the nervous system (such as, traumatic brain injuries, stroke, whiplash, developmental delays, cerebral palsy, multiple sclerosis, etc.). Vision Therapy can effectively treat the visual consequences of trauma (including double vision).
· Sports Vision Improvement - Strong visual skills are critical to sports success. Not much happens in sports until your eyes instruct your hands and body as to what to do! Accurate vision and athletic visual skills can be measured, developed, and enhanced through Vision Therapy. We can measure and successfully improve eye-hand coordination, visual reaction time, peripheral awareness, eye teaming, focusing, tracking, and visualization skills (to mention just a few).
Vision Therapy can be the answer to many visual problems.
You can read about Dr. Bonilla-Warford's personal experience with vision therapy and other information on the Bright Eyes News and Updates. You can also read some of the success stories from vision therapy here. And please don't hesitate to contact us with your questions.
Precise Corneal Reshaping
Precision Corneal Reshaping (PCR), also known as Orthokeratology, makes us of a personally designed therapeutic lens worn during sleeping hours to reshape the front surface of the eye without permanently altering its physiology – giving you ultimate control and flexibility of your vision correction option.
Unlike traditional contact lenses, the shaping lenses do not have a correcting prescription. The rigid lenses gradually reshape the front surface of the eye, allowing you to focus clearly. You simply wear the reshaping lenses at night and take them out in the morning. The result is clear vision the whole day.
This treatment is an option for children and adults. In fact there is new scientific research that indicates that these lenses may not only temporarily eliminate nearsightedness, but may actually reduce its development.
You can download our PCR brochure or go to Bright Eyes News and Updates for more information.
Make life without glasses and daytime contacts a reality. Ask if Precise Corneal Reshaping is right for you today! Check out the happy responses from PCR patients here.
Contact Lenses
To be successful, contact lenses must provide the necessary comfort, vision, and health for your lifestyle. We have been fitting specialty contact lenses for years and have seen some incredible changes in that time. By far the most exciting changes have occurred in the last few years.
One of the most exciting areas in contact lenses is improvements in Multifocal contact lenses that allow one to see far and near without glasses. We offer the with both Wave and Synergeyes lenses.
Optical Showroom
We have a diverse selection of high-quality eyeglass frame for the entire family. We feature names such as Tiffany and Co., Coach, Gucci, Prada, Nike, Disney Princess, and Fischer Price, among others. We sell only the best lenses, such as Varilux progressive lenses, and coatings such as Crizal Alize anti-reflective coating. If you need specialty eyewear such as sports goggles or snorkeling masks, we can provide them with or without prescription power.
Our optical laboratory has the latest in equipment to not only fabricate your glasses, but to maintain and repair them should they become broken or damaged. Our highly qualified staff are able to adjust and fit your glasses to you for extended comfort and vision.
We stand behind the quality eyewear we sell:
OUR 2 YEAR FRAME WARRANTY: We provide an unconditional 2-year breakage warranty on all regularly-priced frames at no additional charge.
FREE ADJUSTMENTS AND REPAIRS: All frames need occasional maintenance. Come by anytime for free adjustments, including screws and nose pad replacements.
SECOND PAIR SAVINGS: Receive a 20% discount on a second pair of glasses purchased within 90 days. Prescription sunglasses and computer glasses also qualify for this discount.
Sunwear
In Florida, having the proper protection from the ultra-violet rays of the sun is a must! We offer the very best sunglasses. From Costa del Mar to Prada and Gucci, you can find the sunglasses that give you the comfort you want, the ultra-violet protection your eyes need, and the look you love. Most of our sunglasses can be made either with or without prescription power.
Eye Infections & Injuries
Our office provides emergency services for eye infections and eye injuries. Please call our office at 813-792-0637 during office hours or Dr. Bonilla-Warford's cell phone 813-469-2366 after hours or on weekends. Our staff will work with you to schedule an appointment as soon as possible. State of the art microscopes allow us to examine the front surface of the eye and facial areas around the eye for infection or injury. After assessing the extent of the injury or infection, a treatment plan will be formulated and explained to you. Treatment may include medications and supportive care. Follow-up visits to monitor your recovery will be scheduled as needed.
Infant Vision
Because Dr. Bonilla-Warford feels proper visual development is so important, he participates in the InfantSEE program from the American Optometric Association. Under this program, any infant between the ages of 6 and 12 months will receive a thorough visual and ocular health evaluation at no charge. Contact us for more information. You can also read more about Infant Vision and watch a video about Infant eye exams at on Bright Eyes News and Updates.
Your baby has a whole lifetime to see and learn. But, did you know your baby also has to learn to see? As a parent, there are many things that you can do to help your baby's vision develop. First, proper prenatal care and nutrition can help your baby's eyes develop even before birth.
During the first four months of life, your baby should begin to follow moving objects with the eyes and reach for things, first by chance and later more accurately, as hand-eye coordination and depth perception begin to develop.
To help, use a nightlight or other dim lamp in your baby's room; change the crib's position frequently and your child's position in it; keep reach-and-touch toys within your baby's focus, about eight to twelve inches; talk to your baby as you walk around the room; alternate right and left sides with each feeding; and hang a mobile above and outside the crib.
Between four and eight months, your baby should begin to turn from side to side and use his or her arms and legs. Eye movement and eye/body coordination skills should develop further and both eyes should focus equally.
You should enable your baby to explore different shapes and textures with his or her fingers; give your baby the freedom to crawl and explore; hang objects across the crib; and play "patty cake" and "peek-a-boo" with your baby.
From eight to twelve months, your baby should be mobile now, crawling and pulling himself or herself up. He or she will begin to use both eyes together and judge distances and grasp and throw objects with greater precision. To support development don't encourage early walking - crawling is important in developing eye-hand-foot-body coordination; give your baby stacking and take-apart toys; and provide objects your baby can touch, hold and see at the same time.
From one to two years, your child's eye-hand coordination and depth perception will continue to develop and he or she will begin to understand abstract terms. Things you can do are encourage walking; provide building blocks, simple puzzles and balls; and provide opportunities to climb and explore indoors and out.
Pre-School Vision
During the infant and toddler years, your child has been developing many vision skills and has been learning how to see. In the preschool years, this process continues as your child develops visually guided eye-hand-body coordination, fine motor skills and the visual motor skills necessary to learn to read.
As a parent, you should watch for signs that may indicate a vision development problem, including a short attention span for the child's age; difficulty with eye-hand-body coordination in ball play and bike riding; avoidance of coloring and puzzles and other detailed activities.
There are everyday things that you can do at home to help your preschooler's vision develop as it should.
These activities include reading aloud to your child and letting him or her see what you are reading; providing a chalkboard, finger paints and different shaped blocks and showing your child how to use them in imaginative play; providing safe opportunities to use playground equipment like a jungle gym and balance beam; and allowing time for interacting with other children and for playing independently.
By age three, your child should have a thorough optometric eye examination to make sure your preschooler's vision is developing properly and there is no evidence of eye disease. If needed, your doctor can prescribe treatment including glasses and/or vision therapy to correct a vision development problem.
Here are several tips to make your child's optometric examination a positive experience: 1) Make an appointment early in the day. Allow about one hour. 2) Talk about the examination in advance and encourage your child's questions. 3) Explain the examination in your child's terms, comparing the E chart to a puzzle and the instruments to tiny flashlights and a kaleidoscope.
Unless your doctor of optometry advises otherwise, your child's next eye examination should be at age five. By comparing test results of the two examinations, your optometrist can tell how well your child's vision is developing for the next major step...into the school years.
School-Age Vision
A good education for your child means good schools, good teachers and good vision. Your child's eyes are constantly in use in the classroom and at play. So when his or her vision is not functioning properly, learning and participation in recreational activities will suffer. The basic vision skills needed for school use are:
- Near vision: The ability to see clearly and comfortably at 10-13 inches.
- Distance vision: The ability to see clearly and comfortably beyond arm's reach.
- Binocular coordination: The ability to use both eyes together.
- Eye movement skills: The ability to aim the eyes accurately, move them smoothly across a page and shift them quickly and accurately from one object to another.
- Focusing skills: The ability to keep both eyes accurately focused at the proper distance to see clearly and to change focus quickly.
- Peripheral awareness: The ability to be aware of things located to the side while looking straight ahead.
- Eye/hand coordination: The ability to use the eyes and hands together.
If any of these or other vision skills is lacking or not functioning properly, your child will have to work harder. This can lead to headaches, fatigue and other eyestrain problems. As a parent, be alert for symptoms that may indicate your child has a vision or visual processing problem. Be sure to tell your optometrist if your child frequently:
- Loses their place while reading;
- Avoids close work;
- Holds reading material closer than normal;
- Tends to rub their eyes;
- Has headaches;
- Turns or tilts head to use one eye only;
- Makes frequent reversals when reading or writing;
- Uses finger to maintain place when reading;
- Omits or confuses small words when reading;
- Consistently performs below potential.
Since vision changes can occur without you or your child noticing them, your child should visit the optometrist at least every two years, or more frequently, if specific problems or risk factors exist. If needed, the doctor can prescribe treatment including eyeglasses, contact lenses or vision therapy.
Remember, a school vision or pediatrician's screening is not a substitute for a thorough eye examination.
Eye Diseases: Cataracts, Glaucoma, Diabetes
Cataracts: The natural lens in the eye gradually becomes less clear as we get older. When opacities develop in the lens and the lens gets too hazy, vision will be impaired. Our office can diagnose and manage cataract care. When the cataract affects the vision to the extent that you cannot read or see distant objects comfortably, we will recommend cataract surgery. Our office co-manages with cataract specialists that are proven experts in cataract surgery. Cataract surgery can provide you with a bright new world of vision.
Glaucoma: Glaucoma gradually destroys the optic nerve tissue in the back of the eye. The greatest danger of glaucoma stems from the fact that the disease is painless and without obvious symptoms until significant damage has occurred. The most common cause is from pressure being too high inside the eye, but vascular disease and other diseases can also cause glaucoma. We always monitor for glaucoma during routine eye examinations. Tests include checking the pressure of the eye, screening for peripheral vision defects and analyzing the appearance of the optic nerve. If you are diagnosed with glaucoma, we typically prescribe medications that lower the eye pressure. Most forms of glaucoma are successfully treated with eye drops. Laser treatments and eye surgery are secondary treatments that offer alternative ways to treat more advanced glaucoma.
Diabetes: Diabetic patients should have a dilated retinal examination each year. Laser treatments have proven to slow the progression of retinal eye disease for many patients. Diabetes often stimulates the growth of new blood vessels in the back of the eye, which ultimately leak and damage the retina. If this condition is discovered early, laser treatment can destroy these vessels. We have the latest instruments used to detect changes in the back of the eye. If we discover advancing diabetic eye disease that can be treated or needs further evaluation, we will refer you for consultation and further testing to a board certified retinal specialist.
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