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.
Feel free to fill out and Print the checklist below
| Yes | No | |
| Frequent headaches | ||
| Eyes frequently red | ||
| Double vision | ||
| Closing or covering one eye | ||
| Eyes tire easily or hurt | ||
| Holding reading close | ||
| Tilting head while reading | ||
| Losing place while reading | ||
| Pointing to keep place on page | ||
| Words moving on page | ||
| Poor reading comprehension | ||
| Focus changes while reading | ||
| Getting drowsy while reading | ||
| Purposely avoiding reading | ||
| Difficulty completing work on time | ||
| Reversing letters/numbers | ||
| Difficulty with spelling | ||
| Poor handwriting skills | ||
| Short attention span | ||
| Blurry vision- far away | ||
| Blurry vision-close up | ||
| Focusing is slow from near to far (or far to near) | ||
| Discomfort during or after computer work | ||
| Poor general coordination | ||
| Motion sickness | ||
| Sensitivity to light | ||
| Color vision problems | ||
| Wearing an eye patch | ||
| Visual therapy |
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