Wednesday, March 5, 2014

Exophoria & Reading: Update

Two out of eight in this family need glasses. Mia has Exophoria and I'm nearsighted.

One of my past posts that still gets hits is the Exophoria & Reading post. I wrote about my daughter, Mia, and her struggles with reading, and how we came to find out that Exophoria was the reason behind the struggles. This is an update on how she is doing.

Exophoria is a condition that causes the eyes and brain to not work together very well when focusing up close--basically anything within arm's reach can be a struggle. At close range, the eyes want to focus outward and away from each other instead of "converging" as normal vision does, causing double vision and "jumping" of words and numbers on a page, the computer screen, etc. Though the eyes want to sort of  "drift" outward in focus, this is different from Exotropia (or Lazy Eye) where others can actually see the eyes drift outward. With Exophoria, the eyes don't physically drift. The only outward symptom Mia had was trouble reading and doing math homework.

Mia has been wearing glasses with prisms in them since August of 2012. They have really made a huge difference in her reading scores. During 4th grade, her scores were so low that we had to have her tested for a learning disability, but nothing showed up. The summer following 4th grade was when I finally clued in that it could be a vision problem and took her to see an eye doctor. Now in 6th grade, her reading scores are considerably better--almost at grade level.

This year we noticed a little backsliding in her reading ability, so I took her back in to the doctor. I wondered if she needed vision therapy (some Exophoria patients do). The doctor reassured me that she just needed an increase in her prism diopters. He explained that Exophoria cannot be corrected all at once, and if they tried, the patient would not be able to tolerate the amount of prism diopters necessary. So they start by correcting a small amount, and as the patient gets used to that correction and it isn't as effective, the prism diopters are increased. Kids usually need increases every so often, and at points of high demand on the eyes (such as studying in high school and then college). During adulthood, the prisms can often be reduced again.  Exophoria is not something you grow out of per se, it is something that is corrected incrementally and managed through life. The prisms can force and teach the brain how to focus the eyes together better, but the underlying problem doesn't go away. The prisms also help the eyes not to have to work so hard to maintain focus at closer ranges, cutting down on the eye strain someone with Exophoria experiences. Eye strain worsens Exophoria symptoms.

Since Mia needed more prism correction, she got to get new lenses, and since we're lucky enough to have good vision insurance, I let her choose new frames (pictured above). She didn't complain about that at all! 

For more on Exophoria, visit Optometrists Network: Children Special Needs and scroll down to the section on "Adequate Convergence." This is a great explanation!

Also, like my frames in the pic above? Check out Warby Parker. The concept is similar to Tom's buy a frame and another is given to someone in need. They have some great options, including single vision lenses, for $95. Not bad! My frames are the Nedwin in amber. Don't miss the "Home Try-On" option. I did it, and it works exactly as described. **Note: I'm not getting anything out of telling you about them--just sharing a good thing!


  1. Very interesting info. Thanks so much!

  2. How many prism diopters does she have in each eye now?


Anything to say?