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Struggling with Reading & Overall Learning Problems

learning at home 640×350During COVID-19, parents are challenged with the task of supporting their children’s studies as they contend with online classrooms and homework. We can certainly acknowledge our teachers have done a phenomenal job at adapting their classroom setting to a virtual one, but a struggling reader or learning problem is hard for a teacher in a remote setting to solve. So, the burden is placed on the parent’s shoulders to bear.

Fortunately, there are multiple avenues to take to help your child feel empowered and gain a better foothold with their online learning. By now, most parents have equipped their child with a fast internet connection, new computer, and quiet learning environment. What else is there left to do?

Encouragement & Support

As much as we’re all under a lot of stress, your child depends on your never-ending support & love. You don’t need to turn to gifts or money to make a child feel appreciated. A personal touch like their favorite snack, quality time, and compliments can go far with anyone.

Digital Eye Strain

Eye fatigue from excessive smartphone/computer usage isn’t unique to children — it affects everyone. Not only do our eyes need a rest from the computer, but digital devices reduce our blinking rate, which also results in dry eye symptoms. Take frequent breaks & stretch your eye muscles by looking out a window once in a while.

Did your child ever have a functional vision evaluation?

While a child who is really struggling at learning can require the help of an educational therapist or tutor, a key step to identifying what’s holding your child back in their studies is addressing their vision — 80 of learning is visual!

We often find children who have struggled in the classroom as “C” students because their vision was never evaluated by an optometrist who specializes in vision therapy.

If your child has an underlying vision problem, no amount of tutoring or work with other specialists will address or treat the problem effectively or at all.

We encourage you to contact The Exceptional Vision Therapy & Learning Center today for a vision therapy evaluation to assess if their vision is what has held them back from their studies.

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Lianne M. Pino, OD, FCOVD Becomes Fellow of the College of Optometrists in Vision Development

Dr. Pino Sports Vision Therapist in MiamiThe International Examination and Certification Board (IECB) of the College of Optometrists in Vision Development (COVD) has certified Dr. Lianne M. Pino of Miami, FL as a Fellow of the College of Optometrists in Vision Development (FCOVD).

The Fellow certification process serves to identify individuals through Board certification who are prepared to offer state-of-the-art clinical services in behavioral and developmental vision care, optometric vision therapy and vision rehabilitation.

To become a Fellow (FCOVD), the doctor must have graduated from an Accreditation Council for Optometric Education (ACOE)‐accredited institution or an international equivalency program; been in active clinical practice for at least three years, at least two of which have included the direct diagnosis and management of vision therapy patients; completed 100 hours of relevant CE or a relevant residency program; successfully completed the guided study portion of the process set forth by the International Examination and Certification Board (IECB), which includes three case reports and six open-book questions, as prescribed by the Fellowship Candidate Guide; and successfully completed the oral and written examinations according to the established criteria of the IECB.

About COVD

The College of Optometrists in Vision Development (COVD) is an international, non-profit optometric membership organization that provides education, evaluation, and board certification programs in behavioral and developmental vision care, optometric vision therapy, and visual rehabilitation. The organization is comprised of doctors of optometry, vision therapists, and other vision specialists. For more information please visit

About Lianne M. Pino, OD, FCOVD

Dr. Pino is a developmental optometrist board certified in vision development, vision therapy and vision rehabilitation.

Our own Dr. Pino in The Florida Villager: Vision and Learning


IN SCHOOL, 75 TO 90 PERCENT OF WHAT WE LEARN INVOLVES our visual system. About 25 percent of students struggle with their visual skills such as eye teaming, eye focusing, eye tracking and visual information processing. In the technological world that we live in now there is a high demand for us to use our visual skills. In addition, children and adults diagnosed with learning disabilities often, about 75 percent, have deficiencies with their visual skills. Vision is one of the most complex processes used in learning, therefore it is very important to have a comprehensive eye exam every year and, if there are symptoms and/or signs of visual skill deficits, seek further evaluation by a developmental optometrist.

People with learning related visual problems have to be assessed for more than just their refractive error (ex. nearsightedness, farsightedness and astigmatism) and their ocular health. There are 3 related areas in the visual functions. 1. Visual acuity, refraction and ocular health. This is evaluated in a comprehensive eye exam. 2. Visual efficiency. A person’s eye teaming, eye focusing and eye tracking skills. This is usually evaluated in a visual efficiency exam (VEE) by a developmental optometrist. 3. Visual information processing. This is the cognitive aspect of our visual skills. Some of these skills are figure-ground, spatial awareness, visual memory and visual-motor integration. These are evaluated in a visual perception evaluation (VEP) by a developmental optometrist.

At Exceptional Vision Therapy and Learning Center (EVTLC) we provide developmental eye exams that evaluate both a person’s visual efficiency and visual information skills. We can also perform comprehensive eye exam next door at Exceptional Vision. Our goal at EVTLC is to alleviate the symptoms and signs so a person can concentrate on learning and not the visual discomfort they are experiencing. We can help alleviate these symptoms by using lenses, prisms and/or vision therapy. With these tools we focus on improving and remediating a person’s visual efficiency and visual information processing.

Often you see people with reading difficulties have co-existing visual and language processing deficits. The best way to approach these deficiencies is in a multi-disciplinary approach to address their needs. Children who exhibit visual skill deficiencies begin to have problems when they begin school. They may have reading, mathematics, writing, spelling, comprehension, sports, playground and/or social difficulties. Unresolved visual deficiencies can cause people an inability to respond fully to their educational needs.

These are a few of the signs and symptoms you may see when someone has a visual skill deficit:

  • Complains of blurred vision;
  • Rubs eyes frequently;
  • Squints; Closes or covers one eye;
  • Occasionally sees double;
  • Able to read for only a short time;
  • Poor reading comprehension or Eye coordination problems.

Numerous research and studies have demonstrated the effectiveness of vision therapy. Vision therapy is not only for children, adults can also benefit from vision therapy. You don’t “outgrow” visual skill deficiencies. Often time’s people are labeled dyslexic or attention deficit before having their visual skills evaluated for a possible contributing factor to their learning disability. Post-traumatic brain injury patients can also exhibit these visual skill deficiencies. These deficits can be remediated with vision therapy to aid people overcome and best manage these learning disabilities.

florida villager article

Florida Villager Article by Dr. Lianne Pino: How Vision Therapy Helps Struggling Students

slideshow vision therapy1

ONE OUT OF FOUR CHILDREN STRUGGLE WITH reading and learning unnecessarily because of undiagnosed vision problems, making vision therapy a simple and effective tool in helping children (as well as adults) overcome these obstacles to perform everyday tasks more easily and efficiently. But what is vision therapy and how does it work? Dr. Lianne Pino is a Developmental Optometrist dedicated to treating children and adults with visual skill deficiencies and founder of the Exceptional Vision Therapy and Learning Center in Palmetto Bay. Offering treatment on a wide range of conditions, including Amblyopia (or “lazy eye”), Learning-Related Visual Disorders (ADHD, Dyslexia), post traumatic rehabilitation (concussions, TBI) and occupational hazards (computer vision syndrome). The center screens patients via a developmental eye exam before creating a program to treat the issue. We spoke with Dr. Pino to learn more about her center, including what to expect from a session, insurance coverage and signs you or your child may be in need of vision therapy.


Vision therapy sessions include procedures designed to enhance the brain’s ability to control eye alignment, eye movements, focusing ability, and eye teamwork. The visual skills are developed through the use of specialized computer and optical devices, including therapeutic lenses, prisms and filters. Throughout the vision therapy process, a person maximizes their visual skills to become more effective in school, at work, or on the playing field.


Like many skills, visual skills are developed. Therefore, they can generally be improved through proper therapeutic techniques. In vision therapy, the doctor prescribes visual tasks to be practiced under controlled conditions with the direction of a vision therapy technician. Repetition of these tasks enhances vision by coordinating and improving eye movements, focusing ability, eye teaming, eye-hand coordination and visual information processing skills.


Weekly office visits are combined with daily home exercises to practice the skills learned in the therapy room. A typical program will last a few months, although the total duration can vary based on the nature and complexity of the condition, the age and motivation of the patient, as wells as other factors.


While each insurance plan is different, they do at times reimburse for the evaluation. After the evaluation we can provide you with the information you need to give to your insurance company to help in determining benefits. Our office will assist you as best we can.


There are many but some of the common signs could be anything from rubbing eyes frequently or complaints of blurred vision. If your child closes or covers one eye or frequently loses their place when reading, those can also be signs that you may want to look into further.

Villager April 2017

March Is Brain Injury Awareness Month

March is brain injury month. Eyesight is the human brains most sophisticated sensory system. About 50 percent of brain injuries demonstrate visual skill deficiencies. There are two types of brain injury: traumatic brain injury (TBI) such as concussions and acquired brain injury (ABI) such as cerebrovascular accident or stroke. Visual symptoms exhibited include blurry and/or double vision, eye fatigue, headaches, loss of visual field, visual perception (visual spatial, figure ground, etc.) difficulty and eye tracking difficulty. Many of these visual symptoms can be treated and alleviated with vision therapy.

Patients who acquire double vision (diplopia) after brain injuries can have a paralysis of a nerve controlling the eye muscle, gaze restrictions from the mechanical stress of trauma or decreased eye teaming ability. Often prisms, lenses and/or vision therapy/rehabilitation can be used to improve a patient’s eye teaming ability by improving their compensating vergences (ability to turn eyes in or out). Worst case scenarios where patients cannot improve their eye teaming ability, occlusion is used to suppress one of the images.

In visual field defects patients are blind in certain field of views. Often, they can use prisms to shift the image in the effected field of view to scan the target. In vision therapy or rehabilitation, the patient can be taught how to scan that image and then shift their central vision to view it in more detail.

Brain injury patients can also have a visual balance disorder. An example of such is Visual Midline Shift Syndrome (VMSS). This can cause brain injury patients to have difficulty with eye tracking skills (oculomotor dysfunction). Difficulty controlling their eye fixation, pursuits (smooth eye movements) and/or saccades (jump eye movements) are often present. Lenses, prisms and vision therapy/rehabilitation can be used to alleviate symptoms.

Developmental Optometrists can greatly help in the rehabilitative process of the brain injury patient. If you or someone you know has had a brain injury and is experiencing visual discomfort, call us to make an appointment for a developmental eye exam. We will assess the visual skills discussed above and, if needed, create a vision therapy/rehabilitation program to improve the visual discomfort.