Individuals with Turner syndrome (TS) are more susceptible to vision problems than the general population. Vision challenges can affect almost every part of a person’s life. Since May is Healthy Vision Month, let’s look at some common vision issues and how they can be treated.
Healthy Vision & TS
You know the saying: “the eyes have it.” This is so true. But what can you do when you or your loved one is struggling with doing ordinary things like reading, driving, taking notes, or walking up stairs? Do you or someone you love have vision problems? They can greatly affect your daily life, but there are ways to address them.
For people with TS, it is especially important to have early and regular eye exams. Multiple vision issues are found in about 35% of those with TS. It is recommended that individuals with TS receive a comprehensive ophthalmological (eye) examination between 12 and 18 months of age or at the time of diagnosis, with emphasis on early correction of eye refractive errors.
Early detection and correction of refractive errors are vital to prevent vision loss in patients with TS
by an MD, not an optometrist) should be part of the regular physical examination.
Of all the major components that make up your vision, visual acuity may be the one that you are most aware of. Visual acuity is the most common clinical measurement of how your eyes function. It’s usually one of the first tests taken during a comprehensive eye exam, to determine how sharp your vision is.
If someone has 20/20 vision, it means they can see the same
amount of detail from 20 feet away as the average person. If someone has a visual acuity of 20/40, they can see the same amount of detail from 20 feet away as the average person would see from 40 feet away. Lacking visual acuity can affect a person’s life in many ways:
- Reading and writing: The print may be too blurry or small to read or take notes of something far away or close by.
- Recognizing faces: It can be hard to tell someone’s distinguishing features from a distance; and
- Driving: It can be hard to see obstacles, cars, signs, and other objects far away.
Hyperopia (far-sightedness) and myopia (near-sightedness) are prevalent in 40% of people with TS.
In addition to visual acuity, visual discrimination is also a major component that makes up your vision. It helps you tell objects apart, especially when there are subtle differences between them. For example, let’s assume that you are trying to sort four forks. They all have the same shape, but two forks are a slightly different color than the other two. Visual discrimination would point out that because of the different color, those two forks would belong to a different group.
Having problems with visual discrimination could cause you to have difficulty with tasks like:
- telling the difference and similarities between objects like coins, making it hard to do tasks like using money;
- matching clothing when doing tasks like sorting laundry (e.g., matching socks); and
- taking medicine, since it’s easy to get the medications and their prescribed amounts confused.
Another major component that makes up your vision is depth perception–the ability to see the world within three dimensions:
length, width, and depth. This helps you determine where an object is in your environment’s space and how far away it is from you or other objects. If someone is having trouble with depth perception, they may have trouble with tasks like:
- pouring liquids and putting objects from one area of a spatial environment to another by judging distances, making tasks like cooking and eating difficult;
- walking and driving, since not being able to judge distances and how objects relate to the spatial environment makes it easy to get too close or too far from objects, like curbs; and
- dressing and grooming, since it can be hard to tell how far grooming tools (which can be hot or sharp) or clothing are from your body.
Sometimes there is an abnormality of the neuromuscular (including brain) control of eye movement. Less commonly, there may be a problem with the actual eye muscles. Strabismus (“crossed eyes,” or any misalignment of the eyes) and amblyopia (commonly referred to as “lazy eye”) can occur in one-third of TS patients.
Eye misalignment can cause amblyopia in children when the eyes are oriented in different directions. The brain receives two different visual images and may ignore the image from the misaligned eye to avoid double vision. This can result in poor vision development of that eye. Also, an eye that sees poorly can become misalinged. Treatment may involve eye glasses, eye
How To Lessen the Effects of Vision Problems
These vision problems, and others, can affect people like you or your loved one in different ways and compound other problems relared to TS. Here are some tips to help overcome vision challenges:
- Play vision-based board and card games.
- Do mazes, word searches, and other puzzle challenges to practice vision-based skills.
- Practice reading and writing skills.
- Search on the Internet for websites like Eye Can Learn to do vision exercises and games.
- Most importantly, consult with an occupational therapist and opthamologist, who can help you or your loved one with vision issues
There are many components to vision that impact you or your loved one’s daily life. The good news is that there are interventions that can help. Seeing an occupational therapist and opthamologist so they can give you personal treatment and recommendations is the most important one!
Want to learn more about the other major components that make up your vision, how they can affect your life, and how you can improve these components? Check out our webinar recording The Impact of Vision on Daily Safety and Function, presented by presenter Dr. Meghan Edwards Collins, OTR/L, CAPS. Dr. Edwards Collins is an occupational therapist who has been an associate professor in the occupational therapy (OT) Department at Winston-Salem State University (WSSU) in North Carolina since 2011. She is particularly interested in OT for visual deficits caused by TS.
To view the webinar and learn more about Dr. Collins Edwards:
Written by Elizabeth Rivera, former TSF Blog Content Coordinator, and edited by Susan Herman, TSF Blog Coordinator.
© Turner Syndrome Foundation, 2022
Thank you for explaining how visual acuity is one of the first tests taken during an eye exam. My daughter has been wondering what kind of tests will be done to check her eyes. I’ll have to share this with her so she’s prepared for her first eye exam.
Thank you for your feedback, Olivia! So glad this information was helpful, and best of luck to your daughter. Please check out our other resources at http://www.TurnerSyndromeFoundation.org.
Susan Herman, Blog Coordinator
Thats why we should campaign eye exams routine, maybe for 1-2 years once. Thank you for sharing Sherman and Elizabeth