GVG Johns Creek


Dr. Daniel Gottlieb




Amblyopia ("lazy eye"): A visual defect that affects approximately 2 or 3 out of every 100 children in the United States.  Amblyopia involves lowered visual acuity (clarity) and/or poor muscle control in one eye.  The result is often a loss of "3D" vision and binocular depth perception.  Vision therapy can benefit this condition, but early detection is very important.  For many years, it was thought that amblyopia (lazy eye) was only amenable to treatment during the "critical period."  This is the period up to age seven or eight.  Current research has conclusively demonstrated that effective treatment can take place at any age, but the length of the treatment period increases dramatically the longer the condition has existed prior to treatment.  Research has also demonstrated that patients with amblyopia are more likely to sustain injuries resulting in the loss of the good eye than individuals with two good eyes.  This condition is one of the many reasons that early childhood eye examinations are essential.

Astigmatism: Is a visual condition that occurs when the front surface of your eye, the cornea, is slightly irregular in shape.  This irregular shape prevents light from focusing properly on the back of your eye, the retina.  As a result, your vision may be blurred at all distances.

Behavioral Optometrist: Behavioral optometrist spend years in post-graduate, continuing education to master the complex visual programs prescribed to prevent or eliminate visual problems and enhance visual performance.  Not all optometrists practice behavioral optometry, which includes developmental and functional optometry.

Binocular Depth Perception: A result of successful "3D" vision; the ability to visually perceive three dimensional space; the ability to visually judge relative distances between objects; a visual skill that aids accurate movement in three-dimensional space. A new book writtten by Dr. Susan Barry, Fixing my Gaze, speaks to the triumph of experiencing binocular depth perception.

Binocular Vision: Vision as a result of both eyes working as a team; when both eyes work together smoothly, accurately, equally and simultaneously.

Binocular Vision Disability: A visual defect in which the two eyes fail to work together as a coordinated team resulting in a partial or total loss of binocular depth perception and stereoscopic vision.  At least 12% of the population has some type of binocular vision disability.  Amblyopia and strabismus are the most commonly known types of binocular vision disabilities.

Convergence: Turning the eyes toward each other to look at near objects (words at reading distance), and maintaining eye alignment comfortably and efficiently over time (attention span). Dr. Gottlieb lectures on convergence insufficiency (problems with convergence) and also has conducted screenings for convergence problems.

Eye-Hand Coordination Problems:  Eye-hand coordination problems are noted as a lack of skill in drawing or writing. Paper work shows poor orientation on the page and the child is unable to stay within the lines when coloring. Often the child will continue to be dependent on his or her hand for inspection and exploration of toys or other objects.

Eye Movement Problems: The information obtained by the child will be reduced if eye movements are slow or clumsy, if the eyes jump, "stutter" or lose their place on instructional materials.

Eye Teaming Problems: While our eyes are supposed to work as a team so that they perform as one, this teaming is not guaranteed by design. It must be acquired through use during the preschool years and not all children adequately develop this skill. It can interfere with learning, especially in the areas of comprehension and spatial relations.

Field of Vision: The area over which vision is possible, including motion, relative position of objects in space, contrast and movement sensitivity in side vision (reading from line to line without getting lost on the page).

Fixation: Aiming the eyes or shifting rapidly from one object to another (reading from word to word on a line).

Form Perception: organizing and recognizing visual sensations as shapes, noticing likes and differences (the difference between was and saw, that and what, 21 and 12, � and O, e and o).

Glaucoma: In its most common form, glaucoma results from sustained elevated internal eye pressure and can cause severe loss of vision. Glaucoma will result in loss of peripheral (side) vision, faded images, and reduced contrast. Probably no other eye disease is more appropriately termed the �sneak thief of sight� than glaucoma. Glaucoma is the leading cause of new cases of blindness in this country.  Heredity and race have an influence on glaucoma.  OPEN-ANGLE GLAUCOMA, the most common variety, rarely causes any symptoms and often goes unnoticed until the peripheral vision loss is severe and permanent. In advanced stages, impaired side and central vision with decreased sight acuity are noted.  Another type of glaucoma called LOW or NORMAL TENSION GLAUCOMA is prevalent when normal-to-low pressure is present.  In this case, as well as chronic open angle cases, the eye cannot maintain adequate blood circulation, which can result in damage to the optic nerve, loss of peripheral vision, and reduced sight.  Glaucoma is a complex condition requiring lifelong extensive care and monitoring. At Gottlieb Vision Group we meet the challenges of diagnosing, monitoring and treating glaucoma.

Hemianopia: Defective vision or blindness in half of the visual field.  Patients suffering neurological insult frequently have visual field loss.  The visual field loss is often times to the right or left, involving one half of ones vision (i.e. a hemifield). When the visual hemifield loss, because of the neurological cause, is equal in the right and left eyes, this is known as a homonymous hemianopsia.  The visual field loss can also be constricted, or within one small area of the visual space. It may be a complete loss of the vision in the affected field, or it may be a relative loss of sensitivity. Visual field loss, or a loss of "sight" in a portion of the visual field, and visuospatial neglect, also known as visual hemi-inattention, may occur separately or in conjunction with each other.

Hyperopia: Farsightedness, or hyperopia, as it is medically termed, is a vision condition in which distant objects are usually seen clearly, but close ones do not come into proper focus.  Farsightedness occurs if your eyeball is too short of the cornea has too little curvature, so light entering your eye us not focused correctly.

Myopia: Nearsightedness, or myopia, as it is medically termed, is a visual condition in which near objects are seen clearly, but distant objects do not come into proper focus.  Nearsightedness occurs if your eyeball is too long or the cornea has too much curvature, so the light entering your eye is not focused correctly.

Neglect: Visuospatial neglect results in a clinical picture similar to visual field loss. However, neglect is different from a visual field loss, in that the brain areas that support sight are intact. The patient with visuospatial neglect has intact sight, but has suffered a perceptual loss of vision, and cannot "see" the objects in the neglected hemifield, because they cannot bring them to conscious perception due to an attentional deficit. Like visual field loss, visuospatial neglect may manifest as a complete loss of visual perception on the affected side, or as a relative loss where less is perceived in the neglected field, particularly when there are competing stimuli in the opposite hemifield. When visual neglect is present with hemianopia, it can cause severe impairment. Dr. Gottlieb's research and lectures regarding driving with vision loss list visual neglect as frequently preventing a return to driving.

Presbyopia: Is a vision condition in which they crystalline lens of your eye loses its flexibility, which makes it difficult for you to focus on close objects.  Presbyopia may seem to occur suddenly, but the actual loss of flexibility takes place over a number of years.

Refractive Status Problems: Nearsightedness (myopia), farsightedness (hyperopia), some cases of astigmatism and focusing problems interfere with a child's comprehension processes and classroom participation. These problems can be developing even though the child may see 20/20 on a Snellen Chart. They need prompt attention by a behavioral optometrist who treats both vision and sight. Current research supports Dr. Gottlieb's insights on prevention of vision changes.

Strabismus ("crossed eye," "wall eye," "wandering eye," esotropia, exotropia, hyperphoria): Affects approximately 4 out of every 100 children in the United States.  It is a visual defect in which the two eyes point in different directions.  One eye may turn either in, out, up, or down while the other eye aims straight ahead.  Due to this condition, both eyes do not always aim simultaneously at the same object.  This results in a partial or total loss of stereo vision and binocular depth perception.  The eye turning may be visible at all times or may come and go.  In some cases, the eye misalignments are not obvious to the untrained observer.

Stereopsis: Determining relative distances between objects by looking at them from two different places (the two eyes) simultaneously.

Stereo Vision: (stereopsis or stereoscopic vision): A byproduct of good binocular vision; vision wherein the separate images from two eyes are successfully combined into one three-dimensional image in the brain.

Syntonics: Syntonics or optometric phototherapy, is the branch of ocular science dealing with the application of selected light frequencies through the eyes.  It has been used clinically for over 70 years in the field of optometry with continued success in the treatment of visual dysfunctions, including strabismus (eye turns), amblyopia (lazy eye), focusing and convergence problems, learning disorders, and the after-effects of stress and trauma.  In recent years, Syntonics has been shown to be effective in the treatment of brain injuries and emotional disorders.  In syntonics optometry, the patient is exposed to one or more colors of light for a fixed period of time.  This is done in a darkened room, with colors generated by a machine known as a syntonizer.  In a typical session, a patient might absorb one color for 10 minutes, then another for an additional 20 minutes.  Treatment typically could involve between three and five sessions a week, for a period of four to eight weeks.  In most cases, syntonics is used in conjunction with other therapeutic procedures. 

Tracking: Tracking is the ability of the eyes to keep attention and focus on moving objects.

Vision: The act of perceiving and interpreting visual information with the eyes, mind, and body.

Vision Therapy: A medical treatment designed to improve visual skills such as:

    eye teaming

    binocular coordination and depth perception

    convergence sustained attention at near

    ocular motor disorders


    acuity (clarity of sight)

    "hand-eye" or "vision-body" coordination

Vision therapy can involve a variety of procedures to correct neurophysiological or neurosensory visual dysfunctions.

Visual Form Perception Problems: Form perception problems usually are a result of difficulties in the discrimination of visible likenesses and differences. There is confusion with similarities, inattention to slight differences, reversals of letter forms, and reversals in reading. This produces difficulties in spelling and writing.