Neuro-Developmental Optometry

What is a Neuro-developmental Optometrist, and what services do they provide?

A Neuro-developmental Optometrist is a fully qualified and registered Optometrist who has undergone extensive post graduate training, combining our understanding of classical optometry with advanced studies in childhood development, psychology of vision and neuroscience.

A Neuro-developmental Optometrist looks beyond health and corrective error of each individual eye and interprets the visual system (the eyes and the brain), as part of the person and the effect it has on a person’s behaviour.

We investigate the way that the eyes work as a team and how that information is processed to enable us to learn, to read, to write, to move around our environment and interact with objects or other people around us.

If our eyes do not work efficiently and we do not interpret the information gathered appropriately it can be very difficult to learn and find our place in society. We may be labelled with an attention problem or a learning difficulty. It is very important therefore that if a child is having trouble at school with their learning, that they are assessed by a Neuro-developmental Optometrist.

Our Neuro-developmental Optometrist will likely be able to spot signs and symptoms of a visual problem during a standard eye examination but to truly understand the impact of those visual problems, and treat them, a full functional eye examination will be recommended.

How is a standard eye examination different from a full functional vision assessment?

A full functional vision assessment is different to a standard eye examination.

Standard eye examination

An eye test lasts approximately 30 minutes.
All children under the age of 16 years (and aged 16 ,17 or 18 in full time education) are entitled to an NHS funded eye examination (at least once every 2 years).

Full functional vision assessment

A full functional assessment lasts up to 2 hours.
A functional vision assessment is a privately funded assessment, incorporating extensive testing and a written report with recommendations.
After a functional vision assessment, a report will be supplied. This will highlight and explain any visual diagnoses. A plan of action will be presented.
Typical recommendations are for a special pair of spectacles with prisms, tints, occlusions or contact lenses. Often these can provide relief from symptoms instantly.
Alternatively, a course of vision therapy may be offered. Vision therapy involves techniques and exercises that are practiced and repeated to teach someone the skills of visual efficiency for life.

Dyslexia and Neurodivergence

People with a diagnosis of dyslexia or neurodivergence can also benefit from a visit to a Neuro-developmental Optometrist. Visual dysfunction is often associated with these diagnoses and vision therapy can help to alleviate some of the symptoms or difficulties and improve the person’s quality of life.
(Please note that Neuro-developmental Optometrists cannot diagnose or treat dyslexia or specific learning difficulties, but want to help alleviate any problems that might be attributed to an accompanying underlying visual problem).


People with strabismus (squint or eye turn) or amblyopia (lazy eye) could also benefit greatly from an appointment with a Neuro-developmental optometrist. Vision therapy could possibly offer an alternative to patching or atropine therapy. It has proved to be a successful alternative to surgery and can be used pre- and post-operatively to enhance visual and cosmetic outcomes.


Myopia or short-sightedness is a global concern and the percentage of children presenting with myopia at young ages is increasing and the rate of progression is exponential. The good news that many Optometrists offer myopia control methods to help slow down and control the rate of progression of myopia.
Neuro-developmental Optometrists look at myopia as an adaptation to the visual system due to near-point stress. Myopia control methods cannot always be predictable, and results cannot be guaranteed but if someone is using a myopia control and are not getting the anticipated results a functional assessment with a Neuro-developmental Optometrist may help.
In younger children, signs of near point stress may be treated with lenses or environmental changes that can prevent the onset of myopia at all in those at risk.

Coloured Overlays

Coloured overlays and lenses can be very powerful tools. These can be particularly helpful for people reporting difficulty reading because the words move on the page or that the white of the page is too bright.
The statistical evidence and understanding of how and why coloured filters help is limited and so they should only be used in special circumstance. Anecdotal evidence proves that overlays can make a significant positive impact but may be of limited short-term use e.g. to help with impending exams.
Coloured overlays should be properly prescribed alongside visual sensitivity tests and rate of reading tests. Overlays will only be issued if the rate of reading significantly improves.

For the individuals who specifically request or are recommended coloured overlays (maybe by school) a functional screening assessment may be indicated. This is also indicated for those who have undergone a recent eye examination and require a second opinion from a Neuro-developmental Optometrist.
These screening tests are much shorter (around 30 mins) and include a questionnaire to be filled in at home, monocular visions, a tracking program, laser fields, cover test, motility, NPC and reading range.

Maria Wheeler will be with us on alternate Saturdays, operating a dedicated children’s clinic. Standard NHS eye examinations, screening assessments and full functional vision assessments will be available to book.