Are vision problems hereditary (passed down genetically) or do they stem from environmental factors? In working with patients in Developmental Optometry and Vision Therapy we often discover similar vision issues in siblings and parents as the patients we treat. Does this suggest the issues could be caused by something in the families shared environment versus genetics? Research is inconclusive but experience may offer some insight.
The most common vision issue that is successfully treated through Vision Therapy is convergence insufficiency (also known as CI). The child diagnosed with CI because of a lack of development in early childhood. The reasons for the lack of development can be attributed to environmental factors such as a child who skipped certain developmental milestones like creeping and crawling in favor of walking early. There are many benefits to allowing a child to creep and crawl in early childhood, such as developing gross motor skills that lend to emergent fine motor skills in the hands and most importantly eye movement. Crawling also aides in developing spatial awareness.
Less common and more complex vision issues cannot be attributed to environmental factors, nor can environment be excluded. It is not always clear as to the exact cause of certain vision issues like strabismus (an eye turned inward or outward) or amblyopia (commonly known as “lazy eye”). This brings us back to the original question of heredity or environment. One of our amblyopia patients, Noah, recently discovered a family “urban legend” (as his mother put it). While talking to a relative about his vision therapy and the success they were experiencing with improved binocularity and focus, he was told of “Boltz Eye.” Here is part of what Noah’s mother described in a recent email:
“So welcome to our family lore. Little did I know, my son Noah and I are part of a family urban legend called “Boltz Eye.” Apparently everyone in our family knew about this (except me so I’m starting the family novel with “it was a dark and stormy night” and I don’t care what anyone says). Considering the date of the first picture, I am a little behind on family news! So the story goes, the Boltz Eye has been passed down to all the branches of our family since way back when. The name came from the Boltz side of the family, where legend has it, this eye predicament originated. The first photo is of my great grandparents on my mom’s side and check out my great grandma’s eye.
Their son (who would have been my grandfather) had really bad eyesight and wore very thick glasses. I was unable find any pictures of him without his glasses, but I would bet amblyopia is there front and center. My mom may have amblyopia as well, although it has not been diagnosed. And then there’s me…..see attached photo or just check me out one day when my eyes are tired! No secrets here — my eyeball turns in and has since I was small. I’ve worn glasses since I was two and was patched, but obviously that was not an effective solution in resolving the problem!
Noah is the next one on the “Boltz Eye” train. FIVE GENERATIONS LATER! Noah suffered from amblyopia of his right eye. Thanks to Dr. Davis and Virginia Vision Therapy Center, he no longer suffers from it and his right eye can now be corrected to 20/20. Also, thanks to Noah’s therapist, Chuck, who gave us great insight and worked diligently to address the issues we were facing. My point in sharing all of this was how important it is to know medical and genetic history issues that run in families. How pivotal knowing this information would have been for me in not hesitating to jump into vision therapy for Noah. It may have even initially helped me to seek earlier solutions for Noah. I don’t know whether science has proven any connection regarding family history yet, but as a mom I’m staking claim that genetics have a ton to do with it — and I’ve got the pictures to prove it!”
Noah’s family history suggest nature may have a role in the manifestation of vision problems. As the “Boltz” legend/lineage may not be typical of all families who suffer from vision issues, it may represent some families. The “Nature v. Nurture” debate remains unsettled; however, successful vision therapy outcomes rely less on how the problem started and more on the diagnosing and treating of vision problems for improved learning and better quality of life.