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Glaucoma Care:

Glaucoma is a disease that causes damage to the optic nerve which initially leads to peripheral vision loss. If left untreated glaucoma can lead to blindness. It is one of the major causes of vision loss or blindness in Canada. Most patients that have glaucoma do not have any symptoms and may not be aware that they have the disease until significant visual loss has occurred. At North Toronto Medical Optometry and Vision care, we use state of art technology to evaluate the health of the optic nerve. Retinal imaging and optical coherence tomography (OCT) are used to document and monitor changes in the retinal nerve fibre layer thickness. While there isn’t a cure of glaucoma, we can control progression of the disease with medications and sometimes surgery. Dr. Echharam and her associates are trained in the treatment and management of eye diseases likes glaucoma. All patients at our office are screened for glaucoma at their annual ocular examination.

Ocular Emergencies:

At North Toronto Medical Optometry and Vision care, our doctors try their best to accommodate ocular emergencies with same day appointments. If you are experiencing a sudden change in your vision, seeing flashes of lights or a shower of floaters, please call our office and our friendly staff will be happy to assist you. Our doctors are trained and certified to diagnose, treat and prescribe medications for most ocular problems. In the event your ocular emergency is out of the realm of our expertise, we have an excellent working relationship with well known ophthalmologists in Toronto and will make referrals as needed.

Vision Therapy:

According to the Canadian Association of Optometrists (, "What we see is the result of signals sent from the eyes to the brain. Usually the brain receives signals from both (bi) eyes (ocular) at the same time. The information contained in the signal from each eye is slightly different and with well-functioning binocular vision, the brain is able to use these differences to judge distances and coordinate eye movements."

What can cause a loss of binocular vision?

  • A loss of the coordination of eye muscles causing each eye to point in a different direction. Also known as Strabismus.
  • Weakened or reduced vision in one eye. Also known as Amblyopia.
  • An issue at the level of the brain affecting how information is processed between the two eyes.

Why is this important?

Since binocular vision is the ability for us to use both eyes simultaneously to see and interpret information, loss of binocular vision can affect our sense of depth, that is how we judge distances, it can affect how we judge the trajectory and speed of things, and it can affect how we perceive objects in 3D (stereo vision).

What are the symptoms and signs of binocular vision disorders?

Binocular vision disorders include convergence and divergence issues, accommodative problems, reduced vision in one eye, poor coordination of eye muscles and much more. Symptoms include but are not limited to headaches, eye strain, eye pain, inability to properly focus leading to blurry vision, and/or doubling of the vision (seeing two images instead of one). Signs may include poor eye muscle control affecting eye movement, poor eye-hand coordination possibly resulting in difficulty with motor skills, poor figure-ground perception and issues with eye-teaming.

Who would benefit from binocular vision therapy?

Patients of all ages who are symptomatic (headaches, eye strain, eye pain/discomfort, blurred vision, doubled vision, etc.), as well, those who visit for an exam who are found to have any of the above binocular vision disorders.

How are binocular vision disorders treated?

Treatment depends on the cause of the binocular vision disorder. In the case of strabismus, surgery is often the accepted method of treatment. In cases like amblyopia or minor loses of eye muscle coordination where surgery is not warranted, exercises can be done.

What kind of binocular vision services are available at your office?

We currently offer both in-office and at home vision therapy services. Our in office therapy includes exercises that train the eyes to focus at different distances (accommodation) and exercises that strengthen the eye muscles for coordinated eye movements i.e. HART chart, Brock String, Eccentric Circles, etc. At home, patients will also work on similar concepts through a computerized home therapy system (HTS iNet or Amblyopia iNet). Therapy is determined after a full binocular vision work up which is done in office following a full eye examination. Please contact our office for more information.

Myopia Management

Myopia, also known as nearsightedness, is defined as being able to see clearly at near distances but objects viewed at a distance are blurry. It is associated with the elongation of the eyeball which can lead to irreversible vision loss in some patients. Eyeglasses or contact lenses must be worn to correct the vision. Progressive myopia leads to retinal thinning and can result in detachments, myopic macular degeneration (myopic maculopathy), and retinal bleeding. The younger a child is when they first develop myopia, the faster their myopia progresses. If your child needs eyeglasses to see clearly before they are 10 years old, then the option of myopia management is available at North Toronto Medical Optometry.

Myopia may be managed by:

  • Spectacle Lenses: Specialized Eyeglasses are prescribed to prevent worsening myopia
  • Soft Contact Lenses: Specialized Multifocal Soft Contact Lenses are fit to minimize elongation of the eyeball
  • Orthokeratology: Specialized Hard Contact Lenses are customized to be worn overnight to supress eye growth and progression of myopia
  • Prescription Eyedrops: Atropine is prescribed to slow down the progression of myopia

Parental Checklist

If any of the following apply to your child, a Myopia Management program might be right for you and your child:

  1. One or both parents are nearsighted and are wearing eyeglasses or contacts
  2. Your child needs eyeglasses to see clearly before 10 years old
  3. Your child’s eyeglass prescription has increased significantly over the last 2 years
  4. Your child is unhappy wearing eyeglasses or contact lenses during the day
  5. You’re concerned about your child’s nearsightedness and eye health getting worse
Myopia Management

Need an eye exam? Request an appointment online.