Please note, Dr. Mackowsky requires a copy of a comprehensive eye exam from the last 12 months prior to being seen.
Dr. Mackowsky’s initial assessment includes a sensorimotor exam and refraction. This specialty comprehensive exam lasts between 60-75 minutes. It will determine if any problems exist with the nerves and muscles of the vision system and includes testing of the following visual areas:
Binocular (Eye Teaming) System
Accommodative (Focusing) System
Ocular Motor (Eye Tracking) System
Sensory (Proprioception) System
Refractive Status
Visual Midline
Visual Processing
Peripheral Awareness
Based upon the results of this examination, Dr. Mackowsky will determine if additional tests are needed to make an adequate determination of diagnosis, prognosis & treatment plan. These tests may include some or all of the following:
Visual Field & Peripheral Awareness Tests
These tests evaluate one’s peripheral awareness, processing speed and scanning ability. Allow approximately 30 minutes for this battery of tests. Please note that insurance does not cover the Peripheral Awareness Test.
NOVA Visual Evoked Potential Test (VEP)
The NOVA VEP test is one of the most highly developed, technological non-invasive/painless testing systems available today, used by neuro-optometrists and other medical professionals to diagnose and treat patients with trauma to the visual pathways in the brain. It is used on children as young as 6 months and any age adult. It allows the physician to establish a baseline for visual function and increases the specialist’s ability to prescribe optical devices or other treatment modalities to maximize one’s visual abilities. Electrodes and conductive paste are used during this process. Allow approximately 45 minutes for this test.
Neurobehavioral Perceptual Exam
The Neurobehavioral Perceptual Exam determines the severity of suspected visual perceptual processing or cognitive deficiencies that can interfere with how the brain interprets or processes visual information. Allow approximately 90 minutes for this test for a child (adult testing takes approximately 30-45 minutes). Medicare does not cover this exam; some out-of-state BCBS policies also do not cover this procedure.
RightEye Test
This test is a non-invasive state-of-the-art eye-tracking technology. The RightEye system enables Dr. Mackowsky to pinpoint functional vision and brain health issues, identify the root cause of reading problems, and improve daily performance. Allow approximately 15-20 minutes for this test.
Based on your RightEye EyeQ test results, Dr. Mackowsky will assign a series of exercises you can complete at home under her supervision. EyeQ Trainer is a non-invasive, computer-based treatment proven to help improve your functional vision. It rehabilitates the movement systems of the eye and promotes positive neuroplasticity, the ability of the brain to make important neural connections. All you need is a computer and an internet connection.
Campimetry Functional Visual Field Testing
Campimetry is a type of peripheral awareness testing used for the determination of interference in the neural flow of input-output processes. When the findings show a constricted field of awareness with a specific color, photobiomodulation (or syntonics) with a certain colored filter may be recommended as a type of vision therapy by Dr. Mackowsky. Allow approximately 20-30 minutes for this test.
HRV-Heart Rate Variability (HRV)
Heart rate variability is the degree to which the heart speeds up or slows down. The changing interval between two heart beats is a reflection of the autonomic nervous system (ANS) that controls 90% of the body functions. The two branches of the ANS consist of the sympathetic and the parasympathetic. These two branches regulate the slowing down and speeding up of the heart rate through their influence on the sinoatrial (SA) node of the heart. The HRV allows Dr. Mackowsky to look at the beat-to-beat changes between one heart contraction and the next, to get an indication of how well one’s ANS and brain are adapting to internal and external stressors which can affect visual processing.
Synoptophore
The synoptophore is a diagnostic tool used to confirm errors in conjugate eye movements typical with patients who have a disruption between the vision and proprioceptive systems. This test allows Dr. Mackowsky to determine if a specific type of prism is needed to rebalance one’s proprioceptive & visual processing.
