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Vision Dysfunctions Children Up to 5 percent of children are born with some kind of visual abnormality, or develop one in their fi rst few years.6 Straining to see often translates to holding the head in unusual positions, which leads to chronic tension in the upper-back, cervical, or facial regions. To illustrate this dynamic, consider strabismus—a term for any misalignment of the eyes. In this condition, the child's eyes point in different directions. One eye may be higher than the other or roll out away from the other. Many children with this problem tilt their head or one shoulder, and often they also have poor gross motor coordination. Other visual difficulties such as astigmatism, light sensitivity, or nearsightedness can cause children to contract muscles in the head and neck as they strain to see. Slouching and a head-forward posture lead to tightness in the pectorals, upper trapezius, levator scapulae, posterior cervical, and sternocleidomastoid muscles, and weakness in the deep neck flexors, rhomboids, and serratus anterior muscles. Some children outgrow these visual difficulties, but many do not. One national health survey found that one in 12 Americans aged 12–17 had significant visual problems.7 Adults In her book Fixing My Gaze (Basic Books, 2009), neuroanatomist Susan Barry gives an excellent example of adults with musculoskeletal issues stemming from uncorrected childhood vision problems. A woman was born with a cataract in one eye, and even after it was corrected with a contact lens, her vision still differed in each eye. It was very difficult for her to use them together, so she developed a habit of turning her head and body sideways so her better eye faced wherever she was looking. Her left eye, left arm, and left leg came to dominate her movements; the muscles of her right side became weaker; and her right hip rotated outwardly. A similar example was a woman born with torticollis (twisted neck); she adapted by constantly turning her head far to the left, so her nose blocked the view from her left eye. It was not until a behavioral optometrist helped her learn how to use both eyes together that her posture straightened and her neck-muscle tightness disappeared.8 Elderly Understanding the visual habits of seniors can be key to dealing with their chronic body tension. As a group, 40 percent of all people over 40 years old have at least one vision problem, including blurring, blind spots in the visual field, double vision, impaired night vision, loss of peripheral vision, or changes in color perception.9 Seniors with these difficulties often hold their head in odd positions, squint, furrow their brow, stare fi xedly, or avoid looking at things altogether, all of which can cause chronic tension in the face, neck, and spine. Many seniors also wear corrective lenses, leading to the effects discussed later in this article. Emotional and Mental Stress Emotional states can affect vision and visual habits. Stress may cause chronic tension in the muscles inside the eye (those which change the shape of the lens and the size of the pupil), or in the external muscles that move the eyeballs, close the eyelids, squint, or furrow the brows. With poor vision, the shoulders and neck may become chronically tense as well. Vision may deteriorate due to stress caused by trauma, illness, fear, trouble at work or home, or other situations. This deterioration can manifest as blurred vision, smaller visual BLIND AND VISUALLY IMPAIRED MASSAGE & BODYWORK MAGAZINE READERS CAN ACCESS READABLE FILES FROM WWW.ABMP.COM/ TEXTONLYMAGS THESE FILES ARE COMPATIBLE WITH JAWS, WINDOW EYES, AND ZOOM TEXT.