Charles Bittel III, O.D., Inc.

Charles Bittel III,O.D.,Inc. Newsletter

Vision and Learning

October 2014
Charles Bittel III, O.D., Inc.


Happy Fall to all. While none of us seem to be excited about our very un-Fall-like heat, there has been a lot to be excited about in our little world. Our back-to-school rush is still going strong. We never look forward to prescribing glasses for kids, but it's nice to be able to help those that are struggling with the vision component of learning. We also have a much overdue bathroom remodel on the horizon. After our staff trip to Vision Expo in Las Vegas, we came home to a slab leak that fortunately did not cause much damage. But some holes had to be cut into the wall of the bathroom so rather than doing a patchwork repair, we're just going to redo the room while we're closed down for the Thanksgiving holiday (hopefully). However while in Vegas, we were able to view the new line of Chloe frames that are absolutely beautiful. They're made in Italy, they look and feel amazing, and they're carried by Marchon so our VSP patients get an extra $20 benefit towards the line :) Our frame room is packed right now with new TOMS, Ray-ban's, Chloe's, and all of our other great designers. So remember that if you have flex account money to burn before the end of the year, you can put that money towards new computer glasses, sunglasses, or just a great second pair of frames. And we also like to remind our patients right about now that the weeks between Thanksgiving and the end of the calendar year are our busiest, so if you know you or one of your family members needs an exam before 2014 ends, we strongly suggest that you schedule it ASAP. We'll get as many exams in as we can during that period, but with Christmas during the middle of the week we will be even more limited in our scheduling. 

On another note, if you or your family has Davis Vision as your vision insurance, please see the news update after the article. 

Thank you as always to all that take the time read our newsletters. Again, please feel free to let us know if there's any  topics you'd like us to cover in the future. And for those that still don't follow us on Facebook, our page is more active now than ever with informative posts and office updates. Just click the link below to Like us on Facebook! 



Dr. Charlie Bittel (Junior)
Dr. Chuck Bittel (Senior)
Dr. Joo Chi
and Staff

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In This Issue
Vision and Learning

Experts say that up to 80% of what a child learns in school is from information that is presented visually. So one of the main objectives we have when giving a child an eye exam is to determine whether or not they can quickly and accurately see the information that is presented to them in their learning environment. This includes, but is not limited to, making sure their distance vision is clear enough to see information presented on a board or screen from anywhere in a classroom. As well as making sure that their near vision is clear enough to focus on a computer screen, tablet, or book. This is the most basic part of a child's eye exam in which we determine whether or not they have any significant refractive error (myopia, hyperopia, or astigmatism), and whether or not they need glasses to correct their refractive error either full-time or just when in their learning environment.

But just because a child passes a school screening or reads the 20/20 line in our office does not mean that they do not need glasses to assist in the vision aspect of the learning experience. Because we do not want children to simply have clear vision. We want children to have clear and comfortable vision when in a learning environment. There are 6 muscles attached to each eye as well as focusing muscles within each eye, and all of these muscles must cooperate in order for a child to have comfortable vision while learning. The coordination of these muscles while learning falls into a category we call visual efficiency. The first area of visual efficiency we monitor is called oculomotor functioning. Oculomotor functioning involves the eyes' ability to track smoothly. If a child has oculomotor dysfunction, they may be likely to skip lines or re-read lines, especially as they advance to a grade level where words get smaller and paragraphs get tighter. Keep in mind though that a certain amount of skipping or re-reading is a normal part of the learning process. The second area of visual efficiency we monitor is the child's phoria, or their muscle alignment. If a child has a large exophoria (muscles trying to pull the eyes outward) or esophoria (muscles trying to pull eyes inward) than they may experience headaches and eyestrain during prolonged period of reading or near activities. The third area of visual efficiency is known as accommodation, which is the eyes' ability to accurately focus at different distances, as well as their ability to sustain clear focus with near work. This is the area of visual efficiency in which we most often see deficiencies that can negatively impact a child's vision-related learning. During the back-to-school period we regularly see children with very clear vision when reading an eye chart, but who complain about not being able to see the board clearly in class or who have difficulty reading for long periods of time. Often times we will see children with accommodation dysfunction complaints when they have a big jump in grade levels, such as from third to fourth grade, elementary to middle school, or middle to high school. It is likely that children who have vision complaints during these transitions have had accommodation dysfunction all along, but as the demand on their visual system increases, it can surpass what they are able to tolerate. Children with accommodation dysfunction are the most likely to end up with "reading glasses", at least until their accommodation system matures to the point where glasses are no longer needed. Unfortunately, children with significant oculomotor dysfunction or muscle alignment challenges are less likely to benefit from glasses, and may need vision therapy (basically physical therapy for eye muscles) to improve their symptoms and make vision related learning a more comfortable process. 

Finally, there is a third area of vision and learning called visual processing. If we think of clear and comfortable vision as being necessary to gather the visual information, visual processing is basically how that information is transmitted to the brain and what the brain does with that information. Children with visual processing difficulties may have other learning disabilities as well. Often there is even an overlap between visual processing dysfunction and other learning disabilities. Even dyslexia is a condition that likely encompasses both a learning disability and in certain cases a visual processing dysfunction as well. Testing for visual processing deficiencies is very specialized and I personally rely solely upon the local optometry college for testing. They are also an excellent local resource for visual processing therapy. 

An evaluation for vision and learning occurs at varying degrees during a routine eye exam and generally depends on the age of the child being examined. For children between the ages of 4-6 we are just making sure that they can see properly and do not have any obvious refractive error that needs correction with glasses. Once a child reaches second or third grade, we start to pay more attention to their visual efficiency skills during the course of the exam, especially if they have a complaint that suggests a visual efficiency dysfunction. And again, we are not equipped to test for visual processing deficiencies, but can often make the proper referral if we think there is a chance a parent's concerns are related to a visual processing dysfunction.  


Davis Vision Patients/Families: Please Read

As of the first of the year (1/1/2015) we will no longer be accepting Davis Vision insurance. Our practice prides itself on exceptional patient care from start to finish. This obviously includes having pride in the products that we dispense to our patients. Unfortunately with Davis Vision, we have been contracted to work with products that too frequently do not meet our standards of exceptional quality for our patients. This includes being forced to display a rounder of over 100 frames in our frame room that are not of our choosing in either appearance and/or quality. And even though Davis Vision customers do not need to pick a frame from this rounder, we are still forced to send glasses to the Davis Vision lab (as opposed to a lab of our choosing) which over the years has too frequently not met the quality standards we typically demand from our labs.

If you have Davis Vision and have not had an exam in the last year or two, we are again accepting Davis Vision through the end of 2014. If you have Davis Vision and would like to continue to see us in 2015 and beyond, please give us a call at 714-779-8521 and we would be happy to discuss other insurance or cash options that would allow us to see you and your family in the future. 

We sincerely apologize for any inconvenience this may cause to you and your family. We truly appreciate every patient that walks in our door and we hope to find some way to continue to see all our Davis Vision patients and their families for generations to come. Thank you for your understanding. 

Charles Bittel III, O.D.


Johnson and Johnson (Acuvue) is still enforcing its unilateral pricing policy (UPP). This means that big box chains and online retailers cannot sell Acuvue products for less than a specified amount. Therefore the majority of the time, our prices on Acuvue products are exactly the same as what Costco and online retailers are charging. We also do not charge tax, we have free shipping on year supplies or 6 month supplies of daily disposables, and have a much more flexible return policy than any outside retailers. 

On a few occasions Costco has been reported as selling lenses for less than the UPP price, so we apologize if we told you our pricing was the same and Costco did have a lower price. But after some intense corporate negotiations, J&J has stood their ground and is still not allowing Costco to sell below the UPP price.


About Us

Dr. Chuck Bittel (Senior) has been practicing in Yorba Linda for over 30 years. His son, Dr. Charlie Bittel III (Junior) has been practicing in Yorba Linda for the last 8 years and took over the practice in December 2012. The business has continued to grow through referrals of family and friends so we are always honored to see your loved ones and feel free to give us a Yelp if you see fit! We are also the first business in all of California to register with the new referral app GWIG (Go Where I Go)!


Learn more about Dr. Bittel Senior and Junior and about their practice on their website and Facebook page. 


For appointments call 714-779-8521 or email:



Charles Bittel, O.D., Inc.
20399 Yorba Linda Blvd.
Yorba Linda, California 92886