Reading an eye chart mounted or projected on a wall is a standard part of every visit to the optometrist today, but it wasn't always that way. Centuries ago, practitioners struggled to measure vis ...View Article
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Vision therapy is a series of treatment procedures prescribed by optometrists to improve certain types of vision problems that cannot be helped with only glasses or contact lenses. Vision therapy is much akin to physical therapy for the eyes, during which vision disorders are corrected to improve patients' visual function and performance.
Vision therapy treats vision problems children have when using their eyes up close, especially at school. Problems with tracking, eye teaming, and focusing make it impossible for children to read, learn, and remain on task. Vision therapy also corrects lazy eyes and crossed eyes, and this is done without the need for surgery. These vision problems are all types of disorders of binocular vision, meaning how we use our two eyes together.
The science of modern vision therapy began in the 1930's and is supported by decades of research, not to mention the testimony of thousands of patients whose vision and lives have been improved.
Vision therapy is prescribed by optometrists who specialize in children's vision. Doctors who are board-certified to provide vision therapy have received certification to diagnosis and treat binocular vision and oculomotor problems. To specialize in vision therapy, doctors must complete extensive post-graduate training beyond their optometric degree, at which time they are eligible to sit for their national boards to become fully certified as specialists in children's vision. A doctor's title after passing the national board in vision therapy is Fellow in the College of Optometrists in Vision Development, or F.C.O.V.D. Optometrists who provide vision therapy but who have not yet sat for their certification exams are board-eligible Associates in the College of Optometrists in Vision Development.
Before a child can begin a vision therapy program, he or she must be seen by the doctor for a complete developmental vision evaluation and diagnostic workup. In addition to checking the child's eye health and sharpness of vision (visual acuity as measured by the eye chart), the doctor will complete a comprehensive assessment to evaluate the child's eye teaming, tracking, focusing, visual perception, and eye-hand coordination skills. A computerized recording of the child's eye movements during reading may also be taken. The doctor interprets the results of the exam, notes any areas of concern, and makes a recommendation for therapy based upon the test results.
Before the child begins therapy, the doctor will meet with the therapy staff and put together an individualized therapy program and set of treatment goals for the patient. This treatment plan is thoroughly discussed with the parents before the child starts therapy and every effort is made to answer their questions, including insurance coverage and available appointment times.
The child's vision therapy program consists of an individualized plan of treatment procedures using lenses, prisms, instrumentation, visual exercises, and occlusion meant to return the patient to normal vision. A trained therapist under the direction of the doctor works with the patient once or twice a week for a period from three to twelve months, depending upon the nature and severity of the patient's condition and how often the patient is seen in the office. Usually home therapy is also prescribed to reinforce the new skills the patient is learning at the doctor's office. Eye patching is often a part of the treatment program. The patient is regularly seen by the doctor for progress examinations as he or she proceeds through therapy and meets each set of treatment goals.
The goals of vision therapy depends upon the patient's vision problem:
Patients with eye teaming, tracking, focusing, visual motor integration, and visual perception problems have weak visual skills which undermine the learning process and can cause such problems as difficulty reading, double vision, headaches, eye strain, and short attention spans. For these patients, therapy improves their visual skills so they can function normally in the classroom.
Patients with crossed, turned, wandering, or lazy eyes only see with one eye at a time. Their brains suppress or "turns off" their weak eye. Therapy is designed to straighten the eye and teach the patient to use both eyes together for normal visual function.
The encouraging news for parents is vision therapy is very effective in treating vision-based learning problems. Unfortunately, children who struggle because of vision problems often suffer needlessly because their condition goes undiagnosed. School screenings and pediatricians only check children's distance vision using the eye chart. They can't run the specialized tests required to determine if a child has all the visual skills he needs to succeed in school. Special near-point tests must be done by a developmental optometrist in order to identify and diagnose the problem. Ask your family optometrist to refer you to an eye doctor who specializes in this area of care.
Once the problem has been correctly identified, vision therapy can return your child's visual system to normal! We invite you to read the following comments from some of our patients.
As patients progress through therapy, improvement in their visual function results in a noticeably higher quality of life. Please read a few of the following examples of comments parents have made about the many ways vision therapy has helped their children.
Eye Teaming Problem:
"When I brought Megan to the vision therapy center, she hated to read. She would lose her place, put words in or leave words out, and sometimes she would turn words around. It was a constant battle last year to get her to do her homework, often taking two or three hours to do work that should have been finished in thirty minutes. Her report cards for the last two years were terrible. She was getting C's and D's. Then we found out she had an eye teaming and tracking problem which didn't let her eyes work together when she read. We started vision therapy to retrain the way she used her eyes, and we worked really hard. Now we're seeing the good results. On her last report card she had all B's and even one A. Megan is really enjoying reading now that her eyes are fixed. She has read forty books for her school reading program already this year! Best of all, homework is no longer a problem. She does her assignments as soon as she gets home from school and is finished in half an hour. The whole family is enjoying the results of her therapy. Thank you very much for making our evenings more enjoyable!"
Crossed/Wandering Eye, or Strabismus:
"Sometimes when I look at Jason's preschool pictures, I'm momentarily shocked by the crossed eye. It's so easy to forget--I'm used to seeing his eyes straight. I'm so glad we decided to put Jason in vision therapy. We'd been told by another doctor that surgery was Jason's best option, but my wife and I did our research. We knew that surgery could make the eye look better but not necessarily perform better. Also, we discovered that surgeries don't always hold and sometimes have to be repeated when the child is older. A friend told us about vision therapy. When we met with the doctor, everything he said about vision and Jason's crossed eye made sense--especially the part about having to teach Jason's brain how to use his two eyes together so there was no need for the weak eye to suppress and turn in. By the time Jason finished therapy, both eyes were perfectly straight, and he had normal vision and depth perception--all without surgery! I would strongly recommend that parents educate themselves on all of their treatment options."
Lazy Eye, or Amblyopia:
"Every time I looked at my daughter I felt guilty about her lazy eye because we hadn't found it until she was in the fourth grade. Two different eye doctors told us that nothing could be done to help Laura because she was too old and past the age when treatment would be effective. Thank heavens I found the vision therapy center and set up an appointment. She went from being nearly blind in her weak eye to normal vision! And to top it all off, she became the best hitter on her softball team. My husband and I are so thankful to the doctors and vision therapy staff. They not only helped our daughter achieve normal vision, but they saved us from some serious guilt!"