What is Vision Therapy?

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Vision therapy, also known as vision training, is a non-surgical approach to treating binocular vision disorders. This method prescribes specific visual activities, which may or may not involve special lenses, aimed at enhancing eye alignment or visual skills that are underdeveloped.

Binocular vision disorders encompass a variety of issues such as focusing difficulties, eye alignment problems, and imprecise eye movements. Amblyopia, commonly referred to as lazy eye, is another condition treated through vision therapy.

Although frequently prescribed for children, vision therapy has shown benefits for adults’ visual skills in certain instances.

Refractive Errors vs. Binocular Vision Disorders

During a routine eye examination, your eye doctor assesses your visual acuity among other factors to determine if you require prescription lenses for refractive errors such as nearsightedness, farsightedness, or astigmatism.

While eyeglasses or contact lenses suffice for most school-aged children experiencing vision problems, approximately 20% of them suffer from binocular vision disorders that glasses or contacts alone cannot correct.

Such disorders include:

  • Convergence Insufficiency – A condition marked by the inability to maintain eye convergence comfortably during close-up tasks.
  • Accommodative Insufficiency – The difficulty in sustaining adequate focusing power for near objects.
  • Accommodative Infacility – A challenge in swiftly and accurately shifting focus between distant and near objects, crucial for activities like note-taking from a board.
  • Vergence Infacility – The struggle to maintain accurate and comfortable eye alignment when shifting focus between distances.
  • Eye Movement Disorders – Difficulties in moving the eyes rapidly and accurately across text, or in smoothly tracking a moving object.

If your child continues to experience eyestrain and headaches at school, even after a routine exam and the prescription of glasses if needed, consider consulting an optometrist who specializes in vision therapy for a comprehensive binocular vision evaluation.

Binocular Vision Evaluation

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This evaluation encompasses various visual skills tests not typically included in a standard eye exam. These tests may involve:

  • Eye Alignment Testing – Beyond the basic alignment test during a routine exam, specialized tests assess the ease with which your child maintains proper alignment, particularly during near-vision tasks.
  • Eye Focusing Tests – These determine the ease of focus change and the potential for eye fatigue, blurred vision, or reading difficulties due to inadequate focusing ability.
  • Eye Movement Tests – Evaluations of eye movement accuracy and speed during reading-like tasks help identify if poor eye movement skills are affecting reading ability.
  • Eye Teaming Tests – Assessments of how well the eyes work together across various visual tasks to identify issues in eye alignment, focusing, and positioning.

Based on these assessments and comparing your child’s results to age-appropriate norms, vision therapy may be recommended if deficiencies are identified.

Vision Therapy Programs

Vision therapy operates on the principle that visual skills can be enhanced through specific visual tasks or exercises, much like physical training can improve the strength and coordination of underdeveloped muscles.

Typically, a vision therapy program combines weekly one-on-one sessions in the doctor’s office with daily home activities. Special lenses and computer programs might also be utilized to fortify visual skills.

The duration of a vision therapy program varies, depending on the specific visual skill deficiencies being addressed, and can last from several weeks to several months.

Vision Therapy vs. Orthoptics

While many optometrists advocate for vision therapy, it has faced criticism, particularly from ophthalmologists. Some ophthalmologists argue that vision therapy is often prescribed unnecessarily and dispute claims regarding its efficacy in treating reading and learning disorders.

Conversely, some ophthalmologists endorse orthoptics, a similar therapy focusing on a narrower range of binocular vision disorders, primarily convergence insufficiency and mild alignment issues. Unlike vision therapy, orthoptics is typically administered by a certified orthoptist rather than a medical doctor, and, like vision therapy, it involves non-surgical eye exercises.

Conclusion

Vision therapy offers a non-surgical solution for individuals, particularly children, facing binocular vision disorders. By focusing on specific visual activities, it aims to correct issues such as eye alignment, focusing, and movement problems that cannot be addressed by prescription lenses alone. 

While it’s widely endorsed by optometrists for its benefits, vision therapy is subject to debate among medical professionals. Nonetheless, for those experiencing persistent visual challenges despite conventional correction methods, vision therapy presents a viable option to explore. Through personalized programs, it holds the potential to significantly improve visual function and quality of life, reinforcing the importance of comprehensive visual health care.