What is Vision Therapy?
Vision therapy is an Optometrist supervised, non-surgical and customized program of visual activities designed to correct certain vision problems and/or improve visual skills.
Unlike eyeglasses and contact lenses, which simply compensate for vision problems, or eye surgery that alters the anatomy of the eye or surrounding muscles, vision therapy aims to “teach” the visual system to correct or improve itself.
Vision therapy is like physical therapy for the visual system, including the eyes and the parts of the brain that control vision. Vision therapy can include the use of lenses, prisms, tinted colour filters and computer-assisted visual activities. Other devices, such as balance boards, metronomes and non-computerized visual instruments also can play an important role in a customized vision therapy program.
It is important to note that vision therapy is not defined by a simple list of tools and techniques. Successful vision therapy outcomes are achieved through a therapeutic process that depends on the active engagement of the prescribing Optometrist, the vision therapist, the patient and (in the case of children) the child’s parents.
Overall, the goal of vision therapy is to treat vision problems that cannot be treated successfully with eyeglasses, contact lenses and/or surgery alone, and help people achieve clear, comfortable binocular vision.
Many studies have shown that vision therapy can correct vision problems that interfere with efficient reading among school children. It also can help reduce eye strain and other symptoms of computer vision syndrome experienced by many children and adults. See below for more on conditions treated with vision therapy.
Vision therapy can correct vision problems that interfere with efficient reading. Vision therapy is sometimes called visual therapy, vision training, visual training or simply “VT.”
What is Orthoptics?
Another name often associated with vision therapy is “orthoptics.” This term, which literally means “straightening the eyes,” dates back to the 1850s and is limited to techniques for training eye muscles for the purpose of cosmetically straightening eyes that are misaligned due to strabismus.
Orthoptics can be very successful and is one type of vision training, but the term “orthoptics” is not synonymous with “vision therapy,” which describes a broader range of techniques used to treat a wider variety of vision problems.
The emphasis in orthoptics is on eye muscles and eye alignment (at least cosmetically), the goal of vision therapy is to optimize the entire visual system, including the eyes and areas of the brain that control vision, visual perception and other vision-related functions. By treating the entire visual system, vision therapy aims to change reflexive (automatic) behaviours to produce a lasting cure.
In many cases of strabismus, vision therapy can be a better treatment choice than surgery. In other cases, it can be a beneficial adjunct therapy before and after surgery to increase the likelihood of a successful outcome.
The Science Behind Vision Therapy
Vision therapy and sports vision training can improve vision skills needed for sports. Studies show that the human brain has a significant amount of neuroplasticity — the ability to change its structure and function in response to external stimuli. These neurological changes in the brain, once thought to occur only during early childhood, have been demonstrated to occur in adults as well.
In one study, for example, experienced adult typists who underwent long-term training to improve their keyboarding skills demonstrated increases in gray matter volume in their brains, suggesting that learning affects not only function, but also brain structure.
Recent findings about neuroplasticity appear to confirm what many vision therapy experts have been saying for years: properly devised and administered programs of VT can cause neurological changes that can correct vision problems and improve visual performance.
Some experts say certain anomalies associated with vision development, visual perception or vision function may be affected by neuroplasticity. If this is true, it’s likely these same vision problems may be successfully treated with vision therapy.
Eye Care Conditions Vision Therapy Can Correct
Vision problems being treated with vision therapy include:
- Amblyopia Also called “lazy eye,” amblyopia is a vision development problem where an eye fails to attain normal visual acuity, usually due to strabismus or other problems of eye teaming.
- Strabismus. The success of vision therapy for strabismus depends on the direction, magnitude and frequency of the eye turn. VT has been proven effective for treating an intermittent form of strabismus called convergence insufficiency, which is an inability to keep the eyes properly aligned when reading despite good eye alignment when looking at distant objects.
- Other binocular vision problems. Subtle eye alignment problems called phorias that may not produce a visible eye turn but still can cause eye strain and eye fatigue when reading also can be minimized or corrected with vision therapy.
- Eye movement disorders. Studies have shown vision therapy can improve the accuracy of eye movements used during reading and other close-up work.
- Accommodative (focusing) disorders. Other research shows near-far focusing skills can be improved with vision training.
- Other problems. Other vision problems for which vision therapy may be effective include visual-perceptual disorders, vision problems associated with developmental disabilities and vision problems associated with acquired brain injury (such as from a stroke or concussion).
Sports Vision Training
Sports vision training is not vision therapy, but it shares some of the characteristics of VT. Optometrists and ophthalmologists who specialize in sports vision offer customized vision training programs for anyone interested in optimizing their visual skills for specific sports. Many Olympic and professional athletes have undergone sports vision training programs to improve their performance.
Sports vision training programs typically are designed to enhance a person’s visual skills for a specific sport rather than to correct a vision problem, the term “vision training” is preferred over “vision therapy.” However, some of the techniques used in sports vision training are similar to those used in vision therapy.
first steps to vision therapy
If you think your child or someone has a vision problem that may be affecting his or her performance in school, sports or life, the first step is to schedule a routine eye exam to rule out nearsightedness, eye health conditions, farsightedness and/or astigmatism.
If the basic eye exam suggests that no glasses are needed (or there is no change in your child’s current eyeglasses prescription) and each eye has 20/20 visual acuity, be aware that a vision problem still may exist. The eye chart used in routine eye exams tests only a person’s distance vision and does not test all critical aspects of visual performance.
For a thorough analysis of your child’s vision, including tests that evaluate vision skills needed for efficient reading, consider scheduling a comprehensive eye exam with an optometrist who specializes in binocular vision, vision therapy and/or vision development.
Examinations used to diagnose non-refractive vision problems differ from routine eye exams provided by most optometrists and ophthalmologists. Usually they are longer and include a number of tests of eye teaming, depth perception, focusing, eye movements and visual-motor and/or visual-perceptual skills.
At the end of the exam, the Optometrist should give you a detailed assessment of your child’s vision and visual skills. If vision problems are identified and a program of vision therapy is recommended, be sure to get information about the likely duration of the therapy and success rates for the specific type of vision therapy being recommended. Also, ask what criteria are used to define “successful” treatment.
Finally, request details about the expected cost of the therapy program, and whether any of the costs will be covered by your health insurance or vision insurance policy. In many cases, vision therapy is not a covered benefit in insurance programs.