What is Vision Therapy?

Optometric Vision Therapy, or VT, is devoted to developing, improving, and enhancing visual performance. Vision therapy can benefit people of all ages.

Optometric Vision Therapy, commonly referred to as VT, is a doctor-supervised program designed to improve the function of the visual system.

Optometric Vision Therapy is:

conducted under the supervision of an optometrist
often administered or guided by a vision therapist employed by the overseeing optometrist
supported by ongoing, evidence-based scientific research
typically supplemented by the use of lenses, prisms, filters, and 3-D activities, among other things
individualized to the unique needs of the patient
non-invasive and in some cases can be a safe alternative to surgery
beneficial to people of all ages

One important thing to understand about VT is that it is not the same thing as "eye exercises" -- this is a very outdated and over-simplified explanation for what VT is and what it does. According to the College of Optometrists in Vision Development, the goal of VT is not to strengthen eye muscles. Your eye muscles are already incredibly strong, and the vision problems VT aims to treat are rarely caused by muscle weakness. Instead, vision therapy aims to retrain the learned aspects of vision through the recently-understood concept of neuroplasticity.

Nearly all humans are born with the potential for good eyesight, but vision - the ability to identify, interpret and understand what is seen - is learned and developed, starting at birth. Neuroscience indicates that we do not “see” with our eyes but our brain. We develop visual skills starting at birth but sometimes people's visual skills do not develop completely. These visual skills are critical for learning as well as for performing everyday tasks like navigating a room, parking a car, engaging in sports, etc. Developing visual skills includes learning to use both eyes together effectively. Having both eyes move, align, fixate, and focus as a team enhances your ability to interpret and understand the potential visual information that is available to you.

Visual skills which can be developed and enhanced through Optometric Vision Therapy include:

TRACKING The ability to follow a moving object smoothly and accurately with both eyes, such as a ball in flight or moving vehicles in traffic.
FIXATION The ability to quickly and accurately locate and inspect with both eyes a series of stationary objects, one after another, such as moving from word to word while reading.
FOCUS CHANGE The ability to look quickly from far to near and vice versa without momentary blur, such as looking from the whiteboard to a book or from the dashboard to cars on the street.
DEPTH PERCEPTION The ability to judge relative distances of objects and to see and move accurately in three-dimensional space, such as when hitting a ball or parking a car.
PERIPHERAL VISION The ability to monitor and interpret what is happening around you while you are attending to a specific central visual task; the ability to use visual information perceived from over a large area.
BINOCULARITY The ability to use both eyes together, smoothly, equally, simultaneously, and accurately.
MAINTAINING ATTENTION The ability to keep doing any particular activity with ease and without interfering with the performance of other skills.
NEAR VISION ACUITY The ability to clearly see, inspect, identify, and understand objects at near distances, within arm’s length.
DISTANCE ACUITY The ability to clearly see, inspect, identify and understand objects at a distance. People with 20/20 distance sight may still have visual problems.
VISUALIZATION The ability to form and retain mental images in your “mind’s eye." For recall, or manipulate into new mental images.

If an individual’s visual skills are not adequately developed, or a person fails to coordinate vision with other senses, vision problems may occur. Unfortunately, school screenings or visits with the pediatrician, are not comprehensive enough to identify most of these issues. Typically, those screenings are merely looking at the anatomic structure of the eye (checking for disease) and acuity (the ability to see clearly at a certain distance). They may overlook critical problems that are hard to identify if the focus is only on anatomy and acuity. With poor binocularity, for example, one eye may locate an object in one place while the other eye locates it in another. These confusing signals may result in:

HEADACHES Especially near the eyes or forehead, or occasionally at the back of the head.
DOUBLE VISION Two objects are seen when only one exists.
REDUCED PERFORMANCE Losing your place while reading, rereading words or lines, difficulty with understanding or recalling what you’ve read, reading slowly.
DISCOMFORT, FATIGUE Body tension, stress or pain; weariness at the end of a school or work day.
SUPPRESSION Information from one eye may be blocked or ignored to avoid seeing double. If the visual problem is not corrected, it may get worse

Vision therapy, usually combined with appropriate lenses, may remedy, improve, or prevent any of these conditions in both children and adults. Therapy is intended to alleviate the symptoms and eliminate the underlying cause - inadequate visual skills and visual stress. Studies show that success in vision therapy depends on an appropriate program prescribed by your optometrist, and on an individual patient’s co-operation, participation and motivation.

Most VT is conducted in-office, in once or twice weekly sessions lasting 30 minutes to 1 hour. There are often "homework" items to supplement in-office work. A therapy program can last from 15 weeks to a year or more depending on the individual’s diagnosis, their age and their commitment and participation level in the program.

Many patients, of all ages, with various diagnoses, from all over the world, have experienced the life-changing impact vision therapy can have. We have shared some of those patient success stories on our blog and we encourage you to look at these additional accounts as well:

Fixing My Gaze: A Scientist's Journey into Seeing in Three Dimensions by Dr. "Stereo Sue" Barry

Jillian's Story: How Vision Therapy Changed My Daughter's Life by Robin and Jillian Benoit

Dear Jillian: Vision Therapy Changed My Life Too compiled by Robin and Jillian Benoit

The Ghost in My Brain: How a Concussion Stole My Life and How the New Science of Brain Plasticity Helped Me Get it Back by Clark Elliott

References:

College of Optometrists in Vision Development

Vision Therapy Canada

British Association of Behavioral Optometrists

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