Vision Therapy

What is vision therapy?

Vision therapy is a term some optometrists and occupational therapists use to refer to treatments that improve your vision through training. This treatment generally includes monitored in-office and at-home eye exercises that you do over the course of weeks to months.

In addition to eye exercises, your vision therapy treatment might also involve other tools. Some examples include training glasses, light-bending prisms, eye patches, electronic devices and much more.

The pediatric eye community doesn’t universally agree on what constitutes vision therapy. But some treatments that might fall under this umbrella include:

• Orthoptic vision therapy. This type of vision therapy typically happens at an optometrist’s or pediatric ophthalmologist’s office if you’re working with an orthoptist. During these visits, which usually take place weekly, an eye specialist will guide you through a series of eye movement exercises.
• Vision therapy for myopia. This type helps you avoid — or at least delay — the onset or worsening of myopia (nearsightedness).
• Amblyopia therapy. This type involves some sort of occlusion or blurring of one eye in people who have poor vision on one side. The goal of the treatment is to try to strengthen the weaker eye. Many — but not all — types of amblyopia treatment are rooted in strong scientific evidence.
• Light exposure therapy. This type of vision therapy, called syntonics, is widely regarded as pseudoscience.
• Behavioral vision therapy. This type involves eye exercises that are meant to improve visual processing and understanding. Occupational therapists and some types of optometrists are more likely to recommend behavioral vision therapy.

What is done in vision therapy?

Vision therapy starts with an in-office evaluation and tests. Those tests help an eye specialist determine if you or your child has an issue with how your eyes align and work together. Based on the test results, your eye specialist may recommend vision therapy. If they do, they may also recommend certain treatments. Your treatment plan can take place over the span of weeks or months.

Vision therapy for convergence insufficiency

Orthoptic eye exercises (also known as orthoptics) can treat convergence insufficiency and a related condition called accommodative dysfunction. Those conditions are forms of binocular vision dysfunction. Convergence insufficiency is when your eyes struggle to point inward so you can see objects that are closer to you. Accommodative dysfunction is when your eyes struggle to focus, which can sometimes go hand-in-hand with convergence problems.

Eye specialists, like pediatric ophthalmologists, optometrists or orthoptists, prescribe and oversee these sessions. Your eye specialist will teach you which eye exercises to do, how to do them and tell you how often you need to do them. You can then do the exercises at home. Vision therapy for convergence insufficiency and accommodative dysfunction can reduce symptoms of blur, eye strain or diplopia and improve the way your eyes work together.

Is vision therapy recommended?

Most vision therapy is controversial among eye care specialists. Research doesn’t support its use for conditions other than convergence insufficiency and accommodative dysfunction. And in some cases, trying certain forms of vision therapy can delay other treatments that will work, which can lead to permanent vision issues.

Multiple expert organizations recommend against the use of behavioral visual therapy for conditions other than convergence insufficiency. The organizations that recommend against using it for other conditions are:

• The American Academy of Pediatrics
• The American Academy of Ophthalmology
• The American Association for Pediatric Ophthalmology and Strabismus
• The American Association of Certified Orthoptists

What can I do if my child is having problems learning in school?

There are several factors that could contribute to learning difficulties for children. And in many cases, it’s more than one factor. Some of the most common include:

• Eye or vision issues. Your child might have difficulty learning simply because they can’t see well. This can happen with conditions like amblyopia (lazy eye) and strabismus (eye misalignment). It can also happen with refractive errors like nearsightedness (myopia), farsightedness (hyperopia), or astigmatism. A pediatric eye doctor can diagnose these conditions with a full eye exam that includes pupil dilation. And there are many potential treatments that can help improve your child’s sight.
• Dyslexia. This isn’t an eye condition. Instead, it happens because your brain incorrectly processes what your eyes see. Behavioral vision therapy and eye exercises aren’t effective for treating it.
• Other learning disabilities and disorders. Learning disabilities aren’t something that an eye care specialist can treat. Your pediatrician can recommend specialists who can diagnose and treat these conditions. Vision therapy also isn’t effective for treating these.