WHAT IS VISION THERAPY?
“Vision therapy” is a term used by optometrists. Optometrists define vision therapy as an attempt to develop or improve visual skills and abilities; improve visual comfort, ease, and how well the eyes work; and change visual processing or understanding of visual information. A vision therapy program is usually made up of monitored in-office and at home eye exercises that are done over weeks to months. In addition to exercises, lenses (“training glasses”), prisms, filters, patches, electronic targets, or balance boards may be used.
There are three main types of vision therapy:
- Behavioral/perceptual vision therapy – eye exercises to improve visual processing and visual understanding
- Vision therapy for prevention or treatment of myopia (nearsightedness)
- Orthoptic vision therapy - eye exercises usually weekly over many months done in the optometrist office
HOW IS ORTHOPTIC VISION THERAPY DIFFERENT FROM THE EYE EXERCISES MY OPHTHALMOLOGIST USES?
Orthoptic eye exercises (also called orthoptics) used by pediatric ophthalmologists and orthoptists, are a different type of eye exercises to improve binocular function (how well the two eyes work together). This type of eye exercise is taught in the office and done at home. ”Orthoptics” is a proven treatment done by “Orthoptists ” who are specialized eye care providers that work with ophthalmologists. Orthoptists also measure and help diagnose eye movement problems, manage amblyopia (weak vision, lazy eye) and treat small eye movement problems.
DOES BEHAVIORAL VISION THERAPY WORK?
Behavioral vision therapy has not been proven by science to work.
DO “TRAINING GLASSES” WORK?
Scientific studies have shown that low-power “training glasses” are not very helpful.
DOES VISION THERAPY help with LEARNING DISABILITIES AND DYSLEXIA?
Many scientific studies have shown that eye coordination, eye movement, and visual processing are often normal in children with dyslexia. Eye exercises or behavioral/perceptual vision therapy has not been shown by science to improve how well children with learning disabilities do with learning and schooling.
DOES VISION THERAPY FOR THE PREVENTION OR treatment OF MYOPIA WORK?
There is no evidence that vision therapy slows the progression of myopia or helps myopia get better.
DO ORTHOPTICS WORK?
Orthoptic eye exercises as prescribed by pediatric ophthalmologists, orthoptists, and optometrists can be helpful in the treatment of eye movement problems that cause blurry vision, double vision or headaches (like convergence insufficiency).
WHY MIGHT A TEACHER RECOMMEND VISION THERAPY?
When a teacher notices that a student has problems with writing or reading out loud, he/she may think that the child has a vision problem. A common misconception or misunderstanding is that dyslexia is a problem where letters or words get flipped. Seeing letters or words backwards or upside down, and writing backwards can be normal for early readers and writers. Children with dyslexia do not usually flip letters and words as part of their learning problem. So flipping letters or words, or writing backwards are not part of the definition of dyslexia. Letter and word flipping and skipping words have been shown to be a sign, not a cause, of reading problems and have been shown to come from speech and reading problems rather than vision or vision processing problems. Children with dyslexia often lose their place while reading because they have a hard time understanding a letter or word combination and/or because they don’t know what they are reading. These reading problems in children with dyslexia are not because of an “eye tracking” issue.
WHAT SHOULD I DO IF VISION THERAPY HAS BEEN PRESCRIBED?
Get a second opinion from an ophthalmologist who has experience in the care of children. Pediatric ophthalmologists can be recommended by your pediatrician or primary care provider. Additionally, if vision therapy is being prescribed in a child with learning problems, you may ask whoever is recommending this treatment for the scientific information that shows how it helps with learning problems.
SHOULD I GET MY CHILD’S EYES checked IF HE/SHE IS HAVING problems IN SCHOOL?
It is a good idea to have a full eye exam to be sure that there are no eye or vision problems if a child is having problems in school. An ophthalmologist who has experience with children would be best to do this type of exam. If there are vision problems those may need treatments in addition to treatments needed for learning problems. Refractive errors (problems focusing due to a need for glasses) may make it hard to see the board or to read. Other possible eye problems include strabismus (eye movement problems) and amblyopia (weak vision or lazy eye),
WHERE CAN I LEARN MORE ABOUT LEARNING AND READING DISABILITIES?
Your best source is your pediatrician or primary care provider. Other online resources for learning and reading problems include:
The official joint policy statement (2014) for learning disabilities, dyslexia, and vision of the American Academy of Pediatrics, the American Association for Pediatric Ophthalmology and Strabismus, and the American Academy of Ophthalmology can be found here