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Vision Therapy

What is Vision Therapy?

The American Optometric Association defines vision therapy as “….a sequece of activities individually prescribed and monitored by the doctor to develop efficient visual skill and processing. It is prescribed after a comprehensive eye examination has been performed and has indicated that vision therapy is an appropriate treatment option. The vision therapy program is based on the results of standardized tests, the needs of the patient and the patient’s signs and symptoms. The use of lenses, prisms, filters, occluders, specialized instruments and computer programs are an integral part of vision therapy” (available at www.aoa.org/x5411.xml)

Research has demonstrated vision therapy can be an effective treatment option for:

  • Ocular motility dysfunctions (eye movement disorders)
  • Non-strabismic binocular disorders (inefficient eye teaming)
  • Strabismus (misalignment of the eyes)
  • Amblyopia (poorly developed vision)
  • Accommodative disorders (focusing problems)
  • Visual information processing disorders, including visual-motor integration and integration with other sensory modalities

AOA Evidence Based Research Position Paper

Visual Acuity, Visual Efficiency and Visual Perception

Vision is more than 20/20. Approximately 80% of learning opportunities involve vision in some manner. Reading, spelling, writing, taking notes, copying from the board, watching classroom demonstrations and sports related activities require the eyes to work together as a team and for the brain to process and filter the perceptual data into meaningful information.

Learning disabilities are usually composed of several factors and variables. Research has shown that visual perceptual and efficiency disorders are seen in 40% of children labeled with a learning disability. Addressing the barriers that inhibit and/or slow the normal cognitive developement of a child may require various professionals including optometrist, psychologists and educators.

Visual Acuity

Visual acuity is simply the ability to see small detail at a given distince. We often hear that 20/20 is the best vision. However, it has been shown that it is possible for the visual system to theoretically see down to 20/7. In fact, visual acuity is better than 20/20 in most professional athletes.

Visual acuity is the most important aspect to any visual system and plays an important part in normal motor and cognitive development.

The first step in addressing any visual disorder is to correct the visual acuity to an acceptable level. This often can eliminate or rapidly improve other visual disorders.

Visual Efficiency

The ability of your eyes to team together begins early in life. Without proper visual input into both eyes during the early years of life, a significant and sometimes permanent visual barrier might develop.

Binocular vision is the ability of your eyes to integrate the information from both eyes into a single image.

Accommodation is the ability of the eyes to clear the image at various distances.

The binocular system needs to work efficiently with the accommodating sytem to have a single fused clear image.

Sometimes the visual system may be able to form a single clear image, but the effort to maintain a single clear image can create visual stress.

Often this leads to several of the signs of a visual efficiency disorder:

  • Complaints of blurred vision
  • Rubbing eyes frequently
  • Squinting
  • Closing or covering one eye
  • Seeing double
  • Able to read for only a short time
  • Poor reading comprehension
  • Holding things very close
  • Tired eyes
  • Headaches when reading
  • Moving head excessively when reading
  • Frequently losing place, skipping lines when reading
  • Using finger to keep place
  • Poor reading comprehension
  • Short attention span

Visual Perception

Visual perception is the active process of extracting and locating information from the environment Visual perception is the dominant perceptual modality. When a child has school-related learning problems, visual information processing skills should be considered and assessed by a behavioral optometrist.

The symptoms of visual perceptual disorders can include:

  • Poor reading comprehension
  • Short attention span
  • Mistakes with words of similar beginnings
  • difficulty recognizing letters, words or simple shapes and form
  • Difficulty distinguishing the main idea from insignificant details
  • Trouble learning basic math concepts of size magnitude, and position
  • Trouble visualizing what is read
  • Poor reading comprehension
  • Poor spelling
  • Poor recall of visually presented material trouble learning right and left
  • Reversal of letters and words
  • Trouble writing and remembering letters and numbers

Visual perceptual disorders can often be one of the most significant barriers to a child with a learning disability. An assessment of the visual processing skills is recommended in all individuals that have been labeled with a learning disability.