As Wow Vision Therapy’s Director of Public and Professional Communications, one of the most common questions I receive is, “What is vision therapy? Is it like going to the eye doctor for glasses and contacts?” To that, I typically respond, “Well, not exactly” then proceed to explain the type of patients we treat and how our treatment is administered. And although glasses and contacts can play an essential role in treatment, vision therapy itself goes beyond seeing 20/20.
The thing is, most people do not know about this important subspecialty within optometry because vision therapy treats a smaller, but yet significant, portion of the population. While there is familiarity with the need for glasses and contact lenses as well as care for ocular diseases, there are a wide array of vision problems that vision therapy treats like:
- Amblyopia (lazy eye)
- Convergence insufficiency (CI)
- Strabismus (crossed or turned eyes)
- Post-concussion vision problems
- Eye tracking and eye focusing problems that affect learning
…plus many other visual conditions.
With that said, it is not uncommon for people to find out about vision therapy inadvertently. Perhaps a parent takes their child in for a behavioral or neuropsychological evaluation and discovers their child’s behavioral and/or learning problems are related to a common binocular vision problem known to affect reading and learning. And after vision therapy, that same child no longer struggles with schoolwork and now loves to read. Alternatively, maybe a parent took their child in for a routine eye exam and discovered their child has amblyopia, a condition known to affect depth perception. Then after vision therapy, that same child can see out of both eyes, is no longer clumsy and is doing better in sports.
These are just a few examples of how vision therapy improves the lives of its patients. So, what is it? Where did vision therapy come from?
Dating back more than 150 years, vision therapy started with ophthalmologists or eye surgeons to provide a safe and effective non-surgical alternative to strabismus (crossed eye) surgery. They developed what is known as orthoptics, which literally means straightening of the eyes. With orthoptics, the patient went through a series of eye exercises in an attempt to treat their eye coordination problems.
While these forms of treatment helped straighten the eyes, it did not resolve many other aspects of vision dysfunction these patients were experiencing, such as poor depth perception, poor tracking, focussing, processing visual information and integrating these functions with gross motor, fine motor, balance and auditory processing. These issues involved the entire visual system which involves much more than the coordination of the two eyes.
Knowing that these critical visual functions required a more advanced model of treatment, a group of optometric pioneers in the mid-twentieth century helped expand and develop the treatment model into what we now refer to as optometric vision therapy. They proposed that for vision therapy to be effective, it must reflect an understanding of the visual process to be more than a mechanical neuromuscular ability.
These treatments included:
- Binocular vision therapy
- Pursuit and saccade therapy (to improve the speed and accuracy of eye movements)
- Accommodative therapy (to enhance focusing stability, flexibility, and comfort)
- Visual-vestibular therapy (to integrate eye movements with balance)
- Visual perceptual therapy (to enhance visual information processing)
- Eye-hand coordination therapy (to develop visually guided movement)
- Visual attention therapy
- Peripheral awareness therapy (enhances the use of vision as a simultaneous sense, synchronously receiving and processing multiple inputs)
- Visual-spatial awareness including laterality, directionality, and visual imagery
- Visual-auditory integration
With this advanced form of treatment, patients were able to see and interact with the world normally. So what does optometric vision therapy look like today?
Today, the American Optometric Association defines vision therapy as a sequence of neurosensory and neuromuscular activities individually prescribed and monitored by a doctor to develop, rehabilitate, and enhance visual skills and processing. The evidence-based research tells us that the most effective model of care for optometric vision therapy is office-based vision therapy conducted under doctor supervision. While there have been attempts to simplify and provide a “self-help” home-based model of care (with periodic office visits) as a basic level of care for patients, research suggests that home-based model of care are ineffective.
On the other hand, office-based vision therapy is done in-office, typically for one hour, usually once or twice weekly. Each session is one-on-one (therapist-to-patient), conducted under doctor supervision. In addition to the office visits, home support activities are provided with careful weekly follow-up and guidance by the vision therapist. Additionally, office-based vision therapy incorporates coordinated movement, balance, auditory processing and cognitive abilities. With this method, optometrists and their therapists develop and/or rehabilitate their patients’ visual system based on models of neuroscience and perceptual learning. This comprehensive model for treatment is the proven design for consistently good outcomes.
Vision therapy is practiced not only in the United States but around the world as well. In fact, there is an international membership and board certification association called The College of Optometrists in Vision Development (COVD) that providers and patients can visit for more info about vision therapy.
Director of Public and Professional Communications
Wow Vision Therapy