Vision Therapy: What It Is and Isn’t

According to the American Optometric Association (AOA), vision therapy is “… a sequence of neurosensory and neuromuscular activities individually prescribed and monitored by the doctor to develop, rehabilitate and enhance visual skills and processing.” This kind of therapy utilizes lenses, prisms and other specialized equipment to treat eye movement disorders, insufficient eye teaming such as convergence insufficiency, strabismus and amblyopia.

While vision therapy has been proven to be a successful treatment for strabismus, convergence insufficiency and amblyopia, as well as helping those with vision problems due to traumatic brain injury to see better, it can’t help with the following:
• “Cure” conditions like autism, attention deficit hyperactivity disorder
• Eliminate the need for eye glasses

Since vision therapy isn’t the cure all for every visual and neurological conditions, how does it help someone with certain visual processing disorders. Taking amblyopia as an example, one type of vision therapy that has shown good results is monocular fixation in a binocular field (MFBF). This is a vision therapy for amblyopia that trains both eyes to work to work together. In contrast, patching the “good eye” in a person with amblyopia, forces the “bad eye” to work harder.

One optometrist learned how effective MFBF can be during his residency. When Matt Roe, OD was a resident at the State University of New York College of Optometry, he wanted to give MFBF therapy a try in the beginning stages of therapy, not during the middle or end of therapy. A parent brought a child into the clinic with amblyopia and he talked about doing MFBF for the course of therapy. The parent agreed. After two months, the child’s vision went from 20/80 refractive amblyope with 5.00D of anisometropia down to 20/40. What Roe found by utilizing MFBF is that the stronger eye became a guide for the weaker eye.

Another instance where vision therapy proved helpful came from firsthand experience. When Alexandria Wiss, OD, was a child, she often saw double. Wiss often attributed this to being tired or stressed. High school was when she realized that something wasn’t right. She was planning to meet friends for a movie after she finished her homework. Her friends contacted her that they were finished and she wasn’t. Wiss then shadowed a pediatric optometrist and she saw him treat patients who were experiencing the same type of problems that she did. She received vision therapy and that lead to her specializing in vision therapy. Wiss now works at Hellerstein & Brenner Vision Center in Denver, Colorado where she sees primary care, pediatric and vision therapy patients. “I can talk to parents and tell them that I’m recommending vision therapy because I understand the possibilities unlocked by this therapy,” Wiss says.

So, when a patient mentions a particular vision therapy that he or she read on the Internet, that is when you have to put on the patient educator hat and remind the person that not everything on the Internet is as great as it seems. Still, for conditions that are responsive with vision therapy, the outcomes are very good.

Sources:

https://www.aoa.org/Documents/CRG/definition-of-optometric-vision-therapy.pdf

https://www.visiontherapy.org

https://www.tsbvi.edu/575-tx-senseabilities/summer-2018/5892-controversies-surrounding-vision-therapy

https://covdblog.wordpress.com/2018/06/20/treating-amblyopia-without-the-patch/

https://www.womeninoptometry.com/where-we-practice/atypical-models/article/even-for-an-a-student-misaligned-vision-made-school-harder/

http://www.strabismusworld.com/faq/how-to-rehabilitate-a-lazy-eye-while-promoting-binocularity/