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Vision Therapy

Posted by Ilena Di Toro | Posted on December 7, 2021

Many vision problems in children, such as dyslexia, convergence insufficiency or anomalies in fixation, saccades or pursuit eye movement, such as amblyopia/lazy eye can’t be detected by way of reading an eye chart. Of course, some such as strabismus/cross eyed have outward signs, such as one eye pointing in the wrong direction.

Of course, for all the vision problems that aren’t found in a doctor’s office, it can be easy to think that the child has attention deficit disorder or just hates reading. So, a comprehensive eye exam should be done before any learning disability screenings are done. Many children have been misdiagnosed with attention deficit disorder, when they really had a visual problem and were prescribed medications such as Ritalin or Adderall. While these medications work to increase focus and concentration, the side effects include sleep disruptions, nausea, loss or increase of appetite, mood swings, depression.

Once a correct diagnosis is made, vision therapy will be done and this involves weekly in-office and home exercises to retrain the visual system to both work better and relieve symptoms. It involves the use of lenses, prisms, eye patches and other instruments to teach better control of eye focusing and coordination. Vision therapy is a big help when a child presents with convergence insufficiency. In fact, results from studies from the Convergence Insufficiency Treatment Trial (CITT) Investigator Group showed that in-office therapy plus home reinforcement showed a 73 percent reduction in symptoms.

As for ways to treat amblyopia or lazy eye, in the past it included patching the good eye so that the vision in the eye that has amblyopia improves. The idea behind patching is that it forces the weaker eye to work harder so that vision will improve. While vision does improve with patching, it can be temporary once the patching regiment is done. Now research has shown that patching isn’t the best to treat amblyopia. Binocular vision therapy can be used to improve the vision of those with amblyopia.

Binocular vision therapy involves the viewing two identical images, similar to an old-fashioned stereoscope. Yet unlike a stereoscope, certain aspects of the images are either diminished or enhanced and the images are moving like a movie or cartoon. It works by targeting the development and strengthening the connections between the eyes and the brain so that both eyes work together for more comfortable vision. What makes binocular vision therapy so great is that it can be utilized on adults who have amblyopia. It was once thought that adults with amblyopia wouldn’t reap any benefits with binocular vision therapy. Studies have shown that it can help amblyopic adults with contrast sensitivity and depth perception.

When it comes to strabismus or cross eye, therapies for that also include eyeglasses, prism lenses, surgery and vision therapy. One novel, yet promising therapy is virtual reality. A patient wears a headset that has small video screens that present a virtual world. Sensors keep track of every movement so when the head changes position, the virtual display reacts accordingly. The scene being viewed is split into two images, one for the strong eye and one for the weak eye. The images are tweaked over the course of the therapy in order for the eyes to learn to work together and to eventually give the person three-dimensional vision.

One person who used virtual reality to correct strabismus is Betsy Yaros, an artist who was born prematurely and had surgery to correct strabismus. That surgery lead to other vision problems. When she read books, she would get headaches. She couldn’t drive because she couldn’t focus straight ahead. She did virtual reality therapy and within weeks she was able to see in three dimensions, something she was not able to do previously. In fact, one day she went for a walk and was startled by shrub. Before virtual reality therapy, she never noticed the details on shrubs and at first it looked like it was going to attack her. Of course, it didn’t.

Surgery and patches aren’t the only options when it comes to correcting visual problems. As more is learned about the vision, new ways of vision treating disorder are developed. Children and many times adults can reap the rewards that come with better vision.


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