vision therapy
Vision therapy (VT) - also known as visual training, vision training or visual therapy - is a group of techniques
attempting variously to correct or improve presumed ocular, oculomotor, visual processing and perceptual
disorders. Vision therapy encompasses a wide variety of non-surgical methods, which may be divided into two
broad categories: (1) orthoptic vision therapy, also known as orthoptics, and (2) behavioral vision therapy, also
known as behavioral or developmental optometry.
Orthoptics aims to treat binocular vision disorders such as strabismus and diplopia. It is practiced by
optometrists and ophthalmologists, as well as orthoptists under the guidance of some ophthalmologists and
pediatric ophthalmologists.
Behavioral vision therapy is practiced primarily by optometrists who specialize in this field. It treats additional
problems including difficulties of visual attention and concentration, which may manifest as an inability to sustain
focus or to shift focus from one area of space to another. The ability to shift the focus of visual attention from one
place to another affects many aspects of life, including reading, most vocations and most avocations. Eye doctors
may also prescribe vision therapy to those who suffer from eye strain and visually-induced headaches; however,
not all such therapy is limited to disorders of the visual system. Professional athletes, for example, may use
vision therapy to enhance sensitivity to peripheral vision on the playing field or increase responsiveness to fast
moving objects.
History
Various forms of visual therapy have been used for centuries. The concept of vision therapy was introduced in the
late 19th century for the non-surgical treatment of misaligned eyes. This early and traditional form of vision therapy
is what is now known as orthoptics. Collaboration of some eye care professionals with educators and
neuroscientists produced an expansion of vision therapy into the treatment of other eye teaming (binocular)
deficits (the use of the flow through the right and left eyes simultaneously to the brain) as well as dysfunctions in
visual focusing, perception, tracking and motor skills.
As a result of this expansion and ensuing confusion over what the term "vision therapy" includes, there is some
controversy as to the use of vision therapy for individuals with learning disorders.
Although ophthalmologists and orthoptists often perform several components of visual therapy, most
non-strabismic VT is performed by optometrists.
Indications
There is widespread acceptance of orthoptic therapy indications for convergence insufficiency. Patients who
experience eyestrain, "tired" eyes, or diplopia (double vision) while reading or performing other near work, and
who have convergence insufficiency may benefit from orthoptic treatment. Patients whose outward drift occurs at
distance rather than at near distance are less ideal candidates for treatment.
Major optometric organizations, including the American Optometric Association, the American Academy of
Optometry, the College of Optometrists in Vision Development, and the Optometric Extension Program, support
the assertion that vision therapy does not directly treat learning disorders, but rather addresses underlying visual
problems which are claimed to affect learning potential.
Advocates cite a number of indications for the use of vision therapy. Some assert that poor eye tracking affects
reading skills, and that improving tracking can improve reading.
Efficacy
In 1988, a review of 238 scientific articles was published in the Journal of the American Optometric Association
defining vision therapy as "a clinical approach for correcting and ameliorating the effects of eye movement
disorders, non-strabismic binocular dysfunctions, focusing disorders, strabismus, amblyopia, nystagmus and
certain visual perceptual (information processing) disorders." The paper concluded, "It is evident from the
research that there is scientific support for the efficacy of vision therapy in modifying and improving oculomotor,
accommodative, and binocular system disorders, as measured by standardized clinical and laboratory testing
methods for patients of all ages for whom it is properly undertaken and employed."
Convergence insufficiency is a common binocular vision disorder characterized by asthenopia, eye fatigue and
discomfort. Asthenopia may be aggravated by close work and is thought by some to contribute to reading
inefficiency. In 2005, the Convergence Insufficiency Treatment Trial published two large, randomized clinical
studies examining the efficacy of orthoptic vision therapy in the treatment of symptomatic convergence
insufficiency. Although neither study examined reading efficiency or comprehension, both demonstrated that
in-office vision therapy was more effective than "pencil pushups" (a commonly prescribed home-based treatment)
for improving the symptoms of asthenopia and the convergence ability of the eyes. The design and results of at
least one of these studies has been met with some reservation, questioning the conclusion as to whether
intensive office-based treatment programs are truly more efficacious than a properly implemented home-based
regimen.
Vision therapy (VT) - also known as visual training, vision training or visual therapy - is a group of techniques
attempting variously to correct or improve presumed ocular, oculomotor, visual processing and perceptual
disorders. Vision therapy encompasses a wide variety of non-surgical methods, which may be divided into two
broad categories: (1) orthoptic vision therapy, also known as orthoptics, and (2) behavioral vision therapy, also
known as behavioral or developmental optometry.
Orthoptics aims to treat binocular vision disorders such as strabismus and diplopia. It is practiced by
optometrists and ophthalmologists, as well as orthoptists under the guidance of some ophthalmologists and
pediatric ophthalmologists.
Behavioral vision therapy is practiced primarily by optometrists who specialize in this field. It treats additional
problems including difficulties of visual attention and concentration, which may manifest as an inability to sustain
focus or to shift focus from one area of space to another. The ability to shift the focus of visual attention from one
place to another affects many aspects of life, including reading, most vocations and most avocations. Eye doctors
may also prescribe vision therapy to those who suffer from eye strain and visually-induced headaches; however,
not all such therapy is limited to disorders of the visual system. Professional athletes, for example, may use
vision therapy to enhance sensitivity to peripheral vision on the playing field or increase responsiveness to fast
moving objects.
History
Various forms of visual therapy have been used for centuries. The concept of vision therapy was introduced in the
late 19th century for the non-surgical treatment of misaligned eyes. This early and traditional form of vision therapy
is what is now known as orthoptics. Collaboration of some eye care professionals with educators and
neuroscientists produced an expansion of vision therapy into the treatment of other eye teaming (binocular)
deficits (the use of the flow through the right and left eyes simultaneously to the brain) as well as dysfunctions in
visual focusing, perception, tracking and motor skills.
As a result of this expansion and ensuing confusion over what the term "vision therapy" includes, there is some
controversy as to the use of vision therapy for individuals with learning disorders.
Although ophthalmologists and orthoptists often perform several components of visual therapy, most
non-strabismic VT is performed by optometrists.
Indications
There is widespread acceptance of orthoptic therapy indications for convergence insufficiency. Patients who
experience eyestrain, "tired" eyes, or diplopia (double vision) while reading or performing other near work, and
who have convergence insufficiency may benefit from orthoptic treatment. Patients whose outward drift occurs at
distance rather than at near distance are less ideal candidates for treatment.
Major optometric organizations, including the American Optometric Association, the American Academy of
Optometry, the College of Optometrists in Vision Development, and the Optometric Extension Program, support
the assertion that vision therapy does not directly treat learning disorders, but rather addresses underlying visual
problems which are claimed to affect learning potential.
Advocates cite a number of indications for the use of vision therapy. Some assert that poor eye tracking affects
reading skills, and that improving tracking can improve reading.
Efficacy
In 1988, a review of 238 scientific articles was published in the Journal of the American Optometric Association
defining vision therapy as "a clinical approach for correcting and ameliorating the effects of eye movement
disorders, non-strabismic binocular dysfunctions, focusing disorders, strabismus, amblyopia, nystagmus and
certain visual perceptual (information processing) disorders." The paper concluded, "It is evident from the
research that there is scientific support for the efficacy of vision therapy in modifying and improving oculomotor,
accommodative, and binocular system disorders, as measured by standardized clinical and laboratory testing
methods for patients of all ages for whom it is properly undertaken and employed."
Convergence insufficiency is a common binocular vision disorder characterized by asthenopia, eye fatigue and
discomfort. Asthenopia may be aggravated by close work and is thought by some to contribute to reading
inefficiency. In 2005, the Convergence Insufficiency Treatment Trial published two large, randomized clinical
studies examining the efficacy of orthoptic vision therapy in the treatment of symptomatic convergence
insufficiency. Although neither study examined reading efficiency or comprehension, both demonstrated that
in-office vision therapy was more effective than "pencil pushups" (a commonly prescribed home-based treatment)
for improving the symptoms of asthenopia and the convergence ability of the eyes. The design and results of at
least one of these studies has been met with some reservation, questioning the conclusion as to whether
intensive office-based treatment programs are truly more efficacious than a properly implemented home-based
regimen.
 |
| |
 |
| |
 |
| |
 |
| |
 |
| |
 |