Eye Care

Vision Therapy

What is

Vision Therapy

Vision therapy is a carefully personalized program of vision procedures aimed at treating eye teaming problems, eye focusing disorders and eye tracking deficits. This is a safe, non-surgical process utilizing specialized equipment for in-office exercises and supplemented with in-home activities. Vision therapy helps to enhance the brain and eyes’ ability to work together in order to provide clear and comfortable vision.

Neuro-Optometric Rehabilitation Therapy

Visual deficits can be a direct result of acquired brain injuries (concussion, trauma, stroke, etc) and other neurological conditions (multiple sclerosis, seizure disorders, etc). Damage occurs to parts of the brain responsible for visual function.

Post Trauma Vision Syndrome (PTVS) symptoms include:
  • Blurry vision
  • Light sensitivity
  • Headaches
  • Dizziness/nausea
  • Double vision
  • Eyestrain
  • Losing place when reading
  • Balance difficulties
  • Changes to peripheral (side) vision

A Neuro-Optometric Asessment by the optometrist can help determine how a person’s visual system has been affected by an injury or disease process. Treatment includes specialized glasses and neuro-optometric rehabilitation therapy. Rehabilitation helps to improve the brain and eye’s ability to function together again.

 

An integrated multi-disciplinary team approach plays a crucial role in the recovery plan. This may include physical, occupational, and vestibular therapy.

Black guy stressting and headache

How does Vision Therapy Work?

Vision therapy helps to improve visual skills with the use of special optical devices such as therapeutic lenses, prisms, and filters. Throughout therapy, these newly acquired visual skills are reinforced and become automatic. Vision therapy is performed under doctor supervision.

Who is

Vision Therapy for?

Vision therapy is effective for both children and adults.

Some symptoms indicating a visual problem and may warrant vision therapy include:

  • Eyestrain
  • Double vision
  • Skipping lines/words while reading
  • Avoiding reading
  • Tired/fatigue after a short period of reading
  • Eye rubbing while reading
  • Intermittent blur while reading
 

Some visual problems that can be improved with vision therapy include:

  • Eye tracking
  • Eye focusing
  • Binocular vision and strabismus (eye turn)
  • Amblyopia (lazy eye)
 

“20/20” vision only means that one can see, but may be lacking the skills needed for learning. 1 in 10 children have a vision problem significant enough to affect their learning. 80% of learning is visual and 20% of all learning disabilities are due to learning-related vision problems.

Tired child rubs his eyes.
Schoolgirl using a maths abacus in classroom

What is

Visual Information Processing (VIP)?

Vision is much more than seeing “20/20.” Vision also includes how our eyes function (eye teaming, focusing, tracking) and processing/perception.

VIP is our brain’s ability to obtain, understand, and utilize visual information. VIP disorders can greatly affect learning in children and they can also arise from acquired brain injuries.

VIP Skills:

  • Visual-Motor Integration
  • Visual Memory
  • Form Perception
  • Visual Spatial Directional Concepts
  • Visual Processing Speed

SIGNS OF VIP DISORDER:

  • Slow reader
  • Below grade-level reading comprehension
  • Difficulty completing work under timed conditions
  • Poor hand writing skills
  • Letter reversals
  • Difficulty remember what has been viewed
  • Poor visual learner


VIP skills are improved and developed through Vision Therapy. Results are achieved techniques that help the brain to strengthen and form new connections in order to develop these skills.

VIP skills are not tested for during a routine eye exam. Contact us for a Visual Information Processing Assessment to help determine if Vision Therapy is the right treatment for you or your child.

Contact us for a Vision Therapy Assessment to find out if it is the right course of treatment for you.

What is

Convergence Insufficiency?

Convergence insufficiency (CI) is a highly treatable binocular vision condition that affects near vision and eye muscle coordination. Convergence of the eyes occurs when the two eyes need to focus on a close object, such as a book, computer, tablet, smartphone, etc.

Convergence insufficiency means the eyes struggle to focus easily for near tasks, affecting school work, attention and office performance in adults. 

A proper diagnosis of CI can prevent a child from being labelled as “lazy,” “spacey,” “clumsy”, “anxious,” and even misdiagnosed with ADHD, dyslexia, or mild autism. 

CI affects up to 1 in every 8 children, that is 13% of all school-aged students.

It is therefore possible, that four children in every classroom may be struggling with this condition!

Diagnosis and treatment of CI is essential for your child’s success in reading, learning, sports performance, and more.

Schedule an exam with an eye doctor who has experience diagnosing and treating CI with vision therapy, if you think that your child could be 1 of the 8 children affected by CI.

There are many different symptoms that can develop as a result of CI— these are the most common:

  • Eyestrain
  • Headaches or muscle
  • tension
  • Blurred or double vision
  • Difficulty reading and
  • concentrating
  • Uses finger or ruler when
  • reading
  • Avoidance of close work
  • Poor hand-eye coordination
  • Anxiety
  • Motion sickness/dizziness


If your child has CI, the following tasks may be challenging:

  • Homework
  • Computer work
  • Attention
  • Reading
  • Writing
  • Comprehension
  • Making crafts

A comprehensive eye exam including specific analysis of visual skills, binocular vision, convergence and focusing is required to enable identification of CI.

A basic eye exam or screening with the 20/20 eye chart is not adequate for the detection of CI.

Convergence insufficiency frequently goes undetected in school age children because comprehensive testing for CI is not included in pediatrician or school vision screenings, and standard eye exams conducted by ophthalmologists.

If an eye test does not include the specific tests mentioned above, this condition may remain undetected, affecting the child’s school and sports performances.

While the good news is that CI responds well to proper treatment— unfortunately, since many children are not assessed for CI, they are not getting the help they need early in life, if ever at all.

Children, teenagers and adults who remain undiagnosed and untreated tend to avoid reading and close work as much as possible or use various strategies to combat symptoms, such as using a ruler or finger to keep one’s place while reading or taking frequent breaks.

 

If untreated, CI can lead to more serious eye problems such as lazy eye (amblyopia) or even an eye turn (strabismus).

If the convergence problems are left untreated, suppression can result. Suppression of vision in one eye occurs when the brain actively shuts off one eye, causing loss of binocular (two-eyed) vision and depth perception.

In this case, some or all of the following symptoms may present:

  • Trouble catching balls and other objects thrown through the air
  • Avoidance of sports and games that require accurate depth perception
  • Frequent mishaps due to misjudgment of physical distances:
    • Trips and stumbles on uneven surfaces, stairs, and curbs
    • Frequent spilling or knocking over of objects
    • Bumping into doors, furniture and other stationary objects
    • Sports accidents
  • Avoidance of eye contact
  • Poor posture while doing activities requiring near vision
  • Frequent head tilt
  • Problems with motion sickness and/or vertigo

Contact a us, if your child has experienced any of the above symptoms.

Vision therapy is the most effective treatment for CI.

Treatments for CI can be categorized as active or passive:

  • Active treatment: A multi-site randomized clinical trial funded by the National Eye Institute called the Convergence Insufficiency Treatment Trial showed:
    • The best treatment for CI is supervised vision therapy in a clinical office with home reinforcement (15 minutes of prescribed vision exercises done in the home five days per week).
    • Children responded quickly to this treatment protocol
    • 75% of all children achieved either full correction of their vision or saw marked improvements within 12 weeks.
  • Passive treatment: Prismatic (prism) eyeglasses can be prescribed to decrease some of the symptoms.
    • Although prism eyeglasses can relieve symptoms, they are not a “cure” and the patient typically remains dependent on the prism lenses.
    • Adaptation problems can lead to the need for stronger prescriptions in the future.

Scientific research, as well as optometric and ophthalmological clinical trials, agree that the primary treatment of CI should be vision therapy.

Unfortunately, No.

Some ophthalmologists may still treat children with ‘pencil-push-ups’. While a 2002 survey of ophthalmologists and optometrists indicated that home-based pencil-push-ups therapy is the most common treatment, scientific research does not support this method.

Studies done on pencil push-ups have shown it to be ineffective in eliminating symptoms.

Vision therapy is highly recommended for treatment of CI.

Standard eyeglasses, contact lenses, medications, and surgery will not be effective in treating the condition. Vision therapy focuses on training the eyes to work together to improve 3-D vision, depth perception, and clear binocular vision.

Treatment exercises for CI may include:

  • Eye tracking with pursuits and saccades
  • Focusing for near and distance
  • Depth perception practice
  • Specialized equipment and tools such as prisms and lenses
  • Training with computerized technology

The goal of vision therapy is to stimulate the communication between the brain and eyes, to enable clear and comfortable vision at all times.

According to Dr. Michael J. Bartiss, O.D., M.D., F.A.A.O., F.A.A.P., F.A.C.S, Pediatric Ophthalmologist, “Fortunately, in most cases, convergence insufficiency is very amenable to orthoptics and vision therapy.”

If you think your child may have CI, schedule an eye exam to assess your child’s vision skills.

Recent published studies have shown that CI can be effectively treated.

An eye doctor near you can prescribe a customized vision therapy program, tailored to your child’s specific needs. Vision therapy can improve your child’s binocular vision— facilitating your child’s healthy development of many essential life skills.

Gorgeous girl with huge eyes looking into camera