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Some visual conditions cannot be treated adequately with just glasses, contact lenses and/or patching, and are best resolved through a program of Vision Therapy.
What is Vision Therapy?
Vision Therapy is an individualized, supervised, treatment program designed to correct visual-motor and/or perceptual-cognitive deficiencies. Vision Therapy sessions include procedures designed to enhance the brain's ability to control:
- eye alignment
- eye teaming
- eye focusing abilities
- eye movements
- visual processing
Visual-motor skills and endurance are developed through the use of specialized computer and optical devices, including therapeutic lenses, prisms, and filters. During the final stages of therapy, the patient's newly acquired visual skills are reinforced and made automatic through repetition and by integration with motor and cognitive skills.
Sometimes people with untreated eye conditions are mislabeled as:
- Attention Deficit Disorder
- Learning Disabled
- Dyslexic
- Lazy
Who Can Benefit From Vision Therapy?
Patients of all ages can benefit from vision therapy. The nature of the therapy program varies with the condition treated. For example, a three-year-old child with amblyopia, or "lazy eye", may simply have the better eye patched for a short period of time. An eight-year-old child with strabismus, or an “eye turn” may require therapy for a period of a year. A thirty-year-old computer programmer may require six months to solve a visual problem that causes significant eye strain.
Children and adults with visual challenges such as the following are often benefited by vision therapy.
Learning-related Vision Problems
Vision Therapy can help those individuals who lack the necessary visual skills for effective reading, writing, and learning (i.e., eye movement and focusing skills, convergence, eye-hand activity, visual memory skills, etc.).
To learn more about vision-related learning problems, visit COVD.
Poor Clarity and Binocular Coordination
Sight is just how clearly a person sees. But there is much more to getting information into a person’s brain than just seeing something clearly. Vision is the act of perceiving visual information with the eyes (Is it double or single? Is it clear? Where is it in space?), mind (visual memory, etc), and body (interacting with what you see). Vision Therapy helps individuals develop normal coordination and teamwork of the two eyes (binocular vision). When the two eyes fail to work together as an effective team, performance in many areas can suffer (reading, sports, depth perception, eye contact, etc.). Some common types of clarity and eye teaming problems are:
- Convergence Insufficiency
- Convergence excess
- Accommodative problems
- Difficulty tracking (saccadic dysfunction)
- Poor Stereopsis
- Suppression
Strabismus
Strabismus ("crossed eye", "wall eye", "wandering eye", esotropia, exotropia): affects approximately 4 out of every 100 children in the United States. It is a visual defect in which the two eyes point in different directions. One eye may turn either in, out, up, or down while the other eye aims straight ahead. Due to this condition, both eyes do not always aim simultaneously at the same object. This results in a partial or total loss of stereo vision and binocular depth perception. The eye turns may be visible at all times or may come and go. In some cases, the eye misalignments are not obvious to the untrained observer. Vision Therapy programs offer much higher cure rates for turned eyes and/or lazy eye when compared to eye surgery, glasses, and/or patching, without therapy. The earlier the patient receives Vision Therapy the better; however, our office has successfully treated patients of all ages…adults as well as children.
Amblyopia
Amblyopia, commonly called lazy eye, occurs when the eyes do not develop properly. This results in seeing poorly out of one or both eyes. Amblyopia is the most common cause of visual impairment in both children and young adults, affecting about 3% of the population.
Symptoms of amblyopia
It is hard to spot amblyopia. Parents often do not realize than anything is wrong with their child’s eyes until they are told about it by their doctor. Sometimes a child will noticeably favor one eye over the other or bump into things on one side. The best way to tell if your child has amblyopia is through a comprehensive eye exam at ages six months, three years, five years, and then annually. Early diagnosis can prevent amblyopia from leading to more serious problems, such as loss of the ability to see three dimensions or functional blindness in the amblyopic eye.
Types of amblyopia
In general, amblyopia is caused by a lack of seeing well while the eyes are developing during infancy and early childhood. There are several types of amblyopia, each of them is a different way that one or both eyes does not see clearly during the developmental period. This blur is so significant that the brain does not learn to see correctly.
Refractive Amblyopia is caused when a baby or young child has high or unequal amounts of far-sightedness, near-sightedness, or astigmatism and they do not get glasses or contact lenses to treat it when they are young. The extreme blur does not allow the connections between the eye and brain to properly develop.
- Strabismic Amblyopia is caused when a baby or young child has one eye that is constantly turned in, out, up or down. The turned eye is “shut off” or not used, and therefore does not develop vision properly.
- Deprivation Amblyopia is caused when a baby or young child has a condition that is blocking vision out of one or both eyes, such as a cataract or droopy eye lid, and the lack of visual stimulation stops the development of the visual centers in the brain.
How to treat amblyopia?
The best way to decrease amblyopia in the population is prevention. The American Optometric Association recommends comprehensive eye evaluations, in addition to pediatrician well-visits, at ages 6 months, 3 years, 5 years, and every year while the child is in school. Because of the importance of early detection for vision and ocular health conditions, many optometrists are providers for the InfantSEE™ program www.infantsee.org, which provides a complimentary comprehensive vision and ocular health evaluation for children less than 12 months of age.
Amblyopia will not go away on its own. Although treating amblyopia during the “critical period” before seven years of age gives the chances of the best possible vision, treatment of some types of amblyopia can take place at any age. However, the length of the treatment period increases dramatically the older the patient is. Research has also demonstrated that patients with amblyopia are more likely to sustain injuries resulting in the loss of their good eye than individuals with two good eyes.
Management is dependent on the type of amblyopia that is present. If the child has refractive amblyopia, treatment starts with glasses or contact lenses in the correct prescription. Deprivation amblyopia must be treated during the first few months of life and starts with removing the occlusion (taking out the cataract, surgically raising the lid). Treatment of all types often includes patching the eye with better vision or putting dilating drops in the better eye. Treatment can take weeks or months. This corrects amblyopia by training the brain to use visual signals from the eye with weaker vision, building a stronger connection between the brain and the weak eye, and allowing vision to develop normally in that eye. Patching is most effective in conjunction with an active vision therapy program .
National Eye Institute Amblyopia Resource Guide http://www.nei.nih.gov/health/amblyopia/index.asp
Stress-induced Visual Difficulties
21st century lifestyles demand more from our vision than ever before. Children and adults in our technological society constantly use their near vision at work and at home. C.V.S. (Computer Vision Syndrome) is one of the fastest growing health concerns in the workplace today. Environmental stresses on the visual system (including excessive computer use or close work) can induce eyestrain, headaches, and/or visual difficulties which can be effectively treated with corrective lenses and/or Vision Therapy.
Visual Rehabilitation for Special Populations
Vision can be compromised as a result of neurological disorders or trauma to the nervous system (such as traumatic brain injuries, stroke, whiplash, developmental delays, cerebral palsy, multiple sclerosis, etc.). Vision Therapy can effectively treat the visual consequences of these conditions.
Sports Vision Improvement
Strong visual skills are critical to sports success. Not much happens in sports until your eyes instruct your hands and body what to do! Accurate vision and athletic visual skills can be measured, developed, and enhanced through Vision Therapy. We measure and successfully improve eye-hand coordination, visual reaction time, peripheral awareness, eye teaming, focusing, tracking, and visualization skills (to mention just a few).
Vision Therapy can be the answer to many visual problems. To look up your specific problem, visit COVD and click on “vision conditions” on the left-hand side of the page.
Our Program
Dr. Gina Gabriel
Gina is the director of the Vision Therapy Program at Eagle Vision and Eye Clinic. She is the doctor who does the initial evaluation to assess the need for Vision Therapy and monitors the treatment with regular Progress Checks throughout the program.
The Vision Therapists who will be working with you weekly are
Elizabeth Simpson, B.C., OPT.A.R., C.O.V.T.T.
Elizabeth received her Bachelor of Science Degree in Consumer Studies at SUNY Buffalo in 1982. She worked at Harvard Community Health Plan Member Service Department, first as a health care representative and progressing to supervisor over a five year period. She later supervised the contact lens clinic at the New England College of Optometry. Since 1994 she has worked at Eagle Vision and Eye Clinic both as a vision therapist and optometric assistant. After extensive national testing she received her Opt. A. R. (registered optical assistant) certification in 1997. Elizabeth received her certification in vision therapy in 1999. This process included 2000 hours of experience, an open book essay test, a written test and finally oral testing by the College of Optometrists in Vision Development. Elizabeth continues her education through annual vision therapy seminars and conferences.
Carol Weber, B.S.
Carol received her Bachelor of Science Degree in Elementary Education in 1973 from Martin Luther College at New Ulm, Minnesota. She was a teacher in Lutheran Elementary schools for 17 years. She has also worked at the preschool level for five years. Carol came to Eagle Vision and Eye Clinic in 2001. She was trained in vision therapy by Dr. Susan Ward-Moon and has attended multiple clinics and workshops in vision therapy. Carol continues ongoing training at annual vision therapy seminars and conferences.
Frequently asked questions re: vision therapy
Is Vision Therapy New?
Although it is a dynamic optometric specialty that improves visual function and performance, vision therapy is actually an outgrowth of orthoptics. Orthoptics, which literally means "straightening of the eyes,” was introduced to this country by physicians in the late 1800s. As physicians became more focused on eyeglasses, medication , and surgery, the benefits of orthoptics were taught to fewer and fewer practitioners. However, optometrists in the mid 1900's took the best that orthoptics had to offer, and pioneered the development of vision therapy.
What Is Involved in a Vision Therapy Program?
Patients typically come to the office once or twice weekly for forty minutes each visit. Patients will also do daily activities at home to reinforce what was learned during the office therapy sessions. Commitment to the home therapy activities and maintaining a schedule of weekly visits are important in the success of the program.
Can I Just Do the Therapy at Home by Myself?
Vision therapy programs are individualized for the patient, and careful guidance and frequent monitoring are required for success. When attempted by patients without guidance, poor visual habits may actually be reinforced. In addition, specialty computer programs with liquid crystal polarizing goggles and other specialized instrumentation are used which do not lend themselves to unsupervised use at home.
Will My Insurance Cover Vision Therapy?
Some of the better health insurance policies cover the medical aspect of vision therapy, however this is rare. Coverage has no relationship to vision care plans which cover eye examinations, eyeglasses, or contact lenses once every year or two. Do not allow insurance companies to make arbitrary decisions that prevent you or your child from receiving necessary care.
Is there any research supporting Vision therapy?
Follow these link to see lots of research supporting Vision Therapy.
What are some things our patients have said about the Vision Therapy program…
“We are surprised at the difference.” –CG
“We all are very happy. Both school work and reading have gotten easier.” –KV
“I haven’t had headaches in months.” –DI
“I’m enjoying reading, my comprehension is better, and I read faster.” –AD
“…great focusing ability, improved reading and confidence, and improvement in hand/eye coordination.” --JW
“She has gone from a first grade reading level to third grade! Her confidence has improved as well as speed and focusing. She doesn’t ever read words backwards anymore…I truly believe, without this program, she never would have been an accomplished and confident reader…Carol and Elizabeth are incredible! Dr. Gabriel is fantastic. Thank you so much. It was worth every penny and minute we spent on it.” -BJ
“Vision therapy is a huge commitment on the child and parents; however, it’s worth the investment. My son’s reading test scores jumped 100 points 5 months into vision therapy. He’s now reading at grade level.” –BB
“We are grateful for the opportunity to do vision therapy to help heal our son’s eyes and make them stronger. Carol and Elizabeth were so helpful and positive. It’s not easy with a six year-old but the opportunity to have healthy eyes wasn’t an option. With perseverance we did it!” –MS
“…great focusing ability, does not complain about blurry words, improved reading and confidence, and improvement in hand eye coordination” –JW
“…increased confidence, better spelling” –LR
“Reading is much smoother, comes with less concentration/hardship…even reads beyond “time” if he’s enjoying the story…fewer letter reversals, fewer missed words and scanning over words or skipping lines when reading.” –SP
“Vision Therapy made daily tasks of reading and schoolwork easier once he worked and trained his eye muscles to do what they were meant to do.” -EW
The following are some examples of symptoms of a person who may benefit from Vision Therapy
- Dislikes reading
- Words seem to move or float on the page
- Working below potential
- Uses finger as a marker
- Skips words, confuses small words, or loses place when reading
- Holds material very close or very far away
- Avoids near tasks
- Blurred vision at near
- Blurred vision at far
- Headaches
- Squinting, eye rubbing, or excessive blinking
- Reverses letters/numbers/words when reading (after 2nd grade)
- Double vision
- Slow change in focus from near to far (or far to near)
- Rubs eyes a lot while reading
- Reads slowly
- Closes or covers one eye
- Eyes that are not aligned
- Working below potential
- Tilts head frequently
- Attention Deficit Disorder (either suspected or diagnosed)
- Learning Disability (either suspected or diagnosed)
- Dyslexia (either suspected or diagnosed)
- Eye strain or fatigue with reading or computer work
- History of a fall, accident, or concussion
- Developmental problem (cp, etc)
- Tutoring or special education
- Distractible at school or work
- Behavioral problems
- Below average reading, comprehension, math, spelling
- Failure to recognize the same word in the next sentence
- Difficulty copying from the chalkboard
- Poor handwriting, misaligns numbers
- Avoidance of/ inconsistent or poor sports performance
- Clumsiness
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