Vision Therapy Overview
Vision therapy is an individualized program of prescribed activities using specialized instruments and computer technology to redevelop and strengthen the neuro-connections between the brain and the visual system thus improving deficient visual skills. Through repetition and intensity, the improved and developed skills become automatic and transfer to everyday function that impact academic, work and sports performance. It is the treatment of choice for diagnosed visual disorders that contribute to reading and learning difficulties. The efficacy of Vision therapy is supported by ongoing evidenced-based clinical research.
OCVT’s vision therapy treatment program consists of Doctor prescribed and supervised one-on-one weekly in clinic sessions directed by a highly trained vision therapist. To reinforce the developed skills in clinic, a specialized program of activities are implemented at home. Regular progress evaluations monitor progress and modify treatments as needed. The Vision Therapy program duration is dependent on severity levels of performance on standardized testing, signs and symptoms and each patient’s individual needs. The program can vary from a few to several months. Read More
Children and adults with:
Learning-related Vision Disorders
Research indicates that 25% of children are affected by a learning-related vision disorder. In these cases, one or more of a child’s visual systems has a deficiency that is inhibiting their ability to learn and achieve at their highest potential. There are two primary types of visual skills that can be affected: efficiency and processing skills. Efficiency skills are related to the mechanics of how the eyes move, track, team, and focus together. If any of those skills are deficient, then the information being sent to the brain could be incorrect, causing a child to lose their spot when reading, inaccurately perceive depth, or copy the wrong word from the board. Processing skills are related to how the sensory information provided by the eyes is processed in the brain. If one of these skills are deficient, children may not be able to quickly grasp math concepts and number values, spell age-appropriate words correctly, or may reverse or transpose letters or numbers when either reading or writing. All of these skills can be tested by a developmental optometrist, and if deficiencies are found, an individualized course of vision therapy can help bring those skills up to age-appropriate levels, allowing the child to learn and achieve their best.
Attention Deficit Hyperactivity Disorder or ADHD is being diagnosed with increasing frequency in both children and adults. ADHD is often diagnosed with children who display inappropriate inattention, impulsivity, distractibility and sometimes hyperactivity for their mental and chronological age. Undetected and untreated vision problems can prompt some of the same signs and symptoms that are commonly attributed to ADHD. In order to determine if a vision problem is causing some or all of these symptoms, a full functional eye exam should be completed with a Developmental Optometrist. Vision Therapy can develop visual skills that will increase visual attention and overall visual function that will allow the individual to sustain attention for longer periods of time.
Amblyopia (Lazy Eye)
Amblyopia, often referred to as a “lazy eye”, is a condition where an eye is unable to see clearly due to neurological neglect. This occurs as a result of either strabismus (eye-turn) or an untreated refractive error. The brain learns to ignore an eye that does not have proper optic nerve development in order to avoid either double vision or blur. As a consequence of the brain receiving input from only one eye, depth perception or seeing in three dimensions does not occur. Vision therapy treats amblyopia by teaching the brain to receive feedback from both eyes in order to increase acuity and binocular functioning. “Learning to see” at any age is the basis of amblyopia treatment.
Autism Spectrum Disorders
Autism Spectrum Disorder (ASD) is a range of childhood developmental conditions characterized by social, behavioral, and communication deficits. Many individuals with ASD commonly have problems with sensory integration that often affect the visual system and other sensory-processing abilities. Vision therapy enhances the neurological connections between the eyes and brain to help individuals with ASD better perceive what their eyes see and make better sense of their environment. Research has found that vision therapy benefits individuals with ASD by improving eye-contact/gaze, visual attention, central and peripheral integration, visual spatial abilities, posture and balance, and visual efficiency and eye-tracking.
Balance / Dizziness Disorders
The vestibular system, which controls a person’s sense of balance, is controlled by three different systems: the central nervous system, the auditory system, and the visual system. If any one of these three systems isn’t sending the correct signals, then the vestibular system may begin to deteriorate, causing a person to experience vertigo, dizziness, and even motion sickness. If you begin to experience these symptoms, a visual efficiency evaluation may provide answers to the root cause of your symptoms, and an individualized program of vision therapy could help remediate the concerns.
Behavioral-related Vision Deficiencies
Deficiencies in eye-focusing, eye-teaming, tracking and visual processing abilities can cause a child to experience difficulty in efficiently performing visual tasks. As a result, these deficiencies can contribute to behavioral problems including inattentiveness, impulsiveness, anger, frustration, defiance, and avoidance of schoolwork. Consequently, children with visual problems can commonly misbehave and be uncooperative in classroom settings and at home. At OCVT, our professional team has experience in thoroughly evaluating the proper diagnosis to determine if an underlying visual deficiency is contributing to specific behavioral concerns. Vision therapy has shown positive improvements in behavioral problems in children with an underlying visual component.
Studies show that greater than 50% of patients with a neurological impairment, either from traumatic brain injury, cerebral vascular accidents, etc. experience some sort of visual and/or visual-cognitive disorder. These can include problems with visual efficiency such as the ability to accurately coordinate the eyes or quickly shift gaze from one object to another, and also problems with vision perception, such as eye hand, foot or body coordination and visual spatial organization. Vision therapy can help to re-train these skills and others in order to help improve a person’s overall visual efficiency and control of their visual system.
Convergence Insufficiency / Eye Teaming
Convergence is the ability to accurately coordinate the eyes on an object in space in order to see a single, three-dimensional image. Equally as important, is the ability of both eyes to team together and give simultaneous feedback to the brain in order to process the target correctly. More than 20 million people in the US suffer from Convergence Insufficiency, the inability to coordinate their eyes when performing close work. Symptoms can include: eye strain, headache, double vision or dizziness and motion sickness. Vision therapy can help to improve eye coordination and teaming abilities as well as eliminate symptoms and discomfort.
Dyslexia language-based processing disorder can hinder reading, writing, spelling, and sometimes even speaking. Dyslexia is not a sign of poor intelligence or laziness or the result of impaired hearing or vision. In fact, most children and adults with dyslexia typically have healthy eyes and sharp vision, yet a large number of individuals with dyslexia have other undetected vision problems.
Although not a cure, Optometric vision therapy treats vision problems that can interfere with learning to read, reading to learn, and the learning process in general. Some of these visual deficiencies can include but are not limited to: oculomotor, vergence, accommodation, binocularity and visual perception skills. By developing these skills, individuals can better cope with the challenges that are often related to dyslexia.
Eye Focusing Problems
The ability to change focus rapidly when looking far away, close up, and back again is called accommodation. The accommodation system is responsible for maintaining clear vision at all distances which is important for visual stamina throughout a day of frequent changes in focus from chalkboard to book, computer, paper, etc. Reduced accommodative skills often contribute to blurred vision, eye strain, headaches, difficulty reading, avoidance of near work, or eye fatigue at the end of the day. A program of vision therapy can help reduce these symptoms by improving eye focusing and increasing the efficiency of the accommodation system.
Eye Tracking Deficiencies
Eye tracking is the coordinated precise eye movements crucial for reading efficiency and sports performance. Fixations are tracking skills of sustained and steady gaze required for visual attention and recall. Saccades are precise eye movements from one target to another that are important for reading efficiency and pursuits are the coordinated eye movements essential for following moving targets and accurate eye-hand coordination. Deficient eye tracking skills can result in loss of place or skipping lines while reading, re-reading lines, or poor eye-hand coordination. Vision therapy can help re-train the eyes to improve those skills needed to track words and objects accurately.
Learning Challenges – Giftedness
Intellectually gifted children and adults oftentimes do not perform at their full potential due to an undiagnosed vision problem. A gifted child or adult may receive above-average levels academically, but commonly will over-compensate for underlying visual deficiencies including tracking and eye teaming. Specific deficiencies in visual information processing can commonly be present in gifted individuals, contributing to academic learning challenges. At OCVT, comprehensive visual efficiency and visual information processing evaluations identify potential visual deficiencies in gifted individuals. Through remediation of these specific deficiencies with an individualized vision therapy program, we have helped gifted children and adults achieve their full potential.
Research shows that 70% of people with developmental delays also have visual efficiency concerns. This can include anyone with special needs diagnoses from Autism to Down’s syndrome. If visual deficiencies are found in an examination by a developmental optometrist, vision therapy can improve the individual’s visual system to help them achieve their fullest potential. Patients with special needs often find developmental optometrists’ offices more accommodating of their needs, as well. Developmental optometrists receive specialized training that allow them to accurately test an individual without needing subjective feedback, so non-verbal patients and patients who aren’t able to provide reliable feedback can still receive the testing necessary to determine their visual skills.
Sports Enhancement Needs
All sports performance requires the use of the visual system to coordinate the body’s movement in some way. In any sport involving a ball, the player must be able to efficiently follow the ball as it moves across the field and be able to accurately discern depth to determine when to catch or kick the ball. Other sports such as golf and archery require players’ eyes to quickly shift focus between far and near targets. If you are interested in improving your performance in any sport, and have increased your practice but are still not attaining the level at which you wish to perform, there could be a visual concern limiting your performance. A personalized vision therapy program would help the athlete hone his or her visual skills to help improve their sports performance.
Strabismus (Eye Turns)
Strabismus, often referred to as an eye turn, is a condition that describes the improper alignment of the eyes. The deviation of one eye often is due to the lack of coordination between the muscles of the eyes. The inability for both eyes to point in the same direction and feed the brain with the same visual information can result in double vision or the appearance of two images inaccurately overlapping. In order to avoid visual confusion, as an adaptation, the brain can learn to suppress/disregard the image seen by the turning eye, which can consequently cause binocular vision dysfunction and the lack of depth perception (3-D vision). Vision therapy helps reduce or correct the eye misalignment, and train the brain to simultaneously use both eyes to merge the images seen by each eye into a single 3-D piece of information. Additionally, vision therapy works on the reinforcement of neurological pathways that ensure eye teaming in all gazes and over a range of distances.
Visual Processing Deficiencies
Visual processing skills, also known as visual perceptual skills, are crucial in analyzing and processing visual information. The ability to accurately interpret what is being seen is as important as the ability to correctly capture an image and relay it to the brain. When looking at an object, our eye teaming and eye focusing systems allow us to see a clear and 3-D image, but it is our visual information processing skills that allow us to understand what we see and give the image meaning. Visual perceptual processing is segmented into categories that include, but are not limited to: visual spatial, visual analysis, visual memory, visual-auditory, visual-vestibular and visual-motor skills. Individuals who have problems with visual processing skills, may present symptoms such as inability to differentiate right from left, letter and number reversals, difficulty remembering what is read or poor handwriting. These visual perceptual deficits often interfere with efficient learning in a classroom environment. If a visual perceptual problem is suspected, it is highly advised to consult an optometrist, who may recommend specific evaluations using standardized testing.
Other Success Stories
Vision and Learning Facts
- 25% of all children have a learning-related vision problem.
- 60% of students identified as “problem learners” have undetected vision problems.
- 70% of children diagnosed with learning difficulties, ADHD, reading/writing/math problems, developmental delays, Dyslexia, or Autism have learning-related vision problems.
- 75% of classroom learning takes place through the visual system.
- 80% of children who are reading disabled have difficulties with one or more basic visual skills.
- 85% of our perception, learning, cognition and activities are mediated through vision.
Vision and Learning Overview
1 in 4 children struggle with reading and learning because of overlooked and undiagnosed vision problems.
Some common symptoms that indicate a learning-related visual problem:
Fortunately, many learning-related vision problems can be corrected through Vision Therapy. If your child exhibits any of these symptoms, consider a consultation with an OCVT Doctor. Read More
- Excessive reversals of letters or words
- Poor reading comprehension
- Repeatedly omits or misreads words
- Difficulty completing assignments
- Loses place while reading
- Mistakes copying from the board
For Teachers & Parents: How do I screen for Learning-related Vision Problems?
Scroll to the bottom of the document to view and print a pre-screening form.
Learning-related vision problems are not detectable by a school vision screening and can be overlooked during a typical and limited eye examination.
Teachers are often the first ones to observe an undetected vision problem in children because you see them under the conditions of prolonged visual demands in the classroom. Vision problems can affect children in different ways. An over-achieving student with a vision problem may have to work twice as hard as a child with a strong visual system. On the contrary, a struggling student with an undetected vision problem may misbehave to avoid visual discomfort when reading or doing schoolwork.
Research shows that children diagnosed with ADHD, Dyslexia, Developmental Delays, or Learning Problems have a higher incidence of learning-related vision problems. It is recommended that any child who is struggling in school have a thorough vision evaluation.
Early detection can save years of struggling.
A typical student is engaged in learning through vision 80% of the school day and will exhibit some common symptoms if they have learning-related vision difficulties. Some common symptoms are the following:
Appearance of the eyes:
- Eyes crossed or turning in, out or moving independently of each other
- Red, watering eyes, or encrusted eyelids
- Dislike or avoidance of close work
- Short attention span
- Using finger or marker when reading
- Difficulty completing assignments on time
- Difficulty remembering what was read
- Reversals of letters or words
Complaints associated with usage of the eyes:
- Headaches, nausea and dizziness
- Blurring of the vision
- Burning or itching eyes
To assist teachers in the pre-screening and early detection of learning-related vision problems, a pre-screening form is provided.
Is my child's struggle in reading associated with vision problems?
It depends; there are many causes of reading difficulties with vision problems being one of them.
Vision is a key component involved in reading. In addition to eye tracking, teaming and focusing skills, higher visual processing skills are needed. For visual processing of the text, word recognition, recall, and comprehension, your child needs developed skills in visual discrimination, attention, memory, and visualization. These skills should be automatic, but for individuals with visual deficiencies excess energy is exerted on the visual mechanics of reading and comprehension suffers.
To determine if your child’s reading struggles are related to vision, a thorough vision evaluation is recommended.
Success in School: Why is 20/20 eyesight not enough?
The term “20/20” means that from 20 ft away, your child can see a standard 20 size letter on an eye chart. Vision goes far beyond 20/20 eyesight. Vision involves the dynamic relationship between the eyes and brain which allow us to perceive, understand and interact with our world. In fact, 75-90% of classroom learning takes place through vision.
Many children with learning-related vision problems have 20/20 eyesight and healthy eyes, so they often pass vision screenings and standard eye exams. If your child has 20/20 eyesight and is struggling in school, he/she may lack the visual skills necessary for successful learning. These skills include eye tracking, teaming, and focusing, spatial awareness, visual memory, visualization, visual attention, and motor integration. A thorough vision evaluation is recommended.
What are signs of Visual Processing Problems?
There are many signs that an individual is struggling from a visual processing problem and the signs can vary depending on the individual. Some of the key things to watch for include but are not limited to:
- Confuses similar words
- Reverses numbers (6 and 9) and letters (b and d)
- Reverses words (was/saw)
- Transposes letters or numbers (12/21)
- Confuses right and left
- Poor spelling abilities
- Overlooks small details (reads “beak” for “break”)
- Improved comprehension when read to
- Vocalizes or moves lips when reading silently
- Difficulty following verbal instructions
- Difficulty with math concepts
- Difficulty completing assignments in a reasonable length of time
- Fails to recognize same word in next sentence or page
- Difficulty recalling what was read
- Writes neatly but slowly
- Difficulty copying from the board/paper/book/computer screen
- Misaligns digits or columns when doing math
- Poor printing/handwriting
If you, your child or someone you know suffers from any of these signs and symptoms, a processing evaluation may need to be completed in order to rule out any visual processing problems.
How are behavioral problems an indication that a child’s vision may be impaired?
Behavior problems can be the result of many factors, including undetected visual problems. Vision deficiencies can cause students to get frustrated or bored in school because he or she has trouble seeing the board, seeing the teacher, reading a book, or processing the information in order to complete an assignment. Therefore, students will act out or misbehave in the classroom because the demands are too high for their visual systems.
Are learning-related vision problems exclusive to school-aged children?
Learning related vision problems are not exclusive to school-aged children. Many adults suffer from learning-related vision problems and have struggled their entire lives. These individuals have learned to cope with these deficiencies in order to be able to function at the level at which they are required. It is never too late to begin to develop these skills in order to increase the level at which you function.