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What to Know About Vision Therapy

Medically Reviewed by Mahammad Juber, MD on August 30, 2022

If your child struggles with their vision, focus, or eye control, they might also have low self-esteem due to the way their condition is being perceived by others. Your child’s doctor or ophthalmologist might have suggested vision therapy to help your child train their eyes and brain to work together.

What is vision therapy? It’s a highly specialized field of treatment that’s similar to physical therapy. Learn more about vision therapy and make a plan to discuss your concerns with your child’s doctor.

What Is Vision Therapy?

The eyes are complex organs that have many jobs. They take in visual information and translate stimuli into images. They also use muscles to track words on a page, focus on a friend's face as they're speaking, and watch a ball soar through the sky at a baseball game. Your child might need vision therapy to help their eyes focus, work better together, or communicate better with their brain.

Vision therapy does not involve correcting vision problems such as myopia (nearsightedness), hyperopia (farsightedness), or astigmatism. These conditions are called “refractive errors,” and they have to do with the shape of the eye, the curve of the cornea, or the way visual information is processed by the retina in the back of the eyeball. They can’t be cured with vision therapy, but they can be corrected with eyeglasses, contact lenses, or laser surgery.

How Does Vision Therapy Work?

Vision therapy is a catch-all term that people use to refer to many different types of vision correction, including:

Orthoptics. This method of vision therapy is legitimate and is found in the field of optometry and ophthalmology. Orthoptists are licensed optometrists who practice this subspecialty of eye care to evaluate and treat conditions like strabismus and amblyopia. 

These professionals work closely with other optometrists and ophthalmologists to treat mild to severe eye alignment problems in adults and children and track their progress over time.

Behavioral vision therapy: This method of improving eyesight with special exercises, equipment, or training lenses is not yet found to be scientifically valid — but some people swear by its ability to improve their kids’ reading abilities. It’s often used as an alternative (yet controversial) treatment for dyslexia or other learning disabilities.

Many children with dyslexia do not have eyesight problems, and they are able to track letters on the page. However, some experts think this type of vision therapy could help dyslexic children because it improves tracking and focusing — two types of eye movement that help improve reading in general.  

What Is Vision Therapy Used For?

Strabismus. Strabismus is the term used when a person’s eyes are looking in two different directions. A child’s eyes might be obviously misaligned, or the difference might be so slight that it’s only noticeable to a trained eye doctor. Even in mild cases of strabismus, it’s important to consult a doctor and consider therapies to help “train” the eyes to look in the same direction. This will prevent problems focusing and perceiving objects later on.

Amblyopia. This condition is a complication that can occur from untreated strabismus. It’s also known as “lazy eye”. While strabismus is the term for eyes that are misaligned, amblyopia is the name for the vision problem that happens when a child (or adult) has untreated strabismus. Amblyopia refers to certain types of vision loss and depth perception abnormalities due to the eyes looking in different directions.

Eye tracking issues. Using vision therapy to improve tracking in a patient with dyslexia is controversial. However, vision therapy can be used to improve tracking for children and adults who do have a legitimate problem following an object or text on a page. For example, a child might have trouble fixing their eyes on an object, following the object, or switching between objects while tracking.

Convergence Insufficiency. This describes when the eyes don’t work together to turn inward at the same time when you’re trying to focus on an object right in front of you.

Is Vision Therapy Effective?

Yes and no — and the answer often depends upon the professional you’re seeing. Many professionals have concerns over the legitimacy of some “vision therapists” who claim to be able to cure nearsightedness, dyslexia, or learning disabilities. While using visual methods to assist with reading can certainly help those with dyslexia, this is not the type of vision therapy that licensed eye doctors provide.

Make sure that your child has undergone a thorough examination for eye health and a checkup that includes screening for refractive errors (like nearsightedness and farsightedness) before assuming they have a learning disability. Don’t seek out vision therapy from a provider who is not licensed. If you have any concerns regarding your child’s treatment, remember that you’re entitled to seek a second (or third) opinion.

Who Is a Good Candidate for Vision Therapy?

Experts recommend that children are evaluated for potential vision problems at their regular pediatric checkups to see if they need glasses or not. Because conditions like strabismus can cause complications for a child as they age, it’s important to start screening for eye direction abnormalities as early as three months of age. 

It’s important to treat these eye conditions both for medical and social reasons. Children can develop vision problems from having misaligned eyes and may also be socially stigmatized due to the way their eyes appear. A study on adults with strabismus found that many adults with strabismus deal with low self-esteem, poorer quality of life, and more anxiety about their appearance than people without this condition. 

If you have any concerns about your child’s vision or the way their eyes align, don’t delay in asking your pediatrician or an ophthalmologist for help. 

Show Sources

SOURCES:

American Association for Pediatric Ophthalmology and Strabismus: “Vision Therapy.”

American Journal of Ophthalmology: “The effects of strabismus on quality of life as adults.”

Boston Children’s Hospital: “Astigmatism, Hyperopia, and Myopia,” “Strabismus and Ambylopia,” “Vision Therapy.”

College of Optometrists in Vision Development: “MDs Talk about Vision Therapy.”

Mayo Clinic College of Medicine and Science: “Orthoptist.”

Mayo Clinic College of Medicine and Science: “Orthoptist.”

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