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Definition of Optometric Vision Therapy

Optometric Vision Therapy is an individualized treatment regimen prescribed for a patient in order to:

  • Provide medically necessary treatment for diagnosed visual dysfunctions;
  • Prevent the development of visual problems; or
  • Enhance visual performance to meet defined needs of the patient.

Optometric Vision Therapy is appropriate treatment for visual conditions which include, but are not limited to:

  • Strabismic and non-strabismic binocular dysfunctions;
  • Ambylopia;
  • Accommodative dysfunctions;
  • Ocular motor dysfunctions;
  • Visual motor disorders; and
  • Visual perceptual (visual information processing) disorders.

The systematic use of lenses, prisms, filters, occlusion and other appropriate materials, modalities, equipment and procedures is integral to optometric Vision Therapy. The goals of the prescribed treatment regimen are to alleviate the signs and symptoms, achieve desired visual outcomes, meet the patient's needs and improve the patient's quality of life.

Approved by the American Optometric Association
Board of Trustees
November 1996

What is Vision Therapy

Position Statement on Optometric Vision Therapy
By American Optometric Association

The American Optometric Association affirms its long-standing position that optometric Vision Therapy is effective in the treatment of physiological neuromuscular and perceptual dysfunctions of the vision system.

The ability to learn in school, achieve on the job, and enjoy sports and recreation depends upon efficient vision. Optometric Vision Therapy assists individuals in developing visual abilities and efficiency most suited to their needs and enables those individuals to achieve maximal levels of visual performance. Optometric Vision Therapy can help individuals achieve and maintain good vision throughout life.

What is Vision?

Vision is more than the limited concept of sight measured in terms of visual acuity. Vision is the process of deriving meaning from what is seen. It involves fixation and eye movement abilities, accommodation (eye focusing), convergence (eye aiming), eye-hand coordination, visual perception and visual-motor integration.

What is Vision Therapy (Visual Training, Vision Training or Orthoptics)?

Optometric Vision Therapy, also referred to as visual training, vision training, or orthoptics, is a treatment regimen to correct or improve specific dysfunctions of the vision system identified by standardized diagnostic criteria. It includes, but is not limited to, the treatment of strabismus and other binocular vision or convergence dysfunctions, amblyopia, accommodation, ocular motor function and visual-perceptual-motor abilities.

The medical necessity for optometric Vision Therapy is determined from a comprehensive analysis and diagnosis of the functioning of the vision system. Treatment plans are directed at specific diagnosed dysfunctions of the vision system and encompass the use of lenses, prisms, occlusion and other appropriate materials, modalities and equipment. Because the therapy is individualized, the procedures used and the duration of therapy are dependent upon the nature and severity of the problem being treated and the specific needs of the patient.

Who Can Benefit?

Optometric Vision Therapy is effective for patients of any age although the objectives and outcomes will vary depending on the diagnosis and circumstances. Optometric Vision Therapy is effective for the treatment of many developmental or acquired and some congenital vision dysfunctions.

Of the entire U.S. population, approximately one half of those three years or age or over require treatment for a vision problem.1 Among school-age children, vision disorders affect one in every four.2 While many of these patients have refractive errors (myopia, hyperopia and/or astigmatism) commonly treated by compensatory lenses, some have additional problems in the functioning of the vision system that are most appropriately treated with optometric Vision Therapy.

Vision and Learning

Many children who experience academic difficulty may have a treatable visual dysfunction in addition to their primary reading or learning dysfunction.1  Vision problems can interfere with the ability to perform in the classroom or can impair the ability to read with comfort and efficiency. These treatable conditions include focusing deficiencies, eye muscle imbalances, motor fusion deficiencies and refractive errors.2  Although optometrists do not teach reading, optometric Vision Therapy programs are used to treat contributory vision problems thus enabling the individual to take better advantage of his/her educational opportunities.3

Management of the learning disabled and/or dyslexic child or adult should be multidisciplinary. Since it is important to deal with any defect or problem that may be causal or contributory, evaluation of a learning disabled individual should include a thorough optometric analysis of the vision system. Interdisciplinary communication and involvement are essential in helping an individual overcome a learning problem.

Optometric Education

Doctors of optometry (optometrists) are uniquely qualified to diagnose and treat vision problems as a result of their seven or more years of college level education and clinical training. Their undergraduate education provides a foundation in the basic sciences, while the four year graduate professional optometric degree program emphasizes the biological, behavioral and visual sciences, and their clinical application. New developments and research within the optometric profession, residency programs and postgraduate education enhance today's optometrist's ability to provide quality vision care for their patients.

Research

Extensive research related to strabismus and amblyopia, accommodative and non-strabismic binocular dysfunction, vision development and learning-related vision problems is conducted at the schools and colleges of optometry and other clinical and research settings. These scientific studies support the effectiveness and value of optometric Vision Therapy in the treatment of vision dysfunctions.4-20

Summary

Vision is a complex process.

An individual with good visual acuity and healthy eyes can still have a vision problem.

Optometric Vision Therapy is an effective treatment of many vision problems.

Evaluation of individuals with learning difficulties (i.e., attention deficit disorder, ad/hd, dyslexia, etc.) should include a thorough optometric analysis as part of a multidisciplinary approach.

The American Association continues to support quality optometric care, education and research in the area of Vision Therapy.

Resources available from the American Optometric Association.

1  Greenstein T. Identification of children with vision problems that interfere with learning. In T. Greenstein, Vision and learning disability. American Optometric Association, St. Louis, 1976, p. 95-114.
2  American Academy of Pediatrics, American Association for Pediatric Opthalmology and Strabismus, American Academy of Opthalmology. Position statement on learning disabilities, dyslexia and vision. Pediatrics, 90(1):124-125, 1992.
3  Solan HA. Learning disabilities, Chapter 21. In AA Rosenbloom and MW Morgan, Principles and Practice of Pediatric Optometry. JB Lippincott, Philadelphia, 1990; p. 486.
4  Ciuffreda KJ, Kenyon RV, Stark L. Different rates of functional recovery of eye movements during orthopedic treatment in adult amblyope. Invest Opthal & Vis Sci 18(2):213-219, 1979.
5  Cooper J. Orthoptic treatment of vertical deviations. J Am Optom Assoc 59(6):463-468, 1988.
6  Cooper J, Selenow A, Ciuffreda KJ, Feldman J, Faverty J, Hokoda S, Silver J. Reduction of aesthenopia in patients with convergence insufficiency after-fusional vergence training. Am J Optom & Physiol Opt 60(12):982-989, 1983.
7  Daum K. Accommodative insufficiency. Am J Optom & Physiol Opt 60(5):352-359, 1983.
8  Daum K. The course and effect of visual training on the vergence system. Am J Optom & Physiol Opt 59(3):223-227, 1982.
9  Flax N, Duckman R. Orthoptic treatment of strabismus. J Am Optom Assoc 49(12):1353-1360, 1978.
10  Garzia RP. The efficacy of visual training in amblyopia: A literature review. Am J Optom & Physiol Opt 64:393-404, 1987.
11  Kran B, Duckman R. Divergence excess exotropia. J Am Optom Assoc 58(11):921-930, 1987.
12  Liu JS, Lee M, Jang J, Ciuffreda KJ, Wong JH, Grisham D, Stark L. Objective assessment of accommodation orthoptics: 1. Dynamic, insufficiency. Am J Optom & Physiol Opt 56(5):285-291, 1979.
13  Rouse M. Management of binocular anomalies: efficacy of Vision Therapy in the treatment of accommodative deficiencies. . Am J Optom & Physiol Opt 64(6):415-420, 1987.
14  Selenow A, Ciuffreda K. Vision function recovery during orthoptic therapy in an exotropic amblyope with high unilateral myopia. . Am J Optom & Physiol Opt 60(8):659-666, 1983.
15  Simons H, Grisham J. Binocular anomalies and reading problems. J Am Optom Assoc 58(7):578-587, 1987.
16  Suchoff I, Petito GT. The efficacy of visual therapy: Accommodative disorders and non-strabismic anomalies of binocular vision. J Am Optom Assoc 57(2):119-125, 1986.
17  Weisz CL. Clinical therapy for accommodative responses: transfer effects on performance. J Am Optom Assoc 50(2):209-214, 1979.
18  Wick B. Accommodative esotropia: efficacy of therapy. J Am Optom Assoc 58(7):562-566, 1987.
19  Wick B, Wingard M, Cotler S, Schieman M. Anisometropic amblyopia: Is the patient ever too old to treat? Optom and Vis Science 69(11):866-878, 1992.
20  Wick B, Cook D. Management of anomalous correspondence: efficacy of therapy. Am J Optom & Physiol Opt 64(6):405-410, 1987.

To locate an eye doctor who provides comprehensive pediatric vision examinations and treatment, including Vision Therapy, request a referral through our Referral Directory: Find a Pediatric Eye Doctor.

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