Where Vision Goes Beyond Eyesight

Vision Therapy

This is what reading looks like with an eye teaming problem:
Double_vision

 

 

Our office also has an information packet about vision therapy, which is available upon request. There is abundant research, referenced in this packet, which proves the effectiveness of vision therapy.

Here is a wonderful TED talk regarding vision therapy and vision and learning:

What is Vision Therapy? Vision therapy is a series if activities that help develop visual abilities to achieve optimal performance and comfort. These activities help patients use their visual abilities in new or more efficient ways. thought processes are involved in vision therapy since the eyes are a direct outgrowth of brain tissue. You can think of vision therapy as physical therapy for the eyes and the brain. The neurological aspect is very important because the eyes are direct physical extensions of the brain. We see with our brains and minds, not just our eyes. There are plenty of web pages which give accurate definitions of vision therapy.

Who Can Benefit From Vision Therapy? Patients of all ages and with all different conditions can be candidates for vision therapy. The program varies with the condition treated. For example a young infant with amblyopia, or “lazy eye”, may simply have the better eye patched for a short period of time. An patient with strabismus, or “crossed eye”, may require therapy for a period of a year. An accountant with computer strain may require three to six months to solve a visual problem causing significant eyestrain. A 50 year-old patient who has experienced head trauma may require three to six months of therapy.

  • With the advent of computers in the work environment, we’re seeing more adults with eye strain-related vision problems, which can be improved through vision therapy.
  • There are special needs patients with developmental or head injury problems which neuro-optometric diagnosis and vision therapy treatment can uniquely help.
  • Children with learning or reading problems who have been through all kinds of interventions. These children have been told that their eyes are healthy and that glasses aren’t necessary, but they continue to struggle with visual processing. Their visual processing problems or developmental vision problems can’t be detected unless the eye doctor specifically tests for them.

“Because reading problems usually have multiple causes, treatment must often be multidisciplinary. Educators, psychologists, eye care practitioners and other professionals often must work together to meet each person’s needs. The eye practitioner’s role is to help overcome any vision problems interfering with the ability to read. Once those are addressed the student is better prepared to respond to special reading education efforts.” (www.cibavision.com, 1999)

Is Vision Therapy New? A form of vision therapy has been around since the late 1800’s. Orthoptics was used to “straighten” people’s eyes by physicians at one time. As these doctors became more focused on surgery and medications the practice of orthoptics was being taught less and less. In the middle of the 20th century a group of optometrists took some of the important principles of orthoptics and developed vision therapy.

What’s Involved In A Vision Therapy Program? Patients typically come to the office once a week for 45 minutes each session. The number In addition, a home therapy book is given which contains instructions and log sheets for activities to be done at home as reinforcement of what is learned during the office therapy sessions. Commitment to the therapy program, and maintaining a schedule of weekly visits, is important in the success of the program.

Can’t I Just Do The Therapy At Home By Myself? Yes and no. We ask all of our patient’s to do some form of home therapy. Vision therapy requires close supervision. To initiate and monitor a home therapy program requires follow-ups and guidance. Without this guidance poor techniques may be re-enforced. Certain patients require special equipment that cannot be taken home.

Will My Insurance Cover Vision Therapy? Although we do not accept assignment from any insurance program, a significant portion of our patients will get insurance reimbursement. Some health insurance policies cover vision therapy under your major medical plan, this has no relationship to vision care plans which cover eye examinations, eyeglasses, or contact lenses once every year or two. We ask our patients to submit claims to their major medical insurance. If in the event an insurance claim is denied we ask for reasons in writing so that we can best help our patients get the coverage they are entitled to.

Here is The College of Optometrist in Vision Development PSA regarding vision therapy:

Treatment Areas

Poor attention and concentration at near, such as reading, are frequent symptoms of a visual dysfunction.

A child with convergence problems, tracking problems or focusing problems may be inappropriately labeled as ADHD. At West Suburban Family Vision and Therapy Center in Westmont we diagnose and treat these problems that may masquerade as ADHD.

 

For more info check out this blog: https://visionhelp.wordpress.com/2013/01/25/new-research-shows-evidence-emotional-and-add-like-behavior-problems-in-children-linked-to-common-vision-problem/

Amblyopia is a brain problem first. It is often referred to as “lazy eye.” The condition results in loss of visual function involving reduced eye sight in one eye, loss of depth perception, delays in visual information processing, visual-motor coordination and can have an impact on quality of life.

It is the most common form of reversible blindness. Some things to keep in mind if you our your child has amblyopia:

-it’s never too late (or you are never too old) to treat this condition, amblyopia does not always go away with patching alone

-stereo blindness and deficient depth perception can still be present when patching has given the patient 20/20 eyesight.

-occlusion therapy is an outdated and ineffective approach to a complex and serious vision disorder.

 

At West Suburban Family Vision and Therapy Center we offer cutting edge treatment options for amblyopia.

Children with autism spectrum disorders, cerebral palsy, pervasive developmental disorders (PDD).

At West Suburban Family Vision and Therapy Center we treat children with developmental delays and help with visually integrated sensory skills. We help our patients with more effective learning, function in day-to-day lives and how to respond better to other therapy services.

The way our eyes team together directly affects our abilities to read, process and understand visual information.

When our eyes don’t team/coordinate together well we can sometimes have double vision, headaches or poor tracking. These side affects of convergence insufficiency can have a significant impact on reading and learning.

At West Suburban Family Vision and Therapy Center we use the most effective treatment for convergence insufficiency.

Our colleague at Wow Vision Therapy in Michigan has made a wonderful video about Convergence Insufficiency. Thanks Dr. Fortenbacher!

Tracking is the ability to move our eyes from one place to another place while maintaining focus on the object we are looking at. It is a very important skill for reading and everyday tasks. At West Suburban Family Vision and Therapy Center we use the most effective treatment for tracking problems.

Reading involves language and vision. Vision is essential. When a child has difficulty reading and is diagnosed with dyslexia there could also be an underlying vision problem. Those that claim that vision has nothing to do with reading must be good at reading with eyes closed. Studies demonstrate that poor eye teaming, focusing, tracking and visual processing can lead to significant difficulties in reading and learning ablitiesl.

see our page devoted to acquired brain injury, traumatic brain injury and concussion

 

Frequently Asked Questions

What is the difference between an optometrist and an ophthalmologist?

The optometrist is a doctor of optometry (O.D.) who diagnoses and treats visual health problems as dictated by state law. Some optometrists specialize in vision therapy. The training required includes an undergraduate degree (BS or BA), and a doctrine of optometry (OD), usually four years after college. Some optometrists continue with a post-graduate residency in a specific specialty area lasting a year or two. The ophthalmologist is a doctor of medicine (M.D.) who specializes in surgery and diseases of the eye. A small number of ophthalmologists work with or refer to vision therapists.

What should patients or parents keep in mind while researching vision therapy on the Internet?

As with any subject matter, the public must be careful to consider the source. Vision therapy is a well established field within the optometric profession. Therefore we, recommend that the reader place most credence in information acquired from optometric web sites or from patient or parent advocate sites which look at the subject objectively. Readers need to be aware that some web pages are misrepresenting vision therapy. Let’s say you were seeking information on the Web about treatment of a hip problem. If you had a question about physical therapy, you would look to a physical therapist (P.T.). For information on surgery, you would rely on an orthopedist (M.D.). In this particular example, you could get accurate information about either treatment options from both professionals. That’s because orthopedic surgeons and physical therapists have learned to work together in the best interests of the patient. Unfortunately, this is not the case in vision care where optometrists and ophthalmologists don’t always agree on vision therapy. Some ophthalmologists have even taken it upon themselves to post unjustifiably negative information on vision therapy on the Internet.

Why would some ophthalmologists and their organizations claim that vision therapy doesn't work?

In 1993, Paul Romano, MD, the editor of Eye Muscle Surgery Quarterly, conducted a worldwide survey of eye muscle surgeons. He asked surgeons to indicate whether they would favor a surgical or non-surgical approach to the treatment of intermittent exotropia (a form of strabismus). 85% of the international group recommended non surgical approaches, as compared with only 52% of the American surgeons. Dr. Romano postulated three important reasons why this might be so:

  • Insurance companies and single-payer systems outside of the U.S. have stricter medical standards in regards to approving payment of eye muscle surgery. Also, they do not pay as well for eye muscle surgery as insurance companies in the U.S.
  • Non surgical therapy isn’t as economically rewarding for the surgeon in the U.S. due to the personnel and fees involved.
  • Due to his lack of training in this area, the surgeon is reluctant to acknowledge the benefits of non surgical therapy for fear of losing patients.

In 2005, Scheiman, Mitchell, O.D. et al published a controlled study in the Archives of Ophthalmology. In this study vision therapy was found to be more efficacious in the treatment of convergence insufficiency than any other modality. Despite the results and the accurate methodology of the study the editor, an ophthalmologist, still felt that non-vision therapy treatments were better for his patients. Despite accurate good studies as a profession ophthalmologists are still unwilling to accept the benefits of therapy.

Does the public assume that ophthalmologists (M.D.s) are the ultimate authorities about everything in eyecare, including vision therapy?

Ophthalmologists are wonderful surgeons and excellent authorities about eye disease, but as a rule they’re under informed about subject areas such as, visual processing, convergence, accommodation and vision therapy. Some ophthalmologists will admit this. In the medical journal, Transactions of the American Ophthalmological Society, eye muscle surgeon and researcher David Guyton, M.D., states: “We [ophthalmologists] have probably abdicated the study of accommodation and convergence to the optometric profession. A perusal of the literature will reveal that most of the advances in this area are being made in the optometric institutions by vision scientists who use definitions and terms with which we are not even familiar.”

If an ophthalmologist says, “Vision therapy doesn’t work”, remember that this is an opinion from a professional who has little knowledge of the subject. Many of the M.D.s who criticize vision therapy have not researched this area in an unbiased manner.

Can vision therapy help with learning problems?

Vision is your dominant sense. Most of your information is aquired visually. People must learn from what they see. In the learning disabled population vision problems can be contributing to learning problems. Although we never claim to “cure” a learning disabled child we do emphasize that our goal is to give the patient the proper tools to receive and manipulate information acquired visually.

The statement on vision therapy and learning disabilities by the American Optometric Association and the American Academy of Optometry makes it clear that a multidisciplinary approach to learning disabilities is recommended, and that vision is but one aspect of the overall picture. Statements to the effect that vision therapy has no place in the treatment of learning disabilities are inaccurate and misleading.

Vision therapy can improve visual function so the patient/student is better equipped to benefit from educational instruction. In 1991, Firmon Hardenbergh, M.D., the Chief of Ophthalmology at Harvard University Health Services, had this to say regarding a double-blind scientific study of children with reading disability and convergence difficulty:

“The application of orthoptics [included in vision therapy] to all learning/reading disabled or deficient children who manifest convergence insufficiency should be the first line of therapy.”

Is there scientific evidence that vision therapy works?

Yes. There are as many studies, and as good of studies involving the efficacy of vision therapy as there are studies involving other rehabilitative interventions such as physical and occupational therapy.

The most concise source of information/ scientific studies on vision therapy can be found at The College of Optometrists in Vision Development’s web site. See Vision Therapy References for other publications.

Does insurance pay for vision therapy?

Yes, in certain cases. Vision therapy requires money; insurance companies aren’t always happy spending money. It may be difficult receiving funds for any medical intervention. In this era of insurance cost cutting measures, it can be difficult to receive adequate insurance coverage. Patients are much more effective in getting reimbursement when they pursue their claims directly, armed with knowledge and facts from the doctor’s office. There are national optometric guidelines formulated for covered conditions and length of treatment. The College of Optometrists in Vision Development (888-268-3770) has an insurance committee that offers to conduct peer review of claims when it becomes obvious that the individual or individuals reviewing the claim are not optometrists. Ultimately the patient must consider the following:

  • What problems or concerns are you having with your vision or performance?
  • What options have you tried other than vision therapy, and what has been the result?
  • If you have not had success pursuing other interventions, and the doctor’s diagnosis and treatment proposal make sense, what value would you place on improvement?
  • Vision therapy is rarely the first form of help that patients discover. If the patient or family is struggling, and other suggestions have not borne fruit, investing in vision therapy makes sense. Insurance reimbursement is helpful, but not all our decisions about our welfare, or our children’s future, are made based on someone else paying for it.

For more information you can review the information on the following link: http://www.covd.org/od/insurance.html

Is it true that there are certain conditions, like lazy eye, where the patient is too old, or it's too late to intervene with vision therapy?

“Lazy eye” or amblyopia (the technical term) means that one eye doesn’t see as clearly as the other eye even with proper glasses or contact lenses. Amblyopia can occur with or without strabismus (a crossing or turning of the eyes). Strabismus is sometimes attributed to one or more weak eye muscles, however the problem is more often due to a defective neurological signal to the involved muscle(s) rather than to an actual muscular abnormality. There are many scientific articles in optometric journals which prove that it’s never too late to treat a lazy eye.