Vision Therapy: What Is It and Who Benefits?

Dr. Cassie Bruno received her doctor of optometry (O.D.) from the Philadelphia College of Optometry and practices in Knoxville and serves on the Board of Club VIBES.

Vision therapy is a relatively new area of optometry that people generally aren’t aware of. The goal of therapy is to improve visual function and efficiency. A person with 20/20 vision may have trouble maintaining good focus or keeping the 2 eyes in alignment which leads to eye strain and fatigue when reading. Each eye has 6 muscles responsible for movement and a muscle inside which allows you to change focus from distance to up close. To read, eyes must converge toward the nose, look down, focus up close, and make quick jerky movements left to right across the page then a quick smooth movement back to the front of the next line. If you have trouble with any of those, then reading is uncomfortable and that can affect learning.

It can also be useful for training a “lazy eye” or amblyopia. That is when the brain just relies on one eye and tends to ignore the other. You can re-train your brain to use the “lazy eye.” People who have an eye that turns in or out may have double vision. Vision therapy can increase the eyes’ range of motion so it is comfortable to bring the turned eye back into alignment which eliminates the double vision and allows for depth perception.

It is similar to physical therapy in that it is a series of sessions done in office, and exercises to do at home. The success of vision therapy depends mostly on patient motivation. It’s just like training to play piano or tennis; you have to be dedicated to monotonous practice to get results. Just like how you decide “What are the best tennis rackets?“, just like that you get the practice done. It’s easier for kids since their neurons are more plastic and adaptable, but the recent research shows it can be effective in adults too.

There has been some controversy in the past surrounding the effectiveness of vision therapy. I believe that stems from providors who prescribe it loosely to people who may not benefit from it. It isn’t often covered by insurance so patients may have to pay out of pocket for sessions (usually 30 minute sessions twice weekly for 8-16 weeks).  But there is more and more good evidence based research proving it is effective. As long as patients are properly tested and actively participate in their therapy,  it can make a tremendous difference in visual comfort and performance. I think it is sometimes also confused with a few programs out there which claim that near-sighted or far-sighted people can train their eyes to see clearly without glasses. That is not the goal of vision therapy.

College of Optometrists in Vision Development (COVD) has some good info on this. Sue Barry is a biology professor who used vision therapy as an adult and wrote a book about it called Fixing My Gave. she also has a TEDx talk about it on YouTube.