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Dr. Dragoo Answers Questions About Vision Therapy

Vision Therapy Girl 2What is vision therapy?

Vision therapy is a progressive program of vision procedures performed under a doctor’s supervision and based on an individual’s needs. It is performed in office one to several times a week. The goal of vision therapy is to help patients improve vision skills and change how they process and interpret visual information.

At Focus Eyecare, our vision therapy program expands beyond traditional vision therapy. Our program not only addresses binocular vision disorders, but we also work on developing life skills, making good choices, improved processing speed, a variety of unique academic strategies and more.

Does vision therapy help with lazy eye (amblyopia) and wandering eye (strabismus)?

Amblyopia and Strabismus are both treatable. Evidence-based research shows vision therapy is proven effective treatment for amblyopia and strabismus for all ages. Vision therapy corrects binocular vision problems, improves depth perception and teaches the two eyes to work as a team. Specialized equipment is designed to treat suppression and improve overall vision skills.

Are “orthoptics” and “vision therapy” the same thing?

Orthoptics means “straightening of the eyes”; it focuses on eye coordination deficits and is limited to eye-muscle training and the cosmetic straightening of eyes. While Orthoptics is part of the vision therapy, it is only one part of the puzzle.

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

Parents should make sure the sources they are reading are reputable. Examples include American Optometric Association and the College of Optometrists in Vision Development. There are many studies including the CITT Study of Convergence Insufficiency, which proves how in office vision therapy is an effective treatment protocol.

Additionally, social media offers opportunities for learning more about vision therapy. The Facebook Group “Vision Therapy Parents Unite” is an excellent resource for first person accounts and experiences with vision therapy.

It is important to remember that while a lot of offices do vision therapy, every program is unique. While we encourage parents to do research on their own, we are always happy to discuss the specifics of our unique program and how it will be completely customized for the patient’s needs.

Why would some ophthalmologists claim that vision therapy doesn’t work?

Ophthalmologists are eye surgeons and are trained extensively in medical treatment of eye disease, as well as surgical interventions to treat eye disease. Medical school, nor ophthalmology residencies train the opthalmologist in vision exercises/ therapy and their effects on learning, dyslexia, traumatic brain injury, strabismus, and any other binocular vision disorder.

In 1993, Paul Romano, MD, editor of Eye Muscle Surgery Quarterly, conducted a worldwide survey of eye muscle surgeons. He asked surgeons to indicate if they would favor 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 3 important reasons why this might be so:

Insurance companies outside the US have strict medical standards in regard to approving payment of eye muscle surgery compared to outside the US. They also do not pay as well for this surgery as they do in the U.S..

Non surgical therapy isn’t as economically rewarding for the surgeon in the US due to 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.

https://pdfs.semanticscholar.org/7564/354585ee57ca360f7d46b87f89f08d8c90ba.pdf

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

Ophthalmologists are exceptional individuals. They are surgeons and experts on eye disease. The public needs to be aware that ophthalmologists are not the ultimate authorities in ALL areas of vision. The majority have no formal training in visual processing, convergence, accommodation, and vision exercises. Optometrists who have specialized in this area are the authorities on the subject of developmental/behavioral vision and vision therapy.

Can orthoptics or vision therapy help with learning problems?

Approximately 80% of learning is presented visually. Focus Eyecare commonly sees patients who have learning problems, including those that are persistent even with other treatments (tutoring, special services). With learning related vision problems, vision does not provide accurate information for the foundations of reading, writing and more.

Vision problems often lead to reading and learning problems. Inaccuracies in eye movements can make reading a frustrating and difficult task. If eyes are not working together, information gets missed and the child misinterprets the information that they see. Vision therapy improves visual function, so the patient/student can succeed in school. Additionally, our program at Focus Eyecare directly addresses academic skills, unlike most other vision therapy programs.

Is there scientific evidence that vision therapy works?

Yes, there are a variety of studies that prove the efficacy of vision therapy. The CITT study is most commonly cited and reflective of current research. Please visit https://www.visiontherapy.org/vision-therapy/vision-therapy-studies.html for specifics. Additionally, we recommend talking with other families who have experienced the life changing effects of vision therapy in addition to traditional research.

What’s the position of educators regarding vision therapy?

Unfortunately, many teacher education programs do not introduce vision therapy to teacher candidates and even experienced teachers may not understand the connections between vision and learning beyond seeing 20/20. We continue to work with educators to introduce them to vision therapy and are happy to do teacher presentations to share the specifics of how vision affects learning.

Can special colored lenses or filters be used instead of vision therapy?

Colored lenses/filters have their uses, but they are not a replacement for in-office vision therapy.

Does insurance pay for vision therapy?

Our office directly accepts medical insurance. We will be happy to research your coverage and explain the specifics of your plan. Medical insurance will often cover binocular vision evaluations and vision therapy sessions, but there are some out of pocket costs associated with starting our program.

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?

Vision therapy works for all ages. It is never too late to start further developing vision skills. Patients of all ages can see an improvement in quality of life through vision therapy. We highly recommend reading “Fixing My Gaze” by Sue Barry. Sue is a professor of neurobiology and after a lifetime of vision difficulties, Sue successfully completed a vision therapy program in her 40s. She detailed the experience in her book. We commonly see patients ranging in age from toddlers, children, teens, adults and seniors.

How long does vision therapy last for?

Our vision therapy program develops a plan catered for each individual patient. We expect to see significant improvements in three months of treatment. With that mind each patient is different, so each program can vary greatly.

Can vision therapy be done at home on the computer?

Focus Eyecare does not recommend at home vision therapy programs. It has been proven that in-office vision therapy is more effective than home programs. The skills you work on in vision therapy have many real-world applications; by limiting the work you do in vision therapy to a computer screen you are limiting the scope of vision therapy. We do use computer games and iPad apps as a limited part of our treatment programs.

Does vision therapy help with ADD/ADHD?

Yes! In fact, there are many common symptoms between a binocular vision disorder and ADD/ADHD symptoms. Through vision therapy, it is expected that these symptoms will decrease and dissipate. Vision therapy helps a child learn to explore the world visually, instead of using tactile and auditory strategies associated with ADD/ADHD.

Is vision therapy helpful for athletes? What is sports vision therapy?

Sports Vision Training is a type of vision therapy that helps with enhancing an athlete’s vision abilities to take their game to the next level. Sports Vision Training helps an athlete by increasing several visual skills like visual processing, depth perception, reaction time and more.

Does vision therapy help with visual symptoms that results from traumatic brain injury, whiplash, stroke, and head injuries?

Yes. Vision therapy is always recommended for those who have experienced any type of head injury, including concussion. At Focus Eyecare, we specialize in treating symptoms from traumatic brain injuries, stroke and different head injuries. Treatment ranges from developing binocular vision skills to expanding collapsed visual fields and more. Our patients often comment about improved quality of life during and after vision therapy.

Why don’t all optometrists do vision therapy?

Like any specialty, vision therapy requires additional training and education. Not all optometrists choose to focus on vision therapy as their specialty.

Can vision therapy help people with developmental disabilities, such as autism?

Yes, individuals with autism often use visual information inefficiently which in turn affects their quality of life. Vision therapy helps patients learn how to understand spatial relationships, coordinate central and peripheral vision, develop excellent binocular vision skills, and improve visual information processing. Vision therapy is interesting and interactive to all patients and the use of lenses, prisms, games and more leads to engagement and cooperation. At Focus Eyecare, we have extensive experience working with all levels of visual skills. We are well-known for working successfully with children who have not been comfortable in other environments.

How do I know if my child’s school issues require vision therapy?

We recommend a traditional eye exam (if not already completed) and binocular vision evaluation here at Focus Eyecare. A binocular vision evaluation is an extensive examination of the child’s vision skills. If further treatment is recommended, the child will complete a comprehensive perceptual evaluation for vision therapy to see what specific skills need to be worked on to help them in school.

What is the success rate of vision therapy?

All patients experience success with regular attendance and vision therapy homework completion. Vision therapy is life changing! Many of our patients who completed our comprehensive vision therapy program express overall improvement in quality of life.

Does vision therapy help with reading issues?

Yes, if a child’s eyes aren’t working together or pointing at the same place at the same time, this can make reading very hard for them. Our program includes a variety of vision skill building exercises that focus on improving accuracy of eye movements, improving reading speed and developing eye teaming skills. Additionally, our unique program directly addresses academics like reading skills.

What age should my child begin vision therapy?

We recommend beginning as soon as possible. While vision therapy is effective for all ages and ability levels, it is best to begin as soon as a problem is detected to prevent any further difficulties for the child or adult.

I saw an online vision therapy program, does it work?

Vision Therapy should be performed under the supervision of a behavioral optometrist as well as a trained vision therapist. By performing an online vision therapy program, you are limiting the scope of success vision therapy can have. Vision therapy is dependent on specific equipment and trained staff. In-office therapy allows for a specialized program that addresses the unique needs of each patient.

Do you have more questions? Consult Dr. Dragoo!

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