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What is Vision Therapy?

Some visual conditions cannot be treated by glasses or contact lenses alone and requires more hands on specialized treatment. Vision Therapy (or VT for short) is an individualized treatment plan prescribed and monitored by a Doctor of Optometry to develop, rehabilitate and enhance visual skills that have become deficient or defective.  Vision Therapy is based on the science of neuroplasticity! Unlike other forms of therapy, the goal of Vision Therapy is not to simply strengthen the muscles of the eyes. Therapy techniques arrange conditions for the patient to learn to use his or her visual system more efficiently and to process visual information more effectively.

Vision Therapy sessions include procedures designed to enhance the brain’s ability to control the following visual skills:

-Eye Alignment                      -Eye Focusing

-Eye Teaming                        -Eye Movements

-Eye-Hand Coordination       -Visual Processing (discrimination, memory, laterality/directionality, closure,                                                  spatial relations

Vision is much more than just seeing 20/20. It is the ability to understand and respond to what is being seen. 80% of learning is visual, so it is imperative that our visual system is working at its highest capacity!

Who Can Benefit From Vision Therapy?

We work with patients who have vision problems that interfere with their ability to learn, to read, to comprehend and even to pay attention. Any person who experiences visual challenges or wants to improve their visual function in daily life activities may benefit from VT. This includes children, teenagers and adults! Common reasons people seek out Vision Therapy include:

-Learning-related vision problems: Does 20 minutes of homework take your child an hour to complete? Vision Therapy can help those patients who lack the necessary visual skills for effective reading, writing and learning

-Poor binocular coordination: VT helps the eyes work together better as a team. This can help with reading eye movements, depth perception, tracking objects and even sports

-Strabismus/Amblyopia: VT can help establish a new brain-to-eye connection to improve vision and eye alignment

-Sports vision enhancement- VT can help athletes enhance their visual function, reaction time and peripheral vision

-Visual rehabilitation after brain injury, concussion or head trauma

What Steps Do I Take?

1. Comprehensive Eye Exam: the first step is to check the eye prescription and eye health. This can be done at our office or at another local office. If visual difficulties are found that may be fixed with Vision Therapy, the Doctor will suggest that the patient receive a binocular vision and/or visual perceptual examination.

2. Binocular Vision/ Visual Perceptual Exam: This 1-2 hour appointment takes an in-depth look at how the eyes, brain and body work together. We will look at many areas of vision, such as: eye teaming, eye alignment, eye focusing, eye movements, hand-eye coordination, reading eye movements and asses visual processing during the perceptual portion of the examination. Dr. Wood reviews the information from this evaluation and writes a detailed report. The parents (or patient, if older) return for a separate consultation where they discuss the results of these tests and recommendations.

3. Vision Therapy Sessions: We meet once a week in-office for an individualized 45-minute session with the Doctor or Vision Therapist to work of specific visual skills that the patient has trouble with. Often times in office we will use lenses, prism, filters and charts to work on these skills. Home activities are often prescribed to supplement in-office procedures and help gain improvements.

4. Mid-Therapy Evaluations: Dr. Wood likes to provide evaluations approximately every 12 sessions, to make sure we are making good progress in therapy.  Afterwards, she writes a detailed report and discusses the results with the parents/patient at the following VT session.

5. Graduate! Our goal is to provide new brain to eye connections that strengthen our patients’ ability to use their eyes, brain and body together in a more efficient and effective manner. When the patient’s vision is maximized, we are excited to see them graduate!

Conditions We Treat?

-Convergence Insufficiency: the inability to use the eyes comfortably at near; the eyes have trouble pointing properly at something up close. Glasses often do not help this condition, Vision Therapy is the key treatment protocol suggested by the CITT Study.

Symptoms of convergence insufficiency:

  • Double vision at near
  • Eye paindouble-vision-can-look-like-this.gif
  • Excessive fatigue after near tasks
  • Covering/closing an eye
  • Avoidance of near tasks
  • Low attention span
  • Blurry vision
  • Postural adaptations
  • Rubbing eyes after reading
  • Poor reading comprehension

-Accommodative Insufficiency/Infacility:  the eyes are unable to focus at near; this may be constant or intermittent. This can sometimes be treated with glasses, but vision therapy can aid in teaching the patient how to control their eyes’ focusing system.

Symptoms:

  • Headaches
  • Avoiding near work
  • Low attention span
  • Reduced stamina over time
  • Poor reading comprehension

-Oculomotor Dysfunction: patients may have trouble following a moving object (pursuits) and/or may have trouble jumping between stationary targets (saccades). This can cause problems with reading, handwriting and even with sports.

Symptoms:

  • Losing place or skipping lines
  • Reading the wrong part of the word (was / saw)
  • Uses finger to keep place when reading
  • Moves head excessively when reading
  • Poor reading comprehension
  • Difficulty tracking a ball
  • Difficulty tracing or following a pencil

The chart below is meant to demonstrate what a reading eye movement dysfunction may feel like.  Follow the arrows and attempt to read the text in a vertical fashion. Did you have trouble? Did you remember what you just read?

Screen Shot 2018-01-23 at 12.04.34 AM.png

-Convergence Excess:  the inability to use the eyes comfortably at near; the eyes tend to overly converge (or point together) when looking at something up close. This can sometimes be treated with glasses, but vision therapy can aid in teaching the patient where to point their eyes.

-Vision And Learning Cases:  Any deficiency in eye focusing, eye teaming, eye tracking, visual motor skills or visual processing can cause difficulties with learning, including reading and sustaining attention.

Symptoms of a vision-related learning problem:

  • Holds things very close
  • Complains of blurred vision
  • Poor reading comprehension
  • Says eyes are tired
  • Able to read for only a short time
  • Has headaches when reading
  • Moves head excessively when reading
  • Frequently loses place when reading
  • Uses finger to keep place
  • Short attention span
  • Can’t distinguish the main idea from insignificant details
  • Mistakes words with similar beginnings
  • Trouble visualizing what is read
  • Poor speller
  • Trouble with mathematical concepts
  • Poor recall of visually-presented material
  • Sloppy handwriting and drawing
  • Can't stay on lines
  • Poor copying skills
  • Can respond orally but not in writing
  • Trouble learning right and left
  • Reverses letters and words
  • Trouble writing and remembering letters and numbers
  • Trouble learning basic math concepts of size, magnitude and position
  • Difficulty recognizing letters, words or simple shapes and forms

-Amblyopia: often called “lazy eye,” amblyopia is poorer vision in one eye compared to the other eye. Sometimes amblyopia can be due to having a larger prescription in one eye compared to the other or can be due to an eye turn (strabismus). Treatment includes full time glasses/contact lenses and in some cases specialized vision therapy is needed to help the two eyes work together.

Symptoms of Amblyopia:

  • Covering or closing an eye 
  • Rubbing eyes/tired eyes
  • Avoiding near work
  • Poor depth perception
  • Fear of heights
  • Clumsy/poor motor control

-Neuro-Rehabilitation of Concussions: Traumatic brain injury (TBI) is damage to any area of the brain due to external force/blunt trauma. In the case of concussions, this damage is usually microscopic but can leave the patient with lingering symptoms related to their visual system. Depending on severity, treatment may include several types of physicians, including Optometrists, OTs, PTs, Chiropractors and Medical Doctors.  Sometimes Vision Therapy is appropriate for those patients with visual deficits.

Vision Conditions That Commonly Manifest after TBI/Concussion:

  • Accommodative Insufficiency:  the eyes are unable to focus at near, this may be constant or intermittent
  • Convergence Insufficiency: the inability to use the eyes comfortably at near; the eyes have trouble pointing at something up close
  • Oculomotor Dysfunction: the eyes have trouble following objects or moving between stationary objects
  • Double Vision: the patient may see double vision occasionally after a concussion, especially if the eyes are feeling tired
  • Reduced Visual Processing Speed/Reaction Time
  • Light Sensitivity: photophobia is common after concussions

Symptoms:

  • Blurry vision at near
  • Double vision
  • Headaches
  • Reduced reading stamina or fatigue with near work
  • Difficulty tracking a moving object, such as a ball
  • Loosing place while reading
  • Rubbing yes after reading
  • Losing your balance or having car sickness
  • Light Sensitivity

-Visual Perception Disorders: visual perception involves how the eyes take in information and what the brain does with this information. There are several key areas of visual perception:

  • Visual Discrimination: being able to noticeable small differences between similar objects. Deficits here can cause trouble learning ABCs and difficulty recognizing words.
  • Visual Memory – remembering what you just saw/read. This is a very important part of short term memory that greatly affects learning in school.
  • Visual Sequential Memory – remembering a series of objects, letters or numbers. This is also greatly important for learning in school.
  • Visual Spatial Relations- being able to tell where an object is in space. Deficits here can cause trouble with letter reversals and poor left/right awareness.
  • Visual Figure Ground – such as hidden pictures, or finding an object in a busy room. Deficits here can cause the patient to be easily distracted and often times they cant distinguish the main idea from the details.
  • Visual Closure – seeing part of the information and inferring the rest of it. Deficits here can cause poor reading comprehension, trouble with spelling and trouble visualizing what has been read.
  • Visual Motor Integration- the eyes help to guide the hands and feet in motor planning. Deficits here can cause poor hand writing, poor hand-eye coordination in sports and sometimes clumsiness.

Deficits in Visual Perception can often times cause difficulty with schoolwork and learning. We have specialized testing that covers all of these areas to see if there are any deficits. Vision Therapy can integrate any of the aspects that the patient has difficulty with listed above.

VT Testimonial

My daughter, Nyah, has been doing VT since February 2018.  The staff at Spartanburg Vision are amazing and we couldn't ask for a better vision therapist.  She is incredible with Nyah and we have seen major improvement over the past 6 months.  Thank you Dr. Wood!                  -Charity Brown