Vision Therapy - What is it and How effective is it?
written by Melissa English, LPN Talent Generalist, Harris Chronic Care Management Services

Vision Therapy - What is it and How effective is it?

Vision therapy is made up of a series of therapeutic eye exercises used to enhance visual skills and improve communication between the brain and the eyes. It is an individual and personalized treatment program used in conjunction with other treatments such as contact lenses, eyeglasses, and surgery. This type of therapy is performed under the supervision of an eye doctor at a prescribed rate of sessions lasting 30-45 minutes reinforced by home practice learned during in-office sessions.

Success with any vision therapy program is due to neuroplasticity, which enables your brain to conquer difficult issues. Adults are usually highly motivated to improve their vision, giving them the willpower to stick to the program. It is like learning a new skill or trade, learning to play an instrument, learning a new language - the more they practice, the more proficient they become.

The following conditions can be improved through vision therapy.

Digital Eye Strain(DES), also known as Computer Vision Syndrome(CVS)

DES/CVS affects over 50% of people overall - including children and adults. According to recent data, approximately 80% of Americans use a digital device for more than two hours/day and 67% use two or more devices simultaneously. Increased device usage results in increased vision problems.

Prescription and OTC reading glasses cannot always prevent these conditions. However, there are specialized blue light screens and blue light glasses with anti-reflective coating that has been found to reduce the symptoms of these conditions.

If you find that you are experiencing headaches, blurred vision, dry eyes, or sleeplessness - talk to your doctor about having your vision checked and be open and honest about your time exposure to devices.

Strabismus (Crossed-Eyes)

Strabismus is when both eyes do not focus on the same object at the same time. One eye looks directly at the intended object while the other eye points in a different direction. This can be any direction - up, down, right, or left. It can be constant or intermittent and it can affect a different eye each time.

Strabismus is usually found in children, though it can develop in adults as well. It does not resolve on its own but can be treated. It is caused by

  • Poor development of eye coordination
  • Severe farsightedness
  • Lazy eye
  • Significant difference of optical prescription between two eyes
  • Ocular muscle weakness
  • Head trauma or stroke
  • Brain tumors or other systemic health issues.

Symptoms include double vision that can be very uncomfortable, headaches, eye strain, and reading difficulty or fatigue. If you are experiencing these symptoms - contact your doctor.

Amblyopia (Lazy Eye)

Lazy Eye is a neuro-developmental vision condition. It is caused when the brain is not receiving the signals from the eye because of a reaction in the brain called suppression.

Suppression occurs when the brain actively ignores the signals coming from one eye to avoid blurry vision or double vision in the other eye. It can cause serious problems and lead to an eye turn, or strabismus.

It can be difficult to recognize this condition. Therefore it is important to schedule an eye exam if you experience any of the following symptoms.

  • shutting one eye or squinting
  • rubbing eyes often
  • poor eye-hand coordination
  • accident prone
  • poor depth perception
  • difficulty with fine eye movements
  • reduced reading speed and comprehension
  • poor eye focusing skills
  • inability to follow an object with just the eyes
  • a cross-eyed appearance
  • unusual eye movements - flickering/blinking

Convergence Insufficiency(CI)

CI is a highly treatable binocular vision condition that affects adults. It affects near vision and eye muscle coordination. It usually presents as difficulty doing near tasks and affects work performance and attention to tasks.

The most common symptoms are

  • Eyestrain
  • Headaches or muscle tension
  • Blurred or double vision
  • Difficulty reading and concentrating
  • Uses finger or ruler when reading
  • Avoidance of close work
  • Poor hand-eye coordination
  • Anxiety
  • Motion sickness/dizziness

If you have CI computer work, reading, comprehension, and writing can become challenging. Many people with this condition use strategies such as using a ruler or finger to keep one's place while reading or taking frequent breaks. If left untreated - CI can result in suppression.

Traumatic Brain Injury(TBI) resulting in Concussion

TBI can result in significant vision problems that may, unfortunately, remain undiagnosed for years. Studies indicate that 90% of TBI patients suffer vision disruptions. These are caused by disruption of communication between the eyes and the brain.

Vision problems caused by TBI usually result in difficulties with reading, balance, and driving. It is imperative that any patient with TBI be assessed for affected vision immediately following TBI and that they follow-up with their doctor regularly following the injury. Even if no symptoms are present at the time of injury - swelling in the brain can cause symptoms to develop later and should be addressed immediately.

Resources

  • optometrists.org
  • Scheiman M, Gwiazda J, Li T. Non-surgical interventions for convergence insufficiency. Cochrane Database Syst Rev 2011 Mar 16;(3):CD006768
  • https://www.cms.gov/medicare/coverage/infoexchange/downloads/rtcvisionrehab.pdf


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