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Home » Eye Care Services » Vision Therapy » Dr. Sharieff Talks About Vision Therapy

Dr. Sharieff Talks About Vision Therapy

Q: What is vision therapy?

  • A: Vision therapy is a fully customized and personalized treatment program designed to improve and strengthen eye-brain connections in children and adults to improve visual skills, and re-train the visual system to interpret visual input with increased accuracy and ease.

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

  • A: Yes, vision therapy helps with lazy eye (amblyopia) and wandering or crossed eyes (strabismus).

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

  • A: Othoptics focuses and is limited to eye coordination difficulties where as vision therapy evaluates and treats a much wider range of eye and visual dysfunctions such as learning related conditions.

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

  • A: Doctor of Optometry (optometry) websites will give the most accurate information about vision therapy as they are formally trained in this field. Medical doctors or ophthalmology websites may give incomplete or inaccurate information as they do not have formal training in this area. Since vision therapy has a neurological approach to testing and treatment, neuro-psychology and neurology has more synergy than ophthalmology content.

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

  • A: Ophthalmologist are focused on the physical structure of the eyeball and all of it’s layers with respect to diseases and treatment with medicine and surgery. Their training does not encompass the neurological approach to visual function to improve visual skills. Here is an excerpt from an ophthalmological 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.”

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

  • A: There may be some that may not be aware that ophthalmologists are not the ultimate authorities in all areas of visual health. Ophthalmologists are trained eye surgeons and authorities about eye disease, but as a rule they’re under informed about subject areas such as functional or inefficient skills that affect learning or working without symptoms of eye strain such as visual processing, convergence, accommodation and vision therapy.

Q: Can orthoptics or vision therapy help with learning problems?

  • A: Orthoptics does not help with learning problems but vision therapy does.

Q: Is there scientific evidence that vision therapy works?

  • A: Yes, there are NIH (National Institute of Health) studies done with scientific evidence that vision therapy works besides other publications.

Q: What’s the position of educators regarding vision therapy?

  • A: Fortunately, there is a gradual increase in schools which recommend that parents of children with visual problems seek evaluation and treatment with a licensed optometric vision therapist. However, there are others who may try to have a staff occupational therapy to work with splinter skills such as gross and fine motor activities particularly handwriting, but they are not trained or licensed in vision therapy. Specifically, occupational therapists cannot administer important vision therapy procedures which involve lenses, prisms, and devices which ensure that both eyes work together as a synchronous team that affects learning.

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

  • A: No, it cannot be a substitute. Our visual system has several aspects that can affect efficient visual skills and will need additional tools to assess and treat.

Q: Does insurance pay for vision therapy?

  • A: Yes, most often there are several medical diagnoses that are accepted by insurance – but this may be dependent on individual policies and this has to be evaluated on a case by case basis.

Q: 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?

  • A: No, the treatment of a lazy eye is not limited to specific age range only. My first lazy eye patient that we treated was 19 years old and many others of all ages.

Q: How long does Vision therapy last for?

  • A: Once the visual skills are improved and integrated (automated) they should not regress just as once you learn to ride a bike it stays with you even if you do not ride for several years.

Q: Can vision therapy be done at home on the computer?

  • A: There are several activities that are interactive and would benefit with in -person therapy, however, we are increasingly able to offer more options for remote therapy.

Q: Does vision therapy help with ADD?

  • A: It has been noted that there are covert visual skills that are unrecognized without professional optometric evaluation that can affect focus and attention. This difficulty with sustained attention and focus can sometimes be mislabeled as ADD. So, it has been shown that once these conditions that cause problems with sustained attention and focus are treated, we have seen that these labels of ADD go away.

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

  • A: Dynamic visual acuity allows you to keep your eyes on a moving target. Eye tracking allows you to keep your eyes on the ball at all times, without moving your head— enabling the ability to maintain better balance and a faster response to the situation.Sports activities in general requires accuracy and speed for optimal performance. These skills allow you to track a ball as it flies through the air, stand in the correct location to catch a ball, and accurately pass the ball to another player.There are several visual skills that are paramount for sports besides dynamic visual acuity, eye tracking are others such as eye focusing, peripheral vision, depth perception, visual reaction time, eye-hand coordination, visual memory, visualization and visual concentration. These skills can be trained and can make a difference if one is serious about improving their sport skills. Professional athletes around the country get sports vision training especially during their spring training.

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

  • A: Yes, there are several aspects of head injury patients that benefit with vision therapy but they may need additional support of specific prisms and other specialized neuro-optometric rehabilitation techniques as well.

Q: Why don’t all optometrists do vision therapy?

  • A: Optometrists who undergo specialized training and complete a fellowship in the College of Optometrists in Vision Development offer vision therapy. Not all optometrists elect to undergo this training, hence not all optometrists offer vision therapy.

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

  • A: Yes, vision therapy and neuro-optometric rehabilitation techniques help people with developmental disabilities such as autism.

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

  • A: There are several signs and symptoms that you can look for. Parents and teachers should be on the lookout for the following red flags that indicate a vision problem:
    • Reading below grade level
    • Reduced reading comprehension
    • Loss of place, repetition, and/or omission of words while reading
    • Confusing similar words, such as ‘was’ and ‘saw’
    • Reversing letters such as b, d, p and q
    • Spelling difficulties
    • Dislikes or avoids homework
    • Writing numbers backwards, such as 2 & 5 or 6 & 9
    • Difficulty maintaining attention
    • Difficulty changing focus from distance to near and back again
    • Poor judgment of depth
    • Messy handwriting

Q: What is the success rate of vision therapy?

  • A: Just as any skill, it can be improved if there is good engagement and reinforcement. So, the onus is also on the participant and not just on the provider and the success rate has been very good.
    Literature has stated that immediately after therapy, 93% were reported as cured. Cohen and Soden34 confirmed Wick’s results. They treated 28 CI patients over 60 years of age. They reported an immediate cure rate of 96%

Q: Does vision therapy help with reading issues?

  • A: Just as any skill, it can be improved if there is good engagement and reinforcement. So, the onus is also on the participant and not just on the provider and the success rate has been very good.Literature has stated that immediately after therapy, 93% were reported as cured. Cohen and Soden34 confirmed Wick’s results. They treated 28 CI patients over 60 years of age. They reported an immediate cure rate of 96%.

Q: What age should my child begin vision therapy?

  • A: It depends on the condition that is being treated. The age would be earlier (2 to 3 years0 if a crossed or lazy eye is involved and about five or six years for learning related and other visual dysfunctions or inefficiencies.

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

  • A: Current research in the treatment of convergence insufficiency has shown that computer-based vision therapy is NOT effective. In fact, it was less effective than the control placebo (fake) therapy.Computer-based vision therapy has the potential to embed poor visual habits.
    However, this should not be confused with remote vision therapy that is done one on one with a vision therapist program under the doctor’s direct guidance via zoom or related platforms that is more comprehensive and can be more successful as it comprises several and individualized treatment regimens.