Vision Therapy

COVD - A Flawed Statement on Learning Disabilities

Information for Health Care and Other Allied Professionals A Joint Organizational Policy Statement of the American Academy of Optometry and the American Optometric Association.

Introduction

Society places a premium on efficient vision. Schools and most occupations require increasing amounts of printed and computer information to be handled accurately and in shorter periods of time. Vision is also a major factor in sports, crafts, and other pastimes. The efficiency of our visual system influences how we collect and process information. Repetitive demands on the visual system tend to create problems in susceptible individuals. Inefficient vision may cause an individual to slow down, be less accurate, experience excessive fatigue, or make errors. When these types of signs and symptoms appear, the individual's conscious attention to the visual process is required. This, in turn, may interfere with speed, accuracy, and comprehension of visual tasks. Many of these visual dysfunctions are effectively treated with vision therapy.

Pertinent Issues

Vision is a product of our inherited potentials, our past experiences, and current information. Efficient visual functioning enables us to understand the world around us better and to guide our actions accurately and quickly. Age is not a deterrent to the achievement of successful vision therapy outcomes.

Vision is the dominant sense and is composed of three areas of function:

  • Visual pathway integrity including eye health, visual acuity, and refractive status.
  • Visual skills including accommodation (eye focusing), binocular vision (eye teaming), and eye movements (eye tracking).
  • Visual information processing including identification, discrimination, spatial awareness, and integration with other senses.

Learning to read and reading for information require efficient visual abilities. The eyes must team precisely, focus clearly, and track quickly and accurately across the page. These processes must be coordinated with the perceptual and memory aspects of vision, which in turn must combine with linguistic processing for comprehension. To provide reliable information, this must occur with precise timing. Inefficient or poorly developed vision requires individuals to divide their attention between the task and the involved visual abilities. Some individuals have symptoms such as headaches, fatigue, eyestrain, errors, loss of place, and difficulty sustaining attention. Others may have an absence of symptoms due to the avoidance of visually demanding tasks.

Vision Therapy

The human visual system is complex. The problems that can develop in our visual system require a variety of treatment options. Many visual conditions can be treated effectively with spectacles or contact lenses alone; however, some are most effectively treated with vision therapy.

Vision therapy is a sequence of activities individually prescribed and monitored by the doctor to develop efficient visual skills and processing. It is prescribed after a comprehensive eye examination has been performed and has indicated that vision therapy is an appropriate treatment option. The vision therapy program is based on the results of standardized tests, the needs of the patient, and the patient's signs and symptoms. The use of lenses, prisms, filters, occluders, specialized instruments, and computer programs is an integral part of vision therapy.

Vision therapy is administered in the office under the guidance of the doctor. It requires a number of office visits and depending on the severity of the diagnosed conditions, the length of the program typically ranges from several weeks to several months. Activities paralleling in-office techniques are typically taught to the patient to be practiced at home to reinforce the developing visual skills.

Research has demonstrated vision therapy can be an effective treatment option for:

  • Ocular motility dysfunctions (eye movement disorders)
  • Non-strabismic binocular disorders (inefficient eye teaming)
  • Strabismus (misalignment of the eyes)
  • Amblyopia (poorly developed vision)
  • Accommodative disorders (focusing problems)
  • Visual information processing disorders, including visual-motor integration and integration with other sensory modalities

Summary

Vision therapy is prescribed to treat diagnosed conditions of the visual system. Effective therapy requires visual skills to be developed until they are integrated with other systems and become automatic, enabling individuals to achieve their full potential. The goals of a prescribed vision therapy treatment regimen are to achieve desired visual outcomes, alleviate the signs and symptoms, meet the patient's needs, and improve the patient's quality of life.

This Policy Statement was formulated by a working group representing the American Academy of Optometry, American Optometric Association, the College of Optometrists in Vision Development, and the Optometric Extension Program Foundation. The following individuals are acknowledged for their contributions:

Gary J. Williams, OD; Chair
Susan A. Cotter, OD
Kelly A. Frantz, OD
Louis G. Hoffman, OD, MS
Glen T. Steele, OD
Stephen C. Miller, OD
Jeffrey L. Weaver, OD, MS

Approved by:

American Academy of Optometry, April 27, 1999
American Optometric Association, June 22, 1999
College of Optometrists in Vision Development, June 25, 1999
Optometric Extension Program Foundation, June 25, 1999

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