Vision Therapy – Voodoo or Veracity?

Most of us have heard of physical therapy (PT), but few have heard of vision therapy (VT). When first hearing about this, one would probably think, you gotta be kidding, exercises for the eye? What will they think of next? Believe it or not, therapy for your eyes exists and its benefits can be just as tangible as those of PT.

Photo courtesy of

Photo courtesy of

VT consists of improving the eye muscles’ teaming skills and focusing system through eye exercises. These are managed by a licensed optometrist who has been specialty trained on these techniques. The eye muscles’ teaming skills and focusing system are what keep things single and clear. An issue with one or both of these results in uncontrollable double vision and/or blur. Most of us at one time or another have seen things go blurry or double for a moment or two, so we may understand just how disconcerting it can be for someone that struggles with it on a grander scale.

Potential trainees can range anywhere from eight years old to 80 years old. Children who are thought to have a learning disability are soon diagnosed with an eye teaming disorder. Elderly patients who have seen single and clear their whole lives slowly begin to see double during everyday activities due to weakening eye muscles. A great VT advocate named Donald Studt, OD, wonderfully illustrates the goal of this particular group by stating, “Good vision is more than seeing 20/20…it is seeing without effort.”

Unfortunately, most eye teaming issues cannot be simply managed through eyeglasses or prism alone. In fact, according to the Convergence Insufficiency Treatment Trial (CITT), “prism glasses were found to be no more effective than placebo reading glasses.¹” So drawing on our PT analogy, it’s like thinking crutches by themselves will entirely solve a person’s physical ailments. Obviously there are situations that call for extra training if the best results are to be obtained. The same holds true in VT. So how exactly does that happen?

First, you must receive a thorough eye exam by your optometrist. Next, you and the optometrist determine if you’re a good candidate for VT. They will either perform the VT in office or refer you out to another optometrist who specializes in this particular field. Then an evaluation is performed to determine severity as well as an adequate treatment plan on how to best alleviate the symptoms you may be experiencing. The therapist will determine how many visits are necessary based on your particular situation. Unfortunately, unlike PT, most VT is rarely covered by insurance, so most optometrists will have discounted packaged deals to make it more manageable.

After that is settled, the doctor will begin with tasks that train you on how to use your eyes and what cues you will look for while training. Just like a physical trainer, the optometrist will guide you through the process. However, you will need to push yourself to do what is needed in order to obtain the necessary results. The norm is often once-a-week, hour-long training sessions usually followed by 10-15 minutes of home VT to practice the skills learned in office.

Most of the instruments used during training appear toy-like and for good reason. They are meant to engage the learner and prevent stagnation, especially since most VT patients are younger children. Like any exercise, there are those that are your favorites and those that require extra motivation. To keep you motivated your doctor will perform periodic progress evaluations to show you just how much you’ve improved or where you still need improvement. Eventually, you and the doctor will agree upon a stopping point. From there, continued maintenance therapy and sometimes even surgery is necessary so that you may reap the benefits of your hard work for the rest of your life. Newfound confidence begins as you start to not only see 20/20, but see without effort. Best of luck in VT!
~Brad Nuttall
SCCO Class of 2017 OD Candidate
California Optometric Student Association


1. CITT group. Randomized clinical trial of treatments for symptomatic convergence insufficiency in children. Arch Ophthalmol. 2008; 1260: 1336–1349.

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