Vision Therapy

(adapted from www.acbo.org.au )

Vision therapy (also referred to as visual training) is a program aimed at remedying and enhancing an individual’s visual abilities. Its function is to:

• Treat existing visual problems such as amblyopia (lazy eye), eye alignment problems, eye coordination problems, poorly sustained near focus, inadequate eye-hand coordination and immature visual processing development.
• Enhance the efficiency and comfort of visual function.
• Help prevent some visual problems.

Vision therapy is best prescribed and supervised by Optometrists with specialised training, qualifications and experience in Behavioural Optometry.

Each program is indivdually designed to suit the specific needs of the individual, both in terms of their visual profile and their goals. Diagnostic testing, training procedures and the use of lenses and prisms may be integral components of the successful treatment of a vision problem. The frequency of consultation, the amount of home training and the duration of a course of vision therapy will vary depending on the nature and severity of the problem being treated and the specific needs of the patient.

Vision therapy is not used to strengthen eye muscles, but to improve the coordination and efficient functioning and processing of the visual system.

 At Russo Optometry the Optometrists have all attained qualifications in Behavioural Optometry and have many years of experience prescribing and managing vision therapy.

We use a number of different methods and programs including the Piggyback visual processing development computer program, the Seerite program, and the HTS functional eye skills development program. We also use free space equipment including lenses, prisms, balance boards and a variety of other equipment. 

Orthoptics is another term often used in conjunction with vision therapy. Orthoptics is one part of a specific vision therapy program directed at improving binocular alignment and visual acuity in individuals with strabismus and amblyopia.

Reprinted in part from the Journal of Australasian College of Behavioural Optometrists

Now! Look away now!

As it has probably taken a few minutes to get to this page, it is now theoretically time for a 'visual break'.

Most eye clinicians agree that extended periods of concentrated close work can contribute to eyestrain. Eyestrain can cause short-term visual difficulties such as transient blur or may contribute to long-term deterioration specifically some types of myopia (short sightedness).

Symptoms of eyestrain can include obvious symptoms such as blurred vision, headaches and also loss of concentration. If you find yourself drifting off or staring into space, it may be that your visual system is not efficient.

Many computer users report eyestrain symptoms but they consider the ergonomic factors of glare, posture and their monitor size etc before they consider their vision. In some cases, spectacle lenses may be appropriate to assist computer users and in some cases vision training is indicated to allow the eyes to work at their peak efficiency.

Improvements in how the eyes aim and focus together can lead to greater concentration and increased efficiency for near work.

Vision Therapy for Children and for Learning Difficulties

We all know that a child's development can vary immensely from child to child. What it is perhaps not as well known that vision also develops! This also means that vision can be trained or learned through appropriate structured vision therapy.

Example:
Unfortunately, like all skills and for various reasons, there is sometimes a delay in a child’s course of development of their visual skills. These delays can cause problems with a child's learning ability. In fact, in some cases, children are not visually ready to read until well after 5 or 6 years of age.

Your child's vision may be clear enough but, they may not have developed the appropriate visual skills for reading. When reading, it is necessary for a child to keep their place along a line of text (tracking skills) as well as keeping the page in focus at the same time (focussing skills). A child with tracking or focussing difficulties is therefore more likely to have difficulty with reading. 

To read left to right partly requires tracking skills but also involves visual-spatial skills. It is important to understand that reading from left to right is actually a culturally and educationally imposed requirement. In many cultures, reading is vertically arranged or in some cases, is arranged from right to left. A child who has not understood or adequately organised the necessary aspects of visual spatial skills will most likely have difficulty with learning to read.

The level of demands on visual skills required for reading increases throughout a child's learning years.

Primary visual skills required for early readers are listed below:

• Tracking and Saccades
  Scanning from letter to letter, word to word, looking ahead and predicting text, moving from one line to the next.
• Visual Memory
  Skills required for word recognition and copying tasks, for example in writing, spelling and reading.
• Short Term Visual Memory
  Recalling information presented quickly.
• Sequencing
  Recognising the order of number or letters in words. Left to right progression when reading and writing.
• Visual Discrimination
  Recognising subtle visual differences, ie between letters (b/d) and words (was/saw or big/dig), reducing reversals and confusion and thus improving overall recognition. Reversals are common in younger children. However, if a child has persisting reversal issues a Behavioural Optometric assessment should be considered to see if Vision Therapy can assist.
• Focusing Skills
  The ability to maintain clear focus at a particular point (a word on a page) and the ability to rapidly change focus from one point to another (copying from the board to the book).

Vision Therapy can assist, overcome or minimise some learning difficulties by reducing visual inefficiencies.

iii) Vision Therapy for sports

Have you ever heard someone say 'that player has great vision'?

Sports commentators often describe a player's ability to accurately judge where other players or the goals are without looking, as 'great vision'.

This ability has nothing to do with the player's 'clarity of vision'; it is about peripheral awareness and efficient visual function. Some sports people have these skills naturally, others need to learn to develop them!

Vision training activities are a structured series of exercises designed to maximise the efficiency of specific visual skills required for all different types of sports.

Examples of how vision therapy can assist your game:

• Tennis: overhead shots require locating exactly where the ball is while looking upwards and aiming the eyes in this position; this is not a natural skill but it can be improved. Vision therapy can also assist your general groundstrokes, and calculating the length of shots is related to eye-hand coordination.
• Cricket: Vision therapy may be utilised to increase visual efficiency of one or both eyes. Many players have found improvements in fielding (judging the flight of the ball). Some batsmen have also noted improvements in seeing the ball more clearly as it leaves the bowler’s hand.
• Football: peripheral (side) vision awareness can be developed with sports vision therapy. Activities involve improving central visual skills and then co-ordinating these skills with peripheral awareness.

So if your sport involves vision (and let’s face it - most do) then consider a vision examination and talk to your nearest Behavioural Optometrist about your specific sport and its visual requirements.

Eye coordination difficulties may manifest as strabismus (turned eyes).

There are many types of strabismus. Some forms are best treated by Vision Therapy used in conjunction with spectacle aids and prisms. Others are best treated by surgical intervention. Strabismus is one of the most complicated visual adaptations that can occur in the human binocular system. It is not always simple to treat and treatment may be lengthy and require a number of different approaches.

Typically, vision therapy for such patients will progress through a series of activities such as monocular (using one eye) and bi-ocular (using both eyes) skills and then fusion (putting the images from both eyes together) and binocular (using both eyes together in all directions of gaze) skills.