Vision Therapy

Advanced Vision Therapy Center serves the Boise, Meridian, Eagle, Nampa, Caldwell, Mountain Home and surrounding areas of Idaho, Oregon and Nevada. Vision therapy at Advanced Vision Therapy Center differs from other programs:

Over 30 years experience providing vision therapy in Boise, Idaho.

Our track record of success gives us more than 30 years of experience and expertise to effectively treat a wide range of visual performance problems, including complex cases. Experience like ours means more accurate diagnosis and more effective treatment plans.

All vision therapy sessions at Advanced Vision Therapy Center are with a Board Certified, Licensed Occupational Therapist specifically trained in vision rehabilitation and certified in Interactive Metronome therapy. Our therapist holds a bachelors degree in occupational therapy and has completed advanced training in vision therapy. An experienced, professional therapist means more effective therapy sessions which means better results. Learn more about our therapist.

All vision therapy sessions are one-on-one. No group sessions. No cookie cutter treatment. Vision therapy programs at Advanced Vision Therapy Center are completely customized for each and every patient – which is why our vision therapy programs are so effective.

Research shows the most effective treatment programs are in-office, which is why we perform all therapy one-on-one with a therapist trained in vision therapy using “active therapy techniques” with limited use of computer based vision therapy. We share that philosophy, and our occupational therapist incorporates active therapy techniques into each therapy session.

What is vision therapy?

Vision therapy (VT) is a sub-specialty of developmental optometry that improves, enhances and develops visual performance through a prescribed treatment program that is designed to create and establish new neural patterns. Vision therapy is a highly effective non-surgical treatment for many common visual problems such as lazy eye (amblyopia), crossed eyes (strabismus), double vision, convergence insufficiency and vision conditions that interfere with learning.

An easy way to better understand vision therapy is to think of vision therapy as a type of physical therapy for the eyes and the brain. In physical therapy, you relearn or enhance the use of various muscles and body parts that are not functioning properly. In vision therapy you relearn or enhance the function of eye teaming, tracking, convergence, visual perception, eye-hand coordination and visual motor integration. This is possible because vision is a learned process.

What types of problems is vision therapy used to correct?

Vision therapy can be an effective treatment option for:

• Vergence problems: Problems with eye teaming abilities. An example of this is convergence insufficiency, which is when the eyes do not work well together. Convergence insufficiency is one of the most common problems that can be treated with vision therapy
• 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
• Oculomotor problems: Problems with eye tracking skills, including fixation, pursuits and saccades. Fixation refers to the ability to continue looking at a stationary target. Pursuits refer to the ability to continue looking at a moving target. Saccades refer to the ability to smoothly change fixation quickly and accurately from one target to another. For example, saccades are especially important in the act of reading.
• Convergence insufficiency
• Visual motor disorders
• Visual perceptual disorders
• Visually-related learning problems
• Accommodative problems: Problems relating to the focusing system of the eye. Accommodative problems include difficulties focusing accurately during close work and difficulties switching focus from distance to near efficiently.
• Traumatic brain injury
• Sports vision enhancement: The visual demands of sports are extremely high.  Many athletes benefit from enhancing the visual skills necessary for athletic competition.

Who can benefit from vision therapy?

Patients of any age can benefit from vision therapy. Vision therapy is not limited to children. Anyone, at any age, who has been diagnosed to have a visual performance problem – or who would like to enhance visual performance is a candidate for vision therapy.

Children who have struggle in school due to difficulties with reading, spelling or writing, take longer to complete assignments than their peers, perform poorly on timed tests, have a diagnosis of ADD/ADHD, are on the autism spectrum or developmentally delayed have a 70-80% chance of having a vision problem significant enough to affect their performance and are candidates for vision therapy.

Professional athletes use vision therapy to increase visual reaction times and improve hand-eye coordination. Athletes commonly use Interactive Metronome combined with vision therapy to increase processing speed and enhance the ability to focus and “filter out” distractions.

Computer users experiencing eye strain resulting from binocular vision problems can benefit from vision therapy to reduce discomfort.

Adults who have suffered strokes or head trauma (traumatic brain injury,or TBI) can benefit from vision therapy.

Vision therapy is not eye exercises

Unlike other forms of exercise, the goal of Vision Therapy is not to strengthen eye muscles. Eye muscles are already incredibly strong. Vision Therapy is not to be confused with any self-directed self-help program of eye exercises or computerized programs which are marketed to the public.

In-office Vision Therapy, with an occupational therapist trained in vision therapy and supervised by a Developmental Optometrist (also referred to as a Behavioral Optometrist), is a highly specialized and structured treatment program using many types of specialized or medical equipment, such as (but not limited to):

• Corrective lenses (regulated medical devices)
• Therapeutic lenses (regulated medical devices)
• Prism lenses (regulated medical devices)
• Directional sequencers
• Optical filters
• Mechanized targets
• Saccadic fixators
• Rotational trainers
• Interactive Metronome
• Balance boards (vestibular device)
• Visual-motor-sensory integration training devices

At Home Programs, Self-Help Eye Exercises with Pencil Push-ups, Kits, or Computer Programs are NOT to be confused with Vision Therapy and are not an adequate substitute for professional evaluation and treatment of binocular vision problems. Vision Therapy involves therapeutic procedures supervised by a Developmental (or Behavioral) Optometrist, performed with a professional vision therapist (a licensed occupational therapist with advanced training in vision therapy) and the use of medically regulated devices, such as lenses and prisms.

Vision is a learned process. This means it is also possible to learn or enhance improper visual skills, worsening the condition and embedding the automaticity of poor vision skills if the vision therapy treatment program is not administered properly.

For the best results possible, is important to use the services of a highly skilled, licensed occupational therapist with advanced training in vision therapy working under the direction of a Developmental Optometrist when seeking vision therapy treatment.

Vision Therapy for Amblyopia

Amblyopia, sometimes called lazy eye, is characterized by poor vision in an eye that did not develop normal sight during childhood. This condition affects approximately 2% to 3% of the population. There are three major causes of amblyopia: strabismus (misaligned or crossed eyes), unequal focus (a refractive error) and cloudiness in normally clear tissues (such as from cataracts). To correct amblyopia, the patient must learn to use the weak eye.

Garzia (1987) summarized findings of earlier studies on the effects of vision therapy for amblyopia in children who failed occlusion therapy. A variety of different vision therapy approaches were used ranging from eye-hand activities to tracing and coloring pictures. While the reviewed reports suggest that active vision therapy can successfully treat a wide range of patients of all ages.

Advanced Vision Therapy Center provides active vision therapy with our Board Certified Occupational Therapist. A variety of therapy modalities are combined and used; thus providing a more effective, active therapy environment.

Vision Therapy for Strabismus

Strabismus is a condition in which the two eyes are directed to different points when looking at an object in space. It is also known as tropia, heterotropia, squint, and manifest ocular deviation. The deviation of the eyes may cause diplopia or double vision as well as suppression of the vision in one eye. It is a visual abnormality in children between the ages of 6 and 17 years and affects an estimated 5.5% to 6.75% of the population. Therapeutic options include lenses, prisms, occlusion and/or eye muscle surgery (Hayes, 2002).

Hellerstein et al. (1994) completed a review of optometric management of strabismus patients and concluded that vision therapy studies showed better treatment success than surgical studies.

Flax and Duckman (1978) also completed a review 9 years before the Hellerstein article was published. They concluded that the cure rate for optometric treatment was 20% greater than the ophthalmologic and orthoptic studies. They also stated that the better results were due to a broader approach utilizing more treatment modalities, techniques and strategies.

Advanced Vision Therapy Center provides active vision therapy with our Board Certified Occupational Therapist. A variety of therapy modalities are combined and used; thus providing a more effective, active therapy environment.

Vision Therapy for Convergence Insufficiency

In a randomized clinical trial, 221 children aged 9 to 17 years with symptomatic convergence insufficiency were assigned to 1 of 4 treatments (home-based pencil push-ups (HBPP), home-based computer vergence/accommodative therapy and pencil push-ups (HBCVAT+), office-based vergence/accommodative therapy with home reinforcement (OBVAT), and office-based placebo therapy with home reinforcement (OBPT)).

A successful or improved outcome was found in 73%, 43%, 33%, and 35% of patients in the OBVAT, HBPP, HBCVAT+, and OBPT groups, respectively. The investigators concluded that 12 weeks of OBVAT results in a significantly greater improvement in symptoms and clinical measures of near point of convergence and positive fusional vergence and a greater percentage of patients reaching the predetermined criteria of success compared with HBPP, HBCVAT+, and OBPT (Convergence Insufficiency Treatment Trial Study Group 2008)

The authors concluded that vision therapy is effective in eliminating asthenopia and improving convergence function in adult male patients, with in-office therapy combined with home therapy producing better results than home therapy alone.

Advanced Vision Therapy Center provides active vision therapy with our Board Certified Occupational Therapist. A variety of therapy modalities are combined and used; thus providing a more effective, active therapy environment.

Vision Therapy for Convergence Excess

To evaluate the effectiveness of vision therapy for convergence excess, a common nonstrabismic ocular motility disorder, Gallaway and Scheiman (1997) retrospectively reviewed the records of 83 consecutive patients with this condition, seen in two private practices over a 3-year period and treated with vision therapy. The mean age of subjects was 11.8 years, with a range of 7 to 32 years. Therapy consisted of once- or twice weekly 45-minute office visits, and home therapy for 15 minutes 3 to 4 times per week. The mean number of vision therapy sessions was 18.5, with a range of 9 to 32.

The investigators observed statistically and clinically significant changes in direct and indirect measures of negative fusional vergence, with 84% of patients reporting a total elimination of initial symptoms through vision therapy.

Advanced Vision Therapy Center provides active vision therapy with our Board Certified Occupational Therapist. A variety of therapy modalities are combined and used; thus providing a more effective, active therapy environment.

Vision Therapy for Exotropia

Coffey et al. (1992) compared the findings of 59 published studies over a 25-year period that evaluated the efficacy of 5 different treatment modalities used for intermittent exotropia: 1) overminus lens therapy to stimulate convergence, 2) prism therapy to compensate for exodeviation, 3) occlusion therapy to reduce suppression, 4) extra-ocular muscle surgery to surgically reduce the exodeviation, and 5) orthoptic vision therapy to increase fusional vergence ranges and normalize sensory function. Using the studies' success measures, pooled success rates were: overminus lens therapy, 28% (n=215); prism therapy, 28% (n=201); occlusion therapy, 37% (n=170); extraocular muscle surgery, 46% (n=2530); and orthoptic vision therapy, 59% (n=740).

There appears to be an agreement that the nonsurgical treatment, vision therapy, is more appropriate in small-angle deviations or as a supplement to surgery.

Advanced Vision Therapy Center provides active vision therapy with our Board Certified Occupational Therapist. A variety of therapy modalities are combined and used; thus providing a more effective, active therapy environment.

The distinction between vision therapy and orthoptics

Optometric vision therapy is a program of care used to develop, restore, or enhance visual function and performance. The procedures are conducted under the supervision of a developmental optometrist and are individualized to meet the needs of each patient. Depending on the case, vision therapy is prescribed to develop or remediate fundamental visual skills and abilities; improve visual comfort, ease and efficiency; and / or enhance how a person cognitively processes visual information and uses it to direct and monitor actions.

Vision therapy is generally conducted in-office in a one-to-one environment with the therapist, once or twice weekly for 30 minutes to an hour, often supplemented with procedures done at home between office visits. The goal of optometric vision therapy is to automatize normative function, not to strengthen eye muscles. It should not be equated with self-directed programs of eye exercises or computerized vision therapy programs marketed to the public. Many specialilzed procedures and equipment are used in vision therapy programs including therapeutic lenses and prisms (regulated by state licensure). Optometric vision therapy is a blend of medical, developmental and behavioral therapies which may include:

• Pursuit and saccade therapy (to improve the speed and accuracy of eye movements)
• Visual-vestibular therapy (to integrate eye movements with balance)
• Visual perceptual therapy (to enhance visual information processing)
• Eye-hand coordination therapy (to develop visually guided movement)
• Accommodative therapy (to enhance focusing stability, flexibility, and comfort)
• Visual attention therapy
• Peripheral awareness therapy (enhances the use of vision as a simultaneous sense, synchronously receiving and processing multiple inputs)
• Visual-spatial awareness including laterality, directionality, and visual imagery
• Visual-auditory integration
• Orthoptics (mechanics of eye movements)

Although optometric vision therapy evolved from orthoptics, orthoptics is only one of many therapies which are used in contemporary optometric vision therapy. Orthoptics, which literally means straightening of the eyes, is limited to eye exercises to treat eye coordination problems by increasing the range of binocular fusion. The treatments used during optometric vision therapy go well beyond the limited definition and scope of orthoptics to treat disorders of the visual system, indicative of vision as a collaboration between the eyes and the brain.

In summary, optometric vision therapy is a complete program of habilitatiave and rehabilitative therapeutic vision care of which orthoptics is a subset. Optometric vision therapy is not synonymous with orthoptics, home vision therapy or computerized vision therapy programs.

View Vision Therapy Studies