Vision Therapy

Vision therapy is a treatment method that develops, maintains and restores visual skills that are required to perform visual tasks during a typical day. These visual skills include:

  • Accommodation (eye focusing)

  • Binocular Vision (eye teaming)

  • Oculomotor Skills (eye tracking)

  • Visual Perception (extracting information from visually-presented material)

  • Visual Processing (quickly being able to 'make sense' of one's visual environment)

 

Vision therapy is a structured treatment process that utilizes skilled therapists, specialized equipment and a carefully planned progression of activities to modify the visual system at the neurological level. Vision therapy improves the speed, flexibility, endurance and accuracy of the visual system's accommodative response (eye focusing), vergence response (eye teaming) and oculomotor skills (eye tracking). Vision therapy also helps develop higher level visual skills, such as visual processing speed and visually-guided motor responses (visual reaction speed or eye-hand coordination).

 

Vision therapy systematically eliminates visual barriers to clear, comfortable, binocular vision while simultaneously developing the proper visual coordination required to maintain stable visual skills throughout life. This process is most effective when overseen by an optometrist with residency-training in vision therapy to ensure proper diagnosis and treatment of your vision conditions. Vision therapy may be used in isolation or in conjunction with other treatments, such as prism glasses or strabismus surgery. Specific recommendations are determined during a Binocular Vision Assessment.

Who Can Benefit From Vision Therapy?

Vision therapy can help people at many stages of life. Vision therapy is an effective treatment modality for many vision conditions in both children and adults. Vision therapy is a type of treatment that you may need if you experience:

  • Discomfort (visual/eye strain, headaches, etc) during visual tasks, such as reading or computer work

  • Blurred or fluctuating vision while performing near tasks (reading, computer, gaming, etc) or when transitioning focus between distance and near (such as when taking notes in class)

  • Double vision, even if experienced occasionally,

  • Tracking difficulties that may impair reading fluency (skipping words, re-reading lines, loss of place, etc)

  • Impaired depth perception that causes poor eye-hand coordination and makes a person appear 'clumsy'

  • Difficulties processing visual information, making it difficult to keep up with the pace of life, work or school

 

Vision therapy is often times the best treatment option for patients who experience deficits with eye tracking, eye teaming, eye focusing and visual processing. By addressing the underlying vision conditions, patients often experience significant improvements in visual tasks, such as reading, working on the computer for extended periods of time, scanning of the visual environment (while driving or playing sports for example) and performing under timed conditions.

 

 

KIDS STRUGGLING WITH READING OR ACADEMIC PERFORMANCE

Vision plays a central role in the learning process. In fact, more than 80% of classroom learning occurs through the visual system. Imagine trying to take notes when the board at the front of the classroom is blurry, or attempting to read when the words appear to move on the page or become double. Studies have shown that something as simple as an uncorrected refractive error can impact learning and emerging reading skills.

 

Some reports in literature estimate that as many as 1 in 4 children have a vision condition significant enough to impact learning. It is important to remember that not all vision conditions result in blurry vision (many children who need vision therapy can see 20/20) and not all conditions are corrected with glasses. The presence of eye tracking, eye teaming, eye focusing and visual processing deficits can have significant impacts on the learning process and should be treated as soon as possible.

 

If a child is struggling with reading or learning, it is important to determine the cause of the struggles (whether they be visual in nature or not). Given the significant role vision plays in the learning process, ruling out a vision condition should be one of the early steps in the process. Efforts, such as more time reading at home or a reading tutor, will be less effective if an underlying vision condition remains untreated.

 

While not all challenges in school are vision-related, treating and removing visual barriers to success is a critical early step in a comprehensive approach to helping your child succeed. It is important to know that vision therapy does not treat learning disabilities, but it does effectively treat vision conditions that impact learning and often are misdiagnosed as a non-visual problem. The types of vision problems that impact learning are often overlooked during a general eye exam. It is important that you work with a team who understands vision, vision development and the vision conditions that impact learning. An eye examination with a Residency-Trained Pediatric Optometrist and a Binocular Vision Assessment with an optometrist who is Residency-Trained in binocular vision is the best way to rule out a vision condition impacting learning.

 

 

INDIVIDUALS IN SUPPORTIVE THERAPIES

(OCCUPATIONAL THERAPY, PHYSICAL THERAPY, SPEECH/LANGUAGE THERAPY)

Vision impacts more than your ability to read 20/20 on the eye chart. Eye tracking, eye teaming, eye focusing and visual processing deficits impact one's functional abilities. These vision conditions negatively affect visual-motor tasks (eye-hand skills), visual-vestibular tasks (balance & mobility) and even language processing (visual-auditory speech integration).

 

It is important that vision conditions be treated to minimize their impact on functional abilities. Additionally, untreated vision conditions can stall or prevent progress with other therapies such as occupational therapy, physical therapy or speech-language therapy. Integrating a vision therapy program at Advanced Vision Therapy Center as part of a comprehensive treatment plan can improve progress and overall efficiency of concurrent therapies.

 

Even if a vision problem is not suspected, it is important that those participating in occupational therapy, physical therapy or speech therapy have a Binocular Vision Assessment. Deficits within the motor, vestibular or auditory systems put more demand on the visual system (the person must rely heavily on their visual system). This means that even subtle vision problems can have a significant impact on overall function. These vision problems will not be identified during vision screenings at the pediatrician's office or at school, during a routine eye examination, or by an occupational therapist, physical therapist or speech-language therapist. These vision problems should be identified and diagnosed by an optometrist with residency training in neuro-optometry, binocular vision and vision therapy. Otherwise they can be easily misdiagnosed or overlooked and continue to impede progress.

 

 

PEOPLE WITH A SIGNIFICANT DEVELOPMENTAL HISTORY

Several vision conditions occur at higher rates for people with developmental conditions. While having autism, cerebral palsy, trisomy 21 or developmental delay does not mean that you have a vision condition, it does carry a higher risk. Given the role vision plays in overall development, it is especially important that all vision conditions be detected and treated. Vision conditions of concern for people with developmental conditions include:

  • Significant refractive error (high prescription)

  • Amblyopia (lazy eye)

  • Strabismus (eye turn)

  • Accommodative dysfunction (eye focusing)

  • Binocular vision dysfunction (eye teaming)

  • Oculomotor dysfunction (eye tracking)

  • Visual perceptual & processing deficits (extracting visual information)

 

While glasses are important to establish clear vision, they do not treat all vision conditions. Vision therapy is extremely effective in treating many conditions that impact functional vision. Providing clear, comfortable, consistent vision allows someone to be more successful in their visual environment. Vision therapy can be a critical part of a greater plan to help an individual reach their potential.

 

 

CHILDREN OR ADULTS WITH A HISTORY OF VISION PROBLEMS

(EX: AMBLYOPIA, STRABISMUS)

Vision therapy can be used as the sole treatment, or in conjunction with other treatments, to address longstanding vision conditions. There are many vision conditions that have lifelong impacts if left untreated. One does not 'outgrow' conditions of eye tracking, eye teaming, eye focusing or visual processing deficits.

 

Conditions, such as amblyopia (lazy eye) and strabismus (eye turn), often benefit from vision therapy as part of a comprehensive treatment plan. For example, not all cases of amblyopia can be treated with glasses and patching alone. Inclusion of vision therapy addresses the underlying binocular vision deficits that result in blurred vision. More recent research has shown that amblyopia can be treated in both children and adults when vision therapy is included as part of the treatment process.

 

Vision therapy is often utilized in the treatment of strabismus (eye turn). In some cases, vision therapy can be used as the sole treatment for an intermittent strabismus (the eye turns on occasion). In other cases, vision therapy can be used to support a more successful recovery following strabismus surgery (similar to the use of physical therapy after orthopedic surgery).

Which Conditions Are Treated With Vision Therapy?

Vision therapy may be used in isolation or in conjunction with other treatments to successfully remediate many vision conditions. These conditions include:

  • Accommodative Dysfunction (Eye Focusing Deficits)

    Eye focusing conditions can result in blurred or fluctuating vision. These conditions are especially frustrating for individuals as they experience blurred vision but can often read 20/20 on the eye chart. This occurs because accommodative dysfunction frequently affects vision during sustained near tasks (such as reading or computer work) or causes blur when quickly changing focus (such as when taking notes in class). This creates a situation where a student may report blurred vision in class, however when they present to the doctor they are seeing clearly (which may mistakenly lead the doctor to think that everything is fine).

 

Vision therapy improves the amplitude (strength), flexibility, speed and accuracy of accommodation. This allows the individual to maintain clear vision throughout various activities, whether sustaining clarity during reading or being able to see clearly while transitioning between the front of the classroom and their desk.

 

  • Amblyopia (Lazy Eye)

    Amblyopia is a vision condition that occurs early in life when barriers to clear vision go uncorrected; typically a high prescription, certain types of strabismus (eye turn), or a condition obstructing vision (such as congenital cataract). Improper development of the visual pathway results in blurred vision (inability to see 20/20) as well as deficits within the binocular vision system.

     

    Vision therapy is often used in conjunction with glasses, surgery or patching to treat amblyopia. Vision therapy treats the underlying binocular vision dysfunction and improves the success of patching or strabismus surgery alone. Including vision therapy as part of a comprehensive amblyopia treatment plan allows for improvement of vision at any age and improvement beyond the plateau experienced with patching alone.

 

  • Binocular Vision Dysfunction (Eye Teaming Deficits)

    Binocular vision refers to the ability to use both eyes in a coordinated manner. Deficits in binocular vision can result in a number of symptoms, including: double vision, headaches, eye strain, dizziness, poor depth perception and difficulties with visual-motor tasks (such as sports). Additionally, binocular vision dysfunction can impair related visual skills, such as eye tracking.

     

    Vision therapy is an effective treatment for many conditions of binocular vision dysfunction. Rather than 'putting a band-aid on the problem' or embedding splinter skills, vision therapy addresses the underlying deficits within the visual system. Vision therapy develops coordination of the visual system as a whole, which provides a permanent solution.

     

  • Convergence Insufficiency

    Convergence insufficiency is a common vision condition that describes difficulties or an inability to use both eyes in a coordinated manner during near tasks (such as reading or computer work). In order to comfortably look at near objects (such as a book), one must converge their eyes. Those with convergence insufficiency often experience headaches, eye strain, blurred vision or double vision while performing near tasks, such as reading. This can result in difficulties concentrating during this tasks or trouble remembering what has been read.

     

    Vision therapy is extremely effective in treating convergence insufficiency. In fact, the Convergence Insufficiency Treatment Trials found in-office vision therapy to be the most effective treatment for convergence insufficiency. Vision therapy develops coordination of the binocular vision system, which improves the convergence response, while also improving foundational visual skills necessary to maintain clear, comfortable, single binocular vision.

     

  • Oculomotor Dysfunction (Eye Tracking Deficits)

    Eye tracking deficits are common among struggling readers. Efficient eye tracking is necessary for fluent reading, scanning our visual environment (ex: driving) and while playing sports. It is important to note that oculomotor skills are dependent on a stable binocular vision system. For this reason, eye tracking deficits must be evaluated in conjunction with underlying binocular vision and accommodative abilities.

     

    Vision therapy is the best approach to remediate oculomotor dysfunction as it is the only treatment method that addresses both the foundational visual abilities and higher level eye tracking difficulties. This is in stark contrast to 'eye tracking' or reading programs that assume an intact binocular visual system while taxing higher level skills – limiting success for the child and increasing frustration.

     

  • Strabismus (Eye Turn)

    Strabismus describes a group of conditions in which an eye 'turns' in (esotropia), out (exotropia) or up/down (hypertropia). Treatment of strabismus can include prism glasses, strabismus surgery, vision therapy or a combination of the three. The optimum treatment approach depends on the specific characteristics of the strabismus - for example, the size (how far the eye turns) and frequency (how often the eye turns) of the strabismus influences treatment decisions.

     

    Vision therapy is a valuable component of strabismus treatment as it addresses the underlying sensory deficits in the binocular vision system. Whereas surgery can 'move the eye' to improve alignment, vision therapy improves the ability for the visual system to coordinate the right and left eyes. In some cases vision therapy can be used as the sole treatment for intermittent strabismus, while in others it is used following surgery to improve sensory abilities (similar to physical therapy after an orthopedic surgery).

     

  • Vergence Dysfunction (Convergence Insufficiency, Convergence Excess, Divergence Deficits)

    Vergence is a visual skill that allows one to maintain binocular vision. Convergence describes the crossing of the eyes to view objects at near (reading, computer, etc) while divergence describes uncrossing of the eyes to look in the distance. Convergence and divergence skills must be fast, accurate and consistent to maintain clear, single vision. Vergence dysfunction can result in double vision, blurred vision, headaches or visual discomfort. Additionally, vergence dysfunction disrupts the visual-vestibular system, which can cause dizziness and balance difficulties.

     

    Vision therapy improves the amplitude (strength), flexibility, speed and accuracy of the vergence system while reducing the latency of the vergence response. Enhancing one's vergence abilities in turn promotes clear, comfortable, single binocular vision.

     

  • Visual Perceptual Deficits (extracting information from visually-presented material)

    Visual perception is a skill set that allows one to interpret visual information; it plays an essential role in the learning process. Many people with visual perceptual deficits are described as auditory learners; they learn well when they hear things but cannot seem to produce the same results with visual material.

     

    Vision therapy develops both the underlying 'mechanics' of the visual system (binocular vision, accommodation, etc) as well as visual perceptual skills. This is important as poor visual input can cause performance that looks like visual perceptual deficits. Once underlying binocular vision dysfunction has been addressed, vision therapy then develops the visual skills necessary to extract visual information and support efficient visual perceptual skills.

     

  • Visual Processing Deficits (quickly being able to 'make sense' of one's visual environment)

    Visual processing speed allows one to quickly interpret visual information and make split-second decisions. Visual processing can be thought of as 'visual reaction speed'. Visual processing speed allows one to keep up with the pace of class, engage in sports and be a safe driver. Poor visual processing abilities require one to slow down and have repeated presentation to understand visual concepts.

     

    Visual processing therapy, which is an aspect of vision therapy, improves visual processing speed. Advanced Vision Therapy Center is unique in offering advanced biofeedback therapy as part of a comprehensive visual processing therapy program. This allows for functional changes in visual processing at the neurological level.

 

Distinguishing the subtle differences between various vision conditions is a critical first step in the treatment process; the right diagnosis leads to the most appropriate treatment option and greatest success. A Binocular Vision Assessment with an optometrist with residency-training in binocular vision, neuro-optometry or vision therapy is the best way to evaluate the need for vision therapy. Working with a residency-trained optometrist ensures that your care is being provided by a doctor with advanced training specific to binocular vision dysfunction.

The Advanced Vision Therapy Center Difference

Established in 1991, Advanced Vision Therapy Center has become the Northwest's premier vision therapy clinic. For more than 25 years, Advanced Vision Therapy Center has worked with patients to improve their vision and overall quality of life – delivering lifelong results for both children and adults. The success of our patients is one of the many reasons why Advanced Vision Therapy Center is trusted by both local patients and those who travel to Boise for care.

 

The success of vision therapy treatment programs at Advanced Vision Therapy Center is based on many factors. We have developed a team of experts in their field who have advanced training, certifications and years of experience providing vision therapy to a wide variety of patients.

 

 

RESIDENCY-TRAINED NEURO-OPTOMETRIST

Ryan Johnson OD, FAAO is the clinical director of Advanced Vision Therapy Center. Dr. Johnson is Idaho's first optometrist with residency-training in neuro-optometry, binocular vision and vision therapy. His post-graduate training at the University of California, Berkeley was dedicated to the management of patients with vision conditions requiring vision therapy, including patients with acquired brain injury and neuro-visual conditions.

 

Dr. Johnson is the first optometrist in Idaho with this advanced training in the sub-specialty of vision therapy. An evaluation with Dr. Johnson is the first step to determine if vision therapy is right for you. His knowledge and expertise in the area of vision therapy allow for the proper diagnosis of your vision conditions. The information gathered during the Binocular Vision Assessment is used to develop your plan of care, whether that include vision therapy, glasses or other treatments. An accurate diagnosis and comprehensive plan of care is essential for timely improvement and ultimate success for the patient.

 

Dr. Johnson serves as the clinical director for Advanced Vision Therapy Center. As clinical director, he oversees every treatment plan. He works with our team of vision therapists to ensure that visual skills are improving and the patient's goals are being met.

 

 

EVIDENCE-BASED TREATMENTS

Another important factor in determining the success of a vision therapy program is the approach to therapy. Vision therapy has been practiced for over 100 years and has been researched extensively. This allows for an evidence-based approach to vision therapy that provides predictable and successful outcomes. We know which vision conditions respond to vision therapy and how to structure a program to provide the best results possible in an efficient amount of time.

 

Understanding the visual system and how it responds to therapy allows our vision therapy team to provide long-lasting improvements in visual function without the need for extended vision therapy programs or so-called 'booster programs'. Many of our patients are excited to see the lifelong changes in visual skills without the need for a maintenance program.

 

 

ONE-ON-ONE THERAPY SESSIONS WITH QUALIFIED THERAPISTS

Every vision therapy treatment session at Advanced Vision Therapy Center is performed one-on-one with a skilled vision therapist. This is important for several reasons.

 

Vision therapy is used to treat a wide range of vision conditions. The specific vision condition (or combination of conditions), the severity of the conditions and the individuality of the patient all need to be considered when performing vision therapy. The environment of Advanced Vision Therapy Center allows for each session to be tailored to the individual needs of the patient. This allows each patient to progress at the rate appropriate for their visual system, which maximizes the success of every vision therapy patient.

 

The vision therapist also ensures that visual skills are being properly developed. If not constantly monitored during treatment, the visual system can struggle to make the necessary improvements. The one-on-one structure at Advanced Vision Therapy Center ensures that every session and every minute are dedicated to the treatment goals and the patient's success.

 

At Advanced Vision Therapy Center patients are not positioned in front of a computer for therapy. Research has shown that in-office, active therapy (not on a computer) is far more successful in delivering results. While technology and advancements in the field of vision science is embraced at Advanced Vision Therapy Center, ineffective computer therapy is not a part of our program. Instead, our therapists, under the direction of Dr. Ryan Johnson, customize each vision therapy session for every patient – using current research and proven treatment methods to meet treatment goals and deliver results. That's the Advanced Vision Therapy Center difference.

No Referral Necessary

If you're looking for answers or have concerns about your vision, we invite you to call to schedule a Binocular Vision Assessment.  

Improvement Starts Here

With over 25 years of proven success, you can trust Advanced Vision Therapy Center to provide the care you need.

Our Clinical Director is Idaho's only residency trained optometrist in vision therapy and neuro-optometry and is a Fellow of the American Academy of Optometry.  His residency at University of California, Berkeley means he has the expertise and experience to treat even the most complex cases.

Read what our patients have to say.

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Contact Us

7960 W. Rifleman Street, #155
Boise , Idaho , 83704 USA
Phone:  208-377-1310
Fax:  208-321-1952