Vision Therapy

Vision therapy (VT) is a non-invasive treatment for binocular vision disorders. It applies optometric science and methods to increase efficiency of deficient neurological connections related to vision that can cause many symptoms that are seen in day-to-day life. It is individually tailored to each patient’s needs, is supervised by the doctor, and is also maintained with home therapy throughout the sessions, although long-term therapy and maintenance is not generally needed.

For children, many learning disorders are heavily linked with vision. Our most common issues we work with are ADHD, autism spectrum disorders, and dyslexia, among many other conditions. Vision utilizes 60-70% of brain processing power, and seeing clearly is a small fraction of vision. Often times, children have to strain their eyes at near, by focusing from far to near, crossing eyes to avoid double vision, or making sense of words and letters that appear to be moving from deficient tracking abilities. These present as skipping words, reversing letters (such as b, d, p, and q), fatigue, overactivity, and sometimes double vision. When these binocular vision issues strain the visual system, the brain spends more energy on vision, greatly decreasing the remaining 30-40% of brain function. This overflow very commonly mimics ADHD, almost perfectly. When strained, the brain sacrifices executive functioning or higher level tasks. For example, memory, planning and organization, impulse control, adaptation to change, and emotional control. The strain can also cause eye fatigue and headaches, which can result in an aversion to near tasks such as reading. Overflow can appear as unnecessary body movements such as fidgeting or squirming in order to assist with concentration. VT gives tasks that challenge our patients to the right level that are broken down to target each area individually. Once the individual areas are strengthened, our patients put them together to increase visual efficiency and function, making learning tasks much easier. This is where we shift from “learning to read” to “reading to learn.” Many children have symptoms of double vision, intermittent blur at near, and words moving on the page, but are unable to communicate the problem because they feel it is “normal.” As they may have had these symptoms since they began to read, they don’t know any difference. If your child is struggling in school or with reading, it is recommended to be evaluated by an optometrist that specializes in vision and learning.

If you or your child has an eye turn (strabismus) or a lazy eye (amblyopia), vision therapy is a great holistic treatment instead of eye surgery. It does take more time and effort, but results tend to be more long-term, as eye turns tend to reappear several years after surgery. If the visual system’s neurological components are treated, there is more stimulus and feedback for the eyes to “want to be” binocular. Sometimes VT is used before or after surgeries to help increase the effectiveness of the surgery. Amblyopia has historically been treated with monocular patching. There are new studies supporting the efficacy of binocular treatments. These improved results are achieved with binocular treatment called “monocular fixation in a binocular field (MFBF).” Dr. Mark heavily employs this strategy for treatment of amblyopia in our practice. Often times when strabismus or amblyopia are present, visual-perceptual issues are co-morbid. In most cases, a similar treatment regimen as above is employed once the baseline issue of the blurry vision or turned eye is resolved.

Some adults may also greatly benefit from VT. After a brain injury, such as a stroke or concussion, the brain gets stressed and needs to rewire to function, making up for the area of damage. Most of the time, these new connections are inefficient and take more processing power. When processing power is diverted to vision, we commonly see symptoms of memory dysfunction, difficulty navigating through space, poor planning, brain fog, sensory overload, poor depth perception, and many other symptoms. It is a misconception that adults do not benefit from VT, as we have recently learned that throughout the entire human life, the nervous system is plastic, always changing, and modifying brain connections. We use this inherent ability to form more efficient pathways, minimizing visual stress, and improving cognitive function.

A subspecialty of vision therapy that Dr. Mark manages is called “sports vision therapy.” This is done for patients that want to improve the vision components of their athletic abilities. Dr. Mark has trained in football, basketball, hockey, field hockey, archery, competitive shooting, as well as many other sports. The first step to high performance is to find the right prescription in either glasses or contacts. Therapy involves high level tasks that incorporate balance, peripheral vision, reaction time, planning, and intake of large amounts of visual information in the matter of milliseconds.

Computer vision syndrome is another new area of VT that has been seen commonly in patients - this presents as headaches, eyestrain, dizziness, nasuea, and general fatigue after being on the computer for an extended amount of time.

Lastly, motion sickness is not commonly associated with vision, but we have seen great success with training the eyes to match the vestibular system (how the body knows where it is in space). Strengthening these connections can greatly relieve symptoms of motion sickness.

Training is done to last a lifetime. We rarely need to see patients back for maintenance therapy. By using loading techniques (adding additional challenges to visual tasks), the visual processes become "automatic,” meaning that every task from day to day becomes a therapeutic activity in itself and skills learned are maintained. Dr. Mark’s philosophy is to empower the patients to be aware of their own vision, and to have full control to manage their symptoms with efficiency.