Sunday, September 29, 2013

VISION THERAPY: Information for Health Care and Other Allied Professionals


A Joint Organizational Policy Statement of the American Academy of Optometry and the American Optometric Association

INTRODUCTION 

Society places a premium on efficient vision. Schools and most occupations require increasing 
amounts of printed and computer information to be handled accurately and in shorter periods of 
time. Vision is also a major factor in sports, crafts, and other pastimes. The efficiency of our 
visual system influences how we collect and process information. Repetitive demands on the 
visual system tend to create problems in susceptible individuals. Inefficient vision may cause 
an individual to slow down, be less accurate, experience excessive fatigue, or make errors. 
When these types of signs and symptoms appear, the individual’s conscious attention to the 
visual process is required. This, in turn, may interfere with speed, accuracy, and 
comprehension of visual tasks. Many of these visual dysfunctions are effectively treated with 
vision therapy. 

PERTINENT ISSUES 

Vision is a product of our inherited potentials, our past experiences, and current information. 
Efficient visual functioning enables us to understand the world around us better and to guide our 
actions accurately and quickly. Age is not a deterrent to the achievement of successful vision 
therapy outcomes. 

Vision is the dominant sense and is composed of three areas of function: 
• Visual pathway integrity including eye health, visual acuity, and refractive status. 
• Visual skills including accommodation (eye focusing), binocular vision (eye teaming), and 
eye movements (eye tracking). 
• Visual information processing including identification, discrimination, spatial awareness, and 
integration with other senses. 

Learning to read and reading for information require efficient visual abilities. The eyes must 
team precisely, focus clearly, and track quickly and accurately across the page. These 
processes must be coordinated with the perceptual and memory aspects of vision, which in turn 
must combine with linguistic processing for comprehension. To provide reliable information, this 
must occur with precise timing. Inefficient or poorly developed vision requires individuals to 
divide their attention between the task and the involved visual abilities. Some individuals have 
symptoms such as headaches, fatigue, eyestrain, errors, loss of place, and difficulty sustaining 
attention. Others may have an absence of symptoms due to the avoidance of visually 
demanding tasks.

VISION THERAPY 

The human visual system is complex. The problems that can develop in our visual system 
require a variety of treatment options. Many visual conditions can be treated effectively with 
spectacles or contact lenses alone; however, some are most effectively treated with vision 
therapy. 

Vision therapy is a sequence of activities individually prescribed and monitored by the doctor to 
develop efficient visual skills and processing. It is prescribed after a comprehensive eye 
examination has been performed and has indicated that vision therapy is an appropriate 
treatment option. The vision therapy program is based on the results of standardized tests, the 
needs of the patient, and the patient’s signs and symptoms. The use of lenses, prisms, filters, 
occluders, specialized instruments, and computer programs is an integral part of vision therapy. 
Vision therapy is administered in the office under the guidance of the doctor. It requires a 
number of office visits and depending on the severity of the diagnosed conditions, the length of 
the program typically ranges from several weeks to several months. Activities paralleling inoffice techniques are typically taught to the patient to be practiced at home to reinforce the 
developing visual skills. 

Research has demonstrated vision therapy can be an effective treatment option for: 
• Ocular motility dysfunctions (eye movement disorders) 
• 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 

SUMMARY 

Vision therapy is prescribed to treat diagnosed conditions of the visual system. Effective 
therapy requires visual skills to be developed until they are integrated with other systems and 
become automatic, enabling individuals to achieve their full potential. The goals of a prescribed 
vision therapy treatment regimen are to achieve desired visual outcomes, alleviate the signs 
and symptoms, meet the patient’s needs, and improve the patient’s quality of life. 

This Policy Statement was formulated by a working group representing the American 
Academy of Optometry, American Optometric Association, the College of Optometrists in Vision 
Development, and the Optometric Extension Program Foundation. The following individuals are 
acknowledged for their contributions: 
Gary J. Williams, OD; Chair 
Susan A. Cotter, OD Louis G. Hoffman, OD, MS Glen T. Steele, OD 
Kelly A. Frantz, OD Stephen C. Miller, OD Jeffrey L. Weaver, OD, MS 
 Approved by: American Academy of Optometry, May 14, 1999 
 American Optometric Association, June 22, 1999 
 College of Optometrists in Vision Development, June 25, 1999 
 Optometric Extension Program Foundation, June 25, 1999 

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