What is Vision Therapy?
Vision Therapy is Administered in the Office Under the Guidance of a Doctor
The Joint Policy Statement can be viewed in its entirety on the American Optometric Association’s Website.
Vision Therapy = Physical Therapy for your Eyes!
The College of Optometrists in Vision Development (COVD) notes that vision therapy is generally conducted in-office, in once or twice weekly sessions of 30 minutes to an hour, occasionally supplemented with procedures done at home between office visits. You can view more information about vision therapy on the COVD website.
The Science Behind Vision Therapy
Vision Therapy Should Be Individualized and Customized
Research on Vision Therapy
There are now many excellent compilations on the subject. Let’s start with a review, published in the highly regarded Cochrane Database Reviews on the National Center for Biotechnology Information’s Website. The citation is Scheiman M, Gwiazda J, Li T. Non-surgical interventions for convergence insufficiency. Cochrane Database Syst Rev 2011 Mar 16;(3):CD006768.
- A successful or improved outcome was found in 73% of the office-based therapy group, 43% of the pencil push-up group, and 35% of the office-based placebo therapy group, and 33% of the home-based computerized therapy group.
- The results of this study are now being used by some insurance carriers to support the need for office-based vision therapy, but only of 12 weeks duration, as was used in the CITT study.
- Unlike drug studies, in which the patient takes a placebo pill, it is challenging to design a placebo therapy group. Placebo therapy must be designed well enough that neither the patient nor the therapist knows that the therapy is not directly addressing the condition. The CITT group did a brilliant job designing this group, which is why they were able to generate such a good rate of improvement that came about from improving sustained visual attention – in fact, a couple of percentage points greater than the home-based computerized therapy group!
- Although the outcome after 12 weeks of therapy was impressive at a 73% rate of improvement, we do not settle for that in our practice. Why would you want only a 73% rate of improvement if by going beyond 12 weeks, and/or adding additional procedures, you can generate a 95% rate of improvement?
- Even if we take what the CITT has proven at face value, since ophthalmologists and pediatricians profess to practice only evidence-based medicine, that means that in the years since the CITT was published the field should have been transformed and have integrated the research outcomes of the CITT. Unfortunately for many patients in need, almost no pediatric ophthalmologists prescribe office-based vision therapy.