Still Doubting Optometric Vision Therapy: Are You Kidding Me?


AOJ coverA good colleague, a Fellow of COVD practicing in North Dakota emailed this morning asking if I had seen a recent article in the American Orthoptic Journal titled: Vision Therapy: Are You Kidding Me?  Problems with Current Studies.  Since the full PDF of the article is not free in the public domain I can’t post it, but here is the abstract.  Given that its author is an orthoptist from Children’s Hospital in Boston, the title isn’t surprising.  You can read why in this earlier blog post.  You may find a few other articles from the current issue of AOJ (published once yearly) interesting.  One that particularly caught my eyes was on fusional vergence amplitude measurement in which the author discovered that encouragement and alertness makes a difference, as does measuring convergence before divergence.  News to any of you?

But back to the article in question, of course the title frames the question in a way that that the answer becomes less important than the question itself.  The most infamous example of this was Dr. Harold Koller’s “Is Vision Therapy Quackery?” article adorning a cover of Review of Ophthalmology.  The basis for this framing bias is evident in the current Kidding Me article when the author writes:  “Vision therapy has become somewhat of an ‘umbrella-term’ for many treatment types, and often has a negative connotation to pediatric ophthalmologists and orthoptists.”  

IMHOWell in my humble opinion, it’s time that biases like this stop being published in professional journals. You can read the article if you’re so inclined, but its conclusion is predictable to those of us who keep calling pediatric ophthalmologists, pediatricians, and orthoptists on the carpet for policy statement hatchet jobs: “Until larger, placebo-controlled, multicenter randomized control studies are obtained for further evaluation of the efficacy of more commonly prescribed treatment for symptomatic CI, this question of effectiveness remains unanswered.”  You’re kidding me, right?

9 thoughts on “Still Doubting Optometric Vision Therapy: Are You Kidding Me?

  1. I don’t understand why in the same journal that criticizes vision therapy for convergence insufficiency, they would bother publishing anything relevant to measuring fusional reserves. What do they do when they find a fusional deficiency? Surgery, prism prescription, and pencil pushups do not have the large placebo-controlled, multicenter randomized control studies that they seem to want vision therapy to have to consider a treatment valid. Why bother themselves with it then? This is professional politics at its grubbiest. Shame on them. This is the same journal in which Hunter has written questioning whether ophthalmology really needs evidence for everything – well, obviously only when they have a political agenda.

  2. Lennie, as my former patient care coordinator once wisely stated, “What goes around, comes around.” Ophthalmology are their own worse enemies! In their “blindness” to the overwhelming success of optometric vision therapy, they have failed to notice a rapid shifting of tides. With the ample access to various studies by the searching public and testimonials by prominent figures like Dr. Susan Barry plus Robin and Jillian Benoit’s new book, even general physicians are turning to behavioral/developmental optometrists to treat their loved ones and patients! I say, allow them to continue to grope in their own self-made blindness and frankly embarrassing ignorance not to mention arrogance! The enlightened public will find a beacon of hope and measurable help in our open-minded of fives!

  3. Dear Lenny,

    It is ironic that Sarah Whitecross , who lists her correspondence address as Boston Children’s Hospital, is taking the standard medical position on the efficacy of vision therapy. It should be noted that Boston Children’s Hospital has a vision therapy service. The program is run by my ex resident and Dr. David Hunter, Chief of Ophthalmology, has been supportive of vision therapy in appropriate cases. Sarah Whitecross is just another in a long line of individuals, who have placed themselves in the path of patients receiving appropriate optometric treatment. The drug industry has used ghost writers and advertising to promote many of their worthless and dangerous drug regimens. The current controversy regarding Cholesterol is another example of this insanity. Most members of the special committee that developed the new guidelines had conflicts of interest with the drug industry. The fact that a quarter of American over 40 are currently on statins is ridiculous and the medical direction is to add children to these statistics.

    Medical journals have become a political tool rather than a source of updated research. The manta for clinical based research is fine until it run counter to your opinion/bias. In the latter case, the strategy is to discredit the research. Vision therapy is an effective method for dealing with many types of vision problems. It is similar to physicians, who use drugs (off label) to deal with many conditions. The CITT study has shown conclusively that vision therapy has a role in improving patient’s quality of life and resolving an underlying vision problem. It is time for physicians and allied professionals to accept the TRUTH rather than creating smoke screens to protect their own self interests.

    Richard

  4. Pathetic paper—why don’t they read the scientific literature, especially on basic aspects of perceptual and motor learning which is the underlying basis for most/all of clinical vision therapy/vision rehabilitation. The optometric (e.g., ‘Academy’ journal, several papers since 1979) and the medical literatures (e.g., JRRD the VA journal, Brain Injury, Neurorehabilitation, and many others over the past 15 years) now have several papers, by different groups, clearly demonstrating with OBJECTIVE (infrared assessment of eye movements and accommodation; VEP; MRI) recording techniques correlated with clinical measures, symptoms, and general/visual attention that “VT works” in both the non-brain injured and brain injured populations!!!

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