The Vision Therapy Opportunity

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Jobson has a very informative interactive online guide that ranges across many ophthalmic topics.  It was intriguing to find a four part guide to “The Vision Therapy Opportunity” there, authored by Erich Mack, a licensed optician in Arizona.  You’ll have to register to view the articles, but it will be well worth your while to gain perspective  from this articulate professional outside the field of Optometry.

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Let me give you a “teaser” from Part One:

“As opticians, we generally describe our profession as one of identifying problems with vision and creating a plan for correcting it. Our usual course of action falls in one of two categories; corrective lenses or medication. But what if our vision fails and the diagnosis calls for something beyond refractive correction and medication? Many in our industry don’t have broad knowledge of an effective third treatment category, called vision therapy …

The Vision Council estimates 25 percent of school aged children suffer from undiagnosed vision problems. Two thirds of the problems are outside the scope of glasses. As a result, children with one or more undetected vision problems may have difficulties learning and thriving in life. In an eye opening study from a New York clinic, youth at risk of dropping out of school were found to have a 25 percent chance of being labeled and placed in special education. All of these children had failed vision screening tests. Adults suffer from these same vision problems just as frequently and are also commonly undiagnosed. These conditions could have been present from birth or brought out later in life from stress, trauma, and disease to name a few. Study after study has shown a large population would benefit from vision therapy yet access and wide knowledge of vision therapy is restricted. Although recently plagued by controversy, vision therapy remains an effective and useful tool for a properly trained practitioner to treat a variety of special case patients and the future is as bright as ever …

To understand vision therapy it is important to have a functional definition of vision. Vision is the dominant sense and is composed of three areas of function. The first function is visual pathway integrity including eye health, visual acuity, and refractive status. The second function is visual skill including accommodation (eye focusing), binocular vision (eye teaming), and eye movements (eye tracking). The third function is visual information processing including identification, discrimination, spatial awareness, and integration with other senses.

Based on this understanding we can identify problems with our visual system. If we analyze the entire visual system there is information that enters the eye and is displayed on the retina. Outside of this is a muscle and a neurological system. Problems with the latter two can cause inefficient vision and are the arena of vision therapy. 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 individuals’ conscious attention to the visual system 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.

Another important concept relating to the visual system is neuroplasticity and activity dependent plasticity. Neuroplasticity refers to changes in neural pathways and synapses, which are due to changes in behavior, environment and neural processes, as well as changes resulting from bodily injury. Activity dependent plasticity is the brain’s ability to retain memories, improve motor function, and enhance speech and vision. To demonstrate this, a right-handed person may perform any movement poorly with his/her left hand but with continuous practice can be just as able with the left. The same concept works with vision as well. For example, amblyopic patients, stroke victims, brain cancer patients, and traumatic brain injury patients all can regain some or all vision loss using vision therapy and harnessing the power of brain plasticity.”



And the conclusion from Part Four:

“The fact that optometrists, ophthalmologists, and educators use different definitions for describing treatments and therapies continues to exacerbate the divide. Certainly there exist many criticisms of vision therapy. But to be clear, the majority of these criticisms arise from a lack of universal definition of disorders, defined experimental methods and methodology, and conflicting professional interests …

Controversy aside, vision therapy is a proven method and logical vanguard approach to patient care. As stated earlier, the necessity of universal definitions and agreed upon methodology is important groundwork that still has yet to be done. Until the time comes when that happens and doctors can put aside non-care related issues, most patients will not have a vision therapy option. Over one hundred years ago, Dr. Javal created the first vision therapy techniques and they have been advancing with more effectiveness and sophistication ever since. Modern brain imaging techniques are telling researchers that more and more disorders are linked to the visual system. With this new evidence it appears that once again vision therapy has a bright future.”


2 thoughts on “The Vision Therapy Opportunity

  1. This is a well written wake-up call to OD’s everywhere! As online glasses and contact lenses erode profits and online exams threaten even that bastion of professional care, Optometry needs to embrace it’s (for now) unique expertise in diagnosing and treating disorders of the visual system if we are to stay professionally viable. Since most ODs do not seem to understand this, I am intrigued with the idea of “therapeutic” opticians who are willing to learn about vision therapy and provide this type of care for patients. It does make me wonder why they didn’t become OD’s. Tuition cost? Is it time for a not-for-profit Optometry school to really teach about vision?

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