Training vs. Therapy: More than Semantics?


In the Preface to Applied Concepts in Vision Therapy, I address the significance of the term “therapy” as opposed to “training”, and indicate a personal preference for the term “therapy” as it is more in line with something done through the patient in contrast with to or for the patient, and consistent with analogous labels in the health care field such as cognitive rehabilitation therapy or occupational therapy.

Alot of people have re-branded “VT” as neuro-optometric rehabilitation, preferring to avoid the baggage perceived to be associated with visual training or vision therapy.


But baggage can be in the eye of the beholder.  The term for all this “stuff” as distinct from orthoptics was visual reconditioning, introduced in the OEP papers in the early 1930s by Louis Jaques (the father of binasal tapes or occlusion) and re-branded into visual training by A.M. Skeffington.  That term, visual reconditioning is pretty interesting, isn’t it?  Has a certain ring to it.  And much as one can make a distinction between visual habilitation (developmental guidance) vs. vision rehabilitation (therapy), a distinction might be made between visual conditioning as routine hygiene or training and visual reconditioning as restorative therapy.  At some level I think that’s what Louis Jaques might have been alluding to.  In fact, when it comes to Sports Vision, visual conditioning might be an ideal term to convey what the athlete does to stay in peak visual shape, don’t you think?

But the beauty of the discussion is that it doesn’t matter as much what you, or I, or Louis Jaques thinks, as it does how our intended audience is able to relate to the terminology.  What got me thinking about this was an article I read this evening on Why More Ballplayers Should Give Their Eyes A Workout.  The piece focuses on newly acquired Toronto Blue Jays’ right fielder Randal Grichuk who has been working hard over the winter to recapture his batter’s eye(s).


From the article:

“The body parts he’s focused on strengthening the most when he steps into the box, the ones he thinks will improve his plate discipline and drive up his on-base numbers, might not be the ones you’d expect: his eyes.  ‘So many people don’t really work out their eyes, and I think there are a lot of muscles in the eyes that are just like normal muscles. You need to train it. You need to work it out,’ said Grichuk, who took a course on vision training specifically to address that … Vision training in sports, though, remains underutilized by athletes, experts say, despite decades worth of evidence suggesting it works.”

And why might vision training be underutilized in sports?  An interesting speculation is offered by Karen Muncey, a non-optometric sports vision specialist in Canada (and a big fan of DynaVision and NeuroTracker):

“One of the big drawbacks with sports vision training is, there’s the tendency to associate (it) with therapy, as opposed to training,” Muncey says. “The term training has a much more positive connotation because it’s used to improve and advance the player’s game and his or her net worth, so consequently they’re really happy to advertise the fact that they’re doing all this hard work and they’re being dedicated to the work. Therapy, on the other hand, has that more negative ring to it, that implication that something’s wrong with me so I’m going to be viewed as flawed and therefore, somehow, less valuable.”


3 thoughts on “Training vs. Therapy: More than Semantics?

  1. I’d like to suggest we consider using the term “optometric” in front of any of these. Only optometrists have the unique knowledge to provide the services our patient really needs. For example, some OT’s suggest they can do visual therapy….some things certainly they can do….but when we look at diagnosing and planning, only the OD can evaluate for underlying issues like papilledema, CVI, Terson’s syndrome, etc. An OT who finds some condition with a visual screening should ALWAYS refer out for a consult by and OD or OMD. I don’t mean to be disrespectful of vision therapists who work under an OD, but remember that only the OD can diagnose and treat eye disease.

  2. Many years ago I presented a paper at Skeffington in DC on the differences between Treatment, Therapy, and Training. Essentially, Treatment is mostly Doctor driven with little input by the patient. Therapy is a balanced integration of input by the Doctor and the Patient. Training involves some input by the doctor and is mostly done by the Patient.

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