What is Vision Therapy, and does it really work?

Optometrist asks child in test eyewear in exam chair to read a card.

For some vision issues, a simple prescription for glasses just won’t do the trick. That’s because there’s a lot more to the eyes than their basic acuity—or, ability to see clearly measured against a 20/20 standard.

An eye that turns in or out, tracking problems that cause “jumpy” vision when reading, eyes that don’t work together close up (convergence insufficiency), and other focusing or visual processing disorders can negatively impact learning, performance, and day-to-day activities. That’s where Vision Therapy comes in.

“Vision Therapy is similar to physical or occupational therapy,” says Elizabeth Pallante, OD, an optometrist who specializes in Vision Therapy at NECO’s Eye Care Clinic. “We find issues with the eyes tracking or working together as a team, and improve that by making the eye movements more regular and fluid.”

Dr. Pallante shares a recent success story: “I have a 9-year-old patient who didn’t like reading. She has tracking and convergence insufficiency, and has been doing Vision Therapy for about three months. Recently, her mom told me they had to force her put her book down to get ready for school. All of a sudden she’s enjoying reading, and for me, that’s the most rewarding thing.”

Some problems are obvious, such as a turned eye, and headaches or double or blurry vision are common with various vision disorders. But it may be harder to connect a child’s dislike of reading or other near activities, a short attention span, clumsiness, or bad handwriting to a vision issue.

“It could be that a child can’t do things up close because it hurts, but they don’t know how to express that,” Dr. Pallante explains. “A lot of kids think what they’re experiencing is normal so they don’t say anything about it. It’s all they know.”

And, a child with these issues might still do well at a school vision screening or basic eye exam, which don’t emphasize testing how well the eyes function together. “They can see fine, but they could have a teaming or tracking problem, and that’s what’s holding them back,” Dr. Pallante says.

Children who need Vision Therapy are usually identified between the ages of 8 and 12, when reading difficulties and poor school performance become more noticeable. And while most Vision Therapy patients are children, adults with vision problems caused by traumatic brain injuries (including concussions), stroke, or unresolved tracking or convergence issues from childhood can benefit equally from it.

When a patient is referred to Vision Therapy, they’ll be assessed for a number of vision disorders. Based on the diagnosis, a Vision Therapist will design a series of individually-tailored exercises, which might involve an eye patch, specialty lenses, or other equipment. Sessions are usually weekly, with homework exercises assigned between appointments.

Depending on the number and severity of the issues, a patient typically does Vision Therapy for three to six months, but it might last up to a year in some cases. According to Dr. Pallante, Vision Therapy is most successful for convergence insufficiency and tracking disorders, but has good success with many other conditions as well. The goal of therapy is progressive improvement, she emphasizes: “I always tell my students that even a 25-percent increase in visual function can be life-changing for a patient.”