Physician Business

What You Need to Know About Vision Therapy

Vision therapy is a type of physical therapy, specifically developed to assist the eyes and brain. It is often a part of the treatment for things like convergence insufficiency, crossed eyes, lazy eye, and certain disabilities related to reading and learning. Often, a learning disability is due to the inability to see well enough to read comfortably. These are the situations where vision therapy can be a great asset to those who were afraid medical science could do nothing more for them and their eyes.

Many who see the term “vision therapy” might immediately think of eye exercises, which some believe strengthen the muscles of the eyes and sharpen vision. While eye exercises can be a part of vision therapy, they are a small part, if a part of it at all. Vision therapy is done under the supervision of an optometrist, ophthalmologist, or other medical professional and can include the use of glasses or other kinds of lenses, eye patches, software programs, and specialized devices used to track and measure various aspects of vision.

There are two main branches of vision therapy: orthoptic and behavioral.

Orthoptic Vision Therapy

Orthoptics are best a dealing with the some of the problems that come with having two eyes. Sometimes, for whatever reason, the eyes don’t cooperate with each other, producing problems like diplopia (double vision), or strabismus (eyes that have difficulty focusing on the same point).

People who complain of tired eyes, or who suffer double vision while trying to focus their eyes on something close are prime candidates for orthoptic therapy. This condition, known as convergence insufficiency, makes it impossible for the patient to read or do anything other work close to the eyes.

Part of the therapy may be the prescription of corrective or therapeutic lenses which help train the eyes to work together, but a lot of the work in this type of therapy can be done at home, especially with the development of computer programs that simulate training exercises shown to alleviate difficulties caused by convergence insufficiency.

Orthoptic vision therapy can include eye exercises, as well, most prominently the “pencil push-up”.  All it needs, as the name suggests, is a pencil.

         Hold the pencil away from your eyes at arm’s length, with the eraser at nose level.

         Focus on the eraser and slowly move it closer to your eyes, to about 12 inches away.

         Hold it there for a few seconds.

         Keep moving it closer until the eraser appears to double.

         Stop there.

         Move the pencil slowly away until it looks like one eraser again.


         Move the pencil back toward your nose about an inch.

         If the pencil starts to double again, hold the pencil there, and do your best to focus and make it look like one pencil.

         Focus on something distant, like a picture on the far wall, for 5 seconds.

         Look back at the pencil and focus on that for 5 seconds.

         Repeat looking close and far for about 30 to 60 seconds.

In this exercise, the point isn’t to make sure the pencil is clear and unblurred. The point is to make it single, so the eyes are trained to better work together.

Behavioral Vision Therapy

This type of therapy focuses more on vision difficulties that might arise from inattentive eyes and the inability to properly process information. These problems manifest as poor tracking abilities or the inability to focus on any one thing for an extended period of time. This may affect the ability to read or to learn to read.

Behavioral vision therapy uses somewhat more specialized and extensive equipment than the orthoptic variety, including:

Balance boards: This is a square board set atop a smaller base, which may be square or round, depending upon the level of difficulty required. The patient stands on the board and attempts to move his or her hips from side to side, not back and forth. Often, the patient has to start this exercise holding on to something firm or to the therapist’s hands at first. While this exercise might seem to have little to do with vision, it does train the patient to control body parts independently from the rest of the body, just as the eyes are to work independently from the head or the rest of the body.

Marsden ball:This is essentially a ball attached to a string, then suspended so the ball hangs down at a certain level. Exercises using the Marsden ball can be matched to the balance board, or the patient could be instructed to bat the ball lightly with a small stick to make the ball rotate in a consistent circle, watching it at all times. The patient is encouraged to move only the eyes when watching, without moving the head. Or the ball can be held over the patient’s head and rotated by the medical professional. There are many ways to use a Marsden ball.

Those two training tools are merely the beginning when it comes to this form of vision therapy, which many claim is helpful for some children who have difficulty learning to read.

Whatever the form of vision therapy, they are not used to sharpen vision. People who are near-sighted or far-sighted are likely to need corrective measures, like glasses or contact lenses. As the name suggests, vision therapy is a therapeutic measure, useful for conditions that can be healed through exercises and training, not for conditions caused by the shape of the eye itself.