The ‘Controversy’ behind Vision Therapy

Why do some doctors say that Vision Therapy is controversial and that it doesn’t work?

Vision Therapy began about 100 years ago. Those doctors who detract from the effectiveness of Vision Therapy often have a vested interest in promoting surgery rather than solving the underlying problem. They recommend surgery for an eye turn (Strabismus), for example, and when the problem returns, they merely suggest more surgery. Surgery, however, does not solve the problem, and at best, it gives a short lived cosmetic benefit. There are no long term studies that show that surgery is effective.

When a child has amblyopia, often called Lazy Eye, they suggest patching. Patching did not work 50 years ago, 20 years ago, or 5 years ago, yet they continue to recommend patching. There is often a short term improvement, but then that improvement levels off and then regresses. Patching ultimately doesn’t work, and their answer is “well, we tried”. There are no long term studies that demonstrate that patching solves amblyopia long term. Another example of outdated and ineffective therapy is “Pencil Pushups” for people who have conference insufficiency. Although some doctors still recommend this, studies have proved that Pencil Push-ups don’t work.

The reason that surgery, or patching, or pencil push-ups don’t work, is because these problems are really brain-based problems rather than eye-based problems. These treatments are not successful, but they are accepted by the medical community as the way to treat these problems. The reason that they disparage Vision Therapy is because it detracts from their source of income; surgery.

The reason that Vision Therapy is successful is because it works on brain visual skills rather than eye skills. Patients who have completed a Vision Therapy program and have done their home activities, learn and develop the skills. Vision is a learned skill and once someone learns the skill, they own the skills, much as learning how to play the piano, learning to cook, learning to play tennis, or learning to speak a language. These are all brain based skills that are practiced until they become second nature.

If someone has difficulty in eye movement (saccades), tracking (pursuits), binocularity (the ability to use the two eyes together as a team), locking on (fixation) they can learn and develop these skills. If someone has difficulty with basic vision skills, they will likely have difficulty reading and learning. Vision Therapy gives the individual the ability to develop these skills. This does not guarantee that a child will then do well in school, however, without these basic skills, even tutoring or additional school help will take longer and success will be limited. The frustration usually continues. It is like trying to build a house without having the right tools to do so.