Vision Therapy

Vision therapy is a structured treatment process that utilizes skilled therapists, specialized equipment and a carefully planned progression of activities to modify the visual system at the neurological level.

What is Vision Therapy?

Vision therapy is a structured treatment process designed specifically for children that utilizes skilled therapists, specialized equipment, and a carefully planned progression of activities to modify the visual system at the neurological level. This therapy aims to enhance the speed, flexibility, endurance, and accuracy of a child's visual system, including eye focusing, eye teaming, and eye tracking skills.

Key Components of Vision Therapy for Children:

  • Accommodation (Eye Focusing): Improving the ability to focus on objects at various distances.

  • Binocular Vision (Eye Teaming): Enhancing the coordination between both eyes to work together effectively.

  • Oculomotor Skills (Eye Tracking): Developing the skills needed for smooth and accurate eye movements.

  • Visual Perception: Helping children extract and understand information from visual stimuli.

  • Visual Processing: Increasing the speed and efficiency with which a child interprets visual information.


​​​​​​​Goals of Pediatric Vision Therapy

Vision therapy systematically addresses visual barriers to clear and comfortable vision in children. It helps develop and maintain the visual coordination required for daily activities, such as reading, writing, and sports. The therapy is tailored to meet the specific needs of each child and is most effective when overseen by an optometrist with specialized training in vision therapy.


This process may be used alone or in conjunction with other treatments, such as prism glasses or, if necessary, surgical interventions. The specific recommendations for vision therapy are determined during a thorough Binocular Vision Assessment.

Who Can Benefit from Vision Therapy?

Vision therapy is a highly effective treatment for children experiencing challenges with eye tracking, eye teaming, eye focusing, and visual processing. By addressing the underlying vision conditions, children often see significant improvements in visual tasks such as reading, computer use, scanning their environment (e.g., while playing sports), and performing under timed conditions.


Table of Contents

  • Kids Struggling with Reading or Academic Performance
  • Children in Supportive Therapies
  • Children with Significant Developmental History
  • Children with a History of Vision Problems


What Conditions are Treated with Vision Therapy?

Vision therapy is tailored to address various visual conditions in children, including:

  • Eye Tracking Issues: Difficulties with smooth and accurate eye movements, affecting reading and other visual tasks.
  • Eye Teaming Problems: Challenges with coordinating both eyes to work together effectively, impacting depth perception and binocular vision.
  • Eye Focusing Difficulties: Problems with maintaining focus on objects at different distances, affecting tasks such as reading and classroom activities.
  • Visual Processing Deficits: Issues with interpreting and making sense of visual information, impacting learning and daily activities.


Vision Therapy: Who Can Benefit?

Vision therapy can be a highly effective treatment for children at various stages of their development. This specialized therapy addresses numerous visual conditions and is particularly beneficial for children experiencing:

  • Discomfort: Visual strain, headaches, or eye discomfort during tasks such as reading or using a computer.

  • Blurred or Fluctuating Vision: Difficulty with clear vision while performing near tasks (e.g., reading, gaming) or when switching focus between near and far objects (e.g., taking notes in class).

  • Double Vision: Occasional double vision that can affect visual clarity and comfort.

  • Tracking Difficulties: Challenges with smooth and accurate eye movements that may impair reading fluency, such as skipping words, re-reading lines, or losing place.

  • Impaired Depth Perception: Difficulty with eye-hand coordination, which may cause clumsiness or affect activities that require precise visual-motor integration.

  • Difficulties Processing Visual Information: Struggles with interpreting and keeping up with visual information, impacting performance in school, sports, or other activities.


Vision therapy is designed to help children overcome these challenges and improve their overall visual performance and quality of life.

Kids Struggling with Reading or Academic Performance

Vision is crucial to the learning process. In fact, over 80% of classroom learning happens through the visual system. Imagine a child trying to take notes when the board is blurry or attempting to read when the words seem to move or appear double. Studies have shown that even a simple refractive error can affect learning and reading skills.


Reports suggest that up to 1 in 4 children may have a vision condition significant enough to impact their learning. It's important to note that not all vision conditions result in blurry vision—many children with vision issues may see 20/20 but still struggle with visual tasks. Conditions affecting eye tracking, eye teaming, eye focusing, and visual processing can greatly impact a child's learning and should be addressed as early as possible.


If a child is having difficulty with reading or learning, it is crucial to identify whether these struggles are due to visual issues or other factors. Since vision plays such a significant role in learning, ruling out a vision condition should be one of the first steps. Additional efforts, such as more reading time or tutoring, may not be effective if an underlying vision condition is untreated.


While not all academic challenges are related to vision, addressing visual barriers is an essential part of a comprehensive approach to supporting your child's success. Vision therapy does not treat learning disabilities, but it can effectively address vision conditions that impact learning and are sometimes misdiagnosed as non-visual problems. These vision problems are often overlooked in a standard eye exam. For the best results, consult with a team experienced in vision development and learning-related vision conditions. An eye examination with a Residency-Trained Pediatric Optometrist and a Binocular Vision Assessment with a specialist in binocular vision are the most effective ways to identify and address any vision issues affecting learning.

Supportive Therapies

(OCCUPATIONAL THERAPY, PHYSICAL THERAPY, SPEECH/LANGUAGE THERAPY)


Vision affects much more than just reading 20/20 on an eye chart. Deficits in eye tracking, eye teaming, eye focusing, and visual processing can significantly impact a child's functional abilities. These vision conditions can adversely affect visual-motor tasks (such as eye-hand coordination), visual-vestibular tasks (like balance and mobility), and even language processing (integrating visual and auditory information for speech).


It is crucial to address vision conditions to minimize their impact on functional abilities. Untreated vision problems can impede or halt progress in other therapies, such as occupational therapy, physical therapy, or speech-language therapy. Integrating vision therapy into a comprehensive treatment plan can enhance the effectiveness and progress of these concurrent therapies.


Even if a vision problem is not immediately suspected, children undergoing occupational therapy, physical therapy, or speech therapy should have a Binocular Vision Assessment. Deficits in motor, vestibular, or auditory systems place additional demands on the visual system, making even subtle vision issues significantly impactful. Standard vision screenings conducted at pediatrician offices, schools, or by other therapists may not detect these subtle problems. A thorough evaluation by an optometrist with residency training in neuro-optometry, binocular vision, and vision therapy is essential to identify and address these issues, ensuring they do not continue to hinder progress.

Children with a Significant Developmental History

Children with developmental conditions such as autism, cerebral palsy, trisomy 21, or developmental delay are at a higher risk for certain vision problems. While having these conditions does not automatically mean a child has a vision issue, the likelihood is increased. Given the crucial role of vision in overall development, it is important to detect and address any vision conditions that may arise.

Common vision conditions of concern for children with developmental conditions include:

  • Significant Refractive Error: High prescriptions that impact clear vision.

  • Amblyopia (Lazy Eye): A condition where one eye does not develop proper vision, leading to reduced visual acuity.

  • Strabismus (Eye Turn): Misalignment of the eyes that can affect depth perception and eye coordination.

  • Accommodative Dysfunction: Problems with eye focusing, making it difficult to maintain clear vision at various distances.

  • Binocular Vision Dysfunction: Issues with eye teaming, which can affect the ability to use both eyes together effectively.

  • Oculomotor Dysfunction: Difficulties with eye tracking, impacting smooth and accurate eye movements.

  • Visual Perceptual & Processing Deficits: Challenges with extracting and interpreting visual information.


​​​​​​​While glasses are essential for clear vision, they do not address all vision conditions. Vision therapy is highly effective in treating many of these conditions and improving functional vision. By providing clear, comfortable, and consistent vision, vision therapy supports a child’s success in their visual environment and can be a critical component of a comprehensive plan to help them reach their full potential.

Children or Adults with a History of Vision Problems

(EX: AMBLYOPIA, STRABISMUS)

Vision therapy can be used as the sole treatment, or in conjunction with other treatments, to address longstanding vision conditions. There are many vision conditions that have lifelong impacts if left untreated. One does not 'outgrow' conditions of eye tracking, eye teaming, eye focusing or visual processing deficits.

Conditions, such as amblyopia (lazy eye) and strabismus (eye turn), often benefit from vision therapy as part of a comprehensive treatment plan. For example, not all cases of amblyopia can be treated with glasses and patching alone. Inclusion of vision therapy addresses the underlying binocular vision deficits that result in blurred vision. More recent research has shown that amblyopia can be treated in both children and adults when vision therapy is included as part of the treatment process.

Vision therapy is often utilized in the treatment of strabismus (eye turn). In some cases, vision therapy can be used as the sole treatment for an intermittent strabismus (the eye turns on occasion). In other cases, vision therapy can be used to support a more successful recovery following strabismus surgery (similar to the use of physical therapy after orthopedic surgery).

Which Conditions are Treated with Vision Therapy?

Vision therapy may be used in isolation or in conjunction with other treatments to successfully remediate many vision conditions. These conditions include:

Accommodative Dysfunction (Eye Focusing Deficits)

Eye focusing conditions can result in blurred or fluctuating vision. These conditions are especially frustrating for individuals as they experience blurred vision but can often read 20/20 on the eye chart. This occurs because accommodative dysfunction frequently affects vision during sustained near tasks (such as reading or computer work) or causes blur when quickly changing focus (such as when taking notes in class). This creates a situation where a student may report blurred vision in class, however when they present to the doctor they are seeing clearly (which may mistakenly lead the doctor to think that everything is fine).

​​​​​​​Vision therapy improves the amplitude (strength), flexibility, speed and accuracy of accommodation. This allows the individual to maintain clear vision throughout various activities, whether sustaining clarity during reading or being able to see clearly while transitioning between the front of the classroom and their desk.

Amblyopia (Lazy Eye)

Amblyopia is a vision condition that occurs early in life when barriers to clear vision go uncorrected; typically a high prescription, certain types of strabismus (eye turn), or a condition obstructing vision (such as congenital cataract). Improper development of the visual pathway results in blurred vision (inability to see 20/20) as well as deficits within the binocular vision system.

​​​​​​​Vision therapy is often used in conjunction with glasses, surgery or patching to treat amblyopia. Vision therapy treats the underlying binocular vision dysfunction and improves the success of patching or strabismus surgery alone. Including vision therapy as part of a comprehensive amblyopia treatment plan allows for improvement of vision at any age and improvement beyond the plateau experienced with patching alone.

Binocular Vision Dysfunction (Eye Teaming Deficits)

Binocular vision refers to the ability to use both eyes in a coordinated manner. Deficits in binocular vision can result in a number of symptoms, including: double vision, headaches, eye strain, dizziness, poor depth perception and difficulties with visual-motor tasks (such as sports). Additionally, binocular vision dysfunction can impair related visual skills, such as eye tracking.

​​​​​​​Vision therapy is an effective treatment for many conditions of binocular vision dysfunction. Rather than 'putting a band-aid on the problem' or embedding splinter skills, vision therapy addresses the underlying deficits within the visual system. Vision therapy develops coordination of the visual system as a whole, which provides a permanent solution.

Convergence Insufficiency

Convergence insufficiency is a common vision condition that describes difficulties or an inability to use both eyes in a coordinated manner during near tasks (such as reading or computer work). In order to comfortably look at near objects (such as a book), one must converge their eyes. Those with convergence insufficiency often experience headaches, eye strain, blurred vision or double vision while performing near tasks, such as reading. This can result in difficulties concentrating during this tasks or trouble remembering what has been read.

​​​​​​​Vision therapy is extremely effective in treating convergence insufficiency. In fact, the Convergence Insufficiency Treatment Trials found in-office vision therapy to be themost effective treatment for convergence insufficiency. Vision therapy develops coordination of the binocular vision system, which improves the convergence response, while also improving foundational visual skills necessary to maintain clear, comfortable, single binocular vision.

Oculomotor Dysfunction (Eye Tracking Deficits)

Eye tracking deficits are common among struggling readers. Efficient eye tracking is necessary for fluent reading, scanning our visual environment (ex: driving) and while playing sports. It is important to note that oculomotor skills are dependent on a stable binocular vision system. For this reason, eye tracking deficits must be evaluated in conjunction with underlying binocular vision and accommodative abilities.

​​​​​​​Vision therapy is the best approach to remediate oculomotor dysfunction as it is the only treatment method that addresses both the foundational visual abilities and higher level eye tracking difficulties. This is in stark contrast to 'eye tracking' or reading programs that assume an intact binocular visual system while taxing higher level skills – limiting success for the child and increasing frustration.

Vergence Dysfunction (Convergence Insufficiency, Convergence Excess, Divergence Deficits)

Vergence is a visual skill that allows one to maintain binocular vision. Convergence describes the crossing of the eyes to view objects at near (reading, computer, etc) while divergence describes uncrossing of the eyes to look in the distance. Convergence and divergence skills must be fast, accurate and consistent to maintain clear, single vision. Vergence dysfunction can result in double vision, blurred vision, headaches or visual discomfort. Additionally, vergence dysfunction disrupts the visual-vestibular system, which can cause dizziness and balance difficulties.

​​​​​​​Vision therapy improves the amplitude (strength), flexibility, speed and accuracy of the vergence system while reducing the latency of the vergence response. Enhancing one's vergence abilities in turn promotes clear, comfortable, single binocular vision.

Visual Perceptual Deficits (extracting information from visually-presented material)

Visual perception is a skill set that allows one to interpret visual information; it plays an essential role in the learning process. Many people with visual perceptual deficits are described as auditory learners; they learn well when they hear things but cannot seem to produce the same results with visual material.

​​​​​​​Vision therapy develops both the underlying 'mechanics' of the visual system (binocular vision, accommodation, etc) as well as visual perceptual skills. This is important as poor visual input can cause performance that looks like visual perceptual deficits. Once underlying binocular vision dysfunction has been addressed, vision therapy then develops the visual skills necessary to extract visual information and support efficient visual perceptual skills.

Visual Processing Deficits (quickly being able to 'make sense' of one's visual environment)

Visual processing speed allows one to quickly interpret visual information and make split-second decisions. Visual processing can be thought of as 'visual reaction speed'. Visual processing speed allows one to keep up with the pace of class, engage in sports and be a safe driver. Poor visual processing abilities require one to slow down and have repeated presentation to understand visual concepts.

Visual processing therapy, which is an aspect of vision therapy, improves visual processing speed. Advanced Vision Therapy Center is unique in offering advanced biofeedback therapy as part of a comprehensive visual processing therapy program. This allows for functional changes in visual processing at the neurological level.

​​​​​​​Distinguishing the subtle differences between various vision conditions is a critical first step in the treatment process; the right diagnosis leads to the most appropriate treatment option and greatest success. A Binocular Vision Assessment with an optometrist with residency-training in binocular vision, neuro-optometry or vision therapy is the best way to evaluate the need for vision therapy. Working with a residency-trained optometrist ensures that your care is being provided by a doctor with advanced training specific to binocular vision dysfunction.