Does vision therapy work, and is it worth it?
September 18, 2013 9:10 AM   Subscribe

Does anyone have experience with vision therapy? I have difficulty focusing both eyes at the same time, and I have been told by optometrists that I basically just have to live with this. But I recently read about vision therapy, which seems promising. If you have gone through it, did it work, and was it worth the time and expense?

It's a little hard to find information relevant to my situation because most of what I've read is about vision therapy for children. However, the optometrist near me who offers the service has told me they treat adults too and that it's never too late.

I have read this question, where the poster's symptoms match mine pretty well. Vision therapy is suggested in the comments, but no results are described.

Also, some people, apparently, consider vision therapy to be along the lines of chiropractic and acupuncture in terms of not being based on traditional medicine and perhaps not offering proven results. Am I better off going to a traditional ophthalmologist?
posted by zadermatermorts to Health & Fitness (8 answers total) 10 users marked this as a favorite
I don't have experience personally, but my kid has a problem where her eyes don't track in parallel. Vision therapy made a huge difference. She needs to re-do the exercises every 6 months or so or the problem comes back.
posted by Runes at 9:35 AM on September 18, 2013

I went through vision therapy at this place and I did find some relief for my eyestrain and fatigue. I also stopped needing drastically stronger prescriptions every time I went for a checkup, but I am not sure if the therapy was responsible. When I started, I had been completely unaware of how to protect myself from eyestrain and rest my eyes. It may be that if you have poor habits you could shake them without a structured program. For me, I was in such a panic about my progressively worsening nearsightedness and extreme fatigue that just the act of getting on a program was probably helpful.

A few years later I got laser surgery. One of my issues was that one eye was always much worse than the other. Apparently that is a common reason for not being able to use both eyes at once and after the surgery the problem pretty much went away.
posted by BibiRose at 9:41 AM on September 18, 2013

Vision therapy is controversial, and it's only been recently that even small controlled studies have started to emerge. It's often touted as a treatment for a whole host of things from reading difficulties to attention problems to social difficulties. My basic rule of thumb with such things is that if it's purporting to "cure" more than 3 totally unrelated things, it's probably not supported. In kids, the American Academy of Pediatrics and the American Academy of Opthalmology published a joint statement a few years ago specifically cautioning against its use for reading disorders. Here is a link talking a bit more about that with some additional references.

That being said, there are a few, small studies looking at this as a treatment for specific problems with gaze coordination, and it looks like it's marginally effective for some. For example, here is a study where adult men over 40 had a 60% response rate (i.e. improvement in gaze convergence) after the therapy.

It's often expensive, it's given as a one size fits all kind of treatment, and it's not covered by insurance. I would say be cautious, get a really good work up from a neuro-opthalmologist who does not provide vision therapy to get an unbiased assessment of whether you actually have gaze coordination issues, and then get his/her opinion if the therapy would be warranted. Be really, really cautious about getting that kind of diagnostic evaluation from someone who provides the therapy, as they're naturally biased to tell you you need it.
posted by goggie at 9:48 AM on September 18, 2013

I am an adult and my optometrist set me up on the Gemstone Vision software.

The site looks like it is just for kids, but it really helped me with my (not serious) focusing and eye teaming issues. I did the therapy twice -- about 7 and 5 years ago -- and it really helped.

However -- further exercises will not help me (my vision is getting a bit worse again) as my eyes are too old now to respond to the exercises...ah middle-age. So it does depend on how old you are I think. I am in my mid-40s now.
posted by Lescha at 9:56 AM on September 18, 2013 [1 favorite]

My daughter had intensive vision therapy when she was in elementary school. She had a lot of trouble with becoming a fluent reader, and as part of a diagnostic work-up we had her vision tested by a pediatric opthalmologist, who noted that her eyes did not track together all the time. He diagnosed this by showing us that the reflection from his penlight reflected from slightly different spots on both eyes. I was extremely skeptical about "vision therapy", and was prepared to dismiss it as bogus, but it actually did help. She went twice a week for several months, and we saw definite improvement.

I can't comment on whether this works for adults - my daughter was probably 8 or 9 at the time. We also had a hellish time getting it covered by health insurance but a script from the opthalmologist helped, and they finally did pay.
posted by citygirl at 10:37 AM on September 18, 2013

I'd start by going to a doctor who is a COVD. We went to a couple of different doctors, not sure if the first one was a member of COVD, but the second was. We were diagnosed with Convergence Insufficiency, which sounds similar to what you are describing.

For me, I'm an adult and I've learned to live with it. I fight to focus or just use one eye at a time. I'm more prone to misjudge distances and low speed / close quarters car accidents. I could have gotten vision therapy, but since I learned to live with it, the doc said it wasn't really worth the outlay of time and money (I was putting several hundred miles on my car weekly in addition to paying out of pocket $65 for a 45 min session for my child.

My child went to Vision Therapy with this COVD doctor for the better part of a year - at seven years old I think they had the vision 'ability' of a three year old. Therapy helped, but it was similar to what is available on Gemstone. We also played (and continue to play) games that involve sighting, focusing, and keeping the lessons in mind. We go back for exams every six months.

While killing time during therapy appointments, I had time to listen to the therapists (and they did the therapy, not students as some other practices that were closer did) talking to other parents with other difficulties. I wish I'd taken notes, but they had therapy for lazy eye and other things, and sent everyone home with homework to supplement the therapy.

Going forward, we have involved the kid in individualized sports, use tools to help read and write (writing is a separate issue that's related in our case) and do 'target' oriented sporting (ball tossing, balance and bounce games, targetting games).
posted by tilde at 10:42 AM on September 18, 2013

My brother did vision therapy as a child, for an issue similar to yours, and it was helpful for him. He was only six or seven years old at the time.

My ophthalmologist, who is the same one who sent my little brother for vision therapy, told me that he didn't believe it would be beneficial for me as I was too old (I was in my early 20s at the time). He basically told me if I was to go for vision therapy, I would be told that the treatments would help, and would pay a lot of money out of pocket, for basically no benefit.

Am I reading your question correctly in that you haven't seen an ophthalmologist yet, just an optometrist? If you've never seen an ophthalmologist yet, I think your first step should be making an appointment with one and get an exam. If you have seen an ophthalmologist, have you asked them about strabismus? Have you been experiencing this problem your whole life?
posted by inertia at 12:35 PM on September 18, 2013

Hi! I'm undergoing a round of vision therapy right now and I'm an adult who has had strabismus since birth. For what it's worth, I am seeing results I can perceive -- I have more, but still incomplete, depth perception since I started. But: It's actually not clear at all, even now that I'm doing it, whether the results will ultimately be worth the time and money. This is hard to predict for several reasons, but you should be able to get some idea from a one-time consult with a vision therapist. (My guy does sessions of eight weekly visits with daily homework, but before you commit to that, he starts with a one-time session where he does a full exam and writes up a diagnosis in detail.)

This book is a neuroscientist's account of undergoing vision therapy in adulthood for strabismus, which is part of what convinced me to try it. I don't think a lot of people can expect the dramatic results the author got, but I do think the book is evidence for vision therapy being a legit thing for adults. I guess it's "not based on traditional medicine" in that it is based on science that has become a thing in our lifetimes, but I would not say it's a totally different paradigm like acupuncture or chiropractic care.
posted by clavicle at 4:50 PM on September 18, 2013

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