Vision Therapy

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Vision Therapy Edmonton at Vision By Design Optometry

Dr. Sarah Keep is passionate about eye health and improving people’s vision. She is one of a few optometrists in Edmonton who provide Vision Therapy and Neuro-Optometric rehabilitation and has a special interest in binocular vision disorders such as lazy eyes (amblyopia) eye turns (strabismus), eye teaming disorders (convergence insufficiency). At Vision by Design we are pleased to offer Vision therapy in Edmonton for those with visual deficits that affect reading and learning, as well as vision issues due to acquired or traumatic brain injury.

What is vision therapy?

Vision therapy is a doctor supervised training program to improve the function of the visual system. Visual therapy can help individuals with various visual challenges so each program is individualized for the unique needs of the patient. The goal of vision therapy is to help patients develop or improve their fundamental visual skills.


Who is vision therapy for?

Vision therapy is beneficial for people of all ages. It is very effective for children with vision insufficiencies, but recent research in ophthalmology and neuroscience have shown both teens and adults can improve visual function because of neuroplasticity. Those with traumatic brain injuries benefit greatly from individualized optometric vision therapy.

Those who benefit from a doctor supervised vision therapy program generally have:

Learning Related Vision Problems

Visual conditions like eye-tracking, eye-focusing, eye-teaming and visual perceptual delays interfere with a person’s ability to learn. Vision is vital to learning as the majority of the information we gather in the classroom is visual. It is important for children who are performing poorly in school, have special needs or have developmental delays to be assessed by a doctor who specializes in vision therapy. Our 2-3 hour long assessment goes beyond a routine eye exam and will test visual tasks such as eye tracking, focusing and teaming as well as visual motor skills and visual perception. If needed vision therapy helps improve muscle coordination and control, improving development, the ability to learn and quality of life. Undiagnosed vision disorders can cause difficulty performing tasks in school such as reading or copying from the board. Children with learning related visual issues can have reduced reading speed or comprehension, skip words or lines when reading, have difficulty with spelling, or have frequent letter reversals. Other children may not complain of symptoms at all if they have learned to avoid visual tasks that cause discomfort.

Crossed Eye (Strabismus) or Lazy Eye (Amblyopia)

Poor eye-sight, double vision and/or reduce depth perception is common among these patients. Misalignment of the eyes or a large variance in lens prescription results in one eye not receiving a quality image. Many people believe that an eye turn occurs from a weak muscle. However in most cases the muscle is completely normal and often has a full range of motion. The underlying problem is due to the brain having difficulty processing information from both eyes. The brain suppresses visual information from the weaker eye to avoid double vision and/or confusion. Vision therapy is very successful in helping people with strabismus or amblyopia by breaking the brain’s active suppression of the poorer eye, training the brain to use both eyes as a team. This can result in improved vision in a lazy eye and better alignment in a patient with an eye turn without the need for patching or surgery.

Traumatic Brain Injuries

Patients who have experienced concussions, stroke or have been in motor vehicle accidents often experience a variety of symptoms including light sensitivity, balance issues, dizziness, double vision and/or visual memory problems. Glasses containing tints, prisms or special lenses, or an individualized vision therapy program can reduce or eliminate symptoms such as headaches, dizziness, blur and balance issues. The changes from a vision therapy program can provide lifelong change in overall comfort and quality of life.

Interest in Improving Athletic Abilities

Vision is extremely important for the success of many athletes. Sports vision therapy helps with hand-eye coordination, tracking, visual reaction time and dynamic visual acuity. Many professional athletes from a wide variety of sports have used vision therapy to take their game to the next level.

What does vision therapy look like?

In order for any therapy to be effective it must be ongoing. Vision therapy typically involves weekly in-office sessions that are typically 40 minutes in duration. Patients are given therapeutic exercises to be done at home on a daily basis. Effective vision therapy programs vary in length depending on the complexity of the patient’s diagnosis.

How is a Vision Therapy eye examination different from a standard examination?

A vision therapy eye exam is designed to identify visual skills deficits in patients who despite having 20/20 vision, have difficulty with eye teaming, eye focusing and eye tracking or other visual skills. A routine examination is typically 15-20 minutes in length and focuses on good eye-sight which as well as looking for diseases that affect the eyes. Our visual skills assessments are ideal for clients of all ages. Our assessment is more comprehensive than a routine eye exam and involves many visual tests that would not be performed during a routine exam. Our assessment is 2-3 hours long and is spread over two appointments. We use the information collected during our session to determine treatment options, guide our Vision Therapy programs, and to monitor for progress. Some of the testing included in our assessment at Vision By Design Optometry are as follows:

Visual Perceptual Evaluation
Visual information is gathered by the eyes however, the brain has to process this information. This evaluation assesses how the brain interprets visual information. A visual perceptual examination tests for skills such as Visual Discrimination, Visual Memory and Visual Closure among others. A visual perceptual evaluation can be performed with clients starting at age 5.

Laterality and Directionality
This testing provides insight to a child’s awareness of left and right. Patients with poor laterality or directionality often reverse letters, and may have difficulty understanding which way to turn, which hand to use or which direction to go.

Binocular Vision and Accommodative Evaluation
Binocular vision problems occur when we have difficulty pointing both of our eyes at the same target. Accommodative vision problems occur when we cannot accurately adjust or maintain our focus at a certain distance. Patients that have binocular or accommodative issues often have significant symptoms while performing near work such as reading, texting or working on a computer. We perform in-depth binocular vision testing for patients experiencing symptoms such as eye strain, headaches, reduced reading comprehension or attention, double vision or other difficulties performing near work.

Visual Motor Testing
Visual motor integration is the coordination of visual and fine motor control. A child with poor visual motor integration may have messy handwriting, have difficulty keeping their writing contained within a line, write with a tight pencil grip, or show poor fine motor control such as difficulty using scissors, rulers or stringing beads. This evaluation is ideal for children 3-6 years old, or older patients with developmental disabilities such as Autistic Spectrum Disorder.

Visual Motion Hypersensitivity
Patients who have suffered a concussion often experience increased symptoms in busy visual environments such as driving, a busy shopping mall, or crowded events. We are able to test for visual hypersensitivities and provide treatment if they are found.

Vision Therapy
Vision therapy can be described as physical therapy for the visual system. Unlike prescription glasses or contact lenses, that compensate for near or far sightedness, vision therapy aims to “train” the visual system to correct itself.

What vision therapy is not.

Neuro-optometric vision therapy is not a set of do-it-yourself eye exercises that are often advertised online or on info-mercials, that promise you can ‘throw away your glasses’.

There is no scientific research behind such programs to corroborate such claims that self-help eye exercises can reverse nearsightedness or other refractive errors.

It is also important to note that a home-based regimen of “pencil push-ups”, computer software or other programs that are not frequently supervised by a doctor should not be considered a vision therapy program, even if recommended by an eye doctor.

Pencil push-ups is an orthoptic exercise where the patient reads fine print with a pencil held at arm’s length. The patient gradually moves the pencil closer to their eyes while maintaining focus. This activity is recommended to help decrease eye strain and other symptoms caused by convergence insufficiency. This activity has not been found to be an effective treatment of Convergence Insufficiency and is not the same as In-Office Therapy.