Writer and Photographer  /  Jessica Kelly

It is commonly believed that 20-20 vision means perfect vision; however, there are many vision problems unrelated to clarity. These include lazy eyes, visual processing problems and vision problems resulting from strokes or concussions. These problems cannot be fixed by glasses or contacts. Prescriptions typically just correct clarity of vision and not how the eyes team or focus, but one way to help is through the process of vision therapy.

“Vision therapy is similar to physical therapy or occupational therapy, but it’s therapy for the eyes,” Developmental Optometrist Erin Buck of Greenwood Vision Development Center said. “What most people may not realize is that vision actually takes place in the brain. We actually do not see anything until our brain tells us what we are looking at, so with vision therapy, we actually are rehabilitating the brain, so that it is helping the eyes work more efficiently.”

Vision therapy is used by specialized optometrists to correct commands in the brain in order to correct the way that the patient’s eyesight and vision are working. Not every patient comes in with the same problem, but there are many different types of problems that vision therapy can correct.

“We see a wide range of patients,” Developmental Optometrist Jenna Liechty of VisionQuest Eyecare said. “Each practice will have maybe a different patient base that they are most comfortable with, but we get referrals from many different places that are seeing children and adults. That’s a common misconception that vision therapy is just for children when in fact it can be very valuable for adults as well, especially the ones that have sustained a concussion or any form of a brain injury. Vision therapy can be very important for any patient that has had a neurological event.”

However, it is more common for a child to need vision therapy than an adult, especially since the vision problem can be taken care of while the patient is still a child. Many parents and teachers have trouble catching a vision problem in a small child though because many of the symptoms correlate with that of ADHD, ADD or dyslexia.

“A lot of the kids that we work with are misdiagnosed as ADHD, and it’s really just their visual system getting in their way,” Buck said. “Vision is your dominant sense, and you gather the majority of information through your visual system. So if you’re not able to do that, then you have to rely on other means.

“So we’re going to talk to our neighbors and use our auditory system, or we’re going to use our tactile system and feel things and want to touch. Also, when the eyes are not working well together, it makes the print on the page kind of jump around, and it is just not comfortable to look at. So instead of trying to force their way through that or get a headache or get sleepy, children just kind of give up and then they are dazing off, appearing like they had ADHD.”

The symptoms are so similar that many children are misdiagnosed, and the only way to be sure of the diagnosis is to get the child checked out by an optometrist specialized in visual therapy.

“Since awareness is so key in this, I always will recommend to parents that if they have a struggling student, they need to see a developmental optometrist, someone who specializes in vision therapy and the development of the vision system,” Liechty said. “They need to see a developmental optometrist for an evaluation to rule out vision problems that might be contributing to their difficulty. This is where it gets hard because there are a lot of optometrists out there, and most of them do not specialize in the visual system. They specialize in glasses and contacts and all different types of eye diseases, but they do not specialize in vision therapy and the functioning, comfort and ease of the vision system.”

Buck and Liechty are optometrists, but they had to do extra schooling to specialize in vision therapy. A normal optometry examination will typically screen for 20-20 vision and eye diseases but not all teaming, focusing, movement, alignment or processing problems. Buck and Liechty suggest a developmental optometrist exam to at least rule out the possibility of an overlooked vision problem.

“I think vision therapy offers hope for struggling readers and their families,” Buck said. “So many times when I sit back here in my office and I have the consultation with the parents, their kids have been struggling for years, and they’re kind of at the end of their rope. They have tried so many different things, they are spending hours at night working on homework and everybody is just frustrated. The nice thing is these vision problems that we see are very correctable with the vision therapy program. It is very successful. So, if parents think there is a problem, then I would highly encourage them to get what I call a Developmental Vision Evaluation.”

After the evaluation is done, vision therapy can start for the patient. Therapy eventually helps the patient read and see more efficiently.

“Vision therapy works with the eyes and the brain together,” Liechty said. “With the different activities that we are doing, every doctor will do it a little bit differently, but we are working on foundational vision skills that are very important for an individual to have to make reading an automatic and efficient skill.”

For children and even adults, vision therapy can even be fun. Much like physical or occupational therapy, the patient will do some stimuli to help the condition at the office and will leave with some options to perform at home in between visits.

“We do different activities. I have a computer program that we use, and we use different lenses, different prisms, 3D images, red and green images. They come in once a week for 45 minute sessions, and then I have them do home activities too,” Buck said.

“Pretty much all of the kids who come into my office like coming in. We try and make it a positive experience. These kids, their confidence is really low because they are usually being pulled out of class for extra help, and they start to feel stupid. They start to not like school, and by the end of the program, they are excited. They are getting As. They are liking to read. They are picking up books on their own.

“I love what I do, and there is hope. Parents can at least get struggling students into the testing at either office (Greenwood Vision or VisionQuest) and see if that is the issue, and we can take it from there.”

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