Vision Therapy

Often described as a kind of “physical therapy” for the eyes, vision therapy is a series of exercises aimed at helping children whose eyes don’t work together properly. Even if they have 20/20 vision, these children may have trouble getting their eyes to focus or follow things in the world — to catch a ball, for instance, or track a line of text across a page. The promise of vision therapy, also known as vision training, is that it may be able to help by training a child’s eyes to work together more efficiently.

However, vision therapy is very much an emerging field. There’s still a lot of controversy around it, especially in regard to its role in helping children with learning disabilities. Vision therapy is not endorsed as an effective or scientifically validated therapy by ophthalmologists or pediatricians.

Here are some other key facts about vision therapy:

  • Vision therapy is usually prescribed and supervised by specially trained optometrists, who are called behavioral or developmental optometrists.
  • The program of exercises is customized for each patient, and can be done in the office or at home — or, ideally, in both settings.
  • These exercises aim to improve overall vision by strengthening skills such as tracking (eye movement), teaming (eye coordination) and focusing.
  • Conditions associated with vision therapy include amblyopia (“lazy eye”), convergence insufficiency, certain types of strabismus (misaligned eyes) and problems controlling eye movement (known as oculomotor dysfunction).

How Boston Children's Hospital approaches vision therapy

Boston Children's Hospital is one of the few pediatric hospitals in the country to venture into the field of vision therapy. David G. Hunter, MD, PhD, ophthalmologist-in-chief at Boston Children’s, explains: “While many ophthalmologists think vision therapy doesn’t work — they truly believe that practitioners are taking advantage of patients who need help — I have seen enough treatment successes that I think it has to be studied. Here at Children’s, we want to offer this service to our patients rather than give them no choice but to seek help elsewhere, and at the same time study its effectiveness.”

For this reason, Boston Children’s recruited Aparna Raghuram, OD, PhD, to offer some types of basic vision therapy while charging just enough to cover our costs. Raghuram is trying to simplify vision therapy and offer only the most promising treatments. Boston Children’s is also planning to set up clinical trials to use science in order to see what works.

Vision therapy: Reviewed by David G. Hunter, MD, PhD, and Aparna Raghuram, OD, PhD
© Boston Children's Hospital, 2011