Vision Therapy | Treatments & Care

After identifying what kind of vision problem your child has, an optometrist specializing in vision therapy will design a personalized plan. The typical program combines hour-long office sessions with at-home exercises, and runs about three to four months. At that point, the optometrist will evaluate your child’s progress and see whether more therapy is needed.

There aren’t any authoritative statistics to give a sense of how successful vision therapy is overall, and much depends on the types of vision problems involved. On an individual level, though, children who can benefit from vision therapy are far more likely to show improvement if their parents help them stick with the exercise program and attend all follow-up visits.

Your child’s vision therapy program

The vision therapy specialist will design a series of exercises specifically for your child, and — depending on the vision problem at hand — incorporate a wide variety of equipment and activities. These include:

  • prisms, filters and lenses
  • paper-based charts and workbooks
  • computer programs
  • a special bead-and-string device called a Brock string

Though vision therapy can be done at home as well as in the office, at Children’s Hospital Boston we believe combining the two (while emphasizing home therapy) is the best way to achieve the goals of treatment. A typical program is built on six one-hour office sessions, scheduled at three-week intervals. At each in-office session, your child will receive the instructions and materials she needs to practice exercises at home (about 20 to 30 minutes a day for at least five days a week).

Sticking to the exercise plan is a critical part of vision therapy. While the optometrist can give face-to-face encouragement during office sessions, it’s up to you and your child to keep that momentum going at home. Skipping exercise practice or cutting it short will only decrease the odds of real vision improvement.

During the final office session, the doctor will review the progress your child has made and determine whether more therapy is needed. If your child has followed the program carefully and developed the needed visual skills, she may receive a few exercises to do at home for “maintenance”—and then only come in for checkups after six months and one year.

Vision therapy and learning disabilities

Candidates for vision therapy often include children who are having trouble with reading or in school. But whether vision therapy helps treat bona fide learning disabilities is a hotly debated topic.

  • Many optometrists (the health professionals who usually prescribe vision therapy) believe it can help children with dyslexia and other learning disabilities by treating related, underlying vision problems.
  • On the other hand, many ophthalmologists (medical doctors who usually do not prescribe vision therapy) say there is no proof that correcting vision problems can reduce the severity of learning disabilities.

To help shed some light on the issue, Children’s Hospital Boston is planning studies on the effectiveness of vision therapy, especially with regard to vision and learning. In the meantime, it’s helpful for concerned parents to remember that vision is just one aspect of their child’s ability to read and learn. While it’s important to rule out vision problems in any child with learning disabilities, there are many other behavioral, cognitive and social factors at play.

Meet Jason, who came to Boston Children's — as an adult — for treatment of strabismus

After suffering a sudden stroke, 34-year-old Jason Crigler also experienced strabismus, a visual defect that occurs when one's eyes don't line up. Jason came to Children’s to see if he would be a good candidate for eye muscle surgery. He was — and in August 2007, he underwent surgery to realign both eyes.

Coping and support

In addition to the clinical information offered on this page, Children’s Hospital Boston has several other resources designed to give your family comfort, support and guidance:

  • Boston Children’s Care for Children with Medical Complexity delivers essential medical care to children with birth defects, genetic disorders and other multifaceted health care needs. Call 617-355-6162 for more information.
  • Our Behavioral Medicine Clinic helps children who are being treated on an outpatient basis at the hospital — as well as their families — understand and cope with their feelings about:
    • being sick
    • facing uncomfortable procedures
    • handling pain
    • taking medication
    • preparing for surgery
    • changes in friendships and family relationships
    • managing school while dealing with an illness
    • grief and loss
  • Boston Children’s Psychiatry Consultation Service is comprised of expert and compassionate pediatric psychologists, psychiatrists, social workers and other mental health professionals who understand the unique circumstances of hospitalized children and their families. The team provides several services, including:
    • short-term therapy for children admitted to one of our inpatient units
    • parent and sibling consultations
    • teaching healthy coping skills for the whole family
    • educating members of the medical treatment team about the relationship between physical illness and psychological distress
  • Boston Children’s Department of Psychiatry and Behavior Sciences offers a free booklet, “Helping Your Child with Medical Experiences: A Practical Parent Guide” (Adobe Acrobat is required). Topics in the booklet include:
    • talking to your child about her condition
    • preparing for surgery and hospitalization
    • supporting siblings
    • taking care of yourself during your child’s illness
    • adjusting to life after treatment
  • Boston Children’s Hale Family Center for Families is dedicated to helping families locate the information and resources they need to better understand their child’s particular condition and take part in their care. All patients, families and health professionals are welcome to use the center’s services at no extra cost. The Center for Families is open Monday through Friday from 8 a.m. to 7 p.m., and on Saturdays from 9 a.m. to 1 p.m. Please call 617-355-6279 for more information.
  • Global Services is a dedicated resource for patients and families from countries outside the United States. The center can provide assistance with everything from reviewing medical records to setting up appointments and locating lodging. Contact the center by phone at 01-617-355-5209 or via email at

Helpful links

Please note that neither Boston Children’s Hospital nor the Department of Ophthalmology at Boston Children’s unreservedly endorses all of the information found at the sites listed below. These links are provided as a resource.

Glossary of useful terms

  • accommodation: The ability of the eyes to focus on objects at different distances, to shift focus from near to far (and vice versa) and maintain focus at a fixed distance.
  • binocular: Of or involving both eyes at once.
  • convergence/divergence: The ability of the eyes to move inward together, to look at something close, and outward together, to look at something far.
  • convergence insufficiency: A condition in which the eyes don’t turn inward properly when focusing on a nearby object.
  • dyslexia: A learning disorder marked by trouble recognizing and comprehending written words.
  • exotropia: A type of strabismus in which one eye turns outward; sometimes known as “wall-eye.”
  • fixation: The ability of the eyes to look at a stationary target.
  • learning disability/learning disorder: A general term that can describe a variety of learning problems, most often trouble with reading, writing, listening, speaking, reasoning or doing math.
  • occlusion: A type of vision therapy that covers one eye, usually with a patch, to stimulate vision in the other.
  • occupational therapist: In a pediatric setting, a health professional who helps evaluate and treat children who have problems with coordination, perception, learning and/or behavior.
  • oculomotor: Having to do with eye movement.
  • ophthalmologist: A medical doctor (MD) who diagnoses and treats all diseases and disorders of the eye and can prescribe eyeglasses.
  • optometrist: A primary eye-care provider who prescribes eyeglasses, contact lenses, and low-vision devices, and diagnoses and treats certain conditions and diseases of the eye. Optometrists don’t perform surgeries. An optometrist who specializes in vision therapy is called a behavioral or developmental optometrist.
  • orthoptist: A health professional who, under the supervision of an ophthalmologist, tests and measures eye muscle alignment.
  • pursuit: The ability of the eyes to follow a moving target.
  • strabismus: A misalignment of the eyes.
  • saccades: The ability of the eyes to make a very quick, small movement from one visual target to another.