There are a lot of misconceptions about vision therapy. The biggest? That vision therapy doesn’t work. Here’s our response to an ad that says just that. (This is part 2 of a two-part series responding to an ad claiming “Vision therapy doesn’t work.”)
As we explained in a previous post, the ad sometimes appears at the top of the page when you Google “vision therapy.” It states, “Vision therapy won’t help” and “Vision therapy has not been proven…don’t pay before you read this.” Then, it leads you to an article from the Children’s Eye Foundation.
Most of the article explains that vision therapy is an “unproven treatment” that won’t fix most vision problems. It’s not only unsettling that their claims are misleading, but that they also don’t include any references to support their opinions.
We’re going to pick up right where we left off in our last post, where we cleared up some misinformation around what the ad referred to as the “three main categories of vision therapy.” We hope our responses provide some clarity for these common misconceptions surrounding vision therapy.
Responding to Six Questions Posed by Children's Eye Foundation
The second half of the article poses six questions that more or less challenge the validity of vision therapy. We’ll write the questions and answers from the article in blue text, followed by our response in standard black text.
1. Do “training glasses” work? The scientific literature shows no experimental evidence of any benefits from a low-plus “training glasses.”
First, let’s get the vernacular straight. Rather than using the term “training glasses,” we prefer to call them “performance lenses” because they improve performance in patients who have trouble reading due to a functional vision problem.
Second, to say that the scientific literature shows no experimental evidence of any benefits of low plus lenses is false. While there have not been many studies on this, here is an example of scientific literature that concludes low plus lenses can be beneficial for reading.
We would agree, however, that there is not enough scientific literature on the subject. We would postulate that this is in part due to the fact that the testing we use to determine the best performance lens for each patient yields very different results.
There are dozens of possibilities when it comes to performance lens prescriptions. The study linked above only investigates three of them. But what if one or more subjects in the study benefited from one of the many other advantages not mentioned?
To be sure, not everyone benefits from this type of lens prescription. For this reason, as part of our Functional Vision Exam, we administer performance testing. Performance testing can include reading, localization, eye movements, convergence and depth perception and is done with and without performance lenses to prove that the lenses actually help. You see, we want evidence that this lens will actually make a difference for our patient!
2. Does vision therapy improve learning disabilities and dyslexia? The scientific evidence does not support the use of eye exercises or behavioral/perceptual vision therapy in improving the long-term educational performance in children with learning disabilities.
Developmental optometrists have never claimed that vision therapy can treat learning disabilities and dyslexia. It can treat vision problems that mimic dyslexia and learning disabilities. Here are three treatable vision problems with similar symptoms as dyslexia. We have had patients with suspected learning disabilities test for both vision problems and learning disabilities, and were found to have vision problems but not learning disabilities.
3. Why might a teacher recommend vision therapy? We don’t have room to include their entire answer, but in short, they say a teacher might recommend vision therapy to a student who demonstrates symptoms of what they believe to be dyslexia.
The American Optometric Association estimates that 25% of children have vision problems that can impact school performance. Based on that, we’d say if a teacher notices a student struggling to read or learn, they should first get their vision checked. In addition, a Functional Vision Exam is much less time consuming and more cost effective than having a child tested for learning disabilities or dyslexia and is therefore a good place to start. Of course, there may not be a vision problem at all. In that case, a vision problem has been ruled out and more specific educational testing can begin.
4. What should I do if vision therapy has been prescribed? Ask the eye care provider to clearly identify the nature of the eye or vision problem, provide scientific evidence of efficacy of the treatment for the condition described, give a percentage of likelihood of success for the condition, and how will success be measured. Additionally, if vision therapy is being prescribed in a child with learning disabilities ask for the scientific evidence specifically related to the improvement of the learning disability. Finally, seek a second opinion from an ophthalmologist who has the experience in the care of children recommended by your pediatrician or primary care provider.
We welcome these good questions regarding a patient’s diagnoses and treatment recommendations. As a potential patient, it’s important you receive all relevant information to make an informed decision about your treatment. We feel so strongly about it that we provide a free patient education visit.
Right off the bat, we can tell you that studies have shown vision therapy to be an effective treatment for many vision problems - often dramatically improving the quality of patients’ lives. While the level of success varies, progress almost always takes place.
Getting a second opinion from a pediatric ophthalmologist may be misleading. It’s important to realize that most ophthalmologists have no training in vision therapy and many do not include in their examinations many of the tests we perform in our Functional Vision Exam. Because of this, it is unlikely they will find the same problems and, as a result, recommend the same treatment.
5. Should I get my child’s eyes evaluated if he/she is having difficulty in school? It is appropriate to have a thorough eye examination to ensure that there are no eye or vision disorders by an ophthalmologist with experience in the assessment and treatment of children because some of these children may also have a treatable visual problem along with their primary reading or learning problem. Refractive errors may make it difficult to see the board or to read. Treatable ocular conditions include strabismus, amblyopia, convergence and/or focusing deficiencies, and refractive errors.
Hey, a point that we agree on! At least partially... We recommend scheduling a Functional Vision Test - which specializes in identifying functional vision problems - as opposed to just taking your child to a general pediatric ophthalmologist. Note that a Functional Vision Test can only be performed by a developmental optometrist, who is an optometrist with specialized training.
6. Where can I learn more about learning and reading disabilities? Your best source is your pediatrician or primary care provider.
Your pediatrician is absolutely not your best source for more information unless they have extensive additional specific training related to reading and learning disabilities. The person you speak with should have training and credentials in learning and reading disabilities.
We recommend starting by speaking with the reading specialist at your child’s school. You could also consider reaching out to a neuropsychologist with a background in educational psychology. If either believe your child’s learning problems could be a vision issue, you should see a developmental optometrist who specializes in vision-related learning problems.
If you’d like to read more about the subject, this page provides summaries of numerous studies on learning and reading disabilities.
We know there’s a lot of information floating around the Internet about vision therapy - and, unfortunately, not all of it is accurate. Hopefully, our responses to this advertisement provide you a bit of clarity on the truth behind vision therapy.