VISION THERAPY FOR
STRABISMUS & AMBLYOPIA
WHAT IS STRABISMUS?
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Strabismus is a condition in which the eyes do not coordinate to team together for distance or near, causing one eye to turn. The eye can turn towards the nose (esotropia), out towards the ear (exotropia), or can turn up (hypertropia) or down (hypotropia). The turn can be there all the time (constant) or some of the time (intermittent). Strabismus can cause amblyopia, double vision, a head turn, a face turn or a head tilt, and poor depth perception. Vision therapy helps teach the eyes how to coordinate, and work together at all distance so that the eye turn is no longer visible, there is no double vision, and depth perception is developed. In some cases the best course of treatment for strabismus is a combination of vision therapy and surgery, however, in many causes vision therapy can be very successful in providing treatment for the strabismus without the need for surgery. We work with adult and children as patients. At times in our childhood years we are able to compensate for an eye turn on our own, and as we get older our compensation methods decrease and the eye turn becomes visible. There is no age limit with regards to vision therapy for strabismus.
WHAT IS AMBYLOPIA?
Amblyopia is reduced vision, even with glasses, contact lenses, or surgery to correct any prescription. Amblyopia happens during development of vision when a child is young. If an eye turn is present, a high prescription in one eye or both, or a cataract or corneal disease in one or both eyes the vision will not develop in that eye. Vision continues to develop after birth and if one or both eyes is not provided with clear vision, the ability to see 20/20 becomes compromised. Most recent research has indicated that treating amblyopia with modified patching and vision therapy can render better and faster results than patching alone to improve visual acuity. Vision therapy has the benefit of also improve accommodation, eye teaming and tracking in the affected eye.
WHAT IS VISION THERAPY?
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Vision therapy is a customized program of exercises supported by evidence-based scientific research, with the goal of remediating any visual skills that are not functioning optimally. Therapy involves weekly in-office therapy sessions with adjunct at home exercises. Repetition of the exercises allow the visual system to integrate the proper skills for clear, comfortable vision. Depending on the condition therapy can take weeks or may be months. For strabismus and amblyopia vision therapy is used to build up abilities in both eyes so they function equally, allow for vision to integrate between the two eyes so that the eyes can work together, and integrate the new visual skills into existing visual skills. This allows patients to eliminate double vision, reduce the need for prism glasses, teaches patients how to cross and uncross their eyes so they can control their eye turn, and improves depth perception.
HOW CAN VISION THERAPY HELP?
PRIMITIVE REFLEXES
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Integrating primitive reflexes can help to allow for better motor control of eye movements and hand-eye coordination. This can lay the foundation for fine eye movements that allow children to control their eye turns.
SPECIALTY LENSES
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Prescription glasses can have a profound effect on controlling an eye turn, or allow the brain to pay attention equally to both eyes. Modified prescriptions can be a passive form of therapy in young children that are not mature enough to engage in a more formal therapy program.
MODIFIED PATCHING
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This isn't your traditional black patch. Alternatives such as drops, and frosted patches (banoerter foils) can be used with exercises to improve outcomes. Sectoral patching called binasals can help with eye turns.
VISION THERAPY
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Vision therapy is done in office once a week with adjunct at home exercises. Therapy is an active process in which the patient is actively participating. Therapy is individually planned for each patient based on the results of their initial consult and the patient's goals. Therapy may be modified for our youngest patients, or passive therapy options may be offered.
VISION THERAPY WITH SURGERY
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Vision therapy can be done before and/or after strabismus surgery to improve the outcome of surgery and help with alignment, amblyopia and depth perception.
HOW DOES AN ASSESSMENT WORK?
COMPREHENSIVE EYE EXAM
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A comprehensive eye exam is a critical first step. Here we check if all of the anatomy of the eye is healthy. In addition we check if a prescription is needed to provide clear vision. We also do screening tests for binocular vision disorders and strabismus.
IN DEPTH BINOCULAR VISION ASSESSMENT
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A binocular vision examination is a more in-depth examination of the eye focusing, eye teaming, and eye tracking system. Specialized prescriptions are tested that may include prism, reading prescriptions, or modified patching techniques. This examination allows us to assess if vision therapy may be helpful.
VISUAL INFORMATION PROCESSING, PRIMITIVE REFLEXES, VISUAL MOTOR INTEGRATION ASSESSMENT
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Should further testing in the area of visual processing and visual-motor integration be required, we generally do it on a separate day as the testing can be long and tiring. This allows us to better customize our treatment and therapy plan for each individual patient.
REPORT, CUSTOMIZED TREATMENT PLAN AND VISION THERAPY
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After all testing is completed a report is sent to the patient and referring doctor. A treatment plan is formulated with the patient and their to ensure all their goals are met. The treatment plan may include a glasses prescription, prism prescription, modified patching, and/or vision therapy.
