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Medical Forum / General / Vision / October 2005Adult vision therapy
Anyone had success or failure with vision therapy? I'm just getting started and I can't seem to find much testimony on-line from adults. My vision has been bugging me subtly, so I sought out a more thorough optometrist. She says my eyes rest slightly outward which is giving me trouble with convergence... now I'm on a 12 week session of VT. I'm not talking about "fix your vision without glasses" stuff by the way. This type of VT is directed mostly to people who have eye coordination issues. This office has something like 40-50 patients, and only a few are adults. Anyway, I'd be curious to hear from anyone who has gone down this road. >Anyone had success or failure with vision therapy? I'm just getting >started and I can't seem to find much testimony on-line from adults. [quoted text clipped - 7 lines] >and only a few are adults. Anyway, I'd be curious to hear from anyone >who has gone down this road. " Fortunately, in most cases, convergence insufficiency is very amenable to orthoptics and vision therapy." http://www.emedicine.com/oph/topic553.htm "Vision therapy is effective in eliminating asthenopia and improving convergence function in adult patients. In-office therapy combined with home therapy tends to produce better results than does home therapy alone." http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1 0457698&dopt=Citation OR: http://snipurl.com/ino8 "Most accommodative and vergence dysfunction responds to the appropriate use of lenses, prisms, or vision therapy." http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=2001&nbr=1227#s26 Good luck!  SignatureLive simply so that others may simply live I've prescribed vision therapy for convergence insufficiency for many patients over the years. It is highly effective, and is one of the few conditions for which most authorities -- MD as well as OD -- will agree vision therapy is indicated. DrG Where does one find a "vision therapist" are all OD's vision therapist? ally There is an organization of optometrists who "specialize" in vision therapy, called COVD. Otherwise, I learned the theoretical and clinical basis for vision therapy in optometry school. I also externed in a practice where vision therapy was done. During the early years of my practice I had much more interest in it, and employed an orthoptist/therapist. It takes years of single-minded dedication and targeted marketing to make a vision therapy practice viable, and my enthusiasm for the utility of it soon waned. I think that vision therapy is under-utilized for some things and perhaps over-utilized for others. DrG Thanks Doc, I've been wondering about this because now at my age, 46, I am having problems maintaining good vision. Most of the time, now at least, it is great, but there are days it just goes awry with vertical diplopia (strabimus) and other strange things happening. I've seen a number of opthalamos because these problems has emerged at various periods in my adult life but none have been able to proffer a solution. Lately I've been thinking about vision therapy but being an Aussie I'm not sure it is that available in Australia. Your comments though reassure me that this is something I should follow through; particularly given optic nerve damage, ptosis from third nerve palsy, and my innate desire to keep on reading til I'm dead! Regards, John. > There is an organization of optometrists who "specialize" in vision > therapy, called COVD. [quoted text clipped - 11 lines] > > DrG > I've prescribed vision therapy for convergence insufficiency for many > patients over the years. It is highly effective, and is one of the > few conditions for which most authorities -- MD as well as OD -- will > agree vision therapy is indicated. > > DrG Most of the stuff so far seems directed at getting my eyes to work together at very close distance. Like it's trying to make me be able to go cross eyed and still see or something. I'm not totally sure I understand where this is going, since my original complaint was with my overall vision in more open spaces. We've also started in on some lens stuff, where my exercise it to alternate reading words with and without a minus lens in front of my normal glasses. I'm supposed to get up to a -6 lens, but right now I can't focus past -3. This is for one eye at a time. What would the purpose of this be? It sounds like you are doing convergence therapy as well as accommodative facility training. Convergence therapy aims to build your convergence reserves, whereas accommodative facility training seeks to improve the flexibility and range of lens focus. I'm not sure what your diagnosis is, but from your description it sounds like you suffer from divergence excess, rather than convergence insufficiency. Anyway, maybe when the treatment has been completed you might be glad that you suffered through it. It's only been slightly more than one week. I would give it at least six weeks before coming to any conclusions about the efficacy. DrG > It sounds like you are doing convergence therapy as well as > accommodative facility training. Convergence therapy aims to build [quoted text clipped - 10 lines] > > DrG I'm not judging right now, I'm just curious what the purpose is of the various things. As I understood my diagnosis, my eyes naturally rest slightly outward, and maybe I can't actually get my eyes to come together on things that are very close. Or I get fatigued when I have to look close for long periods of time. It's true that I seem to have some trouble with very small, cluttered print. My real complaint was with open areas though, and I'm not sure how it all ties together. I'm going with the flow for now. Since I'm pretty ignorant of optics, what does a minus lens do? Does it make things seem far away (they look smaller I think)? Thanks. >> I've prescribed vision therapy for convergence insufficiency for many >> patients over the years. It is highly effective, and is one of the [quoted text clipped - 14 lines] > can't focus past -3. This is for one eye at a time. What would the > purpose of this be? If your eyes naturally point outwards (exophoria), you can't change that. However, you can improve your ability to sustain the effort it takes to hold them your eyes straight ahead. Training is easier to do at the near point and the improvement in muscle control will translate to distance tasks. Working with the minus lenses is to help build accommodative/focussing control. Sometimes exophoria results from imprecise focussing. If that is part of your problem, then building good accommodative control may actually improve the outwards pointing of your eyes. Dr Judy |
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