When it comes to interpreting our reality and making sense of the world around us, it shouldn’t come as a surprise that vision is our most important and most complex sense with research estimating that 80 to 85 percent of our perception, learning and cognition are mediated through sight.
In saying this, good vision ultimately plays an essential role in a child’s overall development.
With Optometry Australia’s 2022 Vision Index finding that one in five Australian children are already diagnosed with a vision problem, it is estimated that another 10 percent of our littlest Aussies are living with an undetected eye condition, potentially leading to learning and behavioural issues as time goes on.
When it comes to addressing certain eye conditions in children, vision therapy has emerged as an effective treatment option to enhance visual skills and function.
Designed to improve various visual functions, such as eye movement control, eye coordination, focusing abilities and visual processing skills, vision therapy differs from glasses or contact lenses by going beyond merely correcting refractive errors and instead aiming to enhance the brain-eye connection and improve overall visual efficiency.
Working collaboratively with traditional optometry approaches, vision therapy is a growing treatment pathway that works to address specific visual challenges while promoting healthy visual development, enhancing the effectiveness of prescriptive eyewear and fostering long-term improvements in visual function and comfort.
We sat down with Hayley McDonald (BMedSc(VisSc), MOpt, SpecCertMPP), Lecturer at Flinders University and optometrist at South Coast Optometrists to discuss the benefits of vision therapy for children with certain eye conditions.
What is the science behind vision therapy?
There have been many studies on vision therapy, with the biggest and most well-known being the Convergence Insufficiency Treatment Trial. It was a randomised clinical trial of 221 children with convergence problems, a binocular vision disorder that occurs when the eyes work normally in the distance but are unable to coordinate and turn inwards to focus on near vision tasks, causing near vision strain. The study outcomes showed that in-office vision therapy provided significant improvement of convergence, accommodation (i.e. the ability to focus clearly on objects up close) and the symptoms.
Can you explain how vision therapy differs from traditional eye care methods like glasses or contact lenses?
Glasses and contact lenses are used to treat blurry vision problems like hyperopia (long-sightedness) and myopia (short-sightedness). Sometimes reading glasses can be a great option for reducing reading vision strain too.
However, there are some eye problems that are caused by weakness of the muscles that move the eyes around, called extraocular muscles. These muscles can be exercised to make them stronger and more flexible which can provide effective and long-lasting improvement in binocular vision disorders such as convergence insufficiency.
It is important to note that vision therapy and eye exercises are not a useful treatment for all eye problems and certainly cannot supersede the need for glasses in every situation.
What specific eye conditions in children can benefit from vision therapy?
The eye condition most often treated with vision therapy is convergence insufficiency. Other binocular vision disorders that affect our ability to focus up close and change focus such as convergence disorders (when eyes struggle to cooperate when turning inwards or outwards), heterophoria (when the eyes are misaligned), and accommodation issues (trouble activating and relaxing focus) may benefit from vision therapy treatment.
How do you assess whether a child is a suitable candidate for vision therapy?
It is firstly very important to check for, and manage, any signs of eye diseases (like amblyopia, more commonly known as 'lazy eye') or refractive errors (like long or short-sightedness). We then do a comprehensive binocular vision work-up assessing how the eyes move, coordinate, focus and react. The results of these tests allow us to diagnose the type of eye problem and assess if it can be treated by vision therapy.
What does a typical vision therapy session entail and how long does it typically take to see results?
Each vision therapy program is designed for the individual child based on their eye’s strengths and weaknesses. Commonly the exercises will include things like focusing on beads along a string and using different strength lenses to challenge the eye's accommodation and convergence. I find that most children will usually start to see noticeable improvements after three or four visits and will need between eight and 16 visits to fully complete their vision therapy program.
Are there any age restrictions for children undergoing vision therapy or can it be effective at any age?
Vision therapy is appropriate for many ages, but early primary or pre-primary school aged children may find some of the tasks tricky. Most of the research has been done on children aged nine to 17 years of age.
How are vision therapy plans customised to meet the individual needs of each child?
Like a physiotherapy treatment program, or personal training sessions at the gym, vision therapy treatments are specifically designed to meet the needs of the individual person. Specific eye muscles and vision processes are targeted to increase strength, flexibility and accuracy and to reduce fatigue.
What role do parents/caregivers play in supporting their child's progress during and after vision therapy sessions?
The biggest assistance that parents and caregivers can provide in the vision therapy process is helping their child stay consistent with the homework exercises. Generally, they will be given one or two tasks to perform for five minutes each day. Supervision and engagement from family is paramount to keeping on-track. Sticker charts can work a treat!
Are there any potential side effects or risks associated with vision therapy and if so, how are these managed?
Because we are deliberately targeting the parts of the eye that are currently weak or insufficient to strengthen them, a bit of eye strain and even headaches may occur early in training. Your child should always take breaks and days-off as needed to manage this. Fortunately, this strain improves significantly after getting through the first week or so of exercises once everything starts moving along.
How do you measure the success of vision therapy in children and what long-term benefits can they expect to experience?
The success of vision therapy is measured in two ways:
- The reduction in symptoms of strain and vision disturbance
- The improvement in measures of eye movement, accommodation and responsiveness
Following the completion of a vision therapy program, the reduction in eye strain and the improvement in vision tends to last for many years. Occasionally, the child may need a short vision therapy program update in the years after the initial treatment to address any recurrence of symptoms.
A final thought
It’s important to understand and remember that vision therapy does not replace regular trips to your optometrist.
It is recommended that every Australian, from the time they start primary school, pay their optometrist a visit every year until age 18, then every two years as an adult, and then yearly again after turning 65, for a comprehensive eye examination.
To schedule an appointment with your local optometrist today, use our easy search tool here.
