Vision therapy is a set of visual and motor activities designed by an optometrist to develop efficient visual skills and processing. A vision therapy evaluation helps determine if this program is the right treatment for you or your child. The evaluation covers multiple areas of visual function to create a complete picture of how the eyes and brain work together.
The first step is a general vision exam to check the overall health of the eyes. The eye doctor examines the external and internal structures, peripheral vision, and color vision. This thorough check helps rule out any underlying eye conditions that may be causing visual problems.
Many vision problems that affect learning or daily tasks are not caused by eye disease. However, it is important to confirm that the eyes are healthy before moving forward with other testing. This baseline information helps the doctor understand the full picture.
Visual acuity measures the sharpness of sight. This test tells the doctor how much blur the patient sees at different distances. Results provide a starting point for the evaluation and help track progress over time. You can use our kids symptom checker to see if your child shows signs of these issues.
A child may have good visual acuity but still struggle with reading or schoolwork. This is because clear eyesight is only one part of the visual system. The evaluation looks at many other skills beyond basic clarity.
Refractive error refers to optical conditions that cause blurry vision. This includes nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. The doctor checks whether the patient needs glasses or contact lenses to see clearly.
Sometimes a small amount of uncorrected refractive error can contribute to eye strain or fatigue. Correcting this problem may be part of the overall treatment plan alongside vision therapy.
The visual efficiency evaluation checks the mechanics of the eyes. It measures how well the eye muscles move, focus, and work together as a team. These skills are essential for comfortable and sustained visual work.
Problems with visual efficiency can cause symptoms like headaches, tired eyes, blurry vision, and difficulty concentrating. The three main areas tested are ocular mobility, accommodation, and binocularity.
Ocular mobility measures how well the eyes can follow a moving target and jump accurately from one target to the next. Smooth tracking movements are called pursuits. Quick jumping movements between targets are called saccades.
Both types of eye movements are essential for reading. Poor ocular mobility can cause a child to lose their place, skip words, or read slowly. Testing reveals whether these skills are working properly for the patient age.
Accommodation is the ability of the eyes to change focus at different viewing distances. The focusing muscles inside the eye must adjust when you look from far away to up close and back again.
The doctor tests how accurately the focusing muscles work, how long the patient can hold focus, and how quickly the eyes can switch between near and far distances. Weak accommodation can make reading and desk work very tiring.
Binocularity describes how the two eyes work together to create a clear, single image and perceive depth. The brain must combine the slightly different images from each eye into one unified picture. If you notice your child squinting, they may need to take our double vision quiz.
Problems with binocularity can cause double vision, eye strain, or difficulty judging distances. Testing helps detect any weaknesses in eye teaming. Some patients learn to suppress one eye to avoid double vision, which can affect depth perception.
This part of the evaluation uses standardized tests to compare a child performance with other children of the same age. These tests show how the brain processes and understands visual information from the eyes. We utilize the gold standard of care for these assessments.
Visual information processing is different from eyesight. A child can have perfect vision but still struggle to make sense of what they see. This portion is often recommended for children having trouble in school or difficulty with reading.
Laterality is the ability to tell right from left on oneself and understand the idea of mirror images on others. This is a foundational skill for reading and spatial awareness.
Directionality is the ability to understand the correct orientation of objects and letters. This skill helps children recognize that letters like b and d or p and q are different even though they look similar.
Visual memory testing shows how well a patient can look at an image and hold a mental picture of it. Strong visual memory helps with reading comprehension, spelling, and recalling written information.
Children with weak visual memory may need to look at a word many times before they can remember how to spell it. They may also have trouble remembering what they read moments earlier.
Visual motor integration measures how well the eyes and body communicate to make accurate and precise movements. This includes both large body movements and fine motor skills like handwriting and cutting with scissors.
A child with poor visual motor integration may have messy handwriting, trouble staying within lines when coloring, or difficulty copying from the board. Sports that require hand eye coordination can also be challenging.
Visual analysis is a broad term that covers several skills used to interpret and understand what we see. These skills help a person problem solve and make assumptions about visual images. Visual analysis can be broken down into five subskills that work together.
Discrimination is the ability to identify and match shapes, letters, and other figures. A child needs this skill to tell the difference between similar looking letters and numbers.
Spatial relations refers to detecting differences in direction among similar images. Both skills are important for reading, math, and understanding diagrams or maps.
Form constancy is the ability to understand that objects of various sizes or orientations still have the same meaning. For example, the letter A is still an A whether it is large, small, or in a different font.
Children with weak form constancy may not recognize a word they know when it appears in a different size or style. This can slow down reading and cause confusion.
Figure ground is the ability to pick out a certain image while ignoring the background. This skill helps children focus on relevant information and filter out distractions on a busy page.
Visual closure is the ability to mentally complete a visual image even when part of it is missing. This skill helps with reading speed because we do not need to see every letter perfectly to recognize a word.
The visual efficiency and visual information processing evaluations are about one hour each. The total testing time depends on which evaluations are recommended for the patient. Some patients may only need one portion while others benefit from both.
A parent conference is scheduled about one week after testing. We ask that both parents attend so everyone can be on the same page and ask questions together. At this meeting, the doctor reviews all results and explains what the findings mean.
Parents receive a detailed written report with specific recommendations. The report includes scores compared to age norms and a clear explanation of any areas of concern.
At Insight Vision Center Optometry, vision therapy takes place at The Eye Gym. We create a fun and welcoming environment for patients and families. Dr. Valerie Lam, OD, FAAO, FOVDR leads the program with support from Dr. Ariel Chen, OD.
Dr. Valerie Lam, OD, FAAO, FOVDR is board certified in Vision Therapy and Pediatric Developmental Vision Care. Dr. Ariel Chen, OD helps manage learning-related vision problems. Our therapy team designs activities that match each child personality and interests to keep sessions engaging.
Children can be evaluated as early as age five or six, though many children are evaluated when they start having trouble in school. The tests can be adapted for different ages and developmental levels. Younger children may need shorter testing sessions spread over multiple visits.
No referral is needed to schedule an evaluation directly with our office. Teachers, tutors, occupational therapists, or other professionals sometimes suggest testing when they notice signs of visual problems. We are here to help you understand your child visual needs.
Coverage varies by insurance plan and our staff can help you understand your benefits before the appointment. Some medical and vision plans may cover portions of the evaluation or treatment. We recommend checking with your provider for specific details regarding your policy.
Vision therapy is a supervised program prescribed by an optometrist based on evaluation results. It includes specific activities designed to improve identified weaknesses and is customized for each patient. The program typically involves weekly sessions with a trained therapist and home practice.
Common signs include frequent headaches during reading, skipping lines, and poor handwriting. Some children reverse letters or numbers beyond the typical age or avoid close work. You might also notice your child covering one eye or tilting their head while reading.
Adults can improve their visual skills through vision therapy to address eye strain or double vision. This is especially helpful for those recovering from a concussion or brain injury. The brain remains able to learn new visual skills at any age through specialized training.
