The Vision Therapy and Rehabilitation Service (VTR) provides care to patients of all ages under the direction of Marc Taub, OD, MS, FAAO, FCOVD, Chief of Service.
Patients are referred to the care of doctors in this service both from within The Eye Center and from other doctors throughout the Mid-South region.
The VTR service specializes in the care of patients experiencing visual deficits secondary to learning and physical disability, acquired brain injury or neurological insult and low vision secondary to ocular disease.
Who can benefit from a vision therapy or vision rehabilitation evaluation?
Many eye diseases and injuries may cause decreased vision. (www.lighthouse.org) Among the most common conditions encountered include macular degeneration, (www.ahaf.org) glaucoma, (www.glaucoma.org) and diabetic retinopathy (www.aoa.org/diabetic-retinopathy.xml.) Genetic diseases such as Leber’s Hereditary Amaurosis, albinism and retinitis pigmentosa may affect vision at an early age.
Acquired brain injury (CVA or trauma) can alter not only a patient’s sight, but the ability to process the information. (www.nora.cc)
Children and young adults may suffer from a binocular vision, accommodative, visual processing or ocular motor dysfunction that may affect academics. (www.childrensvision.com)
An evaluation in the VTR service will determine the need for optometric vision rehabilitation, which is an individualized treatment regimen aimed at the remediation of visual, perceptual and motor disorders. Treatment provided in this service often consists of multi-sensory and neuro-behavioral therapy for disorders not managed solely by eyeglasses or contact lenses. State-of-the-art instrumentation and computerized technology allow patients of all ages to improve their vision for optimum performance not only in the classroom or on the sports field but also in performing the everyday activities of daily living.
Doctors at TEC are specifically trained to provide the highest level of diagnosis and treatment for these conditions. In fact, a majority of doctors in this service area are certified Fellows of the College of Optometrists in Vision Development. (www.COVD.org)
Several types of diagnostic examinations are performed in the VTR Service. The following descriptions will allow for a better understanding about the type of recommended exam.
BASIC VISION SKILLS
This group of tests will help the doctors in the VTR service determine how clearly patients are seeing, how well their eyes focus, how well their eye muscles work together and the quality of depth perception. This type of exam is recommended when experiencing eye discomfort, reading and/or learning problems that may be linked to vision. Many people are surprised to learn that problems with vision can affect so many daily activities. This can be particularly troublesome for children in school, adults whose job requires a significant amount of near work, athletes whose good performance depends upon the quality of their vision and those who have experienced a brain injury.
Visual Perceptual/Developmental Exam
HOW EYES WORK TO UNDERSTAND WHAT THEY SEE
This group of tests is designed to provide detailed information about the way the eyes are developing or have developed and how visual information is gathered and processed. Doctors in the VTR service check the ability to understand, store and manipulate material presented through the visual system alone and in conjunction with other senses (i.e. speech, hearing, touch). Doctors also measure the recognition of symbols and letters and the patient’s ability to draw, write and manipulate printed material. This type of exam is typically recommended when a child or teen is not doing well in school or an adult is experiencing vision difficulty following a problem like a stroke or other accident. At least 80% of all that is learned or experienced comes through our visual system, so problems with perception can be extremely disabling.
Strabismus and Amblyopia Exam
UNDERSTANDING EYES THAT FAIL TO WORK TOGETHER
This exam is designed to specifically address the needs of patients with eye turns and “lazy eye.” This group of tests, like the sensorimotor exam (basic vision skills), checks how clearly patients are seeing, how well their eyes focus, how well their eye muscles work together and the quality of depth perception. In addition, this exam also helps the doctor detect the reason for eye turns and vision loss. Amblyopia, or “lazy eye” as it is often called, is one of the leading causes of preventable vision loss in the U.S. Strabismus, or “eye turn,” is found both in children and in those who have experienced a brain injury. Detection and aggressive treatment can restore vision and eye alignment and positively affect daily activities.
Low Vision Exam
MAXIMIZING THE REMAINING VISION
When other medical or surgical treatment cannot provide any further improvement or when medical or surgical treatment must be delayed, a low vision examination is recommended. The low vision examination is an in depth evaluation of the person’s functional use of the remaining vision. The purpose of this evaluation is to prescribe optical and non-optical aids to maximize use of the patient’s residual vision. Optical aids vary in type from magnifiers and telescopes for seeing at distance and near, to closed circuit televisions that can magnify print up to 100 times, enabling the person to read again. Non-optical aids include items such as talking watches, books on tape, colored filters to reduce glare and other devices aimed at improving activities of daily living. Coupled with the wide variety in types of optical and non-optical aids and extent of vision impairments, it is necessary to perform a special low vision examination to analyze what the best residual vision is and what specific type of aids will best help the person meet their visual needs.
Vision Therapy/Orthoptics is an individually prescribed (often medically necessary) course of techniques designed to strengthen basic vision skills, correct muscle problems (like eye turn) and treat “lazy eye”. Specific activities stimulate the eyes and brain to improve a patient’s ability to control his or her visual system. This therapy may be conducted along with surgical treatment and or spectacle lenses.
Pleoptics involves the use of light to stimulate the eyes and brain. Various techniques are used along with Vision Therapy/Orthoptic procedures to increase treatment results.
Perceptual Therapy involves the use of special activities to help an individual compensate for problems that affect learning. Activities improve a person’s ability to gather and process information received from the eyes. Often this therapy is conducted along with remedial activities at home and school.
Sports Vision Enhancement
Sports Vision Enhancement can be achieved through the use of Vision Therapy in the individual with an otherwise “normal” visual system. Vision therapy has been demonstrated to be effective in improving visual skills for maximum performance in baseball, tennis and even golf.
Visual Rehabilitation Services
Visual Rehabilitation Services are often provided in addition to Vision Therapy for individuals suffering from problems related to stroke and other forms of accidental head trauma.
During a visit to the Vision Therapy and Rehabilitation service, an in-depth report will be prepared. This report will explain any problems with the patient’s visual system and make recommendations for treatment. In some cases, the use of eye glasses, prism lenses, Vision Therapy, optical/non-optical aids for low vision and/or specialized vision devices (including computer software) may be prescribed.
At times, referral may be necessary to another specialist, such as an educational psychologist, occupational therapist, neurologist or reading specialist for further evaluation or even treatment (such as surgery). The doctors in the Vision Therapy and Rehabilitation service will work closely with your referring doctor(s) to ensure that patients receive the best possible care.
Know what to expect during your visit:
For more information about what a vision therapy appointment might look like, parents and children can read and see pictures about a visit to Vision Therapy at The Eye Center in our social stories:
My Vision Therapy Visit to The Eye Center (PDF)