doctors and therapists at the Wichita Vision Development
Center welcome you to our therapy clinic! You'll see some of our
patients at work learning how to develop fully functional visual systems which
will last them a lifetime!
While every practice that provides vision therapy may be a little different
based upon their size and philosophy of clinical care, this page will allow
you to gather a general overview of some of the different types of treatment
your child might receive during therapy. For help in locating a vision
therapy practice in your area, contact the College of Optometrists in Vision
a child begins treatment, a full diagnostic workup is completed to determine
low areas in a child's visual information processing. Normed- referenced
tests check his visual perception skills, writing speed and precision,
eye-hand and eye-body coordination, tracking, and visual reading efficiency.
Combined with the information the doctor gathers during the clinical exam,
these tests help us make decisions about treatment.
Brock String is a simple tool which gives the child a great deal of
visual feedback. It teaches the patient how to aim his eyes
together correctly for varying distances in space and allows him to
experience the difference between convergent and divergent eye aims.
It also allows the child to determine if he is shutting off an eye,
or suppressing, and tells him where his eyes are aimed and how far
off his eye aim may be. This is usually one of the first techniques
the child is taught and is often assigned as home therapy.
are an important part of vision therapy treatment. Orthoptic software
can create a wide range of visual stimuli and affords the variability to
individualize techniques to meet each child's specific needs. The child
can work on programs which train eye movements, eye coordination, stereo
vision, and antisuppression techniques. Therapy always begins at a level
where the patient can succeed and gradually increases the visual demands to
stretch his range and skill.
patient is working on a diagnostic and training machine called a cheiroscope.
It's used to assess binocular stability and alignment and to detect the
presence and extent of suppression. Suppression occurs when the
patient's brain shuts off an eye by blocking its visual input when the child
loses the ability to control his eye aim or alignment. Suppression is an
adaptive neurological response to protect oneself from double vision. Training
on the cheiroscope gives the child important feedback that he is suppressing
and allows him an opportunity to gain the binocular control necessary to
correct his eye aim and eliminate suppression.
a therapist works with a child on a fusional technique called an
aperture rule. The patient is asked to look through a
window in a slide at a series of targets placed at the end of the
instrument. Each eye sees a different part of the target, and
the child learns to fuse the two images coming in from his left and
right eyes into a single picture. The therapist's role
is to coach the child on ways to adjust his visual system to achieve
the goal of clear, single vision.
amblyoscope is a machine which trains a child to use his/her eyes
together. The goal of the instrument is to help the child achieve
binocular fusion, or normal two-eyed single vision with depth
perception. As the child progresses in skill, the doctor
or therapist increases the fusional demands to stretch and normalize
the patient's ability to efficiently use his/her two eyes together.
This machine also allows a child to know when he/she is suppressing
an eye; visual awareness is the first step in successful training.
with unstable visual systems often learn a neurological adaptation
called suppression, in which their brains block the visual input
coming in from one eye. Children unconsciously learn to
suppress at very young ages to keep from seeing double.
Suppression is never normal and is always a sign of an unstable
visual system. Vision therapy trains the eyes to work together
but to do so both eyes have to be "on." Here a
therapist works with a child using special red-green lenses and a
target with red-green letters. One eye can only see the red letters,
and the other the green. If the visual system shuts off an eye, the
child won't be able to see all of the letters. Antisuppression
activities such as these make the child aware of when she is
suppressing and allow her to gain control and learn to leave both
eyes on simultaneously. This is especially important for
children with wandering eyes, crossed eyes, and lazy eyes.
and prisms are always important in visual training. They modify the
patient's world and allow him to the opportunity to create an appropriate
visual response. Here a child is working on a focusing technique
called accommodative rock. The "flippers" hold two different
sets of lenses. One is a pair of plus lenses; the other are minus.
By rapidly alternating between the two sets of lenses, the patient is forced
to relax or increase focusing accommodation in order to clearly see the print,
thus gaining greater facility and control over his focusing system.
Patients always begin with lower powered lenses and gradually increase the
strength at which they can successfully complete the task.
child is working on another focusing technique called "mental
minus" that teaches him to control how much he's focusing.
Focusing problems cause children to see blurry print, especially
when they read small print for long periods or have to make a lot of
focusing shifts between the board and their desks.
patient is working with special polarized slides called Vectograms.
These slides allow a child to work with a variety of targets to
train central or peripheral vision, flat fusion or stereo fusion,
and convergent or divergent eye positions. The targets also
help to control suppression, or the patient's tendency to shut off
an eye when his visual system is stressed. Vectograms allow the
doctor or therapist to control a wide variety of visual stimuli
presented to the child while he is still operating in the natural
seeing environment of free space.
with conditions called convergence insufficiency and exotropia have
difficulty turning their eyes inward at close ranges. As a
result, they often struggle in school because they simply can't
maintain the inward eye aim required for reading and most closeup
activities. These children have to be taught to converge their
eyes. Here a therapist is helping a young patient experience
the "tug" she should feel on both sides of her nose bridge
as muscles located there contract and pull her eyes inward.
Kinesthetic awareness is an important first step in teaching the
child to control her eye coordination.
saccadic fixator is an instrument which trains eye movements,
tracking, visual memory, peripheral awareness, and visual motor
integration. It allows the children to set goals for
themselves as they continually strive to improve their last
performance. Besides children with oculomotor dysfunctions, this
machine is particularly good for young athletes; it improves their
eye-hand-body coordination and response time. Overall, it's an
excellent trainer for visual stamina and efficiency.
rotator is a tracking instrument used to increased a child's ability
to control where she's moving her eyes. The child is asked to
place golf tees in a rotating pegboard. As the child's skill
improves, the speed at which the pegboard is rotating is gradually
increased. This procedure is usually done while the patient is
wearing a patch over one eye. Strong monocular
("one-eyed") skills must be gained before a child can
achieve good binocular, two-eyed skills.
walking rotator integrates the child's eye movements with his or her
body movements. The child is asked to find letters or pictures
on the turning wheel as he walks on a raised rail. This
activity not only helps tracking skills, but it also improves visual
motor integration skills. Our visual systems are continually
sending information to our bodies to help control movement, balance,
coordination, and define where we are located in space.
Children who have poor control over their visual systems often have
poor control over their body coordination. These children appear
awkward and clumsy, do poorly in sports, and may find it difficult
to learn to ride a bike. Fine motor skills are also affected.
Poor handwriting is a common problem of children with poor eye-hand
are samples of some of the many techniques and procedures used by children in
our therapy room to help remediate their poor visual skills. Therapy
sessions are always individualized to meet the child's specific visual needs.
Patients' improvements are regularly evaluated to monitor their progress, and
their therapy program modified as they reach each treatment goal.
In addition to in-office treatment where children learn control over their
visual systems, our patients are also asked to do home therapy each day to
reinforce their new skills and ensure the changes become permanent.
for visiting us!