What is Vision Therapy?

Visual conditions that cannot be treated adequately with glasses and contact lenses are often referred to as “functional” vision problems. Vision Therapy is an individualized, supervised, treatment program designed to correct these visual performance and visual-perceptual deficiencies. Vision Therapy addresses functional vision problems such as:


  • eye alignment
  • tracking and eye teaming
  • focusing abilities
  • eye movements
  • visual information processing
  • visual-vestibular integration

Every patient is different, so before we begin, we do special visual-perceptual and visual skills testing to determine what areas need improvement. Then an individualized protocol is prescribed involving a combination of selected eye movements, gross-motor, fine-motor, and perceptual training routines. These activities require specialized equipment not found in typical practices including trampolines, balance boards, dedicated computer set-ups, prisms glasses and unique devices designed to improve and integrate eye-hand coordination, eye-body movements and visual-vestibular processing pathways.

How long does it take?

The average program is completed in 12 weekly sessions over a 3-month period. More serious or complex cases can run longer and some simple problems can be taken care of in less time.  Dr. Mietus prescribes an individualized program for each patient after a thorough eye exam and functional vision assessment.  The weekly one hour office visits with his vision therapist provide one-on-one therapy. The patient is given exercises to do at home between appointments, preferably daily, but a minimum of 4 days per week. This home therapy is an essential part of the program. Much like in learning to play piano, you have to practice to get good at it!

Why haven’t I heard of this before?

Behavioral Optometry and Vision Therapy have been practiced for decades and the specialty continues to evolve. Because of the specialized training, office equipment, and scheduling necessities of a vision therapy practice, most doctors take the more conventional approach to vision care. The specialty is beginning to grow more rapidly now as the success of vision therapy becomes more widely recognized.

Most people know that having 20/20 vision is a good thing. Most schools and doctors are also under the impression that if you have 20/20 vision…“your eyes cannot be part of the problem.”  This could not be further from the truth. This popular misconception has caused countless children and adults to struggle needlessly against correctable, but “hidden”, visual handicaps.

We tend to take it for granted, but the act of reading requires an incredible degree of precision in the way the eyes must follow each other along a line of print. They dance across the page like Fred Astaire and Ginger Rogers, gliding effortlessly from one word to the next. As in dancing, some of us are not as gifted as others. But, just as anyone can learn to dance, with Optometric Vision Therapy, tracking and focus skills can be improved.

Sometimes, the mind’s visual-processing “software” may be incomplete or disorganized. This can cause a host of problems, including an inability to easily “visualize” things that are read or form mental pictures. Another is visual-spatial processing disorder. This causes poor laterality awareness and the ability to differentiate RIGHT from LEFT and leads to letter and number reversals and problems with math, following instructions and organizing written work on the page. Visual-motor skills can be deficient and lead to eye-hand coordination problems, poor handwriting and difficulty playing sports. Collectively, these are referred to as visual-perceptual problems and are very treatable with vision therapy.

The person with uncorrected functional visual problems, like the ones mentioned here, is prevented from reading and learning in a normal, efficient fashion and is therefore unable to demonstrate their full intelligence. No amount of tutoring or “extra effort” is going to change this. It only creates more frustration and can, over time, lead to feelings of resentment and poor self-esteem.

“My son wore glasses for 5 years before I found out that they were not totally correcting his vision problem.” C. Smith 

As crucial as proper visual skills are in scholastic performance, there is no screening for these functional vision problems in the educational system. Because of this, many students in special resource classes, being treated for A.D.D or A.D.H.D., or labeled as having specific reading disability or dyslexia have been misdiagnosed. Many actually have correctable visual problems underlying their observable symptoms. If so, they can be effectively “cured” of these problems rather than singled out for special help or medicated to work around them.

The importance of this cannot be overemphasized. Unless one has had a thorough, functional visual workup by a doctor who is specially trained to recognize and treat these problems with vision therapy, the chances of misdiagnosis are high!  Ophthalmologists and non-specialized optometrists cannot evaluate nor treat these conditions.  Consider a second opinion with a behavioral optometrist to learn about all your treatment options.