Vision Therapy: Additional Evidence-Based Research

By Dr. Russel Lazarus
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Evidence-based medicine integrates academic research with clinical trials — making it the gold standard of published research. 

The following articles provide just a sample of the many evidence-based research publications on vision therapy.

  1. Quaid, P., Simpson, T. Association between reading speed, cycloplegic refractive error, and oculomotor function in reading disabled children versus controls. Graefes Arch Clin Exp Ophthalmol 251,169–187 (2013)

Background

An estimated one in ten students aged 6 to 16 in the Ontario (Canada) school system have an individual education plan (IEP) for various learning disabilities, many of which include reading difficulties.

Method

  • One hundred children aged 6 to 16 were examined in this study. Included in the participants were 50 students that held IEPs and 50 students that acted as the control group.
  • The following binocular vision related data was acquired: Cycloplegic refractive error vergence facility, vergence amplitudes, accommodative facility, accommodative amplitudes, near point of convergence, stereopsis, and a standardized symptom scoring scale.
  • Both the IEP and control groups were examined using the Visagraph III system, which allows recording of reading speed and the number of eye movements made per 100 words read.
  • Reading comprehension was evaluated using a questionnaire administered at the end of the reading task, with a requirement of 80% or greater comprehension.

Results

  • Cycloplegic examination: The IEP group had significantly greater hyperopia.
  • Vergence facility: The IEP group showed significantly reduced vergence skills. There was also a significant correlation between this visual skill and reading speed, number of eye movements when reading, and a standardized symptom scoring system.
  • Other binocular vision skills: Significant differences were found within the IEP and control groups.

Conclusion

  • This research indicates significant correlations between reading speed, refractive error, and vergence facility.
  • Students being considered for reading IEPs should have a full eye examination with cycloplegia, as well as a comprehensive binocular vision evaluation.
  1. Borsting E, Mitchell GL, Kulp MT, et al. Improvement in academic behaviors after successful treatment of convergence insufficiency. Optom Vis Sci. 2012;89(1):12-18.

Purpose

To determine if treatment of symptomatic convergence insufficiency (CI) will affect Academic Behavior Survey (ABS) scores.

Method

The ABS is a survey developed by the Convergence Insufficiency Treatment Trial Group that enumerates the frequency of negative school behaviors and parental concern about school performance on a scale from 0 (never) to 4 (always) with total scores ranging from 0 to 24.

  • Participants included 218 children aged 9 to 17 with symptomatic CI and enrolled in the Convergence Insufficiency Treatment Trial.
  • The ABS was administered to the parents of the participants prior to treatment and after 12 weeks of treatment.
  • Three groups of children were randomized into different treatment groups:
    • (1) Home-based computer vergence/accommodative therapy with pencil push-ups
    • (3) Office-based vergence/accommodative therapy with home reinforcement
    • (4) Office-based placebo therapy with home reinforcement

Participants were classified as successful, improved, or non-responder after completing 12 weeks of treatment.

Results

  • At baseline, the average ABS score for the entire group was 12.85 (SD = 6.3).
  • The average ABS score improved in children categorized as successful, improved, and non-responder by 4.0, 2.9, and 1.3 points, respectively.

Conclusion

  • Improvement after CI treatment was associated with reduced frequency of negative academic behaviors both in reading and overall school performance, and parental concern.

If you feel you or your child could benefit from Vision Therapy, schedule an appointment with a vision therapy eye doctor and they will answer all your questions.

SEE RELATED: Guide to Vision Therapy

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  1. Leong, D. F., Master, C. L., Messner, L. V., Pang, Y., Smith, C., & Starling, A. J. (2014). The Effect of Saccadic Training on Early Reading Fluency. Clinical Pediatrics, 53(9), 858–864. https://doi.org/10.1177/0009922814532520

Background

Eye movements, necessary for reading, have been shown to relate to underlying cognitive and visual attentional processes during reading activities.

Purpose 

To determine the effect of saccadic training on reading fluency using the King-Devick remediation software.

Method 

  • Elementary students received standardized reading fluency tests at baseline and post treatment.
  • Treatment involved in-school training 20 minutes per day, 3 days per week for 6 weeks.

Results 

Post treatment, the treatment group had significantly higher reading fluency scores when compared to the control group.

Conclusion

  • Saccadic training involves rigorous practice of eye movements and shifting of visuospatial attention— both essential skills for reading fluency
  • With saccadic training, reading fluency can be improved significantly.
  1. Raghuram A, Gowrisankaran S, Swanson E, Zurakowski D, Hunter DG, Waber DP. Frequency of Visual Deficits in Children With Developmental Dyslexia. JAMA Ophthalmol. 2018;136(10):1089–1095.

Purpose

To assess the frequency of visual problems in children with Developmental Dyslexia (DD) and compare this frequency to typically developing (TD) readers. The visual skills assessed included: vergence, accommodation, and ocular motor tracking.

Method

  • An observational study was conducted in an outpatient ophthalmology ambulatory clinic including 29 children with DD and 33 TD children.
  • The following deficits were assessed: vergence (amplitude, fusional ranges, and facility), accommodation (amplitude, facility, and accuracy), and ocular motor tracking (Developmental Eye Movement test and Visagraph eye tracker).

Results  

  • Accommodation deficits were more frequent in the DD group (55%) than the TD group  (9%).
  • Ocular motor tracking deficits were more frequent in the DD group (62%) than the TD group (15%).
  • Vergence deficits were more frequent in the DD group (34%) than the TD group (15%).
  • In total, 79% of children in the DD group had visual deficits in 1 or more domains of visual function compared to the 33% of the TD group.

Conclusion

  • Deficits in visual function are significantly more prevalent in school-aged children with DD than in TD children.
  • Further research is necessary to determine if treating these visual deficits can improve visual symptoms and/or reading skills.

What is Vision Therapy?

Vision therapy is a research-based program that can improve the visual skills necessary for reading and learning. 

To read more about vision therapy and evidence based research, click here.

To learn more about how vision therapy can help your child, search through the many Success Stories written by parents of children who benefited from a program of vision therapy.

LEARN MORE: Guide to Vision Therapy

If you have any questions or concerns regarding your child’s vision and academic success, schedule an appointment with a developmental optometrist near you.