My friend and colleague Dan L. Fortenbacher, O.D., FCOVD wrote on his blog:

For the patient who suffers from the symptoms of double vision, headaches, fatigue and poor reading performance due to a binocular vision problem like convergence insufficiency, now there is scientific proof that office-based vision therapy is the only viable and effective treatment. When compared to all of the other commonly prescribed treatments recommended by doctors in the past, research has now proven that office-based therapy is effective but, pencil push-up eye exercises or computer based home therapy (used alone) are no better than a placebo.

Yes, office-based vision therapy is effective because IT IS NOT eye exercises. Why?

To understand the difference, one must understand that vision problems such as poor binocular control (like convergence insufficiency), accommodation problems (poor eye focusing), oculomotor dysfunction (poor eye tracking), problems in visual processing or visual motor integration (eye-hand coordination) are not typically problems with muscle weakness.
A child that has double vision when reading is not having that problem because their eye muscles are too weak to turn their eyes in the orbit. If you think of any person with double vision like a “computer”, the problem is not with the “hardware” (eye muscles), the problem exists in the “software” (the brain). The visual problem is a “brain coordination problem” not an eye muscle weakness problem.

Thus exercising eyes or eye muscles is no more effective in learning binocular “two-eyed” vision skill than exercising ones fingers in an attempt to learn how to play the piano. Doing finger exercises will not result in becoming a piano virtuoso. The same is true with eye exercises and vision.

Office-based vision therapy is effective because it IS NOT eye exercises. Office-based vision therapy is a process of helping the patient to develop the “brain skills” for proper binocular vision (and much more). This brain skill is a learned ability that, once learned, is like riding a bike…it is not forgotten.

The results of a successful office-based vision therapy treatment program is that the patient will learn proper vision skills and enjoy the lifelong benefit of good binocular vision, symptom free and more productive and competent in the rigorous visual demands of school and work

Comments: Dan, I couldn’t agree with you more…vision therapy is brain therapy…it is taking neuroplasticity to its highest peak and allowing our patients to develop new and improved visual abilities so they can do the best they can in all they attempt. Nicely done.

BTW if you want to go to Dan’s blog…just click on the title above. DM