The Distinction Between Vision Therapy and Orthoptics

Optometric vision therapy is a program of care used to develop, restore, or enhance visual function and performance. The procedures are conducted under the supervision of an optometrist and are individualized to meet the needs of each patient. Depending on the case, vision therapy is prescribed to develop or remediate fundamental visual skills and abilities; improve visual comfort, ease and efficiency; and/or enhance how a person cognitively processes visual information and uses it to direct and monitor actions.1

Vision therapy is generally conducted in-office, once or twice weekly for 30 minutes to an hour, often supplemented with procedures done at home between office visits. The goal of optometric vision therapy is to automatize normative function, not to strengthen eye muscles. It should not be equated with self-directed programs of eye exercises marketed to the public. Many specialized procedures and equipment are used in vision therapy programs including therapeutic lenses and prisms (regulated by state licensure.) Optometric vision therapy is a blend of medical, developmental and behavioral therapies which may include:

  1. Pursuit and saccade therapy (to improve the speed and accuracy of eye movements)
  2. Visual-vestibular therapy (to integrate eye movements with balance)
  3. Visual perceptual therapy (to enhance visual information processing)
  4. Eye-hand coordination therapy (to develop visually guided movement)
  5. Accommodative therapy (to enhance focusing stability, flexibility, and comfort)
  6. Visual attention therapy
  7. Peripheral awareness therapy (enhances the use of vision as a simultaneous sense, synchronously receiving and processing multiple inputs)
  8. Visual-spatial awareness including laterality, directionality, and visual imagery
  9. Visual-auditory integration
  10. Orthoptics (mechanics of eye movements)

Although optometric vision therapy evolved from orthoptics, orthoptics is only one of many therapies which are used in contemporary optometric vision therapy.2 Orthoptics, which literally means straightening of the eyes, is limited to eye exercises to treat eye coordination problems by increasing the range of binocular fusion. The treatments used during optometric vision therapy go beyond the limited definition and scope of orthoptics to treat disorders of the visual system, indicative of vision as a collaboration between the eyes and the brain.3

In summary, optometric vision therapy is a complete program of habilitative and rehabilitative therapeutic vision care of which orthoptics is a subset. Optometric vision therapy is not synonymous with orthoptics.

1 www.aoa.org/documents/DefinitionsOptometricVisionTherapy.pdf. Accessed June 13, 2007.
2 Press LJ. The evolution of vision therapy. In: LJ Press, ed. Applied Concepts in Vision Therapy. St. Louis: Mosby 1997.
3 www.aoa.org/x5417.xml. Accessed June 13, 2007.