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Summary of Recent Research in Vision Therapy

This is long, but worth looking at. This list of recent scientific support of vision therapy was compiled by my mentor, friend, and colleague, Dr. Dominick Maino and can be found on his blog, Maino's Memos.

Be Well!

Dr. Nate

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

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Optometric Vision Therapy (OVT) is not a new therapeutic intervention. It has been available for decades, but few have had the access needed. It usually includes the use of lenses, prism, bifocals, and structured therapeutic activities to facilitate the desired outcomes. This therapeutic approach has been successfully used for amblyopia (lazy eye), strabismus (eyes that turn in/out) and other binocular vision dysfunctions (convergence insufficiency/excess, divergence insufficiency/excess, accommodative dysfunctions (focusing), oculomotor anomalies (problems with saccades/pursuits/tracking).

Since these binocular vision dysfunctions have been linked to learning achievement, OVT is also used along with vision information processing therapy to not only improve vision function but academic performance.

Some say there is no research supporting what OVT offers...unfortunatley the majority of these skeptics never bother to seek out the research in the first place.

We have at least one excellent clinical trial to support OVT (see the many articles generated by this clinical trial) and several papers generated by another clinical trial demonstrating that you can treat amblyopia at just about any age...(see PEDIG papers below as well).

The research supporting OVT and learning is there, but not quite as strong as those papers noted above....(see listing below)...

Convergence Insufficiency Treatment Trial Papers

Effectiveness of Placebo Therapy for Maintaining Masking in a Clinical Trial of Vergence/Accommodative Therapy.
Kulp MT, Mitchell GL, Borsting E, Scheiman M, Cotter S, Rouse M, Tamkins S, Mohney BG, Toole A, Reuter K, Citt SG.
Invest Ophthalmol Vis Sci. 2009 Jan 17. [Epub ahead of print]

Randomized clinical trial of treatments for symptomatic convergence insufficiency in children.
Convergence Insufficiency Treatment Trial Study Group.
Arch Ophthalmol. 2008 Oct;126(10):1336-49.

Feasibility of using placebo vision therapy in a multicenter clinical trial.
Kulp MT, Borsting E, Mitchell GL, Scheiman M, Cotter S, Cooper J, Rouse M, London R, Wensveen J; Convergence Insufficiency Treatment Trial (CITT) Investigator Group.
Optom Vis Sci. 2008 Apr;85(4):255-61.

The convergence insufficiency treatment trial: design, methods, and baseline data.
Convergence Insufficiency Treatment Trial (CITT) Study Group.
Ophthalmic Epidemiol. 2008 Jan-Feb;15(1):24-36.

Accommodative insufficiency is the primary source of symptoms in children diagnosed with convergence insufficiency.
Scheiman M, Mitchell GL, Cotter S, Rouse M, Borsting E, Kulp M, Cooper J, London R, Wensveen J; Convergence Insufficiency Treatment Trial (CITT) Study Group.
Optom Vis Sci. 2006 Nov;83(11):857-8; author reply 858-9. No abstract available.

Randomised clinical trial of the effectiveness of base-in prism reading glasses versus placebo reading glasses for symptomatic convergence insufficiency in children.
Scheiman M, Cotter S, Rouse M, Mitchell GL, Kulp M, Cooper J, Borsting E; Convergence Insufficiency Treatment Trial Study Group.
Br J Ophthalmol. 2005 Oct;89(10):1318-23.

A randomized clinical trial of treatments for convergence insufficiency in children.
Scheiman M, Mitchell GL, Cotter S, Cooper J, Kulp M, Rouse M, Borsting E, London R, Wensveen J; Convergence Insufficiency Treatment Trial Study Group.
Arch Ophthalmol. 2005 Jan;123(1):14-24.

Validity and reliability of the revised convergence insufficiency symptom survey in adults.
Rouse MW, Borsting EJ, Mitchell GL, Scheiman M, Cotter SA, Cooper J, Kulp MT, London R, Wensveen J; Convergence Insufficiency Treatment Trial Group.
Ophthalmic Physiol Opt. 2004 Sep;24(5):384-90.

Validity and reliability of the revised convergence insufficiency symptom survey in children aged 9 to 18 years.
Borsting EJ, Rouse MW, Mitchell GL, Scheiman M, Cotter SA, Cooper J, Kulp MT, London R; Convergence Insufficiency Treatment Trial Group.
Optom Vis Sci. 2003 Dec;80(12):832-8.

Other research/vision and learning:

The efficacy of visual therapy: accommodative disorders and non-strabismic anomalies of binocular vision.
Suchoff IB, Petito GT.
J Am Optom Assoc. 1986 Feb;57(2):119-25.

Vision, learning, and dyslexia. A joint organizational policy statement. American Academy of Optometry. American Optometric Association.
Optom Vis Sci. 1997 Oct;74(10):868-70.

The association between vision quality of life and academics as measured by the College of Optometrists in Vision Development Quality of Life questionnaire.
Vaughn W, Maples WC, Hoenes R.
Optometry. 2006 Mar;77(3):116-23.

Measuring ADHD behaviors in children with symptomatic accommodative dysfunction or convergence insufficiency: a preliminary study.
Borsting E, Rouse M, Chu R.
Optometry. 2005 Oct;76(10):588-92.

Visual factors that significantly impact academic performance.
Maples WC.
Optometry. 2003 Jan;74(1):35-49.

Vertical fixation disparity in learning disabled.
Sucher DF, Stewart J.
Optom Vis Sci. 1993 Dec;70(12):1038-43.

Learning disabilities and vision problems: are they related?
Keys MP, Silver LB.
Pediatrician. 1990;17(3):194-201.

A pilot study. Depth perception and near stereoacuity: is it related to academic performance in young children?
Kulp MT, Schmidt PP.
Binocul Vis Strabismus Q. 2002;17(2):129-34.

Is visual memory predictive of below-average academic achievement in second through fourth graders?
Kulp MT, Edwards KE, Mitchell GL.
Optom Vis Sci. 2002 Jul;79(7):431-4.

Effect of oculomotor and other visual skills on reading performance: a literature review.
Kulp MT, Schmidt PP.
Optom Vis Sci. 1996 Apr;73(4):283-92. Review.

Several Pediatric Eye Disease Investigator Group Generated Papers on Amblyopia

Amblyopia treatment: 1998 versus 2004.
Khazaeni L, Quinn GE, Davidson SL, Forbes BJ.
J Pediatr Ophthalmol Strabismus. 2009 Jan-Feb;46(1):19-22; quiz 23-4.

Pharmacological plus optical penalization treatment for amblyopia: results of a randomized trial.
Pediatric Eye Disease Investigator Group.
Arch Ophthalmol. 2009 Jan;127(1):22-30.

Patching vs atropine to treat amblyopia in children aged 7 to 12 years: a randomized trial.
Scheiman MM, Hertle RW, Kraker RT, Beck RW, Birch EE, Felius J, Holmes JM, Kundart J, Morrison DG, Repka MX, Tamkins SM; Pediatric Eye Disease Investigator Group.
Arch Ophthalmol. 2008 Dec;126(12):1634-42.

Further validation of the Amblyopia Treatment Index parental questionnaire.
Holmes JM, Strauber S, Quinn GE, Cole SR, Felius J, Kulp M; Pediatric Eye Disease Investigator Group.
J AAPOS. 2008 Dec;12(6):581-4. Epub 2008 Oct 30.

A randomized trial of near versus distance activities while patching for amblyopia in children aged 3 to less than 7 years.
Pediatric Eye Disease Investigator Group.
Ophthalmology. 2008 Nov;115(11):2071-8. Epub 2008 Sep 11.

Monocular oral reading performance after amblyopia treatment in children.
Repka MX, Kraker RT, Beck RW, Cotter SA, Holmes JM, Arnold RW, Astle WF, Sala NA, Tien DR; Pediatric Eye Disease Investigator Group.
Am J Ophthalmol. 2008 Dec;146(6):942-7. Epub 2008 Aug 16.

A randomized trial of atropine vs patching for treatment of moderate amblyopia: follow-up at age 10 years.
Pediatric Eye Disease Investigator Group, Repka MX, Kraker RT, Beck RW, Holmes JM, Cotter SA, Birch EE, Astle WF, Chandler DL, Felius J, Arnold RW, Tien DR, Glaser SR.
Arch Ophthalmol. 2008 Aug;126(8):1039-44.

Treatment of bilateral refractive amblyopia in children three to less than 10 years of age.
Wallace DK, Chandler DL, Beck RW, Arnold RW, Bacal DA, Birch EE, Felius J, Frazier M, Holmes JM, Hoover D, Klimek DA, Lorenzana I, Quinn GE, Repka MX, Suh DW, Tamkins S; Pediatric Eye Disease Investigator Group.
Am J Ophthalmol. 2007 Oct;144(4):487-96. Epub 2007 Aug 20.

The effect on refractive error of unilateral atropine as compared with patching for the treatment of amblyopia.
Repka MX, Melia M, Eibschitz-Tsimhoni M, London R, Magoon E; Pediatric Eye Disease Investigator Group.
J AAPOS. 2007 Jun;11(3):300-2.

Treatment of strabismic amblyopia with refractive correction.
Cotter SA, Edwards AR, Arnold RW, Astle WF, Barnhardt CN, Beck RW, Birch EE, Donahue SP, Everett DF, Felius J, Holmes JM, Kraker RT, Melia BM, Repka MX, Wallace DK, Weise KK; Pediatric Eye Disease Investigator Group.
Am J Ophthalmol. 2007 Jun;143(6):1060-3.

Stability of visual acuity improvement following discontinuation of amblyopia treatment in children aged 7 to 12 years.
Hertle RW, Scheiman MM, Beck RW, Chandler DL, Bacal DA, Birch E, Chu RH, Holmes JM, Klimek DL, Lee KA, Repka MX, Weakley DR Jr; Pediatric Eye Disease Investigator Group.
Arch Ophthalmol. 2007 May;125(5):655-9.

Factors associated with recurrence of amblyopia on cessation of patching.
Holmes JM, Melia M, Bradfield YS, Cruz OA, Forbes B; Pediatric Eye Disease Investigator Group.
Ophthalmology. 2007 Aug;114(8):1427-32. Epub 2007 Mar 23.

A symptom survey and quality of life questionnaire for nasolacrimal duct obstruction in children.
Holmes JM, Leske DA, Cole SR, Chandler DL, Repka MX; Nasolacrimal Duct Obstruction Questionnaire Study Group, Silbert DI, Tien DR, Bradley EA, Sala NA, Levin EM, Hoover DL, Klimek DL, Mohney BG, Laby DM, Lee KA, Enzenauer RW, Bacal DA, Mills MD, Beck RW; Pediatric Eye Disease Investigator Group.
Ophthalmology. 2006 Sep;113(9):1675-80. Epub 2006 Jul 7.

A randomized trial to evaluate 2 hours of daily patching for strabismic and anisometropic amblyopia in children.
Wallace DK; Pediatric Eye Disease Investigator Group, Edwards AR, Cotter SA, Beck RW, Arnold RW, Astle WF, Barnhardt CN, Birch EE, Donahue SP, Everett DF, Felius J, Holmes JM, Kraker RT, Melia M, Repka MX, Sala NA, Silbert DI, Weise KK.
Ophthalmology. 2006 Jun;113(6):904-12.

Treatment of anisometropic amblyopia in children with refractive correction.
Cotter SA; Pediatric Eye Disease Investigator Group, Edwards AR, Wallace DK, Beck RW, Arnold RW, Astle WF, Barnhardt CN, Birch EE, Donahue SP, Everett DF, Felius J, Holmes JM, Kraker RT, Melia M, Repka MX, Sala NA, Silbert DI, Weise KK.
Ophthalmology. 2006 Jun;113(6):895-903.

The effect of amblyopia therapy on ocular alignment.
Repka MX, Holmes JM, Melia BM, Beck RW, Gearinger MD, Tamkins SM, Wheeler DT; Pediatric Eye Disease Investigator Group.
J AAPOS. 2005 Dec;9(6):542-5.

A randomized pilot study of near activities versus non-near activities during patching therapy for amblyopia.
Holmes JM, Edwards AR, Beck RW, Arnold RW, Johnson DA, Klimek DL, Kraker RT, Lee KA, Lyon DW, Nosel ER, Repka MX, Sala NA, Silbert DI, Tamkins S; Pediatric Eye Disease Investigator Group.
J AAPOS. 2005 Apr;9(2):129-36.

Randomized trial of treatment of amblyopia in children aged 7 to 17 years.
Scheiman MM, Hertle RW, Beck RW, Edwards AR, Birch E, Cotter SA, Crouch ER Jr, Cruz OA, Davitt BV, Donahue S, Holmes JM, Lyon DW, Repka MX, Sala NA, Silbert DI, Suh DW, Tamkins SM; Pediatric Eye Disease Investigator Group.
Arch Ophthalmol. 2005 Apr;123(4):437-47.

Two-year follow-up of a 6-month randomized trial of atropine vs patching for treatment of moderate amblyopia in children.
Repka MX, Wallace DK, Beck RW, Kraker RT, Birch EE, Cotter SA, Donahue S, Everett DF, Hertle RW, Holmes JM, Quinn GE, Scheiman MM, Weakley DR; Pediatric Eye Disease Investigator Group.
Arch Ophthalmol. 2005 Feb;123(2):149-57.

A randomized trial of atropine regimens for treatment of moderate amblyopia in children.
Repka MX, Cotter SA, Beck RW, Kraker RT, Birch EE, Everett DF, Hertle RW, Holmes JM, Quinn GE, Sala NA, Scheiman MM, Stager DR Sr, Wallace DK; Pediatric Eye Disease Investigator Group.
Ophthalmology. 2004 Nov;111(11):2076-85.

Risk of amblyopia recurrence after cessation of treatment.
Holmes JM, Beck RW, Kraker RT, Astle WF, Birch EE, Cole SR, Cotter SA, Donahue S, Everett DF, Hertle RW, Keech RV, Paysse E, Quinn GF, Repka MX, Scheiman MM; Pediatric Eye Disease Investigator Group.
J AAPOS. 2004 Oct;8(5):420-8.

Recent advances in the treatment of amblyopia.
Quinn GE, Beck RW, Holmes JM, Repka MX; Pediatric Eye Disease Investigator Group.
Pediatrics. 2004 Jun;113(6):1800-2. No abstract available.

A prospective, pilot study of treatment of amblyopia in children 10 to <18>
Pediatric Eye Disease Investigator Group.
Am J Ophthalmol. 2004 Mar;137(3):581-3.

Impact of patching and atropine treatment on the child and family in the amblyopia treatment study.
Holmes JM, Beck RW, Kraker RT, Cole SR, Repka MX, Birch EE, Felius J, Christiansen SP, Coats DK, Kulp MT; Pediatric Eye Disease Investigator Group.
Arch Ophthalmol. 2003 Nov;121(11):1625-32.

A randomized trial of prescribed patching regimens for treatment of severe amblyopia in children.
Holmes JM, Kraker RT, Beck RW, Birch EE, Cotter SA, Everett DF, Hertle RW, Quinn GE, Repka MX, Scheiman MM, Wallace DK; Pediatric Eye Disease Investigator Group.
Ophthalmology. 2003 Nov;110(11):2075-87.

The course of moderate amblyopia treated with atropine in children: experience of the amblyopia treatment study.
Pediatric Eye Disease Investigator Group.
Am J Ophthalmol. 2003 Oct;136(4):630-9.

The course of moderate amblyopia treated with patching in children: experience of the amblyopia treatment study.
Pediatric Eye Disease Investigator Group.
Am J Ophthalmol. 2003 Oct;136(4):620-9.

A comparison of atropine and patching treatments for moderate amblyopia by patient age, cause of amblyopia, depth of amblyopia, and other factors.
Pediatric Eye Disease Investigator Group.
Ophthalmology. 2003 Aug;110(8):1632-7; discussion 1637-8.

A randomized trial of patching regimens for treatment of moderate amblyopia in children.
Repka MX, Beck RW, Holmes JM, Birch EE, Chandler DL, Cotter SA, Hertle RW, Kraker RT, Moke PS, Quinn GE, Scheiman MM; Pediatric Eye Disease Investigator Group.
Arch Ophthalmol. 2003 May;121(5):603-11.

Clinical research in pediatric ophthalmology: the Pediatric Eye Disease Investigator Group.
Beck RW.
Curr Opin Ophthalmol. 2002 Oct;13(5):337-40. Review.

The clinical profile of moderate amblyopia in children younger than 7 years.
Pediatric Eye Disease Investigator Group.
Arch Ophthalmol. 2002 Mar;120(3):281-7.

A randomized trial of atropine vs. patching for treatment of moderate amblyopia in children.
Pediatric Eye Disease Investigator Group..
Arch Ophthalmol. 2002 Mar;120(3):268-78.

The amblyopia treatment study visual acuity testing protocol.
Holmes JM, Beck RW, Repka MX, Leske DA, Kraker RT, Blair RC, Moke PS, Birch EE, Saunders RA, Hertle RW, Quinn GE, Simons KA, Miller JM; Pediatric Eye Disease Investigator Group.
Arch Ophthalmol. 2001 Sep;119(9):1345-53.

The Amblyopia Treatment Index.
Cole SR, Beck RW, Moke PS, Celano MP, Drews CD, Repka MX, Holmes JM, Birch EE, Kraker RT, Kip KE; Pediatric Eye Disease Investigator Group.
J AAPOS. 2001 Aug;5(4):250-4.

Academic Performance and Binocular Vision Dysfunctions/Vision Information Process

Saccade Control in Dyslexia: Development, Deficits, Training and Transfer to Reading Burkhart Fischer, Dipl Phys; Klaus Hartnegg, Dipl Phys
Optometry and Vision Development Volume 39, No. 4, 2008

Computerized Saccadic Eye Movement Therapy to Improve Oculomotor Control during Reading and Reading Rate in Adult Japanese Readersby Tomohito Okumura, MScOptom, MEd, FCOVD, FAAO, et. al.
Optometry and Vision Development Volume 39, No. 4, 2008

Filtered Text and Direction Discrimination Training Improved Reading Fluency for Both Dyslexic and Normal Readers Teri Lawton, PhD
Optometry and Vision Development Volume 39, No. 3, 2008

Subitizing and Visual Counting in Children with Problems in Acquiring Basic Arithmetic Skills Burkhart Fischer, Dipl. Phys., Christine Gebhardt, Dipl. Phys., and Klaus Hartnegg, Dipl. Phys.
Optometry and Vision Development Volume 39, No. 1, 2008

Effects of Daily Practice on Subitizing, Visual Counting, and Basic Arithmetic Skills Burkhart Fischer, Dipl. Phys., Christine Gebhardt, Dipl. Phys., and Klaus Hartnegg, Dipl. Phys.
Optometry and Vision Development Volume 39, No. 1, 2008

The Impact of Vergence and Accommodative Therapy on Reading Eye Movements and Reading Speedby Michael Gallaway, OD, FCOVD and Mark B. Boas, OD, MS
Optometry and Vision Development Volume 38, No. 3, 2007

Evaluating Changes in Quality of Life After Vision Therapy Using the COVD Quality of Life Outcomes Assessment by Kelly M. Daugherty, OD, et. al.
Optometry and Vision Development Volume 38, No. 2, 2007

The Effects of HTS Vision Therapy Conducted in a School Setting on Reading Skills in Third and Fourth Grade Students David Goss, O.D., Ph.D., FAAO, FCOVD-A, et. al.
Optometry and Vision Development Volume 38, No. 1, 2007

A Study of the Effectiveness of Cognitive Skill Therapy Delivered in a Video Game Format Don Helms, O.D., and Sara M. Sawtelle, Ph.D.
Optometry and Vision Development Volume 38, No. 1, 2007

Training Direction-Discrimination Sensitivity Remediates a Wide Spectrum of Reading Skills Teri Lawton, Ph.D.
Optometry and Vision Development Volume 38, No. 1, 2007

Is there a common linkage among reading comprehension, visual attention, and magnocellular processing?
Solan HA, Shelley-Tremblay JF, Hansen PC, Larson S.
J Learn Disabil. 2007 May-Jun;40(3):270-8.

M-cell deficit and reading disability: a preliminary study of the effects of temporal vision-processing therapy.
Solan HA, Shelley-Tremblay J, Hansen PC, Silverman ME, Larson S, Ficarra A.
Optometry. 2004 Oct;75(10):640-50.

Visual deficits and dyslexia.
Solan HA.
J Learn Disabil. 1999 Jul-Aug;32(4):282-3. No abstract available.

Role of visual attention in cognitive control of oculomotor readiness in students with reading disabilities.
Solan HA, Larson S, Shelley-Tremblay J, Ficarra A, Silverman M.
J Learn Disabil. 2001 Mar-Apr;34(2):107-18.

Effect of attention therapy on reading comprehension.
Solan HA, Shelley-Tremblay J, Ficarra A, Silverman M, Larson S.
J Learn Disabil. 2003 Nov-Dec;36(6):556-63.

Coherent motion threshold measurements for M-cell deficit differ for above- and below-average readers.
Solan HA, Hansen PC, Shelley-Tremblay J, Ficarra A.
Optometry. 2003 Nov;74(11):727-34.

Eye movements and speed reading.
Solan HA.
J Am Optom Assoc. 1999 Jul;70(7):435. No abstract available.

Eye movement efficiency in normal and reading disabled elementary school children: effects of varying luminance and wavelength.
Solan HA, Ficarra A, Brannan JR, Rucker F.
J Am Optom Assoc. 1998 Jul;69(7):455-64.

Effect of luminance on visual evoked potential amplitudes in normal and disabled readers.
Brannan JR, Solan HA, Ficarra AP, Ong E.
Optom Vis Sci. 1998 Apr;75(4):279-83.

Frequency of convergence insufficiency in optometry clinic settings. Convergence Insufficiency and Reading Study (CIRS) Group.
Rouse MW, Hyman L, Hussein M, Solan H.
Optom Vis Sci. 1998 Feb;75(2):88-96.

Transient and sustained processing: effects of varying luminance and wavelength on reading comprehension.
Solan HA, Brannan JR, Ficarra A, Byne R.
J Am Optom Assoc. 1997 Aug;68(8):503-10.
PMID: 9279050 [PubMed - indexed for MEDLINE]
Dyslexia and learning disabilities: an overview.
Solan HA.
Optom Vis Sci. 1993 May;70(5):343-7. Review.

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