All About Strabismus
by Dr. Jeffrey Cooper & Rachel Cooper (no relation). © 2001-2009
Treatment Options
Strabismus Surgery
Orthoptics -- Pre- and/or post-surgical
Vision Therapy --Non-surgical or in conjunction with surgery, as appropriate.
Orthoptics
Orthoptics is the medical term for eye muscle training procedures, provided by orthoptists and/or optometrists, which address eye teaming and visual clarity (acuity) only. Technically, there are broad distinctions between Orthoptics and Vision Therapy (which includes Orthoptics). Orthoptics regards strabimus as an eye muscle problem and treatment is directed toward muscle strength. Optometrists who provide Vision Therapy look at the neurological control system of the eyes and thus treat the whole visual system (and whole person). Vision Therapy alters the entire nervous system and reflexive behavior, thus resulting in a lasting cure. In general, orthoptics is home-based therapy. In general, Vision Therapy is performed under supervision in an optometrist's office and home therapy is an adjunct. Recent scientific research has shown that office-based Vision Therapy with homework is more successful than home-based therapy alone. See National Eye Institute: More Effective Treatment Identified for Common Childhood Vision Disorder
Vision Therapy
Vision Therapy is an individualized, supervised, non-surgical treatment program designed to correct eye movements and visual-motor deficiencies. Vision Therapy sessions include procedures designed to enhance the brain's ability to control:
- eye alignment,
- eye teaming,
- eye focusing abilities,
- eye movements, and/or
- visual processing.
Visual-motor skills and endurance are developed through the use of specialized computer and optical devices, including therapeutic lenses, prisms, and filters. During the final stages of therapy, the patient's newly acquired visual skills are reinforced and made automatic through repetition and by integration with motor and cognitive skills.
While Vision Therapy includes the eye muscle training methods of orthoptics, it has advanced far beyond it to include training and rehabilitation of the eye-brain connections involved in vision. Clinical and research developments in Vision Therapy were closely allied with developments in neuroscience during the twentieth century. Research continues in the 21st century.
In Vision Therapy programs, optometrists look at the neurological control system and thus are treating the whole visual-motor system and altering reflexive behavior, which results in a lasting cure. Also, most optometrists rely on office based therapy, which they believe is more accurately performed and monitored.
Vision Therapy for strabismus generally consists of either weekly or bi-weekly office based therapy. Some doctors reinforce in-office therapy with home therapy. This is based upon a case-by-case determination. Milder intermittent cases may be handled with home therapy. Older children are generally more cooperative and thus obtain a greater benefit from therapy.
To learn more about Vision Therapy, go to: Interview with an Eye Doctor and What is Vision Therapy? and Find a Doctor
A Parent's Choice: Choosing Between Surgery or Vision Therapy
Read what several parents and adult patients have written about choosing Vision Therapy and/or surgery at success without strabismus surgery and comments on strabismus surgery.
