About Vision Therapy

Facts and Fallacies, by VisionHelp, is a site that provides accurate information about vision therapy.  Written by leading optometric experts in the field of developmental vision, Facts and Fallacies is dedicated to debunking the myths and misrepresentations about vision therapy that occur in the media or through misinformed professionals and other groups.

 

Learn more about the authors here.

 

REALITY CHECKS

The Snake Oil Myth

The Expensive Treatment Myth

 

The Snake Oil Myth

Claim

Vision Therapy is unproven and unscientific

 

Status

FALSE

 

Origin

Therapy helps many areas of our function, such as speech therapy, physical therapy and occupational therapy. But a group of doctors got together and decided that therapy can’t improve vision, and that vision has little if anything to do with learning. If that sounds pretty goofy to you, it’s because it is.

 

The Myth and the Media

In 1972 several medical organizations put out a Joint Organizational Policy Statement on Vision, Learning and Dyslexia. It was this policy statement that encouraged pediatricians and ophthalmologists (eye surgeons) to draw illogical conclusions about optometric vision therapy. It has been re-circulated in various forms, and continues to this day to rely on flawed and outdated information.

 

When physicians want to discredit something, particularly if they feel it’s embarrassing not to be able to explain it, the simplest approach is to characterize it as “bogus” or “snake oil”. A prime example of this can be viewed here.

 

The Snake Oil Argument against vision therapy has been criticized by a prominent neurologist as well as by another physician who served as a consultant to the President's Council on Bioethics, because of the propensity of Policy Statements by organized medicine to misinform than inform”.

 

A recent article publish ed in the March 14, 2010 edition of the New York Times Sunday Magazine, available here.

 

The faulty logic here can be seen in the comments following the article, available here.

 

Evidence Against the Snake Oil Myth

Dr. Kenneth Ciuffreda, one of the world’s foremost vision researchers, has written a scholarly paper on the scientific basis of optometric vision therapy. The snake oil critics are ignorant of this paper. Dr. Harold Solan, one of the world’s leading authorities on the visual aspects of learning disabilities, has written a review article on the subject in a multidisciplinary journal about learning disabilities. Again, the snake oil myth crowd chooses to overlook this evidence.

 

Dr. Paul Romano, a medical critic of vision therapy, acknowledged the poor track record of ophthalmologists in this area: “There is no doubt in my mind that the exams most orthoptists, ophthalmic technicians and ophthalmologists, including pediatric ophthalmologists, perform for the learning disabled or the dyslexic child are too often inadequate or incomplete and are unable to find these subtle abnormalities of monocular and binocular vision which may give rise to these problems.”

 

The American Optometric Association has published Clinical Practice Guidelines. Even a cursory reading of these guidelines makes it clear that the snake oil notion about vision therapy is nonsense. The definitive and accurate picture about vision therapy is available as a Joint Organizational Policy Statement of the American Academy of Optometry and the American Optometric Association.

 

The snake oil myth critics claim that vision therapy isn’t appropriate for learning problems because learning problems are rooted in the brain and not in the eyes. This is an intentional distortion of the issue, as reviewed in a document from the American Optometric Association on vision as a collaboration between the eyes and the brain.

 

Variants of the Snake Oil Myth

The most common variant is the ad hominen attack on optometrists leveled by ophthalmology: “If vision therapy had any substance to it, ophthalmologists (eye surgeons) would be doing it. Since we don’t do it, it must be proof that it doesn’t work.”

 

Here’s the rub with that argument: ophthalmologists aren’t trained in optometric vision therapy and know very little about it (see the admisstion by Dr. Paul Romano cited in section V). An example of an online forum in which this variant of the myth occurs is:

 

http:// forums.studentdoctor.net/showthread.php?t=709092

 

The forum makes this statement: “Vision therapy is costly, and optometrists who do it are biased because they stand to make a lot of money from it.”

 

That’s a pretty odd argument, isn’t it? After all, when a physician recommends eye muscle surgery or cataract surgery that requires an out-of-pocket expense on your part, does that mean you should doubt the surgeon’s motive in suggesting the procedure? Another variant of the snake oil myth is that vision therapy is practiced by a fringe group, as if it were some sort of cult. The illogic of this is borne out by the information we’ve cited from the American Optometric Association, which is the country’s largest optometric organization.

 

Acknowledgements

Dr. Stan Appelbaum
Dr. Merrill Bowan
Dr. Kenneth Ciuffreda
Dr. Brock Eide
Dr. Fernette Eide
Dr. Rochelle Mozlin
Dr. Leonard Press
Dr. Harold Solan
The American Optometric Association
The American Academy of Optometry
The College of Optometrists in Vision Development
The Optometric Extension Program Foundation

 

Sources

The references for items cited above


1. The American Optometric Association regarding vision therapy: http://aoa.org/x5411.xml
2. The College of Optometrists in Vision Development regarding vision therapy:
http://covd.org/ResearchWhitePapers/tabid/188/Default.aspx
http://covd.org/Home/AboutVisionTherapy/tabid/71/Default.aspx
3. Eide F, Eide B. More vision wars: Visual training for dyslexics. Eide Neurolearning Blog. August 3, 2009. Available at: http://eideneurolearningblog.blogspot.com
4. Dr. Rochelle Mozlin on evidence regarding vision therapy:
http://covdblog.wordpress.com/2010/03/17/where-is-the-evidence/
5. Dr. Leonard Press on frequently asked questions about vision therapy and on the bias of snake oil myth critics:
http://visiontherapy.org/vision-therapy/faqs/vision-therapy-FAQs.html
http://www.sovoto.com/profiles/blogs/behavioral-economics
6. Dr. Merrill Bowan’s rebuttal of Medical Policy Statements against Vision Therapy, in a peer-reviewed journal: Bowan MD. Learning disabilities, dyslexia, and vision: a subject review. A rebuttal literature review and commentary. Optometry 2002; 73:553-
7. Clinical Practice Guidelines from the American Optometric Association are available at:
http://aoa.org/x4813.xml
The relevant guidelines are:
Care of the Patient with Learning Related Vision Problems (CPG20)
2000 | Revised 2008
Care of the Patient with Accommodative and Vergence Dysfunction (CPG18)
1998 | Reviewed 2006
Pediatric Eye and Vision Examination (CPG2)
1994 | 2nd Edition 2002 | Reviewed 2007
Care of Patient with Amblyopia (CPG4)
1994 | Revised 1998 | Reviewed 2004
Care of the Patient with Strabismus: Esotropia and Exotropia (CPG12)
1995 | Revised 1999 | Reviewed 2004
8. American Optometric Assocation white paper on Vision: A collaboration of eyes and brain, is available at: http://www.aoa.org/x5417.xml
9. Ciuffreda KJ. The scientific basis for and efficacy of optometric vision therapy in nonstrabismic accommodative and vergence disorders. Optometry 2002;73(12):735-
10. Solan HA. Learning-related vision problems: How visual processing affects reading efficiency. Learning Disabilties 2004;13(1):25-32.
11. Romano PE. Optometric vision therapy and training for learning disabilities and dyslexia. Binoc Vis Strabismus Qtrly. 2002; 17(1):12-14.
12. Joint Organizational Policy Statement of the American Academy of Optometry and the American Optometric Association on Vision, Learning and Dyslexia, is available at: http://aoa.org/x5420.xml
13. The following is a Resolution on Vision and Learning Disability passed by the House of Delegates of the American Optometric Assocation: