Vision Therapy - Areas of Training

The vast majority of children we see with learning difficulties have problems with accommodation, ability to converge, smooth eye tracking, knowing right from left, and visual memory and auditory skills.

1. Eye Movements

Eye movements require the highest level of precision in the human body. This skill allows rapid and accurate shifting of the eyes in all directions of gaze.

Image Source: Code Exercise

There are two types of eye movement:

  • Following or pursuit eye movements (reading along a line)
  • Jump, point to point eye movements called saccades (jumping from one line to the next)

Difficulties with eye movement tracking can result in: sore eyes, poor form reproduction, poor letter formation and spacing between letters, poor printing or handwriting, poor eye hand coordination, loss of place when reading, skipping and omitting words, skipping lines or sentences, copying is difficult and slow, slow processing speed, and changed body posture so that eyes are excessively close to the page when reading or writing.

2. Accommodation

This is the ability to change focus from near to far and vice versa, similar to a camera finding its focus. Accommodation infacility is the technical term for when the eyes struggle with doing this, and experience blur. This skill is used constantly in daily life, such as copying from board to book, watching the road ahead to checking the speedometer, reading a book to looking up and talking to someone across the room, etc.

3. Convergence/Divergence

This is the ability for the eyes to come together when looking at something close, and moving apart when looking at something further away. Ideally, this skill should work so well that no interference exists between the two eyes. However, when there is a lack of movement in one direction or another, this can result in double vision, sore eyes, headaches, or suppression of one eye.

In turn, this can cause:

  • avoidance of near work,
  • lowered text understanding and speed,
  • increases fatigue and distractibility,
  • and shortened attention span.

Image Source: Minesota Vision Therapy Centre

4. Vision Movement

Many children perform academic tasks inadequately because they have not mastered the control of movement. It is through movement that the child develops knowledge of same and not-same, more or less, up or down, near or far, and direction and sequence. General movement is the foundation of discriminative movements of eyes and hands, which in turn must be well developed to allow efficient writing. Movement leads to an awareness of self sidedness (laterality) and eventually to awareness of sidedness of space that is not self (directionality).

4. Laterality and Directionality

Both of these are crucial components of visual spatial skills, which are important as when a child begins to learn at school where everything is directional and they must always start on the left side and work in the same direction from left to right. It is also important to realize that letters have different names when they face different directions (such as b, d, p, q). Reduced visual spatial skills can lead to reversals when reading and writing i.e. read ‘was’ as ‘saw’, or write alphanumeric symbols in reverse.

Image Source:

5. Visual Memory

Visual memory and Visual sequential memory are associated with spelling and reading ability. Memory is much easier if you can accurately analyze the stimulus with the eyes. Sequential analysis is essential for phonetic decoding of words and for comprehension when reading.

Image Source:

5. Visual Auditory

Visual auditory skills are essential for reading and spelling. First, they enable the child to receive and recall oral communication effectively. Second, they make it possible for the child to be aware of the individual sounds that will be represented by letters when they start to learn to read and write. When learning to read, children first learn to discriminate the letters of the alphabet and recognize them as distinctly different symbols. Then, they must also ‘map’ sounds onto these letters i.e. attaching certain sounds to letters or combinations of letters.