Vision Therapy For ADHD.

I recently came across an article in the NY Times that speaks of using vision therapy to correct problems in children like learning disabilities and ADHD.  The article explores the divide that exists between what mainstream medical practitioners think and optometrists think when it comes to vision therapy.  Most of the health practitioners who practice vision therapy for leaning disabilities happen to be optometrists.

Behavioral optometry, as it is called when optometrists focus on these types of conditions, is a growing field within optometry.  This is similar to my own chiropractic profession in which regulated subspecialties like neurology, radiology and nutrition have emerged over the last 20 years or so.  Behavioral optometrists use eye exercises to improve conditions such as ADHD, Autism, learning disabilities and even neck pain.

Mainstream medicine, of course, finds this abhorrently offensive because it does not fit into their own paradigm of drug therapy.  To them, everything that can be known is known and anything ‘outside the box’ is without a doubt wrong and probably dangerous.  As a matter of fact, they will often tell you if you seek these treatments the practitioners offering it are ‘quacks’ and are out to steal your money.  This may sound harsh, but it is not an exaggeration.  I have heard it many times from my patients who were unsuccessfully lobbied by their primary care doctors to stop seeing me for their treatments.

Eye exercises along with other modalities is something that we use with regularity to treat children with a range of conditions that includes ADHD, Autism and other learning disabilities.  It is extremely successful.  Many doctors will say that there is no scientific research that shows it works.  Takes this quote for instance.

“It has no validity,” says Marshall Keys, a Rockville, Md., pediatric and adolescent ophthalmologist who is an outspoken critic of vision therapy.

Dr. Keys clearly has not picked up a neurology text in a very long time. The fact that they eyes and the brain act as virtually one entity is well known.  If they eyes do not work properly the brain cannot process information correctly.  If the brain is not working properly it cannot control the eyes.  The connection is easy to understand.  Try this simple demostration:

Stand up and put your feet together and with your eyes open look up at the ceiling and roll your head in several circles.  Now repeat this with your eyes closed.  It was much easier to stand and roll your head in circles with your eyes open wasn’t it?  You felt more stable with your eyes open.  Why?  Because you depend very heavily on your eyes for your sense of balance.  When you close your eyes you rely solely on the information coming from your inner ear and the receptors in the joints of your legs and spine.  Without the input from your eyes, your brain finds it slightly more difficult to process information.  Now extrapolate this to reading, writing, attention, etc.  Is it not easy to see that if you had an issue with your eyes or your brain that these tasks might be difficult to perform?

I do take exception to one thing in behavioral optometry.  They tend to attribute everything to a problem with the eyes.  While this is the case many times, just as many cases are problems in the brain.  I have seen many children with learning disabilities and sometimes the problem is with the eyes and sometimes it’s in the brain.  The treatments, however, are similar.  You must retrain the eyes or the brain.  To do so eye exercises, light therapy, sound therapy, vestibular therapy, cognitive visualization and balance exercises are applied to name a few.  This, when applied correctly and specifically, corrects the underlying issue.  It is really very amazing.

The brain is an amazing environment, but it is not perfect.  It makes mistakes and can under function just like other parts of the body.  When this happens it needs to be rehabilitated.  This rehabilitation is a simple process, but often requires months to be effective.  This is because of the very nature of the brain.  While it is malleable, it resists change.  A perfect example is trying to master a new skill.  You can’t master it overnight.  It takes many hours of repetition before the skill has been mastered.  Rehabilitating the brain is similar.  Exercises must be done over and over again in order to reap the rewards and see benefit in the end.  People are often frustrated at the pace of therapy, but are extremely pleased with the overall results.  You wouldn’t expect to be able to run a marathon after training for a month would you? The brain is very similar to a muscle.  It must be trained and maintained to function at its very best.  When it isn’t working well, training is the only way to fix it.

If you have a child that is having trouble in school have someone who is trained in functional neurology examine them.  A great website with a list of doctors is www.acnb.org.  They have a doctor locator in which you can put your address and zip code in and find all of the doctors within a defined radius.  If you ask your pediatrician for advice, your child will end up on drugs that have dangerous, even lethal side effects with no prospect of producing any permanent benefits.  Functional brain rehabilitation is the only way to permanently change the function of a child’s brain.

3 Comments

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3 responses to “Vision Therapy For ADHD.

  1. Thanks for a fair look at optometric vision therapy. I would just like to point out a few things:

    1.) OVT used to be called vision training, visual therapy, and even “eye exercises”. It is really “therapy” that changes the way the brain interacts with the world. You’ve kept up to date on the research in neuroplasticity…so you are aware of this and I won’t go into more detail. If you’d like an optometric viewpoint on neuroplasticity, however, I invite you to read Maino D. Neuroplasticity: Teaching an Old Brain New Tricks. Rev Optom 2009. 46(1):62-64,66-70 by going to http://www.revoptom.com/continuing_education/tabviewtest/lessonid/106025/.

    2.) Although our ophthalmology colleagues continue to claim this…optometry has not stated that OVT treats learning disabilities for decades. We do say that we treat “learning related vision problems”. Now if the OMD could only get that right!

    3.) When you are trained as a hammer…the solution always seems to be “hit something”….so when optometry or any other profession may appear to look at and then treat these problems from a “vision is everything” angle it is probably understandable. You will, however, find that most of us actually use the skills of special educators, psychologists, occupational therapist…and yes, even Chiropractic practitioners….in the treatment of our patients.

    4.) I would also suggest that your patients go to http://www.covd.org to find a Board Certified optometrist in the area of pediatrics and optometric vision therapy…and…

    5.) Go to http://www.MainosMemos.blogspot.com to find out the latest in children’s vision research….

    Questions? Feel free to contact me at dmaino@ico.edu

    Dominick M. Maino, OD, MEd, FAAO, FCOVD-A
    Professor, Pediatrics/Binocular Vision
    Illinois Eye Institute/Illinois College of Optometry

  2. FYI….I posted an edited blurb about what you said about OVT….and suggested they come to your blog to read the whole commentary….my blog is at http://www.MainosMemos.blogspot.com

    Thanks…

  3. Dr. Michael Margaretten

    “Once established by the hallmark of authority, it takes more than facts to change one’s mind. It takes time.”

    Daniel Defoe
    Journal of the Year of the Plague

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