I’ve heard a wide range of opinions on optometry from both professionals and the general public. Most people report positive experiences with their eye doctor, but there are still some misconceptions and skepticism—especially when it comes to vision therapy and its effectiveness.
Optometrists have been referred to as doctors that push prescription glasses just to make more money, I have heard people say, “if you go in, they will tell you there is something wrong with your eyesight even if you can see just fine.”
Eye exercises are often met with doubt. Do they actually work? Is there any real benefit? Even within the healthcare field, some professionals question the effectiveness of vision therapy altogether.
People frequently ask me, “Can you really train the visual system?” It’s a fair question—and one that deserves a clear answer. Not all optometrists are the same, and not all approaches to vision care are equal. Let’s dig a little deeper.
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Types of Optometrists and Their Roles
Understanding the different types of optometrists helps clarify where vision therapy effectiveness fits within the broader field of eye care. Not all optometrists offer the same services, and some specialize in very specific aspects of visual health.
1. General or Primary Care Optometrists
Role: Provide comprehensive eye exams, diagnose common eye problems, and prescribe glasses and contact lenses.
Focus: Routine vision care and minor eye conditions.
2. Pediatric Optometrists
Role: Specialize in eye care for children and adolescents.
Focus: Early detection and management of vision issues like amblyopia (lazy eye), strabismus (crossed eyes), and developmental visual delays.
3. Geriatric Optometrists
Role: Focus on eye care for older adults.
Focus: Managing age-related vision changes and conditions such as cataracts, macular degeneration, and glaucoma.
4. Behavioral or Developmental Optometrists / Vision Therapy Specialists
Role: Address how vision affects learning, behavior, and coordination, particularly in relation to motor control, balance, and sensory integration.
Focus: Treat binocular vision disorders, tracking problems, and visual-motor issues—often through customized vision therapy programs. These non-surgical therapies aim to improve visual function, including conditions like convergence insufficiency and poor eye teaming.
5. Low Vision Optometrists
Role: Help patients with significant visual impairments that cannot be corrected with standard glasses or contact lenses.
Focus: Prescribe visual aids and adaptive devices to enhance daily functioning. Often collaborate with occupational therapists and low vision specialists.
6. Specialty Contact Lens Optometrists
Role: Fit complex or custom contact lenses for challenging conditions.
Focus: Manage conditions such as keratoconus, post-surgical corneas, or severe dry eye using therapeutic lenses.
7. Medical Optometrists
Role: Diagnose and manage ocular diseases, often working in tandem with ophthalmologists.
Focus: Conditions like glaucoma, diabetic retinopathy, uveitis, and eye infections, as well as post-surgical care.
8. Neuro-Optometrists
Role: Specialize in visual disorders stemming from brain injury or neurological disease.
Focus: Address visual complications related to concussions, strokes, multiple sclerosis, and brain tumors through therapies like vision therapy, prism lenses, and multidisciplinary rehabilitation.
“Do all optometrists get the same education?
Erin Jubas COVT Owner/Educator ABC VT
The simple answer is NO. Not all optometry schools are created equal.”
Inside Vision Therapy Practice
It should be clear that optometry is more than meets the eye (pun intended). Optometry schools expose students to all areas of the field, from general care to specialties—but only one branch truly checks all the boxes (yes, I’m biased).
Many students stumble into the world of Behavioral Optometry through powerful personal experiences. These practitioners understand there’s more to vision than just eye health and refractive error. In my opinion and experience, optometrists who specialize in vision therapy are some of the most passionate and dedicated people you’ll ever meet.
Doctors who open vision therapy practices often develop their programs from the ground up—driven by deep knowledge of the visual system, intuition, and sheer grit. They may deliver therapy sessions themselves or train skilled vision therapists to work alongside them.
Vision Therapists: Key Players in Patient Success
Vision therapists are educated not only in how the visual system functions physiologically, but also how it develops and adapts. With enough experience, these professionals can pursue certification as vision therapists, becoming key extensions of the optometrist and vital guides in a patient’s journey toward better visual function.
Who Provides Vision Therapy?
Vision therapy effectiveness begins with the professionals behind it. Optometry doctors with extensive knowledge of the visual system work one-on-one with patients to design and implement therapy programs.
When possible, these doctors train vision therapists to carry out the customized procedures chosen for each individual—based on comprehensive optometric findings and perceptual testing.
This testing determines their level of ability and functionality of their visual system and guides the doctor or therapist to design a program based on each patient’s specific needs and deficits compared to normative data.
There is no school dedicated to train the art of vision therapy procedures. The doctors typically educate vision therapists on their custom VT program designed by the doctor or with the help of mentors and the experience/education of those that came before them.
A Complex, Multidisciplinary Knowledge Base
The learning curve is steep. There are a multitude of concepts to learn, including eye anatomy/function, neurology of the visual system, concepts of oculomotor development and skills, binocular vision/dysfunctions, accommodation ability/facility, bilateral body integration, visual vestibular, traumatic brain injury, sports vision training, and occasionally primitive reflexes. We are educated about all visual diagnoses and can work with any patient demographic with the help of the optometrist.
How Vision Therapy Works
A typical program reflects the individualized nature of effective vision therapy. No two clinics will offer the exact same approach. Most programs include 30–60 minutes of in-office therapy weekly, conducted one-on-one with a doctor or vision therapist. Patients are also prescribed home-based reinforcement activities to complete 3–4 times per week.
Some practices integrate virtual reality, computer-based tools, sports vision training, or primitive reflex integration—others do it all. Despite this diversity, the core goal remains consistent: improve functional vision through structured, targeted exercises.
What Does A Typical Vision Therapy Program Look Like?
Vision therapy programs are personalized and often evolve over time based on patient progress. Most last around six months, with structured phases to support development and reinforce lasting change.
Phase One: Building Visual Awareness and Control
Many programs last an average of 6 months with progress evaluations along the way to determine progress. The first 3 months is focused on developing the visual processing (the pathway from the eyes to the perception of vision in the brain), and control of the motor aspect of the visual system (eye coordination) We use open ended questions designed to help the patient learn how they make their eyes and body move. We want them to develop the ability to communicate what they see and feel and learn control.
Phase Two: Stabilizing and Expanding Visual Skills
The second three months aim to stabilize newly developed visual abilities and deepen visual-motor integration. This phase introduces higher-level visual tasks combined with other sensory systems like balance and spatial movement.
To challenge and strengthen the system, we use accommodative lenses and prisms to create new visual experiences. This helps patients adapt, improve resilience, and perform complex visual tasks with greater ease.
The End Goal: Reduced Visual Stress
Ultimately, the purpose of a vision therapy program is to reduce stress on the visual system and improve the patient’s quality of life. This personalized, whole-body approach is a major reason why vision therapy effectiveness is both measurable and meaningful for so many patients.
Vision Therapy Effectiveness: Why Do Patients See Results?
An inefficient visual system will cause stress and create a multitude of symptoms. Many symptoms’ patients report are related to vision:
– pain behind the eyes,
– headache,
– dizziness,
– double vision,
– eye fatigue,
– brain fatigue,
– inability to advance in school,
– blurry vision (all the time, intermittent, in one eye only…),
– clumsiness,
– lack of attention,
– nausea with visual tasks
… the list is long.
Vision Is Everywhere in Daily Life
We integrate vision into everything we do in the VT room because vision is in nearly everything we do in our daily lives. Think about something you do that doesn’t involve vision. I’ve tried and still can’t think of an example. There is always a visual component. But think of the most complex task you do, and I guarantee vision is essential.
Seeing Clearly Is Not the Same as Having Good Vision
There is huge difference between seeing clearly and vision. I think this is something that has created some confusion with patients and other professionals. Sight is how clearly you can see. You need to be able to see up close, far into the distance and everything in between. If you are unable to see clearly you may have a refractive error that can be corrected with prescription glasses, contact lenses or surgery.
“There is huge difference between seeing clearly and vision.”
Erin Jubas COVT Owner/Educator ABC VT
Alternatively, you may have an accommodative dysfunction (your ability to make a target clear and focus or relax that focus isn’t functioning appropriately). If the refractive error is corrected and there are still symptoms of discomfort, or the issues go beyond seeing clearly, we have entered the world of behavioral optometry. How the patient coordinates eye movements have to do with brain and we train it.
When we begin vision therapy, we make sure the patient has goals and a reason to do VT. Without this we don’t have compliance. Without compliance we don’t have participation, and this is very similar to going to the gym- if you don’t practice you won’t get better.
Vision Therapy Is the Gym for Your Brain and Eyes
Going to the eye doctor is like getting a gym membership. You get the exam, you get the glasses prescription if there is one, but you need to do more to resolve the underlying issues. Vision therapy is the gym. If you go to the gym consistently you will see change- it is very nearly guaranteed.
If you practice using your eyes and your brain and your body together, vision therapy effectiveness becomes visible over time. VT works. We do it all. If you practice, you will improve awareness and ability. If you do nothing…
Vision Therapy Addresses Multiple Areas of Development
Vision therapy effectiveness depends on its ability to address multiple systems—visual, motor, cognitive, and sensory. That’s why no two programs look exactly alike and why results can be life-changing when done properly.
“When I became a vision therapist in 2008 I had no idea how to describe what my job was. I tried to tell my family that vision therapy was like physical therapy for the eyes and brain. And I still hear people say that. Now when people ask me what vision therapy is, I ask if they really want to know and how much time they have. 17 years later, certified in VT, and dedicated to helping vision therapists and doctors fully understand the incredible we work do so they can work with any patient.”
Erin Jubas COVT Owner/Educator ABC VT LLC
“If you didn’t know what VT was, I hope you do now.
If you still have questions, how much time do you have? ”
