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Posted on 07-03-2016

Does Vision Therapy Help Myopia?

Originally published 8/28/2013:

This question came up on a parent support list.  Many parents are looking for trying to understand why their child is going near-sighted, and what options are available.  Thoughts and comments welcome!


girl-with-glasses-reduced

"My 5 year-old daughter has been diagnosed with myopia that is progressing very quickly, as well as basic esophoria, accommodative insufficiency and accommodative spasm. She began reading right when she turned 3, and now I have been told that has most likely caused these issues - too much time spent looking close up.
Can anyone tell me if they have tried vision therapy for these conditions (or most specifically the myopia)?"







It might help if you look at myopia as a SYMPTOM of the vision problem, rather than as the problem itself.


The visual system has made an adaptation based on how it is being used. Your daughter has placed so much interest in working at near-point that her eyes have become specialized for this function.


The question is not whether you can treat the myopia directly, but whether you can prevent or minimize progression by helping your daughter learn how to be flexible. This is flexibility in focusing and relaxing focus, flexibility in converging and diverging the eyes, and flexibility to work with both the focusing and eye-teaming systems in tandem.


Your goal should not be to reduce the myopia (although some degree of prescription reduction is common). You are looking to support your daughter to change the cycle which is causing myopia progression.


There is a strong correlation between parents having myopia and their children developing myopia. But this may not be purely genetic!  It may be from habits, which are learned (often from our parents), AND from personality traits which impact how we function. These traits may also be inherited (like tenacity!). So, identifying a HEREDITARY COMPONENT does not mean that her genes have been encoded to make her myopic no matter what. There is always a FUNCTIONAL COMPONENT as well.


Behavioral/developmental optometrists prescribe glasses for near-point (perhaps bifocals) and may prescribe activities to improve flexibility of vision function in order to stabilize and support the visual system at the problem area. The problem is visual dysfunction at near-point. The symptom is myopia (near-sightedness).  If the problem is addressed, the progression of myopia will come under control.  In some cases, the patient may even learn to function with a lower prescription.


In studies which do show a very positive impact from the prescription of bifocals in reducing myopia progression, the greatest effect is found in those who have ACCOMMODATIVE EXCESS (spasm) and ESOPHORIA at near-point. This implies that your daughter is among those with a strong FUNCTIONAL COMPONENT... therefore, highly remediable!


I would recommend finding a behavioral/developmental optometrist who can assess whether it is a good idea to try therapy now, or to just monitor closely with some glasses prescription changing, and initiate therapy if she is showing progression.


Best of luck!


Samantha Slotnick, O.D., F.A.A.O., F.C.O.V.D.

6 comments on “Does Vision Therapy Help Myopia?
  1. Vilma says:

    Hi,
    My 13 year old daughter had perfect vision through age 8. Suddenly, her vision changed and progressed very quickly (in 3 years) to -6.00 and -6.50. Two years ago, we learned she had sugar issues and that this was likely the cause of her vision issues early on. We were then told the test of the problem was that she was given glasses she probably didn’t need. That and the sugar problem took her to -6.00. Her sugar is under control now – mainly through diet and exercise. Her vision has not gotten worse either, but she is left with -6.00 and -6.50. She also cannot see up close. She sees things clearly at 4 inches from her face. Could vision therapy and vision exercises bring down her prescription?

    • Hi Vilma,
      Thank you for writing.

      I’m sorry to hear your daughter is having such a challenging time.

      Generally speaking, vision therapy is aimed at remediating problems in how efficiently and effectively a person uses their visual system. The purpose of vision therapy is not to reduce prescription power, although this may be a side-effect of increased flexibility in the focusing system.

      The first step should be a thorough evaluation with a behavioral optometrist, to determine if there are visual skills in need of support. Your daughter may have problems with focusing and/or eye coordination. Her high prescription may have evolved due to a struggle with using her vision at near-point, and not having enough focusing ability or focusing flexibility to do the work on her own. If this is the case, there is probably room for improvement and stability.

      Co-existing problems, such as “sugar issues,” as you describe, may complicate the visual status, but would not be a barrier to improvement with vision therapy.

      We would be happy to evaluate your daughters’ visual system and provide more specific insight following her exam!

      If you need to find a doc in your area, you can look for other visual function experts at covd.org or oepf.org.
      Best wishes,
      Dr. Slotnick

  2. Bhuvaneswari Nagalingam says:

    Hi,
    My daughter is 4 yr old. She was diagnosed as myopia L -3.5 R -3.25. We need to cure it. Is it possible to cure myopia through eye exercise without wearing glasses?
    If so please give me the details I will start train my kid through eye exercise.

    Eagerly waiting for ur answer.
    Thanks in advance
    Bhuvana

  3. saket says:

    hiii iam 20 year old i suffer from mayopia i have L .75 R.75. plz tell me some way to remove maopia…

    • Hello,
      That is a very low prescription. You may start by reading and working on your computer without your glasses, as your natural eye power is now like wearing mild reading glasses.
      In addition, I strongly recommend you have your vision evaluated by a behavioral or developmental optometrist. Our colleagues are trained to help support vision development. You may find one on http://www.covd.org or http://www.oepf.org.
      I hope this is helpful.
      Sincerely,
      Dr. Samantha Slotnick

If you have additional questions or comments about how to manage myopia progression please share your thoughts!  

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