title: Efferent Vision Therapy.
abstract: BACKGROUND
  Traditional orthoptic therapy used by ophthalmologists, orthoptists, and optometrists is directed at improving visual acuity, ocular alignment, or both. For example, convergence exercises are used to treat convergence insufficiency (CI). However, other forms of "vision therapy" are directed at improving "visual processing and efficiency." The therapeutic regimen often entails repetitive ocular motor tasks performed during multiple office visits with a behavioral optometrist. These ocular motor tasks are used to treat diverse conditions such as learning disabilities, poor reading ability, dyslexia, and attention-deficit hyperactivity disorder (ADHD). Evidence regarding the efficacy of therapy directed at ocular motility for the treatment of multiple conditions is reviewed.
  
  
  METHODS
  Review of literature.
  
  
  RESULTS
  Randomized, controlled, double-masked studies show that convergence exercises reduce symptoms and improve signs of CI in otherwise healthy patients. However, the most efficacious convergence tasks, and the optimal duration and frequency of these tasks, remain unknown. Patients with learning disabilities, poor reading ability, dyslexia, or ADHD do not consistently have unique ocular motor deficits. Patients who acquire ocular motor deficits do not develop these conditions. There are no randomized, controlled studies that show treatment consisting of repetitive ocular motor tasks improves learning disabilities, reading, dyslexia, or ADHD.
  
  
  CONCLUSIONS
  Convergence exercises effectively treat CI in healthy patients. The optimal treatment regimen is unknown. There is insufficient evidence to recommend "vision therapy" for the treatment of learning disabilities, impaired reading, dyslexia, or ADHD.
authors.affiliation: Department of Neurology (JCR), New York University School of Medicine, New York, New York; and Department of Ophthalmology (PHP), University of Arkansas Medical Center, Little Rock, Arkansas.
authors.forename: Janet C
authors.initials: JC
authors.lastname: Rucker
authors.forename: Paul H
authors.initials: PH
authors.lastname: Phillips
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000503:physiopathology / Q000628:therapy; D004410:Dyslexia / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D015835:Ocular Motility Disorders / Q000503:physiopathology / Q000628:therapy*; D009988:Orthoptics / Q000379:methods*; D011932:Reading; D015354:Vision, Low / Q000503:physiopathology / Q000628:therapy*