An OT’s Role in Vision Therapy

Posted on January 12th, 2013 by Denise | No Comments

An OT’s Role in Vision Therapy


Denise Koonce OTR


Visual perception or visual perceptual processing can be divided into two components, visual – reception or visual-efficiency and visual cognition. Visual reception or efficiency is how the eye takes in the information it sees.   Visual cognition is how the brain interprets, applies and stores the information for use.  In vision therapy an occupational therapist can work independently on helping a client improve their visual perceptual skills or they can work in conjunction with a developmental optometrist (DO).   The DO can assess the visual efficiency of the eye by assessing the health and oculomotor aspects of the eye.  If a visual efficiency deficit exists then the developmental optometrist can prescribe lenses, optometric intervention or visual therapy components.  An OT and DO together can provide a patient a full range of treatment for visual perceptual processing deficits.  Below I have listed the general role of an OT in vision therapy. 

The visual receptive or efficiency areas an occupational therapist can provide supportive services and assist through patient education are for low vision, visual acuity, nystagmus, refractive conditions, and binocular disorders – strabismic and non-strabismic.  All therapists involved in the child’s care should encourage the patient’s prescribed eye glass or eye patch wearing schedule during therapy and their daily routine.  The treating occupational therapist can provide parents, caregivers, and educators information regarding setting up an appropriate environment to minimize visual eye strain as well as secondary uncomfortable conditions or impairments.    

The visual efficiency areas an occupational therapist can provide compensatory services are visual field deficits, low vision, and nystagmus.  Compensatory techniques for someone with a visual field deficit might include teaching the individual to use scanning techniques, provide markers for activities such as reading or in the environment so the patient can determine the edge of an activity.  Compensatory techniques for low vision or nystagmus could include the use of larger print, magnification, the use of contrasting colors on labels and areas of environment, modifying work distances and altered lighting. 

The visual efficiency areas an occupational therapist can provide direct services along with a consulting optometrist are ocular motility disorders such as problems with fixation, saccades, pursuits, poor tracking and scanning, poor divergence or convergence; binocular vision disorders – strabismic, non-strabismic and amblyopia; and accommodative disorders.  Numerous visual therapy techniques can be used to improve the visual efficiency in these populations.  Some of the techniques or activities may include:  Hart Chart Saccades, numerous tracking sheets and activities, flashlight and penlight activities, tracing activities and mazes, puzzles, and a suspended ball to name a few. 

Once visual efficiency has been addressed and progress made you can begin to work on the visual cognitive aspect of visual processing.   The visual cognitive aspects of visual processing include visual attention, visual memory, discrimination and the integration of the visual stimulus along with the other sensory systems.  These are common treatment areas especially for a pediatric sensory integrative therapist and heavily entwined in a sensory integrative approach. 

The team approach to vision therapy that includes an occupational therapist and a developmental optometrist can be very thorough and productive for the patient.  Many occupational therapists have experience in treating the visual cognitive aspects of visual processing but may desire to have additional training in the visual efficiency aspects of vision therapy.   There are excellent continuing education courses offered specifically for therapists on vision therapy and vision related treatment approaches.  This education will enhance your skills as a therapist, offering you a “bigger bag of tricks” and therefore provide a broader treatment perspective.  Share with us some of your vision therapy experiences both in treatment and education.

Continuing Education Providers in the area of Managing Visual Deficits

                Vision Education Seminars

                Professional Developmental Programs


Please note that some resources used for the content of this blog are from books written and courses given by Mitchell Scheiman, O.D., FCOVD including the book Understanding and Managing Vision Deficits: A Guide for Occupational Therapists, 2002.

Leave a Reply

You must be logged in to post a comment.