People often ask what type of activities are performed in Vision Therapy. Here are some common Vision Therapy activities that meet the therapeutic needs of many visual challenges.
- Hart Chart – This activity can be used for visual attention, eye movements, and accommodation. The patient will typically be instructed to use one small chart and one large chart, as pictured here, and stands about 10 feet from the larger chart while holding the smaller chart. The center of the chart on the wall (the larger one) should be at eye level with the patient. During this activity, the patient alternates reading from the larger and smaller chart.
- a. For accommodation issues, the smaller chart may be held at arm’s length, then brought as close as possible before images appear blurry, or the chart may be moved slowly closer as the patient reads.
- b. For eye movements, only the distance chart is used and the patient is asked to alternate reading letters from 2 columns.
- Brock String – This activity exercises convergence and divergence ability. One end of the string is typically tied to a door knob. The beads (one green, one red, and one yellow) are on the string and the patient is asked where he sees the string cross while focusing on a particular bead.
The position that the patient sees the strings crossing provides feedback for the therapist. The patient will experience the feeling of converging and diverging, giving the therapist feedback as to whether both eyes are working together.
- Marsden Ball – With this activity, the patient will utilize accurate eye movements while incorporating peripheral awareness and eye-hand coordination. This is a fun activity which allows for visual attention as the patient reads the letters in motion.
The ball will typically be hung from the ceiling and brought to a height below eye level. The patient will stand slightly behind the ball and one eye will be patched. The patient will typically be asked to tap the ball and call out the letter he is hitting.
- Tondel Arrows – This activity exercises convergence and divergence ability. This allows for vergence improvement, after initial training with the Brock String, by training precise eye alignment as patient perceives arrow heads touching.
Tondel’s Arrows consist of a card with 6 pairs of arrows, and the arrow heads from each pair are touching. This card is held as shown in the picture below.
The patient is typically asked to focus on each pair of arrows while holding the card at their nose.
- Lifesaver Card – This activity helps to develop and maintain accurate binocular skills of convergence and divergence. A transparent or opaque lifesaver card is used, depending on whether the patient is unable to diverge or converge their eyes and maintain that eye posture comfortably.
Difficulty increases as the patient goes up the chart, where the lifesavers are farther apart.
The patient will be instructed to hold the card at eye level.
All the above Vision Therapy activities can be simplified (unloaded) or made more difficult (loaded) depending on specifications of the patient’s customized VT program.
These activities must be prescribed and monitored by a Behavioral Optometrist.
Please note: In-office, Optometric Vision therapy, under the direction of a Behavioral Optometrist using prisms, filters and lenses, as used with our patients, is far more effective than home-based therapy.