Point/Counterpoint 4 Vision Therapy at Home

Mark Menezes, BSc(Hons) Optom
Gregory Kitchener, OD


Optometric vision training/therapy (VT) comprises therapeutic optometric procedures that are used to modify visual function.1 Office-based VT typically involves one to three visits to the office each week. The question is whether these in-office visits are sufficient on their own or whether practice at home is a necessary part of a VT program.





Birnbaum advocated seeing patients twice a week in- office, as he found this produced better results in a shorter period of time. In his experience, the benefits of this modality of treatment became more readily visible to both patients and parents, resulting in better compliance. Birnbaum felt that home practice was a foundation of therapy and reinforcement of skills learnt between in-office sessions.2 Peachey talks of seeing patients in-office either once or twice a week, supported whenever possible by home practice of 15-30 minutes daily. A VT program without home practice would be considered a compromise.


 The assignment of specific VT procedures to be completed as “homework” is frequently included in descriptions of VT.1-6 The primary rationale for this inclusion seems to be that if repetition is a necessary element of the therapy, more repetition through homework is better. Naturally enough, this follows a line of thought in the field of education where acceptance of homework as an element of school programs is nearly universal. Our personal experience with required homework in our formal schooling may have established a model that we glibly adapt to our VT programs.







While optometrists did not originate the concept of homework, if we are going to exploit the practice, we should understand it. Although little research is available on the role of homework in VT, there is some research on perceptual learning, and there is significant literature on the efficacy of homework in educational programs.