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The History of Vision Therapy

Over 3,600 years ago, ancient Egyptians wrote of the treatment for eye muscle disorders. Written during the time of Moses, the Ebers Papyrus of 1700 B.C. states; "For turning of eyes, equal parts of tortoise brain and oriental spices rubbed up together". Don't worry, our clinic is all out of oriental spice, so you won't be given this treatment!

No mention of further treatment choices was made until 600 A.D. when eye muscle masks were used. The masks were hoods that encouraged the straightening of the eyes to see out of the holes simultaneously. It is hard to believe any child would wear these hideous masks for long. Use of them was suggested again in 1509 by Ambrose Pare, the father of modern surgery.

In 1863, an innovative physiological optics engineer from France, Emile Javal, revolutionized eye therapy by inventing a techniques which was designed to retrain the brain to interpret signals from the eye.

His father had crossed eyes. Surgery caused them to become wall-eyed and unleveled giving him a hideous appearance. Javal's younger sister, Sophie, inherited the crossed-eyes. Naturally, they were reluctant to operate on Sophie.

The success of Javal's technique was vastly improved compared to the eye muscle masks. In fact, his programs were the treatment of choice until about 50 years ago, when 'behavioral vision' programs were designed.

Traditional Visual Therapy, Orthoptics

During the 1930's, "Orthoptic therapy" began to be used in the United States. In this method, frequently called "traditional eye exercises", a patient visited the orthoptist three or more times a week.

Various large cast iron instruments were used in a dark room to stimulate use of the eyes. Children were seated for twenty minutes at a time at machines which crossed and uncrossed the eyes.

Many of these early apparatuses showed depth perception and 3 Dimensional pictures for the first time. Others monitered the brain's shutting off of an eye (suppression) by flashing lights before the offending eye so fast the brain did not have time to ignore them.

The procedures required expensive instruments which were difficult to master. The results were generally satisfactory for the intended use. As a consequence, this type of visual therapy gained wide acceptance among optometrists and ophthalmologists alike.In fact, Orthoptic therapy is still a popular program in some parts of the country.

Developmental Visual Perceptual Therapy

In the 1970's, Dr. Nathan Flax, Professor at the State University of New York (SUNY), Optometry school had an inspirational idea. He noted that many children improved their performance in school and sports activities after Orthopic therapy.

Other children did not improve as much. In an effort to understand this he looked to see it visual therapy could be effecting skills other than sensory input.

Why did Aaron's reading level shoot up while Timmy's didn't? What did the muscle exercises have to do with reading ability?

Eye doctors all over the United States were seeing improvements in their patients that were not explainable by eye movement, focusing, and eye teaming abilities alone.

A restless man and a perfectionist, Dr. Flax's need for complete understanding became an obsession.

The Value of Persistence

Like many puzzles, the answer seemed to be within his grasp only to slip away. To crawl into these children's brains and interpret the changes in their eyesight was impossible. A lesser man would have quit a thousand times. But Dr. Flax persisted, and persisted, and persisted.

He tried searching the Optometric literature. He used computers to seek out articles in the National Medical Libraries that could give him that clue as to what was going on in the brains of Aaron and Timmy.

The main problem was that those who saw the miraculous results of visual therapy lacked the background of child development and education. Those with expertise in education knew nothing of vision and visual therapy.

Finally, the clue he had been looking for.

Dr. Flax Visits a School Psychologist

An inspiration occurred to Dr. Flax while reviewing a school psychological report of one of his patients. The Psychologist tested to see if the child's brain was interpreting the images from the eyes correctly. He was testing Perceptual processing.

Could it be that eye muscle exercises were affecting Visual perceptual skills? Fervently he reviewed the literature on perceptual testing and function in children. Although he found much reference to measurement of abilities there was no information on how to remediate lags in perceptual development.

The puzzle was coming together. If he could match specific perceptual skills to specific visual therapy procedures, he could cure conditions resulting in school failure!

'Visual Therapy-A Major Advance

A tremendous breakthrough in visual therapy had occurred. Dr. Flax could correct specific visual perceptual dysfunction with specific visual therapy procedures.

Children with normal IQs doomed to failure could succeed! Johnny could to read. Timmy could learn to read. And no surgery or drugs or pain!

Dr. Flax had indeed solved the problem of why many children improved in school following orthopic therapy while others did not.

He called his new program Visual Perceptual Therapy.

Orthoptics and visual perceptual therapy are used today by thousands of eye doctors to the benefit of many patients. Over a million people can thank Dr. Javal and Dr. Flax for their foresight and efforts in contributing to today's modern visual therapy programs.

Peter Shaw-McMinn, O.D.

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Written for Our Blog on Oct 17, 2014


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