The way a person’s eyes move, collaborate, and focus can have an impact on their ability to read, absorb, and comprehend information. Deficits in any of these areas, according to studies, might cause major learning difficulties. These issues can be overcome with vision treatment, which improves the ability to read and learn.
- loss of vision as a result of a concussion, stroke, or injury (see VISION REHABILITATION)
So what is vision therapy?
Vision therapy is a type of neuromuscular retraining; it’s similar to physical therapy for the eyes! Vision Therapy is defined by the American Optometric Association (AOA) as
“a series of activities prescribed and monitored by a doctor in order to build effective visual skills and processing.”
It entails a personalized treatment plan that aims to improve the brain’s ability to control: visual-motorand/or perceptual-cognitive deficits.
Each patient’s vision therapy program at Advanced Family Vision Care is personalized to address their specific visual deficits and is based on the findings of standardized testing. The vision therapy program includes the use of lenses, prisms, filters, specialized instruments, and computer programs.
Vision entails much more than being able to see 20/20. If you suspect you have a vision problem, the first step is to schedule a full eye exam, followed by specialist developmental vision testing to assess visual skills and abilities that are necessary for reading, learning, and everyday life. A vision therapy treatment program will be recommended if indicated to satisfy the patient’s and/or family’s customized goals.
Is Vision Therapy Covered by my Insurance?
Yes, in a lot of circumstances. Vision therapy services are covered by several major insurance companies (such as BlueCross BlueShield, United, Aetna, and others). The following factors influence vision therapy insurance coverage:
Dr. May and Dr. Cioffi are among the few optometrists in Maryland who take insurance for vision treatment; Advanced Family Vision Care personnel will work with you to determine coverage choices and the best course of action.
When vision therapy is covered by insurance, each session normally comes with a co-pay (usually the same as your regular medical payment) or co-insurance (if that is part of your plan). Vision therapy services, like any other form of medical treatment, count toward your annual medical deductible; if you have not met your deductible, you may be charged additional fees in addition to your co-pay/co-insurance.
What will my treatment be like?
A full eye health exam including a refraction is always performed before a vision therapy evaluation to guarantee overall eye health and identify the necessity for glasses or contact lenses. After a thorough examination, Dr. May or Dr. Cioffi will do specialized sensorimotor testing to assess eye teaming, eye movement, and concentrating abilities. If necessary, additional testing to assess visual perceptual ability will be conducted.
Dr. May or Dr. Cioffi will develop a treatment plan tailored for you after a complete evaluation to address your symptoms and diagnoses. Once a week, therapy sessions are held in the office and last around 45 minutes. You will be given “home treatment” to perform between sessions, which will aid in facilitating and expediting your progress so that you can successfully complete your in-office therapy program. The doctor will re-evaluate your visual skills every six to eight sessions in order to track your progress and guide your therapy program. Following the end of your therapy program, the doctor will re-evaluate your visualskills at one month and again at six months to ensure that no gains are lost once the program is over.
Can Vision Therapy treat Attention Deficit Hyperactivity Disorder (ADHD)?
NO, Vision Therapy is not a treatment or a cure for Attention Deficit Hyperactivity Disorder (ADHD) or Attention Deficit Hyperactivity Disorder (ADD/ADHD) (ADD). There is, however, a link between ADHD/ADD and visual function. Convergence insufficiency (CI), a common vision problem that affects 13% of school-aged children, with symptoms that are similar to those of ADHD. If left unchecked, CI might be mistaken for ADHD. In fact, a recent study from the University of San Diego’s Children’s Eye Center discovered
“… a three-fold higher frequency of ADHD among individuals with CI as compared to the overall US population’s incidence of ADHD” (1.8-3.3 percent ).
In addition, there appears to be a three-fold higher frequency of CI in the ADHD population.”
When CI or another type of visual impairment is present, vision therapy can typically considerably lessen symptoms, if not fully eradicate them.
What health insurance covers vision therapy?
Vision therapy is a treatment for children who are having difficulty reading or performing well in school. Medical doctors (ophthalmologists – MDs) rarely recommend this treatment; instead, optometrists (ODs) who specialize in this field do. Many ophthalmologists tell their patients that vision treatment has little value, and while there are few randomized, controlled trials that show this, there may be some circumstances when vision therapy is beneficial. We offer limited forms of vision therapy at Boston Children’s Hospital, and we’re getting ready to conduct trials to try to scientifically validate these treatments.
Vision therapy for tracking, focussing, and eye teaming challenges has been practiced by a subset of optometrists known as developmental/behavioral optometrists for decades. Only a few credible scientific research on the effectiveness of vision therapy have been conducted, resulting in a low level of global acceptance of such treatment choices among all vision care specialists. We are in the process of establishing research that will help us better understand the efficacy of vision therapy, particularly in terms of vision and learning, as Dr. Hunter indicated. It’s also worth noting that eyesight is only one aspect of reading and learning. While it is critical to rule out substantial vision deficits in children with learning difficulties, other behavioral, cognitive, and social learning aspects must also be investigated.
Children who are struggling in school may be assessed by a nurse or occupational therapist and found to have problems with eye tracking or other functions. The first step in these situations is to undergo a comprehensive eye examination. If an issue is discovered, the eye doctor may refer you for a vision therapy evaluation.
A full eye exam and binocular vision screening can help to identify conditions that could benefit from vision therapy treatment. Following medical diseases have been checked out and a proper medical examination of the eye has been conducted, some frequent symptoms of people who might benefit from vision therapy include:
Vision therapy is a set of eye exercises designed to improve the quality and efficiency of one’s vision. It’s also known as vision therapy. Vision therapy improves the efficiency of your eyes, allowing you to do daily tasks such as reading and writing more efficiently.
Despite the fact that vision treatment is commonly referred to as “orthoptics,” we do not use that term. An orthoptist is a doctor who specializes in assessing strabismus patients’ ocular movement and binocular function (misaligned eyes). Many orthoptists collaborate with our ophthalmologists at Children’s Hospital and may recommend exercises for specific types of strabismus. Optometrists are the ones who prescribe various sorts of vision therapy, not orthoptists.
Difficulties with eye tracking skills, such as fixation, pursuits, and saccades, are referred to as oculomotor problems. Fixation is the capacity to stare at a stationary target for an extended period of time. The capacity to keep staring at a moving target is referred to as pursuits. Saccades are the capacity to quickly and precisely change fixation from one target to another. Saccades, for example, are very useful when reading.
Difficulties with the eye’s focusing function are known as accommodative problems. Among the accommodative issues are difficulties focusing precisely during close work and transitioning concentration from distant to near efficiently.
Problems with eye teaming abilities are referred to as vergence problems. Convergence insufficiency, which occurs when the eyes do not work well together, is an example of this. One of the most frequent visual impairments that can be corrected with vision therapy is convergence insufficiency.
Both in-office and at-home activities are part of vision treatment. After a problem has been recognized, a set of exercises tailored to the person will be created to improve visual function. A typical program will consist of six one-hour vision treatment sessions spaced out over three weeks. At each in-office visit, the patient will be given instructions and materials for the exercises, which should be done at home for around 20-30 minutes five days a week. The final office session is a progress evaluation, which evaluates how far you’ve come in therapy. At that point, it will be assessed whether or not additional workouts are required.
As previously stated, there has been much debate among specialists over the efficacy of vision therapy. This is owing to a lack of consistency in the scientific literature and insufficient study designs. A recent National Eye Institute (NEI)-funded study using multi-center, randomized, double-blind clinical trials found that office-based vision therapy was successful in 75 percent of patients with convergence insufficiency (eye teaming difficulty), with normal or significantly improved symptoms. In children, office-based therapy proved to be more effective than home-based and placebo therapy.
While vision therapy definitely helps with amblyopia (wearing an eye patch improves vision in the “lazy” eye) and convergence insufficiency (as Dr. Raghuram points out), there aren’t many clinical trials that support it to the point where it’s been embraced by the ophthalmology community. However, we do see a lot of kids with eye tracking, accommodation, and vergence issues, and we’ve seen a lot of them benefit from some of these treatments. We offer examination and, in certain situations, treatment, or referral to tutors or other experts in learning or neuropsychological development in order to help children who may be suffering in school due to one of these issues. Dr. Raghuram is also working on research protocols to compare vision therapy to a placebo treatment in patients who are willing to participate in the study. The goal is to either confirm or invalidate many of the prevalent vision therapy approaches in the future.
How much does visual therapy cost?
A Vision Therapy Center representative will present the patient and/or the patient’s legal guardian(s) with the results of the testing as well as our doctor’s recommended treatment plan during a free 90-minute Patient Education Visit.
The Patient Education Visit is designed to give you plenty of time to talk about your test results and treatment plan, as well as to answer any concerns you may have.
Treatment
The cost of vision therapy sessions is $152, but the total cost will vary based on the eyesight impairment. The cost of treatment might range from $1,000 to $7,000. During the Patient Education Visit, you will be fully informed about your expenditures.
We’re very aware of the cost of this program, especially given that many people pay for it themselves. Given the amount of people we’ve treated and the lives we’ve changed, it’s no surprise that many of our patients believe the treatment costs were well worth the investment.
Why is eye therapy not covered by insurance?
We’d like to highlight an article from The College of Optometrists in Vision Development for today’s blog post (COVD). It’s a great resource for dealing with insurance companies about vision therapy coverage, such as Vision Restoration Therapy or NeuroEyeCoach.
Vision therapy is used to treat vision problems that have been identified. Vision Therapy may be the only available and effective therapy option for certain disorders in some circumstances. Major medical insurance policies might cover this treatment. As a cost-cutting tactic, some insurance companies and managed care plans may deny or severely limit reimbursement for Vision Therapy services.
You, the consumer and/or patient, have the right to request a review of any service that is denied coverage or for which coverage is severely limited under all types of medical insurance policies. You should seriously consider asking a review if you believe your plan has erroneously reviewed your claim for coverage, acted arbitrarily, or discriminated unfairly in determining coverage.
Steps to Take When Requesting a Reconsideration of a Coverage Denial for Vision Therapy
1. First, look over your medical plan’s Explanation of Benefits booklet to see if there’s anything in there concerning Vision Therapy or Orthotics being covered or not. Overage for certain services is explicitly prohibited in some plans.
Some plans may not cover Vision Therapy for educational issues including learning difficulties, dyslexia, and so on. The treatment of learning disabilities and dyslexia is an educational issue that is not covered by large medical insurance. However, acquiring coverage for Vision Therapy, which is the treatment of a diagnosed vision condition, should not be a problem.
2. Request a formal statement explaining why coverage was denied or limited. If a corporation or plan makes an arbitrary declaration that Vision Therapy is not considered medically necessary or helpful in treating the diagnosed problem, demand documentation to back up that claim.
The effectiveness of Vision Therapy/Orthoptics has been supported by numerous research studies and clinical reports. Unfortunately, this material may not have been vetted by your insurance company or plan.
3. Some insurance plans may state that the treatments were assessed by a “medical consultant” who advised against covering the services. You may want to inquire about the consultant’s qualifications, particularly in the area of determination (i.e., was it a Doctor of Optometry?).
It is standard medical procedure to have doubts about the medical need or appropriateness of treatment examined by a “medical peer,” another doctor with similar training and experience in the area of care. True “peer review” did not occur if the claim for Vision Therapy services was not assessed by an optometrist who also delivers these services.
The College of Optometrists in Vision Development (COVD) is a worldwide organization that certifies doctors who provide Vision Therapy services. Fellows of COVD (FCOVD) are Vision Development and Therapy Board Certified. You can have your claim examined by a Fellow of the College of Optometrists in Vision Development or the College’s Peer Review Committee to get authentic peer review services for Vision Therapy.
4. When claims are denied because the insurance company or their consultant believes there isn’t enough research to back up Vision Therapy’s effectiveness, providing documentation of available research may result in coverage approval.
5. If your claim for Vision Therapy is still denied after going through the previous steps, you may wish to investigate the following options:
- If your employer provides medical insurance, bring the situation to the notice of your company’s Employment Benefits Manager and request his or her aid.
- If you bought your own insurance, contact your agent and ask for assistance in getting your claim settled.
- Consider filing a complaint with the office of your state commissioner of insurance if you are unable to get a satisfactory resolution to your claim.
It’s crucial to realize that your insurance company’s refusal to pay for certain treatments does not negate the need for therapy. Consult your doctor about payment options that may be available to you or your family to help you get the care you need.
Is vision therapy proven?
The brain and the eyes make up the visual system, and the eyes are actually physical extensions of the brain!
Most binocular vision disorders, according to eye experts, are caused by issues with the eye-brain connectionthe brain’s processing of visual information received through the eyes, also known as visual processing.
Is vision therapy legitimate?
Vision therapy is based on the idea that many learning impairments in children are caused by vision issues that can be remedied with eye exercises. Vision therapy has been labeled a pseudoscience and its practice as quackery due to a lack of scientific evidence.
Vision therapy is a broad term that refers to a variety of therapeutic options. These include treatments for convergence insufficiency (commonly referred to as “vergence therapy” or “orthoptic therapy”), as well as for a wide range of neurological, educational, and spatial issues.
Is vision therapy worth the money?
Computer-based vision therapy is not beneficial in the treatment of convergence insufficiency, according to current studies. In reality, it proved less successful than the placebo (false) therapy used as a control. Poor visual habits can be embedded via computer-based vision therapy.
How long does it take for vision therapy to work?
When it comes to vision therapy, how long does it take to see results? It’s vital to remember that vision therapy’s goal is to enhance functionality rather than total healing. Gains can be felt fairly quickly for some folks. Others may need up to six months or more to see meaningful improvements.
What is done in vision therapy?
Optometrists use the term “vision therapy.” Vision therapy is defined by optometrists as an attempt to build or improve visual skills and talents, as well as to increase visual comfort, ease, and efficiency, as well as to alter visual processing or interpretation of visual information.
Does Medicare pay for vision therapy?
Medical insurance is covered through Medicare Part B. Some vision care is covered by Medicare Part B, but not routine vision tests. Unless you need vision correction following cataract surgery, Medicare Part B does not cover vision correction such as eyeglasses or contact lenses. Refractions are likewise not covered by Medicare Part B.
For patients who are at high risk of glaucoma, Medicare Part B pays yearly glaucoma screenings. Patients with a family history of glaucoma, African Americans 50 and older, Hispanic Americans 65 and older, and diabetics are all at high risk. Only state-approved vision care doctors are allowed to administer glaucoma screenings on a yearly basis. Subject to your annual Medicare deductible, you pay the 20% Medicare coinsurance for vision care expenditures allowed by Medicare.
Cataract surgery is covered under Medicare Part B vision benefits. Following cataract surgery, Medicare pays the cost of an artificial lens to replace the lens that has been impacted by cataracts, as well as the cost of vision correction items such as glasses with standard frames. Subject to your annual Medicare deductible, you pay the 20% Medicare coinsurance for the amount allowed by Medicare.
Eye prostheses are covered by Medicare Part B vision insurance for individuals who have lost or shrunk their eyes due to a birth defect, trauma, or surgical removal. Under the vision benefits of Medicare Part B, polishing and resurfacing of vision prosthesis are covered twice a year, as well as one expansion or reduction in size of prostheses without documentation. Only when medically necessary are additional enlargements or reductions covered. If a vision prosthesis is lost, stolen, or permanently destroyed within the first five years, Medicare will cover the cost of replacement.
Ocular photodynamic therapy with verteporfin, which is a treatment for people with macular degeneration, a vision impairment caused by aging, is covered by Medicare Part B.