Vision Therapy ControversyBy: Carmen Willings
teachingvisuallyimpaired.com Revised June 25, 2025 What is Vision Therapy?A subset of optometrists—known as developmental or behavioral optometrists—have practiced vision therapy for decades. Also referred to as vision training, this individualized, supervised treatment program is primarily used for children (and sometimes adults) with binocular vision problems. These include:
What is the Controversy?Vision therapy is generally prescribed by optometrists, not medical doctors or ophthalmologists. While some individual cases report success, many ophthalmologists question its overall effectiveness, citing a lack of rigorous, peer-reviewed research and few randomized, controlled trials supporting the therapy's benefits.
Additional concerns include:
Do Schools provide Vision Therapy?Vision therapy is a clinical service provided by licensed vision therapists or optometrists, not by Teachers of Students with Visual Impairments (TVIs). It is generally not part of school-based services, although school districts may choose to fund outside therapy on a case-by-case basis.
Under IDEA and the Every Student Succeeds Act (ESSA), schools are required to use evidence-based educational practices. Since vision therapy lacks a strong body of scientific evidence, it is not considered an educational intervention and is not provided by TVIs. Note: A few states, such as California, do employ vision therapists as part of school services. These professionals are separate from TVIs. Vision Therapy and the IEPVision therapy is typically considered a medical service, and as such, is excluded from IEPs in most states. If a family chooses to pursue therapy, it should be arranged privately through an optometrist or vision therapy clinic.
It’s important to distinguish between vision therapy and visual efficiency training. TVIs do provide instruction in visual efficiency skills (such as using residual vision effectively), and this instruction can be included in a student’s IEP as part of the Expanded Core Curriculum. Accommodations in the ClassroomWhile students receiving vision therapy may not require or qualify for special education under the category of visual impairment, accommodations may still be helpful in the classroom. Such accommodations are usually simple to implement and may be recommended by the student’s optometrist. These might include:
Sources & Position PapersThis summary draws from resources including:
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History of Visual Impairments
Professional Practice
Vision Professionals
Professionalism
Teacher Resources
Professional Publications
VI Book Resources
Family Resources
VI Referrals
Medical vision exams
visual diagnosis
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