Vision Therapy: Occupational Therapy’s Role

NeuroRehab Team
Thursday, August 14th, 2025

vision therapy

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Vision and occupational therapy address a major health concern that affects millions of Americans. The United States has about 12 million people over 40 who struggle with vision impairment. This includes one million blind individuals, three million who still have vision problems even with correction, and eight million who need but don’t have vision correction.

Vision problems affect people of every age group. About 25% of children have vision issues that hurt their performance at school. The numbers get worse as people age. Only 1% of people in their late 60s have poor vision, but this jumps to 17% for those over 80. Vision disability also ranks among the top 10 disabilities that adults over 18 face.

Occupational therapy gives adults with low vision proven ways to improve their daily life quality. Research shows that this therapy works well for older adults who face vision challenges. These patients often struggle more with daily tasks and experience higher rates of depression and anxiety than other elderly people. Occupational therapists use special techniques, adaptive equipment, and changes to the environment. These methods help people with low vision move around more safely and comfortably in their surroundings.

Understanding Vision Therapy and Occupational Therapy

What is vision therapy?

Vision therapy is a specialized treatment program that develops and improves visual skills and abilities. Eye doctors mainly oversee these sessions that go beyond simple eye exercises to boost brain-eye communication and help the visual system work better ^[1]. A complete vision therapy program includes tailored exercises done at the clinic through weekly 30-60 minute sessions. Patients also practice exercises at home ^[1].

The treatment uses several tools like therapeutic lenses, prisms, filters, patches, electronic targets, and balance boards ^[1]. Vision therapy helps with many conditions including convergence insufficiency, amblyopia (lazy eye), strabismus (crossed eyes), focusing problems, and visual processing issues ^[1].

How occupational therapy supports visual function

Occupational therapy helps people with visual impairments through rehabilitation techniques to guide their daily activities. These therapists review how vision problems affect a person’s tasks and adjust environments to reduce limitations ^[2].

The therapists teach strategies to work around visual deficits like loss of visual field, depth perception issues, glare sensitivity, and poor contrast perception ^[3]. Their training focuses on key visual skills such as eccentric viewing (using peripheral vision), visual tracking, and systematic visual scanning ^[2].

Differences between vision therapy and occupational therapy

Vision therapy and occupational therapy use different approaches to visual rehabilitation despite some overlap. Vision therapy works on improving eye movements, focusing abilities, eye teaming, peripheral vision processing, and visual-motor skills ^[4]. Occupational therapy takes a wider view by working on physical, cognitive, psychosocial, and sensory-perceptual aspects ^[5].

The professional training and tools create another key difference. Occupational therapists help people gain or regain abilities through sensory-motor exercises that improve coordination and awareness ^[1]. Vision therapy specialists can prescribe therapeutic lenses, filters, and prisms that substantially change how someone sees ^[6].

These two fields work well together. Eye doctors identify and treat vision problems that affect daily tasks, while occupational therapists help patients participate in meaningful activities ^[5]. This team approach often creates the best results for patients with visual impairments.

Key Occupational Therapy Interventions for Vision Rehab

Occupational therapists employ specialized techniques to help people with vision impairments make the most of their remaining sight and regain their independence. These interventions target visual function and daily living needs.

Eccentric viewing and visual scanning techniques

Eccentric viewing helps people with central vision loss use their peripheral vision well. Occupational therapists find each patient’s Preferred Retinal Location (PRL), which is different for everyone ^[7]. The technique teaches patients to look slightly away from objects to see them through clearer parts of their visual field. Regular practice helps patients “rewire their brains” and find the right viewing position naturally ^[7]. The technique feels strange at first, but patients get used to it quickly and see better results ^[8].

Visual scanning therapy (VST) shows patients how to adapt their eye movements and scan their surroundings systematically ^[9]. Patients who spend an hour each day on 5-6 weeks of VST sessions usually see improvements in their scanning accuracy, exploration times, and daily activities ^[9]. The benefits can last up to 8 months after treatment ^[9].

Use of adaptive equipment and assistive technology

Assistive technology plays a vital role in vision rehabilitation and improves independence and safety by a lot ^[10]. The available options range from simple to advanced solutions:

• Screen readers and magnification software that convert screen information into speech or larger text
• Braille keyboards, refreshable displays, and embossers
• Optical Character Recognition (OCR) systems that turn printed text into digital format
• Voice-activated assistants to manage calendars, create lists, and control smart home devices
• Talking or large-print devices such as calculators, watches, and scales ^[10]

Environmental modifications for safety and function

Environmental changes focus on better lighting, contrast, and organization. Good lighting combines natural light, overhead fixtures, and task lighting ^[11]. Strong contrast between objects helps people see where things begin and end ^[11]. On top of that, it helps to reduce visual clutter for patients with cortical visual impairments who find it hard to process multiple visual inputs at once ^[11].

Training in daily living tasks with low vision

Occupational therapists develop practical strategies for everyday activities. They teach patients to manage medications using tactile markers on bottles, cook safely with high-contrast cutting boards and marked appliances, and read better using proper magnification and lighting ^[12]. The core team also teaches specific techniques to improve mobility, including orientation training that helps vision-impaired people move safely in their surroundings ^[13].

Assessment and Planning in Vision Occupational Therapy

A full picture of vision problems forms the foundation of effective occupational therapy. OT assessments go beyond general vision screenings to understand how visual deficits affect daily activities.

First vision assessment in occupational therapy

Detailed vision assessments in occupational therapy go beyond simple visual acuity testing. OTs evaluate eye alignment, convergence, saccades, smooth pursuits, visual fields, distance, intermediate, and near acuity, plus contrast sensitivity ^[1]. The Brain Injury Visual Assessment Battery for Adults (biVABA) helps evaluate functional visual impairments with validated subtests ^[1].

OTs take a “look and listen” approach that combines functional observations with patient feedback. They watch for signs like head tilting, squinting, eye fatigue, and light sensitivity ^[1]. The Brain Injury Vision Symptom Survey (BIVSS) helps clinicians spot visual symptoms patients might miss ^[1].

Setting functional goals with clients

OTs create tailored rehabilitation goals after assessment. Good goals need purpose, meaning, function and achievable results ^[14]. Therapists use rating scales (0-3) to measure abilities in various activities where possible ^[14].

The goals target areas like medication management, meal preparation, reading, and financial tasks ^[14]. Research shows social participation tops the list of common goals, while instrumental daily living activities appear least often ^[15].

Working with optometrists and other specialists

Vision rehabilitation works best with coordinated teamwork. OTs and optometrists achieve better results through collaboration, especially for patients with special needs and vision problems ^[2].

Optometrists conduct detailed vision evaluations and prescribe exercises that OTs implement with supervision ^[1]. Patient outcomes improve when OTs focus on occupation-based interventions rather than isolated vision exercises ^[1]. Clear communication matters – optometrists should send summary reports with findings and recommendations to referring OTs ^[5].

Evidence-Based Outcomes and Case Applications

Research shows that occupational therapy helps people with low vision. A well-laid-out approach to improving visual function creates measurable results and enhances quality’s life directly.

What research says about OT in low vision rehab

Evidence strongly supports using multiple components in vision rehabilitation that equip patients with specific knowledge and skills to overcome visual limitations ^[16]. Multiple training sessions with low vision devices and special viewing techniques help improve daily activities effectively ^[17]. Customized, goal-directed interventions produce better outcomes than non-individualized approaches consistently ^[17].

A prospective study revealed 47% of adult patients who received vision rehabilitation achieved important clinical improvements in their overall visual ability within 6-9 months ^[18]. The study also showed 27-44% of patients experienced most important functional improvements in specific areas ^[18].

Case study: Improving independence through OT

A patient with post-stroke visual deficits participated in a well-laid-out vision therapy program that included ten one-hour sessions over four weeks ^[6]. The patient’s specific needs determined the intervention plan that included exercises to meet, fuse vision, and control eye movements ^[6]. The patient showed improved visual perseverance after completing the program, even with remaining mental fatigue ^[6].

The second case focused on an adult with small-angle esotropia. After 30 sessions of vision therapy and daily patching, the patient improved amblyopic eye visual acuity to 20/25 and learned how to appreciate stereopsis of 250″ ^[4].

Limitations and future directions in vision OT

Vision therapy research today has relatively small sample sizes, lacks control groups, or doesn’t describe interventions well enough ^[1]. Many occupational therapists don’t feel adequately prepared to handle oculomotor deficits ^[1].

Research priorities should focus on determining the best shared practices between OTs and optometrists ^[1]. The field shows promising growth – a 2019 survey revealed that 86% of vision therapy studies happened in the previous five years ^[1].

 

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Conclusion

Vision therapy occupational therapy helps millions of Americans with visual impairments of all ages. Specialized occupational therapy techniques have improved daily functioning and quality of life by a lot for people with vision challenges.

Occupational therapists do much more than traditional vision care providers. Their detailed approach helps patients not just with visual deficits but also with meaningful daily activities. Eccentric viewing techniques, visual scanning therapy, and systematic changes to the environment work together. These methods help patients make the most of their remaining vision and encourage independence.

Occupational therapists and optometrists work together to create an exceptional framework for vision rehabilitation. Optometrists help improve specific visual skills through therapeutic lenses and specialized exercises. Occupational therapists then turn these improvements into real-world gains in everyday tasks. This mutually beneficial partnership creates better outcomes than either specialist could achieve alone.

Research strongly supports the effectiveness of structured, individual-specific vision occupational therapy. Patients with conditions from stroke-related visual deficits to amblyopia show real improvements after targeted therapy programs. The research also shows substantial functional gains in a variety of areas after goal-directed rehabilitation.

Vision occupational therapy is growing as a specialized field. Current research methods and professional training don’t deal very well with all cases yet. However, increasing interest suggests future breakthroughs are coming. Patients who get proper vision occupational therapy gain more than better visual function. They rebuild their confidence, independence, and ability to participate in life’s meaningful activities. This field is without doubt a vital part of detailed healthcare for people with visual impairments.

Key Takeaways

Vision therapy occupational therapy offers evidence-based solutions for the 12 million Americans with vision impairments, helping them regain independence and improve quality of life through specialized interventions.

• Occupational therapists teach compensatory strategies like eccentric viewing and visual scanning to help patients maximize remaining vision and navigate daily activities safely.

• Collaborative care between occupational therapists and optometrists delivers optimal outcomes—OTs focus on functional daily tasks while optometrists address specific visual skills.

• Environmental modifications, adaptive equipment, and assistive technology significantly enhance independence for people with low vision in their homes and workplaces.

• Research shows 47% of patients receiving vision rehabilitation achieve clinically important improvements within 6-9 months of structured, goal-directed therapy.

• Assessment goes beyond basic vision testing to evaluate how visual deficits impact real-world activities like cooking, reading, and medication management.

The field continues to evolve with growing evidence supporting multicomponent approaches that address both visual limitations and their functional impact on meaningful daily activities.

References

[1] – https://pmc.ncbi.nlm.nih.gov/articles/PMC8171233/
[2] – https://www.pediastaff.com/blog/ot/collaboration-between-occupational-therapists-and-optometrists-2573
[3] – https://lighthouseguild.org/news/ot-can-help-people-with-visual-impairments/
[4] – https://clinicalinsightsineyecare.scholasticahq.com/article/94928-case-series-neuroplasticity-and-vision-therapy-in-adults-with-unilateral-small-angle-esotropia
[5] – https://www.aoa.org/AOA/Documents/Advocacy/HPI/HPI Care Coordination Between OD OT PT and Other Rehabilitation Team Members for Patient-Centric Care.pdf
[6] – https://pmc.ncbi.nlm.nih.gov/articles/PMC6452491/
[7] – https://lighthouseguild.org/eccentric-viewing-to-improve-vision/
[8] – https://spectrios.org/eccentric-viewing/
[9] – https://pmc.ncbi.nlm.nih.gov/articles/PMC4515568/
[10] – https://www.ncoa.org/article/how-assistive-technology-and-adaptive-equipment-help-people-living-with-vision-loss/
[11] – https://www.perkins.org/resource/adapting-environments-individuals-vision-loss/
[12] – https://www.brightfocus.org/resource/how-occupational-therapy-can-improve-life-with-low-vision/
[13] – https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/vision-loss-occupational-therapy
[14] – https://www.scranton.edu/faculty/nastasij2/pdfs/Essentials_of_an_Occupational_Therapy_Low_Vision_Evaluation_5-7-10.pdf
[15] – https://research.aota.org/ajot/article/77/Supplement_2/7711500008p1/24199/Goal-Setting-for-Patient-Identified-Goals-by
[16] – https://research.aota.org/ajot/article/67/3/263/5790/Effectiveness-of-Occupational-Therapy
[17] – https://pubmed.ncbi.nlm.nih.gov/23597685/
[18] – https://www.ncbi.nlm.nih.gov/books/NBK402380/

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