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The guiding principle of vision care provided by all members of COVD is that vision can be
developed and improved. For example, we know that infants are not born with fully developed
visual abilities and that good vision is developed through a learned process.
The mission of COVD is improving lives by advancing excellence in optometric vision therapy
through education and board certification. COVD seeks the active support of parents, teachers
and the public health community in this endeavor.
Established in 1971, COVD provides board certification for optometrists and vision therapists
who are prepared to offer state-of-the-art services in:
¾ Developmental and behavioral vision care
¾ Vision therapy
¾ Visual rehabilitation
These specialized vision care services develop and enhance visual abilities and correct many
vision problems in infants, children, and adults.
COVD board certification process includes a rigorous evaluation of the eye care professional's
knowledge and abilities in providing developmental and behavioral vision care for patients.
Optometrists who successfully complete the certification process are Board Certified in Vision
Development and Vision Therapy and are designated Fellows of COVD (FCOVD). Vision
therapists are certified to work with COVD Fellows as Certified Optometric Vision Therapists
(COVT).
Evaluation: An initial eye examination found that she had 20/20 visual acuity.
Specialized vision testing revealed that Kaitlyn’s eye tracking skills and focusing ability
became unstable when she was reading.
Solution: She began a program of vision therapy to help her better control her eye
movements and improve eye-focusing abilities. At the conclusion of therapy, Kaitlyn’s
mother reported: “Kaitlyn has improved two grade levels in reading and math. She has
not had a headache in two months and no longer suffers from frustration due to slow
learning. Kaitlyn has improved much faster than we thought possible.”
Brandon, Age 16
Problem: Brandon started struggling with reading when he was 9 years old. His mother
had taken her son for eye exams on a regular basis and had been told everything was fine,
aside from the need for glasses for his nearsightedness. As a result, she had never even
considered the possibility that vision was playing a role in her child’s difficulties.
Brandon had been diagnosed with ADD, CAPD, was in Learning Disabilities classes in
school, and was even seen by a neurologist. His mother ended up homeschooling
Brandon because he was so depressed about his reading problems and nothing else
seemed to be working.
Marien, Age 12
Problem: Marien was a bright twelve-year-old who struggled to read. A neuro-
psychologist had evaluated her and suspected the root of her academic problems was an
emotional disorder and possibly dyslexia. This diagnosis perplexed Marien’s parents
because it seemed to only partially identify Marien’s struggles.
Dustin, Age 7
Problem: At the beginning of first grade Dustin tested at the fourth grade level in science
and social studies, but was on a preschool level in math and reading. He also hated any
activity that dealt with a ball of any sort. If a ball was thrown to him, nine times out of
ten he was unable to catch it. A school psychologist assessed him to be five points above
functionally retarded. He withdrew from all activities that made him feel challenged.
Evaluation: Frustrated by the school system’s inability to determine why Dustin was
unable to succeed, his parents sought a comprehensive vision evaluation.
Solution: Testing determined the need for vision therapy to help him learn to more
effectively process visual information. Dustin’s parents noticed improvements in his
school performance in less than a month. “When Dustin started vision therapy he could
not recognize any letters of the alphabet, nor copy anything written down in front of him.
Today he can copy sentences with proper spacing and read a beginner’s book with
assistance,” his parents reported. “Dustin shows a noticeable improvement in self-esteem
and is beginning to flourish in all avenues.”
Solution: A program of vision therapy soon improved her reading skills. “Not only am I
a faster and more accurate reader, but I can enjoy it more and read for longer periods of
time,” she said. “This program has made school easier and homework time shorter. My
only regret is not doing this earlier in my life so that I would be more confident and
would have done better. Vision therapy makes me feel like a better person.”
“Eyesight” is a physical process of focusing light within our eyes, whereas “vision”
involves our ability to understand what is seen.
It is estimated that as much as 80 percent of all learning during a child’s first 12 years
comes through vision.
Because a child has 20/20 visual acuity according to the Snellen Test (eye chart) does
NOT mean he or she has good vision. The eye chart used by most schools for visual
screening assesses if a child is able to identify letters at a distance that a normal child
would be expected to see—20 feet.
While statistics show vision disorders are the number one handicapping condition for
children, the Snellen Test typically identifies only five percent of children having
problems seeing clearly in the distance.
A: Learning-Related Vision Problems affect the way a child’s eyes work with each other and the
brain to collect and interpret visual information. They can be as simple as an inability to see
close-up (eye focusing problem) or as complex as a cognitive inability to “visualize” or interpret
what their eyes are seeing or a problem with how the eyes converge (convergence
insufficiency). In many cases, a child’s visual abilities aren’t sufficiently developed for him/her
to be able to read – or learn to read – effectively. Unfortunately, children with learning-related
problems usually don’t tell a parent or teacher they have a problem. They don’t realize they are
supposed to see letters, numbers, objects – the world – in a different way.
A: Research indicates the problem can be due to a difficulty in either acquiring or processing the
information we receive through our eyes. The visual skills needed to see effectively may be
lacking or the brain may not be sufficiently trained to interpret what the eyes see. Without these
abilities, the child or adult spends so much energy just “looking at” and “decoding” the written
word, there is little mental energy left to comprehend and remember the word’s meaning.
A: Inadequately developed or ineffective visual abilities in the following areas can lead to
Learning-Related Vision Disorders:
¾ eye tracking skills (eyes staying on target)
¾ eye teaming skills (eyes working in synchronized fashion)
¾ binocular vision (blending images from both eyes together at the same time)
¾ accommodation (eye focusing)
¾ visual-motor integration (eye-hand coordination)
¾ visual perception (visual memory, visual form perception, directionality)
A: Many children diagnosed with Attention Deficit Disorder (and labeled as candidates for drug
treatment) have not been properly evaluated for visual problems. What may be thought to be a
lack of interest in reading and schoolwork by these children may actually be an inability to keep
their eyes properly focused on their books or other deskwork. These children become easily
distracted and may appear to be hyperactive.
A: Vision therapy has been successfully used in the treatment of vision problems for more than
70 years. The College of Optometrists in Vision Development maintains an archive of published
research articles and clinical studies on the effectiveness of vision therapy. In addition, thousands
of patients each year who experience the benefits of vision therapy can attest to its positive
impact on their lives.
Q6: Why is vision therapy provided mostly by optometrists rather than ophthalmologists ?
A: Traditionally, optometrists have concentrated upon the functional and mental processes
involved in good vision (eye tracking, eye teaming, binocular vision, visual-motor integration,
visual perception), while ophthalmologists have concentrated on the physical nature of the eye
(eye disease and surgical treatment). Although vision therapy has its early roots in
ophthalmological procedures for the treatment of crossed-eyes (strabismus) and lazy eye
(amblyopia) called orthoptics, its use for the treatment of other forms of binocular vision
disorders and visual perceptual problems has largely been developed and provided by
optometrists.
Myth Reality
There’s no difference between Sight and vision are actually two very different things.
sight and vision. While seeing is the physical process of focusing light
within our eyes, vision involves the ability to understand
what is seen.
If you have 20/20 eyesight, you If a child has 20/20 visual acuity according to the Snellen
have perfect vision. Test, it does NOT mean he or she has good vision. The
Snellen Test, or eye chart used by most schools for visual
screening, assesses if a child is able to identify letters at a
distance that a normal child would be expected to see—20
feet. This is what is called visual acuity and has nothing to
do with how the child interprets or understands what he or
she sees. In addition, the test does not assess visual skills
such as seeing close-up, focusing, depth perception,
peripheral vision or eye coordination.
If a child has a chronically short Children with vision problems are unable to concentrate on
attention span and has frequent their work and therefore often exhibit a short attention span.
behavior problems, that child In addition, many children are embarrassed by their
likely has ADD/ADHD. difficulty reading or performing other activities and act-out
as a diversion. Before a drastic diagnosis of ADD/ADHD is
made and medications prescribed, parents and teachers
should first consider a comprehensive eye examination for
their children. Much is at stake in the event of a
misdiagnosis.
The effectiveness of vision therapy Numerous scientific studies published in Optometry and
is not scientifically proven. Vision Science, Optometry: Journal of the American
Optometric Association, American Journal of Optometry
and Physiological Optics, Documenta Ophthalmologica
and American Journal of Ophthalmology show that vision
therapy is an effective treatment for vision problems
including eye focusing, eye coordination, amblyopia (lazy
eye) and strabismus (crossed eyes).
Kids who are already busy with One of the goals of vision therapy is to make schoolwork
homework and after-school and homework easier for students. Poor visual abilities are
programs don’t have time for often a reason that completing assigned tasks takes so long.
vision therapy. Following vision therapy, children are able to complete
their assignments more efficiently and do not have to
devote as much time to homework as before.
Adults cannot be treated with It is never too late for adults to receive vision therapy.
vision therapy. Numerous executives, office workers and administrators
who spend a lot of time reading or in front of computers
consistently suffer from headaches and eye fatigue.
Thorough examination by a developmental optometrist
often reveals these individuals have suffered from life-long
errors in the way their eyes work. These people can usually
be far more productive when they’ve been trained to use all
their visual abilities more effectively through vision
therapy.
Children with crossed eyes will Untreated, this condition (also known as strabismus) can
eventually grow out of them. lead to amblyopia (lazy eye). Unfortunately, amblyopia
can lead to permanent vision loss if untreated. With
amblyopia, one eye becomes stronger than the other,
suppressing the image of the other eye until eventually the
weaker eye becomes useless.
If a child has problems seeing, Unfortunately, children with vision problems usually don’t
they’ll tell a parent or teacher. tell a parent or teacher they have a problem. They don’t
realize they are supposed to see letters, numbers, objects –
the world – in a different way.
¾ Vision disorders are the number one handicapping condition for children. Yet, 18 million children
will not have an eye examination by an eye doctor by the time they enter school. (Only Kentucky has
passed a law that requires every child to have a comprehensive eye examination before entering public
school.)
¾ Children needlessly struggle for years in schools across the country because they have undetected,
learning-related vision problems.
¾ Children are often misdiagnosed as having ADD/ADHD, labeled “dumb,” or misplaced in a resource
room when their academic or behavior struggles actually stem from correctable vision problems.
¾ The Myth of 20/20 “Vision:” Vision problems most often go undetected when it is assumed a child
has perfect eyesight because he/she passed a school screening eye chart test with “20/20 vision.” It is
a little known fact that this test does not measure how well a child can see at near distances, nor does it
evaluate other visual skills necessary for learning or sports such as eye focusing, depth perception,
peripheral vision, eye coordination or eye teaming.
¾ When a child is struggling with academics, sports or behavior, parents and teachers should be
encouraged to consider a vision problem. There are time-tested signs to look for that a child may have
a vision problem (see “Signs of Learning-Related Vision Problems).
¾ Developmental optometrists provide specialized vision care called vision therapy that is proven to help
correct many vision problems, improve visual skills needed for reading, and restore self-esteem.
¾ Statistics demonstrate the critical need for higher awareness of learning-related vision problems:
• An estimated 10-million children suffer from vision problems, according to the National Parent
Teacher Association.
• One in four school-age children have vision problems according to statistics from Prevent
Blindness America.
• Sixty percent of students identified as problem learners have undetected vision problems, the
American Optometric Association reports.
• A study conducted by Roger A. Johnson, Ph.D. showed that 70 percent of juvenile offenders had
undetected and untreated vision problems.
• A recent study highlighted at a conference at the Harvard University Graduate School of
Education shows that visual perception and eye movement abilities are strong predictors of
academic scores.
• In 1995, the economic impact of visual disorders and disabilities was estimated by the National
Institutes of Health to be more than $38.4 billion.
• In 2008, the National Institute of Health stated that 5 percent of school-age children are
affected by convergence insufficiency and it is the most common vision disorder in
children other than the need for eye glasses.
Accommodation (eye focusing): The ability to focus the eyes to see clearly up close, to change focus
from distance to near and back again, and to maintain clear focus for an extended period of time. Poor
eye focusing ability can make it difficult to concentrate on reading from a book for a long period of time.
Amblyopia (lazy eye): Reduced vision in an eye, not correctable with eye glasses, as a result of the eye
not receiving adequate use during early childhood. Most often it results from either misalignment of a
child’s eyes or a large difference in image quality seen with the two eyes. Over time the eye with the least
clear image is ignored or suppressed making 3D/stereo vision impossible.
Binocular vision (eye coordination): The ability of both eyes to work together as a team. Each eye sees
a slightly different image and the brain, by a process called fusion, blends the images into one three-
dimensional picture. Good eye coordination, a skill that must be developed, keeps the eyes in alignment.
Poor eye coordination comes from a lack of adequate vision development or improperly developed
control of eye muscles.
Convergence insufficiency: a form of a binocular vision problem where the two eyes don’t turn
in correctly. When we read our eyes have to turn in and they have to point to the same place on
the page. If one eye doesn’t line up with the other it can cause problems with reading, such as
loss of place, loss of concentration, reading slowly, eyestrain, headaches, blurry vision and
double vision.
Ocular motility (eye tracking): The ability to smoothly and accurately move the eyes along a line of
print or follow a moving target with our eyes. Poor eye tracking can result in skipping words, losing one’s
place on a page, having to re-read materials, or difficulty copying from the chalkboard.
Strabismus (crossed eyes): An inability of the two eyes to aim at the same place at the same time. This
can result in an eye turning in, out, up or down. A child with crossed eyes may experience periods of
double vision and if untreated this condition can lead to amblyopia.
Visual perception (visual information processing): The process by which the brain interprets and
understands the visual information received by the eyes. Aspects of visual perception include visual
memory, size and form perception, directionality and color perception. Poor visual perception may
contribute to letter reversals or difficulty with comprehension when reading.
These are representations of what it might look like if you had a Learning-Related Vision Problem.
The first step in any vision therapy program is a comprehensive eye health and vision
examination. Following a thorough evaluation, a developmental optometrist will
prescribe vision therapy if he/she feels it is appropriate in order to:
Specialized medical equipment and materials used in vision therapy may include
therapeutic lenses, prisms, filters, occluders or patches, electronic targets with timing
mechanisms, stereoscopic devices, rotating targets, and computer software.
The National Institute of Health funded a study to determine the best treatment protocol
for convergence insufficiency. The results of the study demonstrated that in-office vision
therapy is the treatment of choice as it is the most effective treatment for convergence
insufficiency.
Research also supports the effectiveness of vision therapy for a variety of other vision
problems including eye focusing, eye coordination, amblyopia and strabismus. Numerous
scientific studies have been published in journals such as Optometry & Vision
Development, Optometry and Vision Science, Optometry: Journal of the American
Optometric Association, American Journal of Optometry and Physiological Optics,
Documenta Ophthalmologica, and American Journal of Ophthalmology show that vision
therapy is an effective treatment for vision problems. Please see the contacts below for
study abstracts and/or full text of articles.