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The specific goal for the treatment of visual efficiency deficits is enhancement of the range, latency, accuracy, facility, and sustainability of accommodative and vergence responses. At the conclusion of therapy, ocular motility should be more accurate, and the incidence of accompanying head and body movement lower.Correction of refractive error and treatment of visual efficiency dysfunctions can result in improved visual information processing.75 Nevertheless, the treatment of vision information processing deficits usually requires vision therapy, which can begin during the later stages of visual efficiency therapy. When deficits in visual efficiency are minor, information processing therapy can be initiated at the outset. The approach is typically hierarchical, beginning with visual spatial orientation, then continuing with visual analysis and concluding with visual-motor integration. Attention should be directed toward improving the rate of visual information processing. The goals of visual information processing therapy can be found in Table 9. Developing intrinsic motivation so that the patient becomes aware of increasingmastery of the skill being acquired is an important part of the therapy program.19The Care Process 35Table 9Goals for Visual Information Processing Therapy Develop motor planning ability to accomplish isolated and simultaneous movements of the extremities Develop motor memory of the differences between the right and left sides of the body• Develop an internal awareness of both sides of the body, including identification of body parts• Develop the ability to project directional concepts to organize visual space, including the spatial orientation of alphanumeric symbols• Develop an understanding of the distinctive features of objects; namely size, shape, color, and orientation Develop the ability to select and attend to a stimulus from an array of distracting stimuli, as well as the spatial relationship of that stimulus relative to other background stimuli• Develop the ability for identification of visual stimuli from incomplete information• Develop short-term visual memory abilities, including the recall of the spatial characteristics of the stimulus and the sequence of multiple stimuli• Develop the ability to create a visual image of a previously presented stimulus and the capacity to mentally manipulate it Develop the ability to integrate visual processing skills with the fine-motor system to reproduce complex visual stimuli Develop the ability to integrate visual processing skills with language efficiently and rapidlyVision therapy is usually conducted in the optometrist’s office, with prescribed home support activities. One or two office visits per week for 12 to 24 weeks may be required for uncomplicated cases. Office therapy sessions usually begin with review of the activities assigned for practice at home. This review should include a demonstration of the procedures and an indication of the level of compliance.36 Learning Related Vision ProblemsSupportive activities performed at home 4 to 5 days per week for 20 to 30 minutes each time are an important adjunct to office-based therapy, providing continuity of care and enhancing opportunities for practice and mastery of skills.
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