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Consistent application of supportive activities at home may reduce the number of office visits required and the potential for regression.Many vision therapy techniques and procedures available to addressvisual information processing problems are described in several recommended compilations.^183,194-203 Computerized vision therapy programs are available for office and home therapy.²⁰⁴After this initial period of therapy, a re-evaluation should be performed, using the same visual information processing tests employed previously, and an exploration of improvements in clinical signs and symptoms made. An improvement in test performance of at least 1.5 standard errors of measurement is considered clinically significant.¹⁸² Additional therapy may be indicated if clinical signs and symptoms -- although improved -- persist to some degree. When the patient has made sufficient progress, and has achieved the major therapeutic goals for visual information processing skill enhancement and reduction in clinical signs and symptoms, a home-based maintenance program should be recommended. This maintenance program can include practicing a few procedures 2 to 3 times per week for 10 to 15 minutes each time for 3 months.When underlying neurological problems, cognitive deficits, or emotional disorders are suspected, referral to another health care professional or the educational system may be indicated. Occupational or physical therapy can complement optometric vision therapy when the deficiencies are severe.H. PARENT AND PATIENT EDUCATIONSpecific communication with the patient’s parents or caregivers should occur after the examination to review the test outcomes. This discussion should begin with a review of the chief complaint. An explanation of the nature of the vision problem and its relationship to the presenting signsThe Care Process 37and symptoms is necessary. The management plan and prognosis should be presented to the patient and parents or caregivers. Communication with education professionals about the diagnosis, proposed management plan, and expected outcomes should be initiated. This should lead to a coordinated effort with the patient’s classroom teachers, special education teachers, and therapists. The importance of continuing eye care should be discussed with parents or caregivers. Other education and health care professionals should be informed about the presence and nature of the learning related vision problems and their relationship to extant learning difficulties.38 Learning Related Vision ProblemsCONCLUSIONLearning related vision problems comprise deficits in visual efficiency and visual information processing that have potential to interfere with the ability to perform to one's full learning potential. These deficits may cause clinical signs and symptoms that range from asthenopia and blurred vision to delayed learning of the alphabet, difficulty with reading and spelling, and skipping words and losing place when reading.

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