Prevalence & Models
While the prevalence of convergence insufficiency is 3-6% in the general population, it jumps to this percentage range in concussed patients.
28-60%
After a patient begins weekly therapy, a check-in or retesting typically occurs at this frequency to ensure symptoms are improving.
10-12 sessions (or every 3-4 months)
This common symptom of binocular vision dysfunction often occurs specifically when switching between looking at different distances.
blurred vision
If double vision has a sudden onset, it is likely not a binocular vision issue but rather this type of issue.
neurological
For a 25-year-old patient, a score greater than this on the CISS indicates they are symptomatic.
21
These are the four components of the Skeffington Model of Vision.
Identification, Speech-Auditory Process, Antigravity, and Centering
Once a patient graduates from VT, they should perform a follow-up at this interval and continue doing therapy at about half their previous rate
3 months
Visual headaches related to binocular vision issues are generally located in these two regions.
brow or frontal regions
Double vision that occurs monocularly (in only one eye) is considered a red flag and is likely not related to this.
binocular vision (BV) issue
This visual category includes accommodative, vergence, and oculomotor skills.
Visual Efficiency
In the Skeffington Model, this specific skill is considered the key to centering and spatial localization.
vergence
Piaget’s Model describes this specific "lightbulb moment" where everything comes together for the patient.
AH-HA! Development
This symptom is described as words appearing to move in a specific way relative to the paper.
floating on the page
These are three systemic symptoms (e.g., related to the extremities or stomach) that suggest a headache is not caused by visual dysfunction.
tingling of extremities, nausea, and vomiting
This survey is specifically used for mild traumatic brain injury (mTBI) patients, where a score over 31 is highly suggestive of TBI.
BIVSS (Brain Injury Vision Symptom Survey)
This fundamental concept of Vision Therapy asserts that vision involves more than just visual acuity and is developed over time.
Vision is Learned
In the "VT Flow," therapists focus on teaching only these two types of learning to resolve conflict.
High-level and AH-HA learning
A binocular vision-related headache is most likely to occur at this time of day
end of the day
Unlike intermittent binocular vision issues, a headache or double vision that is constant is highly suspicious of this.
neurological disease
Children with this developmental condition show a higher prevalence of accommodative, vergence, and oculomotor deficits compared to typically developing children.
dyslexia
This Skeffington circle involves finding meaning from what you are looking at and requires accommodation as a key component.
Identification
he primary goal of therapy is to teach patients this, so they can recognize and recreate specific visual skills when needed.
how their eyes feel
If a patient reports double vision in this orientation, it is most likely a vergence issue
horizontal
A headache that is present first thing in the morning is unlikely to be a BV issue, as visual strain should be relieved by this.
rest
This specific type of visual dysfunction has been linked to delayed development of speech.
oculomotor dysfunction