Troubled student finds help in vision therapy

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Gina Duwe
November 30, 2014

DELAVAN--Laura Feit has been telling her friends to look into vision therapy if their children are having difficulties in school.

The Delavan mother said she wishes she had known about the treatment option sooner after her 9-year-old daughter, Julia, struggled with everything from bumping into walls to skipping groups of words while reading.

“She was frustrated, and I was frustrated. The tutor was doing the best she could,” Laura said. “It's not that Julia didn't understand it, it's just all of those processes coming together were not working properly.”

Eye exams and testing for learning disabilities didn't provide conclusive answers, so Laura took her daughter for an extensive eye exam at a clinic specializing in vision therapy. She learned about the process after hearing about a friend's child receiving vision therapy.

Julia was diagnosed with convergence excess. Laura described Julia as not having peripheral vision. When she's anxious, Julia's eyes over-dilate, which makes reading stressful.

“It's just like this vicious cycle, as soon as she gets upset about reading,” Laura said.

Vision therapy is a series of vision exercises and activities designed to improve function of the vision system, said Dr. Kellye Knueppel, a developmental optometrist specializing in vision related learning problems, sports vision and rehabilitative optometry. Knueppel works at The Vision Therapy Center, which has offices in Madison and Brookfield.

“(It's) really training the brain to send the right signals to the eyes. It's not about making eye muscles stronger,” Knueppel said. “It's really how your brain is controlling how your eyes are working, and how you understand what you see.”

Such vision problems aren't detected in a regular 20/20 eye screening, she said. Knueppel describes that as a test for eyesight, while vision is includes other tasks the eyes undertake, such as focusing and eye teaming—how your eyes work together.

“The main reason vision therapy works is because you learn how to use your vision,” she said.

Knueppel referenced a study published in the Archives of Ophthalmology that definitely shows in-office vision therapy is the best treatment for convergence insufficiency. With vision therapy, a person does not aim both eyes at the same point in space.

Vision therapy is nationally recognized and included in the Wisconsin statute law that defines optometry, said Peter Theo, executive vice president of the Wisconsin Optometric Association. However, not all optometrists practice vision therapy, he said.


Knueppel said her passion is helping kids. She said about half her patients are smart students who get Cs, Ds and Fs in school, but shouldn't.

“(There's) a lot of kids who have double vision who don't realize they should tell anybody … They don't know what it should look like,” she said.

Such problems can share the same symptoms as ADD/ADHD.

“We work with a lot of kids where vision is the main problem, and once their visual system is taken care of their attention problems go away,” Knueppel said.

It is possible, however, for a person to have visual problems and ADD, she said.

“We wouldn't want anyone to think we can cure every case of ADD,” Knueppel said.

In September, Laura's husband, Tony, began taking Julia to The Vision Therapy Center for weekly one-hour therapy sessions. Julia's parents help her with 20 to 35 minutes of therapy at home.

“I can see improvements week to week based on the exercises they give us to do,” Laura said.

Her insurance, however, doesn't cover the therapy. An initial exam focused on a child struggling in school is $350 to $450, Knueppel said. Therapy sessions can be anywhere from a few visits to between 30 and 50, and each session is $152, with some additional costs, she said.

The clinic relies on patients practicing at home. The goal, Knueppel said, is to have patients learn the therapy well enough that they just do it themselves, with improvements continuing after therapy ends.

Therapy sessions can include using special glasses, computer programs, prisms and hand-eye activities with lenses, she said.


Laura quickly found out vision therapy is not offered at most clinics, and those in the optometry field often didn't know what she was talking about when she asked around.

Knueppel said the biggest reason for this is the public is not demanding such therapy “because the public doesn't know about it.” She said she's been trying to raise awareness throughout her career, speaking nationally and internationally.

Chicago has the closest optometry school, and Knueppel has four students from there who train in her clinic each year.

Not many doctors of optometry solely practice vision therapy, as Knueppel does, Theo said. While he didn't have numbers, Theo said through the work of Knueppel and others, vision therapy is becoming more widely practiced.

Theo said education might be a reason why vision therapy isn't widely available.

“Perhaps there's not as much education or continuing education for vision therapy,” he said. “I think it's a matter of doctors becoming more and more educated and trained in vision therapy, either to identify issues and treat it or identify and refer it out to a specialized optometrist in vision therapy.”

Laura said she felt guilty for not being able to help her daughter sooner and wondered why nobody had told her about vision therapy earlier.

“It was a huge release just to know that this is what the problem is, and this is how we can fix it and get her to where she needs to be,” she said.

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