Success without Eye Muscle Surgery for Lazy Eye, Strabismus, Exotropia, Hypertropia, Esotropia, etc.

... there is no appearance of a turn and people who hear my story don't believe that I've ever had an eye turn. [More]

... eye hospital told Chris [mother] they could operate for cosmetic purposes only, but that Brittany would have to "grow out" of her problems. ... she searched until she found Dr. X. He developed an individualized program for Brittany ... "The changes have been life-altering for all family members," comments Chris. [More]

We are extremely happy that we took this [non-surgical] route. Looking back, surgery seems a barbaric choice. We feel like it very well could have made the whole situation worse, by trying to surgically fix an 'intermittent' problem. If we ever need to repeat anything, I'd much rather repeat therapy than repeat surgery. [More]

Vision Therapy Saves Boy From Surgery: 10 Years Later Family Still Thankful. [More]

My recommendation is to try Vision Therapy. If it doesn't work then surgery is a possibility. On the other hand, surgery is permanent and if doesn't work, it is a real mess to go back and fix it with therapy. [More]

I can't understand why such a simple solution to a mild adult strabismus is not in the repertoire of every eye care provider. [More]

He told me that Vision Therapy was a joke and not to consider it! I had been through Vision Therapy [myself] and knew that it worked. [More]

See also After Surgery, Crossed Eyes (Eye Turns), Depth Perception, and Double Vision (Diplopia)

I was diagnosed with strabismus at 18 months old and wore an eye patch for the next four years. At that point, in the early 70s, my parents were being told that not getting surgery would condemn me to blindness and that Visual Therapy was akin to quackery. Thank goodness for my parentsí bravery in the face of so much opposition. They decided to go with Vision Therapy. After my parents had decided to go the therapy route, they met a man in his early 20s who had already had 7 surgeries, none of which had been successful.

I began Vision Therapy at age 5, and although the level of severity was such that one eye had shut down completely; I am now fully functional with full eye coordination [binocular vision, tow-eyed vision]. I still have some problems with stereopsis, but considering the extreme nature of my case, I am doing amazingly well. I can even catch balls and everything! Every few years, I go back for a few sessions of Vision Therapy to bolster my coordination. I still wear bifocals with prisms, but even without them, my eyes feel strong and coordinated. Visually, there is no appearance of a turn and people who hear my story don't believe that I've ever had an eye turn.

I think my biggest frustration is with parents who are unwilling to hear about the benefits of Vision Therapy. Yes, it does take more work and time, but the pay-off is so incredible. I have literally found myself approaching parents of strabismic children in the grocery store, and one time a pizza joint, just to say that there are other options besides surgery and that it's important to look at them when considering a life-changing decision like surgery. Of course, it's a difficult argument when insurance companies will always pay for surgery and maybe not Vision Therapy.
Name Withheld

Brittany and her mom, Chris, are all smiles. For the first time ever, Brittany, a 4th grader, brought home a report card with "As" in all her academic subjects! And, although Brittany worked hard for those grades, it was "a walk in the park" - compared to how it used to be.

It used to be - before Vision Therapy - that Brittany and Chris struggled for hours every night (with frustration, tears, and arguing) to complete homework and study for tests. But the results did not reflect the great effort put into every task. Due to deficiencies in eye movement control, the use of both eyes together [binocular vision, eye teaming], focusing, tracking, and poor visual sequential memory, Brittany's perceptual (information processing) abilities and motor skills (including balance) were nearly two years behind (she couldn't even ride a bike with training wheels).

No matter how much Chris explained the homework, Brittany was unable to understand what she was seeing. She was confused by the printed page; her handwriting was sloppy and disorganized. Brittany said, "I thought I was 'stupid' - I hated school." She was performing below grade level by second grade. Chris- heart broke to see her child, whom she knew was intelligent, unable to work to her potential. Worst of all, there was tremendous anger and tension within the family, between the parents (who almost split up as the situation worsened), and between Brittany and her parents.

After friends told Chris about behavioral optometry [or developmental optometry], she searched until she found Dr. X. He developed an individualized program for Brittany, which addresses not only her amblyopia [lazy eye], but her visual motor and binocular problems as well.

"The changes have been life-altering for all family members," comments Chris. Brittany has achieved success in school as never before, enjoys reading books on her own, can ride a bike, and is captain of her softball team (she even got an A in Physical Education). Most importantly, Chris says that Brittany's self-esteem has improved dramatically. She is happy and has confidence in herself. And, Chris reports, the family is happily intact: the nightly struggles, tears, and arguing are gone!
written by the doctor from conversations with Chris, Brittany's mom.

Dear Dr. X,

Here we are at the end of our daughter Haley's therapy sessions and we can't believe how far we've come. A year ago we were being told that our only option was surgery. She was diagnosed with intermittent exotropia, which means her eyes have a tendency to go out instead of focusing on what she's seeing. I am writing this letter not only to thank Dr. X and his amazing staff of therapists, but also for any other parents who need some affirmation that therapy works and could for them, too, be an alternative to surgery.

When we were being told by the pediatric eye doctor we were seeing that Haley's condition was "neurological" and therefore only treatable with surgery, I asked to speak to other parents who had had the surgery for their kids. After all, this was about our most beloved possession in the world and we were looking at a very frightening wall. It became apparent that this request was not one they often got. It took doggedly calling that office, to plead with them to follow up, for about four months before they were finally able to give me a couple of parents to call. These parents were extremely nice and more than willing to speak of their experiences, but neither had the condition that our daughter has. What I did learn was that when a small child has corrective eye surgery, the likelihood of having to repeat surgery as that child grows is extremely high. One parent I spoke with had a child, who had just turned thirteen, and had just undergone his third eye surgery. The other parent I spoke to was anticipating a second surgery for her child. As in our case, neither of those families were told of therapy being an alternative to surgery. We had been to that office six times over six months charting Haley's condition. Each time, that office was packed with kids. I'm sure that surgery is absolutely necessary at times, but I'll bet a lot of those kids would have benefited from therapy.

But here's the ironic thing - most insurance will pay for surgery, but not therapy. This is such a monumental disservice. The fact that therapy is not covered by insurance forces many families to opt for surgery. But then, most people aren't even made aware that therapy is even an option. The climate in our eye doctor's office was "sit and be quiet." I was told by the staff that if a child isn't in her seat when the doctor came into the room, that he would turn around and leave for the next patient. We had always to be on best behavior there. Also in the doctor's rulebook, was that the parents sit in a chair and remain seated and quiet throughout his exams. We could ask questions after this exam, but his answers were fragmented, he talked in circles, and it was extremely frustrating. That's initially why I thought we'd gain from speaking to other parents. Now, I honestly don't think he really knew the answers to my questions. I wanted to know how Haley's condition labeled "intermittent," meaning "not consistent" and "not always," could be fixed with surgery. Never, never, never, did I ever get an answer that I could make any sense out of. This doctor's policy of "sit and be quiet," sets up an intimidating psychology. One that makes parents feel powerless and, thus, more apt to give their blind faith.

We felt we owed it to ourselves and to Haley and her future, to just go ahead and look into other options. Even though we honestly didn't know if therapy was for us. After all, we'd been told time and time again that she needed surgery. My husband set about searching the Internet and found your web sites. It was very enlightening and gave us hope.

I'll never forget our first appointment with Dr. X. Unlike the surgeon who wanted me to stay in my seat, Dr. X wanted me to step forward and please witness what he was finding with Haley's eyes. I will never forget that. What a gift this optometrist had just handed us!! For the first time, being asked to be a part of Haley's condition, as well as part of the solution. I saw the doctor give her tests which showed me for the first time, the severity. I saw for the first time, what a difficult time our precious baby must have been having all along. It still brings me tears. You went on to explain what we could do in therapy to remedy Haley's eyes, but we'd already made up our minds. We were going to give therapy a try and be a part of a system where we, as parents, were going to be active participants.

Here's what life was like "before" Vision Therapy. First of all, we were lucky to have caught the problem when Haley was just four. Even though we'd always thought something was amiss, our previous pediatrician in NYC thought her eyes were just fine. But we were seeing various developmental things that made us wonder. Things that were being dismissed by teachers and her doctor as "just part of her personality." We have an incredibly bright and monumentally creative child. Yet she would not sit down and do a puzzle, unless I sat down for long periods and made the pieces come to life. In other words, by engaging her creative and compassionate side. For instance, a frog puzzle ... the froggy would be sad he was missing his other eye or his leg, etc. Blocks? Not interested. Catching a ball? Forget about it. Art? Not interested. Basically, anything she needed to focus her eyes on, except playing with dolls. None of this made sense because she was so bright and inquisitive and creative. I would look at other kids around her, younger than she, thriving on these basics. Then Haley got a new best friend, Nina, when we moved to the west coast. Another bright, creative kid. I noticed how Nina would look at me intently while speaking and I started noticing the same with other kids. I watched the way they looked at things, at people. And I watched Haley. Haley, being very dramatic and talkative, would never focus for very long on anyone or anything. This had always been a part of her "personality." But I began to worry that the 'Ninas' would someday leave her behind. Our new pediatrician recognized immediately that Haley had a vision problem and we set about getting a diagnosis, which eventually led us to Vision Therapy.

And here's how life has changed since Vision Therapy. I would say sometime about a third of the way through, we started to really see Haley focus on objects near and far and hold her eyes on people while speaking to them. For some reason, that was really important to me. I guess, it helped me to see that she'd now have a chance in school and hopefully excel. She'll never get mislabeled as ADD. Then about halfway through, she just took out a puzzle one day and wanted to do it all on her own, and proceeded to do so. That just blew me away! She's still not as fast at putting them together as others her age, but at least she has the interest now and she steadily improves. Now she can focus on what she's looking at! There's this one vision test where you look at a line of objects and one object is supposed to come forward. I think it's a depth of field test? Anyway, Haley didn't get any of those on her exam before therapy. At her halfway exam [during therapy] she sailed through all of them!

Haley had had a very difficult time focusing and getting her eyes to "fuse." Now, it's no problem. And now she draws every day. When asked what her favorite thing to do is, she says "Drawing." She told me yesterday "Drawing is my life!" And she loves to paint now. She likes thick, drippy paint. Her favorite artist is Vincent Van Gogh. She even painted valentines for all her classmates that were with thick, swirly paint, inspired by Van Gogh. We see her eyes focusing on things up close more and more. Even things like looking at her sandwich while eating it are positive signs to us. And now she can catch a ball with the best of kids her age, and probably better! That's one thing my husband has done with her every night since therapy began. It was always a part of her nightly Vision Therapy homework. And she's developed an amazing throwing arm! That kid can whip the ball and with accuracy. It's taken a lot of hard work, and hours and hours of life, but we can't think of anything more worthwhile. And we are proud of Haley. She's five now and getting ready to start Kindergarten. She has concentrated and worked very hard and as a result has shown she can control her condition. I think she feels empowered by it.

We are extremely happy that we took this [non-surgical] route. Looking back, surgery seems a barbaric choice. We feel like it very well could have made the whole situation worse, by trying to surgically fix an "intermittent" problem. If we ever need to repeat anything, I'd much rather repeat therapy than repeat surgery.

So, thank you very much, Doctor. Thanks to you and your therapists. We are very happy and grateful patients!
Karen Hyden and Simeon Soffer, parents of Haley Hyden-Soffer

To correct Joey's lazy eye, the doctor recommended surgery. The Camisas balked at the idea of their little boy undergoing such an ordeal. In the meantime, Joey was prescribed eyeglasses with very thick lenses while his parents decided what step they should take next. "We really didn't know what to do, or what would be best," said Judy.

Fortunately, the Camisas' instinct to delay the surgery was correct. As good fortune would have it, Judy accompanied her father-in-law, an Eye Center patient, to his appointment one day. It was there that she and Joey met Dr. X. Noticing Joey's eye, Dr. X recommended Vision Therapy, a one-on-one treatment to improve visual function, performance and quality of life. All without surgery.

Relieved to find an alternative to surgery, the Camisas jumped at this opportunity. Joey underwent Vision Therapy for about six months, which included weekly visits and nightly therapy sessions with his parents.

"Within a couple of weeks, we noticed a big difference in his sight," said Judy. "When he took off his glasses he could definitely see better and he enjoyed coming to the office each week. To this day, we are thrilled about what [Vision Therapy] did for Joey."

Today, Joey is 15-years-old and his poor vision is a thing of the past. Wearing regular prescription glasses, Joey is a good student and a talented saxophone player in a jazz band. He, along with his whole family, has routine eye exams and remains thankful for their positive experience.

These are my comments regarding the choice of Vision Therapy vs. surgery. Vision Therapy is a viable alternative for strabismus. It can be hard work, though. I would recommend two consultations [get that second opinion!]: one with a pediatric ophthalmologist and one with a behavioral optometrist.

The argument that surgeons weaken a muscle deliberately to straighten the eye is horrendous. The problem in strabismus is NOT muscular , it is neuromuscular [the signals or instructions that the brain sends to the muscles]. For example, ask the surgeon to explain why when he covers the patient's "good" eye, the other eye suddenly straightens.

Compare the treatment of binocular dysfunction [strabismus, crossed eyes, wandering eyes, etc.] to the treatment of speech problems. Does a surgeon cut someone's tongue because they lisp or does a speech therapist attempt to re-train the person's neural pathways? And, yes, the brain is plastic and can be re'trained. Otherwise, there would be no hope for stroke patients in rehab today.

There are cases where surgery is necessary, but even then the patient should do therapy in conjunction with the surgery. Two important questions any person should ask both the surgeon and the optometrist is "what are the goals of this treatment?" and "what is the criteria for success?" Most surgeons only strive for cosmetic improvements [straighter looking eyes], not functionality [improved vision). Also, it is critical to ask the surgeon how many surgeries they average on each patient. It usually isn't just one!!!

My recommendation is to try Vision Therapy. If it doesn't work then surgery is a possibility. On the other hand, surgery is permanent and if doesn't work, it is a real mess to go back and fix it with therapy.
by Elizabeth Lund, 5/31/97

For a number of years I was trying to get help with my double vision, which forced me to drive with one eye closed. The only option given by the doctors I consulted was wearing an eye patch while driving or a double eye surgery. Dr. X suggested including prism in the prescription and following up with Visual Therapy. The prescription worked like a charm. No more double vision!

I can't understand why such a simple solution to a mild adult strabismus is not in the repertoire of every eye care provider.
Maurice Damast, 7/6/2004

I am a graduate of Vision Therapy and I now have 3 children going through the therapy as well. My kidsí eyes are getting better and I am very excited to see the progress.

My 5th grader started Vision Therapy when she was in 1st grade. She was having odd problems with letter reversals and I was looking into dyslexia when a friend told me about her son who had the same problem. In the 4th grade he was considered a learning disabled child. Then, after his vision therapy, he became an honor roll student! When she mentioned this I flipped because I had gone through vision therapy myself, but I had never considered vision as the reason my daughter was having problems.

I was very fortunate that the doctor who had treated me as a child was still in practice, so I took my daughter to him and she received an hour long exam that was very thorough and he showed me via a camcorder how her eye would shoot out instead of focusing. I also took her [my daughter] to a doctor in our insurance program (a great eye-surgeon, ophthalmologist). He told me my daughter definitely had a problem and that she was not a candidate for eye surgery (what a relief). He said she was close to being near-sighted and I should wait until her eyes reached that state, then he would prescribe glasses!! He told me that Vision Therapy was a joke and not to consider it! I had been through Vision Therapy [myself] and knew that it worked. I told him he was a joke and left.

My daughter is now in 5th grade and is still not wearing glasses! The eye doctor just prescribed reading glasses (very low prescription) to decrease the eye strain. She is improving in school and last year her grades started to go up and up

Since she was the oldest, as soon as the other two started kindergarten I had them tested and they are going to the eye-doctor as well. I am very thankful my eye-doctor is around and that "The Quack" (as the ophthalmologist might say) is there for them. All three children just finished an updated test to see how they are doing and all three are reading further down the eye-chart and progressing along.

I wish there was a way to make people realize there is hope, but there are a lot of parents that frown at the thought of going to a doctor once a week for who knows how long. I believe my children were put here for me to help them in any way possible and if I have to drive an hour one way each week to see the doctor that is what I will do. We are excited now, because two of the children have advanced to every other week visits. There will be a day when we don't have to do that drive and my kids do not have to experience the trauma of having an eye patched or having surgery.

Take care and thanks for your web sites!!
Ms. K.J. Berri