TrainYourEyes is deeply rooted in Research
Ongoing research is being done in the field of visual therapy, of which TrainYourEyes is also an active party in collaboration, with among other things, Copenhagen university. The very essence of the TrainYourEyes-training is thus based on evidence. It is primarily about eye movement training, convergence ability and accommodation ability.
Training shows improvement of both reading fluency as well as reading speed. The training of eye movements is an important part of the TrainYouEyes-training:
- The Effect of Saccadic Training on Early Reading Fluency
- The effect of visual therapy on the ocular motor control of seven to eight year old children with developmental coordination disorder (DCD)
- Efficacy of vision therapy in children with learning disability and associated binocular vision anomalies
- The Effect of the King-Devick Reading Acceleration Program on Reading Fluency and Comprehension: A Summary of Randomized Clinical Trials
Convergence - the Ability to turn the Eyes inwards
Training shows improvement regarding eyestrain, headache, blurred vision, double vision, tiredness, concentration problems, jumping text, loss of reading understanding after a short while of reading and/ or performance of near activities. The training of the convergence ability is a large and leading part of the TrainYourEyes-training:
- A Randomized Clinical Trial of Treatments for Convergence Insufficiency in Children
- Effectiveness of Vision Therapy in School Children with Symptomatic Convergence Insufficiency
- Effect of treatment of symptomatic convergence insufficiency on reading in children
Accommodation - the ability to sharpen your eyesight as well as to move focus from one distance to another.
Training shows improvements in terms of blurred vision in the reading distance, short-term blurred vision, when looking upwards from short to a long distance, headache, running or burning eyes, tired eyes, loss of concentration and abandonment of near activities. The training of accommodation is included as a fixed part of the TrainYourEyes training.
- Treatment of Accommodative Dysfunction in Children: Results from an Random Clinical Trial
- Effect of treatment of symptomatic convergence insufficiency on reading in children
- Chen, AM; Scheiman, MM; et al., 2020, Effectiveness of vergence/accommodative therapy for accommodative dysfunction in children with convergence insufficiency, Ophthalmic Physiol Opt, 2020 Oct 29
Long-lasting effect of Training
Since visual therapy is not just training of the individual eye muscles, but rather training the brain`s control of the action of individual binocular vision, the effect of visual therapy has proven to be long-lasting:
- Leong, 2014 The Effect of Saccadic Training on Early Reading Fluency
- Coetzee 2013, The effect of visual therapy on the ocular motor control of seven to eight year old children with developmental coordination disorder (DCD)
- Convergence Insufficiency Treatment Trial Study Group, 2010, Long Term Effectiveness of Treatments for Symptomatic Convergence Insufficiency in Children
Frequency - General Population:
At least 20% of all children and adults have binocular vision problems (BVD: Binocular vision dysfunction). Depending on study, age, method, selection: 15-51%:
- Swanson, 2018, Frequency of Visual Deficits in Children with Developmental Dyslexia
- Davis, 2016, Convergence Insufficiency, Accommodative Insufficiency, Visual Symptoms, and Astigmatism in Tohono O'odham Students
- Leat, 2013, Binocular vision and eye movement disorders in older adults
- Lanca 2013, Binocular vision and reading ability in a Portuguese population of scholl age children.
- Cooper 2012, Convergence insufficiency-a major review
- Muzaliha, 2012, Visual acuity and visual skills in Malaysian children with learning disabilities
- Abu Bakar, 2012, Comparison of vision disorders between children in mainstream and special education classes in government primary schools in Malaysia, Singapore
- Heim 2004, Slutrapport fra prosjektet syn og lesning hos elever i grunnskolen
- Rouse, 1999, Frequency of Convergence Insufficiency Among Fifth and Sixth Graders
- Porcar 1997, Prevalence of general binocular dysfunctions in a population of university students
When reading it is essential to turn the eyes inwards, so that both eyes hit the same spot in the book. This is called to converge. If the eyes cannot converge correctly it is called convergence insufficiency (CI) WHO-diagnose code for this condition is: ICD H 51.11
Problems with convergence insufficiency could be:
- Double vision/ shadows on the text
- Tired, irritated eyes and eyestrain
- Difficulty reading - words get blurred/fall to pieces
- Loses the reading spot
- Reads too slowly
- Reduced desire to read
- Reduced ability to concentrate
- Blinks or rubs the eyes
- Closes one eye when reading
- Results in impaired visual endurance
- 15%/34%-without dyslexia, 15% contra dyslexic children 34% (Swanson, 2018)
- 5%- all age groups (Cooper, 2012)
- 13%-fourth and fifth grade (Rouse, 1999)
- 7,7%-Students (Pocar, 1997)
- 6,2%-11,67 years +/-1,81 years(Davis, 2016)
- 14%-8-12 years old with reading problems (Muzaliha, 2012)
- 3,7%/31,5% - “ordinary children” 3,7% contra “Special class children” 31,5% (Abu Bakar, 2012)
When reading it is essential to focus sharply on the text in the book and, at the same time, be able to shift focus from one distance to another. This is called to accommodate. If the eyes cannot accommodate correctly, it is called accommodation insufficiency (AI). The WHO-diagnosis code is ICD H 52.533.Problems accommodating might be:
- Difficulty in adjusting vision from short to long distances-and the other way round
- The text jumps and/or changes sharpness
- It takes a while, before a given text is sharp
- Unclear vision after a long time reading
- Double vision/ shadows
- Irritated eyes
- 9%/55%- without dyslexia 9% contra dyslexic children 55%(Swanson, 2018)
- 6,2% - Students (another 10,8% AE) (Pocar, 1997)
- 23,3% - “Special class children” (Abu Bakar, 2012)
- 18,2%-3.-8. Class (Davis, 2016)
- 26%-8-12 years old children med learning disability (Muzaliha, 2012)
Eye movement deficiency (inadequacy)
When reading it is important to be able to move the eyes from letter/ word quickly and precisely as well as be able to change line correctly. The eye movements are used for this. These eye movements can be divided into smooth pursuit eye movements (following movements) and saccade eye movements (eye shift movements). If the eye movements are not optimal, the condition is called eye movement deficiency. The WHO- diagnosis codes are ICD H 55.81 (saccades) and H 55.89 (smooth pursuit). Problems with uncoordinated eye movements could be:
- Reduced reading speed
- Reduced reading understanding
- Difficulty reading fluently
- Rereads/ skips lines
- Difficulty in finding around the text and finding the reading spot if the focus is moved
- Swapping letters e.g. and “b” and “d”
- Reduced concentration ability
- Tiredness around the eyes at the end of the day
A study with dyslexia-word blindness
Study by(Swanson, 2018) of respectively dyslexic and non- dyslexic children
- 29 Developmental dyslexia (DD)- eye blind children-Mean age 10.3 years
- Accommodation insufficiency AL: 55%
- Convergence insufficiency CI: 34 %
- Eye movement problems: 62%
- 33 children without dyslexia (TD)
- Accommodation insufficiency AI: 9%
- Convergence insufficiency CI:15%
- Eye movement problems: 15%
Conclusion:79% with dyslexia and 33% without having at least one binocular vision problem
A study with “Special class” children
- 1010 children with learning disability from 8-12 years in Malaysia (Muzaliha, 2012)
- Accommodation insufficiency AI: 26%
- Convergence insufficiency CI: 12,1%
- Conclusion: nearly 30% of the children had accommodation problems and convergence problems.
A study with “ADHD” and convergence insufficiency
266 patients with CI (convergence insufficiency) in eye clinics, thereof 9,8% with diagnosed ADHD
Conclusion: Three times greater prevalence of ADHD among patients with CI compared to the prevalence of ADHD in the general American population. (1,8-3,3%). Moreover, there is three times more prevalence of CI in the ADHD-population.
Citizens with traumatic brain injury
When it comes to traumatic brain injury, it is research concerning the prevalence of visual-and binocular problems. Thus, up to 60% of the patients with traumatic brain injury have effects on vision. . Studies show that, patients blink more and move their eyes less.. I.e. they have trouble deciphering and overlooking the world in everyday life.
Other studies show that, up to 51% get problems with uncoordinated movements, up to 56% get the diagnosis code: convergence insufficiency, i.e. they cannot control the eyes inwards , while up to 41% get the diagnosis: accommodation insufficiency i.e. they cannot focus. Furthermore, up to 50% have a mal functioning vestibular-ocular system, that may cause dizziness, nausea and motion sickness etc.: Wallace, 2016, Traumatic brain injury and vestibulo-ocular function: current challenges and future prospects og Hoffer, 2004, Characterizing and treating dizziness after mild head trauma samt Cripps, 2013, The value of balance-assessment measurement in identifying and monitoring acute postural instability among concussed athletes og Chamelian, 2004, Outcome after mild to moderate traumatic brain injury: The role of dizziness.
Visual Consequences of a Stroke - Study 2019
Across three hospitals in England 1033 patients, that had a stroke, were examined.
- 75% had visual problems
- 56% had reduced central vision
- 40% had trouble moving their eyes
- 28% had lost parts their visual field
New systematic Review - Meta Analysis – Study 2019
- 42,8% (31,3 to 54,7%) had accommodation dysfunction (trouble focusing)
- 36,3% (28,2-44,9%) had convergence problems (fixation problems)
- 18,2% (10,6-27,1%) had lost parts of their visual field
- Therapist-assisted visual therapy increased peripheral visual consciousness
- Furthermore, the patients felt more secure in the traffic and by outdoor activities
- The reading speed increased significantly, from 88-140 words a minute
- The ability to keep a moving object in focus was enhanced. Neurological stationary patients can benefit from visual therapy
More studies show that, 100% of the patients with cerebral vascular injuries improved after visual therapy and the results were stable after 2-3 months, that there are promising results regarding visual rehabilitation of the vision, that visual therapy can improve reading significantly and lastly training improves eye movements and reading simultaneously. Furthermore studies show that, visual therapy improves both convergence capability and reduces binocular vision problems and at the same time increases visual awareness, just as the significant changes suggest that, visual therapy affects the visual system at early visual-cortical levels, which are involved in visual alertness.
When elite sportsmen`s brain performance is compared to non-elite athletes, significant difference is seen in several studies:
F 1 Drivers:
- Here, differences were found in the parts of the brain, that manages interaction between vision and motor skills, as well as strengthening areas, involved in planning and execution of movement.
- Areas in the retro-spinal cortex are also more well developed in F 1 drivers. These areas are thought to be involved in episodic memory, navigation, planning and visual data management.
- There are distinctly physiological differences in the way F 1 drivers brain manages visual-motor data also during simple tasks.
- Bernardi, et al., 2014
- Vann, et al., 2009
- Bernardi, et al., 2013
- Elite football players have better dynamic visual acuity as well as accommodation: quick and precise focus shift. Attackers have a faster conversion of vision than defenders.
- Robert, et al., 2017
- etter dynamic visual acuity
- Markedly quicker eye movements
- Significant better stereopsis (3D-vision) in major than in minor league players
- Laby et al., 1996
- Uchida et al., 2013
- Elite athletes are quicker “picking up perceptual cues” and “visual search”-i.e. scanning an area and choose the most important, because they use less fixations of shorter duration than non-athletes.
- Visual-perceptual and visual-cognitive skills have improved in elite athletes compared to “ordinary”
- Mann et al., 2007
- Starks et al., 2003
- Williams et al, 1999
The effect of targeted Visual Therapy
- Significant improvement as to reaction time, depth vision, accommodation (swift and precise visual adaption), saccadic eye movements and batting performance.
- The control group and placebo group improved a little as to batting performance but did not show any visual improvement.
- It can be concluded that visual therapy improves the visual abilities of cricket players, which can lead to improvement of batting performance.
- Balasaheb et al, 2008
- Significant visual and eye motor improvements after visual therapy – much better than the control group as well as the placebo group.
- The present analysis therefore concludes that, visual therapy improves the basic visual skills, which on the other hand can be transferred to sports- specific presentation.
- Maman Paul et al, 2011
- After the visual therapy the players had a better vision, less strike-outs, created more runs- which lead to 4-5 extra team-victories. The visual therapy program, based on perceptual learning principles, shows results, that are directly transferable to the sport.
- Deveau et al., 2014
- All batting parameters were improved with at least 10% after visual therapy. Visual therapy can combine traditional and technological methodologies in training athletes` eyes and improve their batting performance.
- Clark, et al., 2012
- Significant improvement in visual performance as well as the pistol shooting scores after visual therapy
- The visual improvement is significant as to phoria at long distances, faster recovery of the vergences (the visual endurance) at a distance, negative relative accommodation (vision change) and saccadic eye movements (the fast scanning-eye movements).
- Junyent et al., 1995
- Significant improvement after visual therapy regarding to three parameters: Near-distance speed, Target Capture and Go/No-Go.
- Appelbaum, et al., 2016
- All three groups, who received visual therapy, obtained a significant increase in their netball-passing rate.
- Players, that received visual dynamics and training of visual skills also achieved a marked increase in their passing accuracy.
- These results indicate that dynamic visual therapy seems to be the most effective approach to help players maximizing their use of vision during sports presentation.
- Bressan, 2003