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Under plans with no such exclusion, Aetna considers up to 12 vision therapy visits or sessions medically necessary for treatment of convergence insufficiency. Requests for vision therapy exceeding 12 visits for this indication is subject to medical review. This policy addresses active vision therapy. This policy does not address use of passive orthoptic or pleoptic devices, such as occlusion which is considered medically necessary for amblyopia, and prism adaptation that is considered medically necessary prior to surgery for strabismus.
Orthoptic or pleoptic devices are considered durable medical equipment. Aetna considers vision restoration therapy, alone or in combination with transcranial direct current stimulation, for the treatment of visual field deficits following stroke or neurotrauma experimental and investigational because its clinical value has not been established. Aetna considers the use of visual information processing evaluations experimental and investigational because its clinical value has not been established. In addition, most Aetna benefit plans exclude coverage of services, treatment, education testing or training related to learning disabilities, or developmental delays. See also CPB 0078 – Learning Disabilities, Dyslexia, and Vision, CPB 0250 – Occupational Therapy, and CPB 0469 – Transcranial Magnetic Stimulation and Cranial Electrical Stimulation. Background Vision therapy encompasses a wide variety of non-surgical methods to correct or improve specific visual dysfunctions. It may include eye exercises, as well as the use of eye patches, penlights, mirrors, lenses, prisms, and patches.
Other modalities in use by vision therapy proponents include sensory, motor, and perceptual activities. Orthoptics and pleoptics are common forms of vision therapy. Orthoptics are exercises designed to improve the function of the eye muscles. Proponents consider these exercises particularly useful in the treatment of strabismus and other abnormalities of binocular vision. Pleoptics are exercises designed to improve impaired vision when there is no evidence of organic eye diseases. There is a broad range of vision therapy techniques and methods among practitioners who perform vision therapy making the practice of vision therapy difficult to standardize and evaluate. It is the opinion of these organizations that any claims of improved reading and learning with the use of these methods usually are based on poorly controlled studies.
Thus, there are no eye or visual causes for dyslexia and learning disabilities, and there is no effective treatment. However, there is little data available on the efficacy of vision therapy for treating learning disabilities or dyslexia. It involves the use of lenses, prisms, and specialized testing and vision training procedures. Vision therapy is a term used to refer to a variety of non-surgical approaches to the treatment of a variety of visual dysfunctions.
Active vision therapy has primarily been used in the treatment of strabismus, as well as other disorders of binocular function and ocular motility. A wide variety equipment and techniques are used, including penlights and mirrors, biofeedback, video games, tracing pictures, puzzle completion, etc. In some instances, electronic or computerized optical instruments are used to enhance the treatment. Asthenopia is a term used for discomforts attributable to visual dysfunctions, including headaches, visual fatigue, and excessive rubbing of the eyes. Active vision therapy has also been advocated as a treatment for learning disabilities and for improvement of sports performance in normal individuals. Professional opinion is divided on the effectiveness of vision therapy.