In 1993, Paul Romano, MD, the editor of Eye Muscle Surgery Quarterly, conducted a worldwide survey of eye muscle surgeons. He asked surgeons to indicate whether they would favor a surgical or nonsurgical approach to the treatment of intermittent exotropia (a form of strabismus). 85% of the international group recommended nonsurgical approaches, as compared with only 52% of the American surgeons. Dr. Romano postulated three important reasons why this might be so: 
- Insurance companies and single-payer systems outside of the U.S. have stricter medical standards in regards to approving payment of eye muscle surgery. Also, they do not pay as well for eye muscle surgery as insurance companies in the U.S.
- Nonsurgical therapy isn’t as economically rewarding for the surgeon in the U.S. due to the personnel and fees involved.
- Due to his/her lack of training in this area, the surgeon is reluctant to acknowledge the benefits of nonsurgical therapy for fear of losing patients.
Can vision therapy help with learning problems?:
Vision therapy can improve visual function so the patient/student is better equipped to benefit from education instructions. In 1991,
Firmon Hardenbergh, M.D., the Chief of Ophthalmology at Harvard University Health Services, has this to say regarding a double-blind scientific study of children with reading disability and convergence difficulty:
“The application of orthoptics (included in vision therapy) to all learning / reading disabled or deficient children who manifest convergence insufficiency should be the first line of therapy.”
Regarding visual processing and learning disabilities, Corinne Smith Ph.D., Associate dean of Education at Syracuse University, noted in her 1997 text on Learning Disabilities, that students with visual perception disabilities have trouble making sense out of what they see.
“The problem is not with their eyesight, but with the way their brains process visual information.”
Vision therapy is directed toward resolving visual problems which interfere with education instruction. A multidisciplinary team approach to treating learning disabilities is recommended, and vision is one aspect of the overall picture.
Check out Jennifer's story