Various forms of visual therapy have been used for centuries. The concept of vision therapy was introduced in the late nineteenth century for the non-surgical treatment of misaligned eyes (strabismus). This early and traditional form of vision therapy is what is now known as 'orthoptics' - although this term does not limit the work of Orthoptists who today often work beyond the realm of strabismus. Collaboration of some Eye care professionals with educators and neuroscientists produced an expansion of vision therapy into the treatment of other eye coordination (binocular) deficits as well as dysfunctions in visual focusing, perception, tracking and motor skills.

As a result of this expansion and ensuing confusion over what the term "vision therapy" includes, there is some controversy as to the use of vision therapy for individuals with learning disorders.

Vision Therapy encompasses a wide variety of non-surgical methods which some have divided into two broad categories based on their clinical acceptance and general practice by eyecare professionals:

It may be prescribed to patients with problems of visual related skills required for reading, eye strain, visually-induced headaches, strabismus and/or diplopia[citation needed] It is commonly practiced by optometrists and behavioral optometrists - however, more specialized problems are co-managed between orthoptists and ophthalmologists.

Behavioural Vision Therapy does not limit itself to disorders of the visual system. For example, Behavioral Optometrists hold that the sensitivity of a Professional athletes peripheral vision on the playing field may have enhanced responsiveness to fast moving objects with vision therapy, beyond the normal realm general improvement with practicing their sport.[citation needed] Ophthalmologists and orthoptists do not endorse these exercises as having clinically significant validity for improvements in vision. Usually, they see these perceptual-motor activities being in the sphere of either speech therapy, occupational therapy or physical therapy.

Orthoptics aims to treat binocular vision disorders such as strabismus, and diplopia. Key factors involved include: Eye Movement Control, Simultaneous Focus at Far, Sustaining Focus at Far, Simultaneous Focus at Near, Sustaining Focus at Near, Simultaneous Alignment at Far, Sustaining Alignment at Far, Simultaneous Alignment at Near, Sustaining Alignment at Near, Central Vision (Visual Acuity) and Depth Awareness. .

Some of the exercises used are:

There is widespread acceptance of orthoptic therapy indications for:

Convergence insufficiency is a common binocular vision disorder characterized by asthenopia, eye fatigue and discomfort. Asthenopia may be aggravated by close work and is thought by some to contribute to reading inefficiency. In 2005, the Convergence Insufficiency Treatment Trial (CITT) published two large, randomized clinical studies examining the efficacy of orthoptic vision therapy in the treatment of symptomatic convergence insufficiency. Although neither study examined reading efficiency or comprehension, both demonstrated that in-office vision therapy was more effective than "pencil pushups" (a commonly prescribed home-based treatment) for improving the symptoms of asthenopia and the convergence ability of the eyes. The design and results of at least one of these studies has been met with some reservation, questioning the conclusion as to whether intensive office-based treatment programs are truly more efficacious than a properly implemented home-based regimen. The CITT has since published articles validating its research and treatment protocols. Its most recent publication suggested that home-based computer therapy combined with office based vision therapy is more effective than pencil pushups or home-based computerised therapy alone for the treatment of symptomatic convergence insufficiency.

Behavioral vision therapy is practiced primarily by optometrists who specialize in this field. Behavioural VT aims to treat problems including difficulties of visual attention and concentration, which may manifest themselves as an inability to sustain focus or to shift focus from one area of space to another.[citation needed]