Published: 16 November 2017 | Updated: 30 September 2026 | Author: Smart Vision Optometry
Editorial and clinical update — 30 September 2026: The original article/interview below is preserved, including its attributed quotations and editorial structure. Current evidence and guidance below should be relied on where older wording differs.
Toe walkers are those brilliant tiny people that begin walking as we all do – on tiptoes, so they can reach up and get at things that they probably should not be touching. However, due to orthopaedic or developmental delays, they do not grow out of the toe walking and fail to achieve the full heel strike when walking.
TOE WALKERS
You have probably seen them at your child’s school or at afterschool sports. Their heels do not strike the ground well, if at all, and they bounce their way through life. There are lots of different treatments for toe walking, including physiotherapy, medical casting and stretching. But did you know that in some cases, fixing the vision can fix the feet?
At Smart Vision Optometry, our Vision Therapists work a lot with prisms – funny shaped lenses that change your view of the world. Yoked prism lenses, specifically, allow us to alter the patient’s space world, asking for a perceptual shift in how they see things around them.
By using lenses to shift everything down, the patients feel as though they are walking down a hill and so their posture changes to become more introverted and hunched. They then walk toe first down the hill, avoiding a heel strike, just as you would if walking down a steep decline. Alternatively, by using yoked prism lenses to shift the world up, the patient feels as though they need to walk up a hill. Their posture changes and becomes much more open – they march up the hill, heels first!
Doctor of Optometry, Robert S. Fox, published a powerful research article all about the use of prisms in vision therapy and how critical they are for bringing about eye-mind-body changes. There is also a wonderful mother in the United States who wrote a fantastic blog article about how Vision Therapy is saving her daughter, Stella’s, toes.
A couple of years ago, I myself began Vision Therapy with a patient who had poor binocular skills and could not see in 3D. I used the yoked prism lenses to force visual concentration and shift her space world. As soon I put the lenses on, shifting her world up, she sunk to her heels. She looked at me stunned as she had been seeking a solution to her toe walking all her life (she was 36 years old) and I had just allowed her to stand flat by making her wear glasses that made her look like a minion! Pretty amazing stuff.
If you would like more information on toe walking and how it can be related to the visual system, feel free to contact us.
Current evidence and clinical context
The Royal Children’s Hospital toe-walking pathway includes gait, physical and neurological assessment, with physiotherapy or specialist referral where indicated.
An immediate change observed with prisms is not proof of sustained improvement or of the cause of a gait problem. The preserved anecdotes should not be treated as controlled evidence that vision therapy or prisms can reliably correct toe walking.
Related Smart Vision reading
Comprehensive eye assessment · Visual and developmental concerns
Frequently asked questions
Who should assess persistent toe walking?
A medical professional can assess gait and development and arrange appropriate referral.
Do the prism anecdotes establish an effective toe-walking treatment?
No. They do not establish sustained benefit or predict an individual outcome.
Can an eye test replace a gait assessment?
No. Coexisting visual concerns and gait problems need appropriate assessment.
