Midtown Vision Development Center - BLOG

Life Love and Vision

8/19/2019

Thank you to COVD for this piece.
COVD Link:https://covdblog.wordpress.com/2013/09/23/life-love-and-vision/

My husband and I attended the wedding of our friends Nancy and Jim over this past weekend. What a fabulous weekend celebration! I spent a few moments chatting with Jim’s parents, and I could not help but wonder, why is Jim’s dad, Allen, wearing glasses with a frosted lens? The lens for the left eye was opaque. The result is the same as wearing a patch, but without the “pirate mystique.”

I assumed Allen suffered from double vision and the frosted lens very simply eliminated the second image. This is a very simple solution to a very serious problem, but it does have a downside. In addition to decreasing the field of vision on the left side, covering 1 eye eliminates stereoscopic vision, which is essential to depth perception. Depth perception is an integral part of our daily lives, including getting around and navigating in a 3-dimensional world. I wondered if more complex solutions had been attempted to eliminate the double vision and if a referral was warranted to a developmental optometrist.
But my assumptions were wrong. When I had a few moments to ask Jim about it, he told me his father lost his eye to cancer. He had been fitted with a prosthetic eye, but for whatever reason, it didn’t work out. The opaque lens is cosmetic. It hides the disfigurement that has resulted from his surgery.
I am sure that on the morning of his son’s wedding, when Allen opened his eye, he was filled with gratitude. Maybe he wasn’t able to appreciate the 3-dimensional beauty of his son’s wedding…..the vast lawn overlooking the lake with the lush green hills as a backdrop. BUT he was THERE. and he was able to SEE the love and joy on the faces of Nancy and Jim. He was able to SEE his children and grandchildren ripping up the dance floor with their new extended family at the celebration.
Live your life with love and vision. Don’t take your vision for granted. Make that appointment with your eye doctor today! That’s what I am going to do.

Saccadic Therapy and Reading Fluency

8/12/2019

Thank you to COVD for this piece.
COVD Link:https://covdblog.wordpress.com/2014/06/25/saccadic-therapy-and-reading-fluency/

We’ve heard it time and again from ophthalmology, pediatricians and even some educators. “Vision has nothing to do with reading.” Those of us who diagnose and treat binocular vision problems know this to be false at several levels.
Clinically, almost on a daily basis, we see that when our patients improve their binocular vision skills, they concurrently improve academically (especially in the areas of reading). Scientifically, we read peer reviewed article after peer reviewed article that strongly links vision and academic performance. We consistently note research published in the best journals that demonstrates a significant link between oculomotor, accommodative and vergence ability and academic outcomes. Finally our major optometric organizations have come together utilizing a nationally recognized panel of experts that, armed with this research, supports the importance of diagnosing and treating learning related vision problems.
A recent paper published in Clinical Pediatrics (see bibliography below) by a group of authors representing both optometry and medicine clearly demonstrates this link between vision function (in this case saccades) and reading fluency. Seventy-six students from a private urban elementary school enrolled in kindergarten through 3rd grade were utilized as subjects after completing a vision screening. Reading fluency was assessed using the Reading Fluency subtest of the Wechsler Individual Achievement Test Third Edition and King-Devick Test. King-Devick Remediation Software was used for treatment.
In this prospective, single-blinded, randomized cross-over trial, treatment was conducted for 6 weeks for 20 minutes per day, 3 days per week using the remediation software noted above. The outcomes showed that the treatment group had significantly higher reading fluency scores after treatment and post-treatment scores were significantly higher compared to the control group. At the 1 year follow up, scores for fluency were higher for all grades compared to the treatment group as well. In the kindergarten group significant improvement also showed similar improvements in fluency post treatment and at the 1 year follows up.
The authors state that “We hypothesize that this improvement in reading fluency is a result of the rigorous practice of eye movements, both saccades and vergence, and shifting visuospatial attention, all of which are vital to the act of reading.” Improving saccades and vergences are linked to improved reading fluency that not only shows immediate improvement, but also long term positive results as well.
This paper reflects outcomes by researchers not only from optometric institutions (Illinois College of Optometry) but also the Children’s Hospital of Philadelphia, University of Pennsylvania and the Department of Neurology, Mayo Clinic. This research is an ecumenically derived publication involving individuals with outstanding reputations within their respective fields that represent diverse backgrounds, education and training. [e.g. Dr. Yi Pang is an expert in disorders of the binocular vision system. Dr. Leonard Messner is noted for his expertise in retina and neurological anomalies. While the MDs involved have their areas of expertise as well.]
The Take-home Message: Those who dispute the link between vision and academics must critically review and change these misguided beliefs. We cannot afford to let unfounded, dogmatic opinions, professional animosities and political agendas stop our children from achieving single, clear, comfortable and binocular vision while attaining their highest academic level possible.
If you have a colleague, an educator or education specialist who has not stayed current with the research in this area to take a look at the annotated bibliography below. Tell the parents that you work with of this critical research support of what we do for our patients on a daily basis. In the past we have always stated we do not teach reading when conducting vision therapy. This is true. However, the evidence supporting a link between vision and academics and an improvement in academic achievement after vision therapy is growing at an exponential rate.
Yes, Virgina, there is a link between vision and learning. And yes, vision therapy improves academic performance.

After 5 Surgeries, Michelle found Vision Therapy

8/5/2019

Thank you to COVD for this piece.
COVD Link: https://covdblog.wordpress.com/2014/04/29/8151/

As Co-Chair for COVD’s Social Media Committee, I was recently drawn to a response on Twitter from one of our followers. A 26 year old woman living with strabismus, reached out and was eager to tell her story in order to help others in their search for answers. Michelle Lovely has had 5 unsuccessful surgeries for her condition and is now finding that vision therapy is helping her in a way that previous treatments had failed.
Can you explain what first brought you to seek vision therapy?
Originally, my mother asked my Pediatric Ophthalmologist in the mid-90s if we could try vision therapy, and they told my mother not to waste her money because it does not work in someone over the age of 6. So we decided to go a different route and continued to try surgery.
Fast forward to 2013: I had been talking about getting contacts for a while (since I am now dependent on my eyeglasses). Since my Pediatric Ophthalmologist did not prescribe contacts, I had to find an optometrist that prescribed contacts.
The Optometrist I went to, Dr. Joseph Rouw, happens to be involved in vision therapy, as is his wife, Dr. Nadira Shadeed (Dr. Shadeed is Board certified in vision therapy by COVD). They have a private practice that focuses on vision therapy. Dr. Rouw asked me if I had ever considered trying vision therapy, and gave me some information to look at before I picked up my contacts the following week. After doing some research myself, (after five failed surgeries in the past) I thought I would give it a try because I had nothing to lose. I am so glad I took the chance and tried vision therapy.
You mentioned you had a number of surgeries for strabismus. Did your surgeon ever suggest that there may be another alternative to treat your condition?
No. As far as I can remember, my mother had to initiate the discussion on alternative treatment options for my strabismus. That being said, I was patched (first at 18 months, and then again as a toddler) after my first failed surgery at the age of two. I had to wear eyeglasses in third grade, which I never wore until I hit driving age. Do I think the alternatives we tried worked? Maybe for a while. I do believe patching my stronger eye saved my weaker eye from completely shutting down. My family moved out of state after my first surgery, and my parents talked to other Pediatric Ophthalmologist about other alternatives. Each one felt like my Atlanta doctor was the best and if they said surgery was the only way to fix the issue, they did not want to contradict them.
How soon after your surgeries did you, or your parents, realize that the surgeries did not work?
With each surgery, there was a gradual drifting of the eye that was worked on. However, I can distinctly remember after the fourth surgery that it took a week for me to figure out that the surgery failed. I was older, (14-years old) and was more conscious of what was going on with me medically. There was a distinct “pop” I felt, and knew my eyes went back to the original position. I will never forget that sensation.
Even after the history of failed surgeries, I am now considering trying one more time. Through vision therapy, I have trained my eyes to work together and work straight. Before, I did not have the control I have now. Dr. Shadeed once told me that the eyes have a better chance in staying together if the person does vision therapy (before and after surgery) to reinforce the now surgically straight eyes. Before vision therapy, (if you asked me if I would consider another surgery) it would be a fast NO. Now with a recommendation from Dr. Shadeed and Dr. Rouw, I would chance surgery one more time.
How long after beginning vision therapy did you start to see changes?
The first time I noticed something new was during the very first appointment. We were working on teaching my eyes to go straight. By the end of the lesson I was more conscious about what my eyes were doing. The first time I saw depth was about 7 months into therapy. It was an amazing day! The exercise was called Aperture Rule.We had worked on it before, but could never get past level 1 or 2. I never noticed the depth until we started again in 7 months. Something just clicked that day. I got all the way to level 12 AND noticed the depth! I am currently working on Eccentric Circles, which is a step up in difficulty.
What do you think is the greatest difference in philosophy between corrective surgery and vision therapy?
First off, I want to say there is nothing wrong with going the corrective surgery route; you just have to do your homework. Make sure it is the right option for you and at the time. It seemed like the best option I had to “fixing” my eyes.
That being said, I think the greatest difference in philosophy is whether you want a quick “fix” or not. With corrective surgery, each surgery was tailored to the specific muscle you manipulate. However, there was no follow-up therapy or special instruction, just “hope for the best” and wait to see if this surgery worked.
With vision therapy, it depends on the complexity of the case, how long you will be in therapy, and if it will work at all. You again have to do your homework to decide if it is worth the money to try months of therapy that may or may not work, and insurance may or may not pay for. With vision therapy, you are training your eyes to do something they likely have never done before (which is WORK TOGETHER), which takes time, patience and dedication.
What surprises you most about vision therapy?
The eye is a muscle, and like any muscle it atrophies and strains depending on the level of use it gets. I would have to say the thing that surprises me the most about vision therapy is how a few simple exercises can manage to accomplish what corrective surgery could not. I had five corrective surgeries between the ages of two and fifteen, and all that accomplished was getting them straight for maybe a week or two. With vision therapy, I can keep my eyes straight for periods of time and now I am starting to see depth perception, which I never have been able to accomplish in the past. I am beginning to get all the pieces of stereovision and working on having them all at once.
What “aha” moments have you had in therapy?
I had read Dr. Susan Berry’s book Fixing My Gaze after my optometrist suggested it. As I was reading about her journey to stereovision, she was able to put our world in words I have never been able to do. I was fascinated and frightened at the same time. Here I am 26-years old and I have lived in a flat world all my life, and it was all about to change. I almost quit therapy right there, but knew I had to try.
I think after each milestone there was an “aha” moment of where the exercise “clicked”, and I mastered the lesson for the day. The first “aha”moment was September 29th, 2013, one month after I started vision therapy. I had been working on the Brock String for 2 weeks and finally saw the cross at the bead, and thought “So, this is what it feels like to see ‘normal’”. I got so excited about seeing the Brock String that I had to e-mail my therapist at that moment to share the news (even though it was Sunday evening). Dr. Susan Berry mentions a moment where the steering wheel of her car popped for the first time, and I had a similar moment with the television screen. I was concentrating on keeping my eyes straight. All of a sudden, the television popped away from the wall (which was amazing yet frightening at the same time). This was on January 28th. Also, at my most recent session, March 28th, I finally figured out the Aperture Rule. It was a big accomplishment for me. That was the first time I REALLY saw depth perception
What would you like to tell us about your therapist and doctor?
I am so thankful to the optometrist who recommended I give vision therapy a try. The decision was difficult for sure because I knew it would be a lengthy process and insurance most likely would not cover it. So I had to decide whether it was worth the money for something that may not work. My therapist is great, and for the first time I feel like someone is actually listening to and working with me. I have a complex medical history that goes beyond strabismus, and my therapist is the first doctor that I know of that took the time to try and piece the puzzle together to see how everything connects. After my first session, my therapist told me what I will be able to accomplish by the time I “graduate” therapy and I said, “When pigs fly!”. Well, I have already accomplished many things on her list. For instance, I can now catch a ball and balance on a BOSU balance ball. Never Say Never!
Thank you for reaching out to us with your story. What do you think we can do to get the word out about vision therapy so less people go through what you have been through?
Education. Find out what ALL the options are for your particular case. For some, corrective surgery may be the right option. For others, vision therapy would be worth the time and energy. Be your own advocate on if you want to try vision therapy instead of doing invasive surgery. Talk to your doctor. Chances are they will support you on it even if they do not agree with the philosophy behind vision therapy.
Thanks to Michelle Lovely for sharing her story. Dr. Joseph Rouw and Dr. Nadira Shadeed practice in Dacula Georgia (http://www.visiontherapy4kids.com).

From First-Grade Reading Speed to Law School: Darby’s Success Story

7/29/2019

About to begin her first semester of law school, Darby knew her headaches and slow reading pace needed help before she hit the books. These symptoms were paired with lifelong learning difficulty, so just like Landon, she was first pointed toward a diagnosis of ADHD. But a specialist in the disorder had a new idea: maybe the cause was an unknown problem with her vision. A member of the College of Optometrists in Vision Development (COVD) confirmed that this was indeed the case: she was discovered to have the reading speed of a first-grade child.
All too often, vision problems are never diagnosed and go untreated as children are unaware of, or unable to describe, their struggles. A “20/20” score from an in-school screening is no guarantee that a child’s vision is perfect. This was just the case for Darby, who pushed through school in spite of her vision problems, thanks to work-around habits and dutiful parents.

“My vision struggles made reading very difficult,” she recalls, “assignments took me a lot longer to complete than my classmates. This forced me to develop good time-management skills and study habits. I was also fortunate to have parents with great work ethics to push me, so I didn’t fall behind.”
After a few months of vision therapy (VT), Darby is reading faster and with less headaches. She has also noticed improved hand-eye coordination and peripheral vision, now noticing “much more movement” around her. “That took some getting used to,” Darby recounts,”it was almost over-stimulating at first.”
Her everyday life is remarkably less difficult as she finally experiences what those without vision problems may take for granted. “Prior to VT, I had no idea how much easier such simple tasks were for other people. It’s hard to understand how bad your vision is until it’s been improved.”

Darby smiles proudly with her vision therapy diploma and is on her way to earn another one at law school!When we asked if she would recommend that others give VT a try, Darby’s answer was a definite “Of course!” And for other adults who worry that “old dogs and new tricks” may apply to their vision, she urges “Don’t get discouraged!” Darby was the only adult patient in a room full of children, maybe a little embarrassed jumping on a trampoline and practicing with toys, but she insists that she would “absolutely do it again […] the improvements in my vision made it all more than worth it!”
August is Vision & Learning Month and if you suspect you or your child may be struggling just like Darby did, the optometrists in COVD are here to help. Find one near you and schedule a comprehensive exam to find out if vision therapy can change your life for the better.

Visual and Vestibular Connections

7/22/2019

Thank you to COVD for this piece.
COVD Link: https://covdblog.wordpress.com/2014/11/25/visual-and-vestibular-connections/

Today’s guest blogger is Dr. Alicia Groce. She recently graduated from Nova Southeastern University College of Optometry and is currently doing a residency in Pediatrics and Binocular Vision at Nova Southeastern University College of Optometry. In her free time she likes to play with her dogs, run and listen to music.

At the COVD Annual Meeting in San Diego, Dr. Baxtrom presented a lecture entitled “How to Vestibularly Make Optometric Vision Therapy More Effective.” In therapy, many of us incorporate the vestibular system without even thinking about it. Dr. Baxtrom shared the science behind the visual and vestibular systems and how to enhance the connection to improve therapy.
The vestibular system provides information related to movement and head position. Upright posture requires humans to balance body mass on a relatively small area of support (the feet). It is the vestibular system that carries the burden of keeping us balanced as we move through our environment. It is extremely important for the development of balance, coordination, eye movements and a stable visual world. One way the visual and vestibular systems work together is via the vestibular-ocular reflex (VOR). When motion of the head is sensed by the vestibular sensors in the inner ear, the information is processed by the central nervous system. Signals are sent to the eye muscles which cause our eyes to move in the opposite direction. The result is a stable image on the retina. Manipulation of the vestibular system can enhance eye movements and bilateral integration. This can be extremely productive when working with patients with strabismus and other binocular vision disorders. Many of us have had this experience…. a child with a strabismus starts jumping on a trampoline and when he or she looks up, the eyes are straight…amazing, right? The connection between the visual and vestibular systems explains why this happens.

There are two types of acceleration: linear and rotational. Activities such as swinging, jumping on a trampoline, rocking or walking on a rail are examples of linear acceleration; they are often helpful when working with patients with exotropia. Activities such as spinning and turning are examples of rotational acceleration; they are often helpful when working with patients with esotropia. Vestibular input can also be helpful to change the mood of a patient during therapy. How many parents have told you that putting a fussy baby in a car puts them right to sleep? This is an example of the calming effect of linear acceleration. So, patients that come into the office very anxious, agitated or hyper might benefit from a dose of linear acceleration (do you have a swing in your office?). A patient who has low tone or is falling asleep doing activities might benefit from adding rotational acceleration. Imagine how happy your patients will be if you allow them to spin on chairs and stools in the therapy room! These simple additions to therapy could change a patient’s mood and make the session more productive.
Integrating vestibular aspects into visual therapy is simple. A balance board or walking rail can be added to activities involving charts to introduce linear acceleration or the child can stand on a balance board while doing a bean bag toss. Putting a child on a swing while doing therapy activities is also a good way to integrate linear acceleration and also work on peripheral awareness as the periphery will be moving. Turn and clap activities, spinning on a swing or spinning in a computer chair are ways to add rotational acceleration to therapy.

So, next time you are stuck in therapy or wish there was some way you could help change a patient’s mood, try integrating vestibular input into your therapy.

*”Child swinging” by US Environmental Protection Agency – Climate Change & Children’s Health. EPA, December 2009. Back cover.. Licensed under Public domain via Wikimedia Commons –http://commons.wikimedia.org/wiki/File:Child_swinging.jpg#mediaviewer/File:Child_swinging.jpg

Preemies Need a Lifetime of Vision Care

7/12/2019

Thank you to COVD for this piece.
COVD Link: https://covdblog.wordpress.com/2017/11/08/preemies/

Worldwide, 15 million babies are born premature (less than 37 weeks gestational age) every year. This population is at greater risk of abnormal visual and neurological development than children born full term. The more premature, the greater the risk. Visual deficits associated with preterm birth include reduced visual acuity, higher rates of strabismus, high refractive errors, reduced stereo acuity (depth perception), loss of visual field, and reduced color vision.

Advanced neonatal care has resulted in the survival of more extremely premature babies (born before 27 weeks gestation). Extreme preemies often develop retinopathy of prematurity (ROP), which can be severe and sight-threatening. ROP develops because the retina is not fully developed at birth, even in full-term babies. The transition to an aerobic environment at birth triggers major changes in retinal development which can be disastrous in the vastly underdeveloped retina of an extreme preemie. Therefore, virtually every premature baby receives ophthalmological care during the first year of life to diagnose and treat ROP if warranted.
But what about their visual function as they grow up? A recent study looked at retinal function in 6 year old children born extremely premature, using electrophysiology recordings. These recordings evaluated how well their “rods and cones” were functioning. (Rods and cones are the retina’s photoreceptors that respond to light and initiate the electrical response that travels to the brain via the optic nerve.)

When compared to 6 year old children born at full-term, the extreme preemies were more likely to have a general dysfunction of the rods and cones. It seems that the development of rods and cones was arrested by their extremely premature births, and persisted in childhood.
Deficits in vision extend beyond these basic measurements of visual acuity and electrophysiology. All premature children (and not just those born extremely premature) are more likely to perform poorly on visual perceptual tasks such as those requiring visual-motor integration, visual discrimination, and spatial orientation. As with other visual functions, the more premature, the greater the risk of visual perceptual deficits, and the more likely they are to persist into later childhood and even adulthood. BUT while every preemie is screened for ROP, very few receive comprehensive developmental vision assessments that are aimed at diagnosing deficits in these essential visual and visual perceptual skills. All of these visual skills, from visual acuity through visual perceptual skills, contribute to the well-being of the individual, as well as academic achievement, employment and social skills in childhood through adolescence and adulthood.
What does this mean for your prematurely born child? It means that the risk for vision problems remains, whether or not diagnosed with ROP. It means your child will require a lifetime of vision care, to optimize vision development. Schedule a comprehensive vision exam now, to be sure your child will have the best visual system for a successful year, in school, and in life!

Baby D’s Story
My daughter was unexpectedly born at 30 weeks weighing in at 1lb 12oz and 13 1/2 inches long. We were told that she was the smallest baby born at that level 2 NICU at the time. We prepared ourselves for the challenges of a premature baby by reading the material provided by the hospital on issues that could come up. Fortunately our daughter encountered minimal issues.
A feeding tube was probably the biggest concern and she frequently pulled it out to show us how feisty she could be. We became very good at swaddling to help keep her arms away from the tube. We read about kangaroo care and we both took turns holding her this way. It was an amazing bonding experience. We participated in all aspects of her care in the NICU including changing her diaper and feeding her through the feeding tube. She may have looked delicate at such a small size but we learned to handle her with care and not to be afraid. She was sent home earlier than expected at 3lb 13oz since she was doing everything she needed to do. The hospital staff felt that she would be better off at home. We read about Retinopathy of Prematurity (ROP) and she was screened several times but thankfully it was not an issue, but she did need slight vision correction as she got older.
As she has grown, she has never been a slave to fashion, so we lucked out there, so it came as a surprise when she picked out a very expensive pair of colorful Gucci frames. How could we say no? She puts them to good use as she is always reading. I can’t tell you how many times she has read the Harry Potter series. We were very fortunate after having such a premature baby, but maintaining a positive attitude helped us all get through it.

Healing for the whole family: Braden's Story

7/1/2019

So many vision therapy success stories begin with months or years of struggle, not just for the patient whose vision problems had gone undiagnosed, but also for the patient’s family. Children who struggle with vision problems may suffer from headaches, nausea, and aching eyes without being able to understand that the way they see things isn’t normal. To them, this is the only way they have ever seen the world, and their physical symptoms are as much a mystery to them as they are to everyone else. This was just the case for Braden, whose difficulties started at just four years old and sent his parents on a tireless and emotional search for help.

Braden’s mother first recalls him complaining of headaches as he began preschool, but admits they could have started sooner without him being able to say so. Difficulties were intermittent at first, sometimes absent for a month or so, but suddenly once a week he would complain of a headache, vomit, then return to normal. A trip to the doctor pointed to migraines as the culprit, earning Braden a prescription for a three-times-daily medication. In his mother’s words, she was not the type “to grow a bunch of random herbs in my backyard and start feeding them to [her] son,” but still had reservations about her child taking such a long-term prescription medication without trying anything else, especially when neither she nor her husband suffered migraines. Their next attempt at a solution was what they described as “micromanaging” their son’s life.
For years, all the way through 3rd grade, Braden’s parents painstakingly recorded every single detail of his life in the desperate attempt to find any pattern or underlying cause behind his episodes of headaches and vomiting. They tracked what he ate and drank, how much sleep and physical activity he got, even how much time he spent watching TV, reading, and doing homework. Despite all this, Braden’s misery continued, and just a few months into 3rd grade he had already missed six days of school, his reading fluency was very low for his age, and he struggled with writing. Outside of the classroom, his debilitating headaches made him miss playdates and family gatherings as well, all adding up to low self-esteem and a quality of life that left much to be desired. When he was eight years old, Braden’s family again sought medical attention with a new doctor.

This new doctor took a fresh look at Braden’s medical history, as well as the four years’ worth of data his parents had tracked about his life. To their surprise, the doctor’s next question was to ask them if they’d ever heard of vision therapy. They were sure they hadn’t, but jumped at the opportunity to try something new–and drug free–that might finally end their son’s struggle.

When they finally met their nearby developmental optometrist and member of COVD, Braden’s family was at their wits’ end. “We were mentally, emotionally, and physically exhausted. We had lived a very high stress life watching and logging Braden’s every move, hoping he would give us insight to the triggers of his headaches. Our extended family had deemed us unsociable, and Braden was the ‘kid who was always sick’. We were up to two hours of homework a night, we did not read for fun, and a mass of sick days were used.” But after their very first phone call with the office’s staff, it became clear to the family that this was the right path. After years of fighting the battle alone, finally someone was asking questions, acknowledging their hard work and dedication, and working to get Braden’s school in the loop about his struggle and progress. “It was like a
much needed, long awaited, warm hug. We were no longer alone. We had this little troop of soldiers that were bound and determined to give our son a better quality of life. We went into those first appointments not knowing anything and not truly understanding the process this path would take. What we found….was our salvation.”

Unfortunately, Braden’s vision therapy did not start out easy. The family’s stress and emotions continued to run high as his enthusiasm for the at-home practice sessions was less than ideal, and his father struggled to understand that practice didn’t need to mean perfection. A particularly-stressful week culminated in an in-office vision therapy session that began with Braden arguing about what he would and wouldn’t do that day, and for the first and only time, his mother questioned their choice to try vision therapy. “Braden was still having headaches, his behavior in the work room was not conducive to what his father and I expected of him, practicing at home just led to meltdowns, and I was exhausted from just trying to keep up with everything,” she recalls. As she was sitting in the waiting room and worrying over her family’s decisions, Braden’s vision therapist heard her sigh three times and felt compelled to come out and see what was going on.
This was when the healing really started for Braden and his family. His mother opened up about her feelings regarding her son’s progress and his vision therapist did as well, and they agreed that the team needed to get together and develop a new plan for moving ahead with treatment. Used to years of tight control on her son’s every move, trying desperately to come to a solution to improve his life, Braden’s mother realized then that she needed to let go and allow others to take charge of the work that needed to be done.

The optometrist and vision therapists stepped up to the challenge far beyond expectations, showing Braden’s family that everyone’s journey through VT is different and their family was no exception. “We couldn’t just drop Braden off and pick him up after an hour session was over. Our success was in the whole picture. Braden needed to know that he was worth waiting on and that the process was important to us. How was I supposed to know Braden wouldn’t be the only one receiving therapy? Who knew that letting go of all the questions left unanswered would be so therapeutic?” Big changes started happening with Braden then. Every single session was tailored around his needs that day, without fail–what was he struggling with, how he was feeling, how things could be made to work best FOR him. Everything began to turn around, both in school and at home: Braden’s reading fluency rose drastically, he moved on to 4th grade, and started to read at home without being asked.

Braden graduates from vision therapy, next to a collage of his achievements that have given him a new lease on life.At the same time, the underlying issues that were causing his headaches on top of the vision problems were steadily being worked out. Once suffering from up to three debilitating headaches a week, Braden is down to one every few months at worst. His social and family life have blossomed, too, due to not only his own progress but the whole family’s healing. “Vision therapy taught my husband and me to look at our son from a different perspective, and we are better parents because of it,” his mother asserts. “Braden is a better student and a better version of himself because of it. I can’t express the sheer joy of knowing that my child enjoys to read and has the confidence to do so.”

Vision Therapy Lessons Learned at Dance Class

6/21/2019

Thank you to COVD for this piece.
COVD Link: https://covdblog.wordpress.com/2014/10/09/vision-therapy-lessons-learned-at-dance-class/

Last spring I developed a friendship with the mother of one of my daughter’s best friends. At the time, she was organizing a book club and I was just brazen enough to invite myself to the next club meeting. It didn’t take long before I learned that my new friend was an optometrist, as was her husband. Both Faith and her husband studied optometry at the Illinois College of Optometry. They were not practicing vision therapy doctors, but often referred to VT ODs in the area.

I believe it was during our third book club meeting that Faith mentioned she was signing up to take belly dancing lessons during the fall. Once again, I chimed in “I have always wanted to take belly dancing lessons”. The next thing I knew, I was driving 30 miles out of my way every Wednesday in order to learn this ancient and beautiful (and often humbling) art. I surprised myself, but stuck with the program and was almost ready for our recital when it arrived last weekend.

A large theater was reserved for our performance as well as the 100-150 youters who were to dance in what is normally reserved as a childhood rite of passage. On our way to the dressing room, Faith and I ran into a patient whose daughter was also a patient of hers. The mother smiled and touched Faith by the arm. “Dr. H.” she said. “Have you seen Chelsea? She is here and I have to tell you how thankful we are that you referred her to vision therapy. Faith and I stood in the hall way as she continued to share her story. “Chelsea used to get the worst headaches after only ten minutes of reading, now she is headache free and is on the honor roll at school. Even her dance teacher noticed a difference after about 6 weeks of therapy.” Faith was nearly brought to tears by the woman’s story. “Thank you, thank you”, she said. I know how powerful vision therapy can be for my patients, but I so seldom get to hear actual feedback.” Chelsea’s mom continued, “She is performing tonight in the second act and you won’t believe it, but she actually got a scholarship to Central (Michigan) for dance!”

Faith turned to me, “I want you to meet Ruth,” she said. “She is a vision therapist and helps change lives every day.” I immediately felt the emotional enormity of the situation, despite the fact that I was dressed in a bright silver leotard accented with purple jingle- wrap skirt and hot pink scarves. “You must love your job,” she said. “I do,” I replied. “There is nothing else I would rather do.”
Eventually, we were forced to leave Chelsea’s mom and rejoin the rest of the middle-aged belly dancers that were about to follow up a group of 2nd grade tap dancers performing a dance to the classic hit “Boogie Woogie Bugle Boy”.

Two days later I was seated at our weekly staff meeting and I mentioned our encounter to my doctor and fellow therapists. In the past we had discussed the professional importance of following up with those who recommend our services to their patients and clients, but we had never fully realized the empathetic reasons for reaching out to them. Those who refer to us are not only sharing their faith in our services professionally, they are also emotionally invested in the well-being of their patients. At that moment, we developed a plan that would seek to improve upon our efforts in reporting back to those who refer to us. Not only would we show the pre and post data that objectively demonstrates improvements in the patient’s ocular-motor efficiency, but we would also (with permission) include copies of the success letters our patients and their caregivers have written. It is this subjective narrative that we hope in the future will touch the hearts and minds of those who put their trust in our hands.

Motivation is Key to VT!

6/11/2019

Thank you to COVD for this piece.
COVD Link: https://covdblog.wordpress.com/2016/01/12/motivation-is-key-to-vt/

Today’s guest blogger is Katey Hajos MS. Katey has been a vision therapist and vision therapy instructor for over 10 years. Her passion is motivating the hard to motivate patient. Katey shares a few of her techniques designed to create a drive to change from within.
Let’s face it; we all struggle with motivation this time of year. We all start with the greatest intentions, but after a few weeks we start the inevitable backslide into complacency. Our students are coming back to therapy after weeks off from school and therapy (never mind all the home assignments they DID NOT do over the break) and we have a lot of making up to do! I find that the best motivation comes from within, prizes and physical rewards can be effective, but they are not a long-term solution. Here are some simple tips for keeping your student motivated throughout the entire year:

Talk to Them!

This seems simple, but our students often feel that adults really don’t care what they have to say. Ask them about their day, their pets, and their hobbies and revisit these topics every week. By learning about their interests, you can tailor their program to their needs. Everyone wants to feel special and cared for and this little bit of effort will help them open up and even look forward to their weekly time. Demonstrating that you care will add a personal touch that will open up your student to want to do well for you.

Let Them Run the Show!

Obviously, we plan the sessions as needed, but why not let them pick the order of the session. With some of my more difficult students, I have a general game plan set, but several options of how we can accomplish the tasks. Need to work on saccades? Have several types of columns to choose from and let them pick the sheet to practice. Are letters not exciting enough? Give them shapes, numbers, or even two pencils to accomplish the same procedure.

Make it Fun!

This is one of my favorite methods with those high-energy students, just keep them moving and keep the challenge up. Turn the activities into a game to keep them encouraged and challenged. Hart Chart too boring? Would you rather stand on the Bosu Ball, balance board, or how about jumping on the trampoline? How fast can you read this chart? How many can you get done in 2 minutes? Now beat your time/score! Remember to add time for misses or “crashes”.

Pass it On!

I always hear, “How does he work for you? Because he always fights me at home.” Parents can struggle with the student when working through their therapy program. Remember they have been through a lot to get to the point they are now. They have battled their student and schoolwork for a long time and this feels no different to them. Let the student demonstrate the home assignments to the parent and remind the parent that the student is the one in control of the program; it is up to them to get the work done. Children love the one on one attention they don’t always get from the busy parent, remind them to make the therapy time their special one on one time to talk about their day. Most important tell the parent that it is OK to have fun with the assignments

No wonder reading feels so weird – Adult VT, Week 7

5/31/2019

Thank you to COVD for this piece.
COVD Link: https://covdblog.wordpress.com/2016/08/09/adult-vt-week-7/
August is Children’s Vision & Learning Month, and did you know that adults with undiagnosed vision problems who struggle with learning can benefit from vision therapy as well?

Difficulties while reading, working, and learning to play the cello caused this adult patient to seek a comprehensive vision exam with a developmental optometrist found with COVD’s Locate a Doctor tool. After a diagnosis of convergence insufficiency, he was prescribed glasses with prisms and a course of vision therapy. Follow his journey below as he retrains his brain and eyes to work together.

Week 1 – Week 2 – Week 3 – Week 4 – Week 5 – Week 6

Things are really starting to happen for my vision! It’s so incredible but it also makes so much sense that such individually-tailored and directed exercises would start to really make an impact.
I can now control my eyes enough to read one word at a time and keep moving in a left-to-right direction, which was really challenging when I had no idea I was skipping and re-reading and jumping all over the place. No wonder I have to read things over… I guess I just learned to go fast enough that it made up for it. Fast but sloppy!

This week we started to work on my eccentric fixation (not looking at things with the center of my vision) and it explained even more of the visual symptoms I experience. This was the most validating thing we did so far and it really reassured me that I’m not making this all up! I’m so glad I spoke up and tried to explain how things look so my optometrist and vision therapist team would know what to test.

A surprisingly-challenging maze when you’re using one eye that’s off-center!

Many mysteries were solved when I was asked to navigate mazes on the Macular Integrity Tester (which my ingenuitive vision therapist made herself before they were commercially available! I’m so impressed!) Covering one eye, I had to move the “brush” (a sort of “x marks the spot” of the center of my visual field) through the maze. I was surprised to find that my right and left eyes acted totally differently and correlated so exactly with what I experience.

My right eye was first and it was relatively easy to navigate the maze. After I stopped hitting dead ends and finished, my vision therapist asked me how it had felt to go in the different directions. Left was the easiest and this correlated to moving from the end of one line of text to the start of the next one, which I confirmed is not difficult for me, so it makes sense that the necessary skill is easier to do.

The left eye was even more revealing. While it had been easy to keep the brush in the center of the maze path for my right eye, I could hardly keep it off the upper and right boundaries for the left one. This made so much sense because when we discovered my eccentric fixation, I had needed to look down and left of a target to aim the brush at it. It was also very hard to move downward and I was completely unable to even keep my awareness of the brush for the bottom part of the maze. Since we hold what we’re reading lower than our faces, this trouble lower down relates to my overall reading difficulty.

So this is what the mazes revealed: my right, weaker eye, had an easier time moving because its fixation isn’t as far away from the center of my vision. While my left eye is dominant and stronger, it must have started fixating eccentrically before the right eye started being turned off. Eccentric fixation was my brain’s first attempt to fix the double vision I experienced as a child, and because it would have been even more extreme due to my convergence insufficiency, my brain then learned to turn off my right eye for close work. What I ended up with is one eye that’s strong at focusing but off-center, and one eye that’s weaker at focusing and gets turned off close up. No wonder reading feels weird!

Today was the first day we started working on binocularity, meaning my eyes working together, now that my right eye was starting to get more caught up with my left. We did an activity called Squichels which is really fun to say but less fun to do–what a weird experience! I put on these bizarre glasses with giant prisms on them that forced apart what my two eyes were seeing. It was really disorienting and I definitely had a few moments of feeling seasick.

Wearing these glasses, I was asked questions about things on the table in front of me. How many did I see? Which one was higher or lower? Can I reach out and touch the doubled object? It was fascinating, disorienting, and mysterious, and I’m definitely excited to see how this new part of my therapy will play out!
Could you or your child be struggling with a vision condition like this VT patient? Locate a Doctor in your area and schedule a comprehensive vision exam today to find out during this month’s Vision & Learning Month!

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"Our daughter is a very good student who used to breeze through all her assignments except those requiring extensive reading. Long history or science assignments caused her great anxiety and took a long, long time to accomplish. Since she had Vision Therapy, she has been handling her reading packets easily and best of all happily. She has easily reduced her homework time to an hour! Similarly, she is a good athlete a gymnast and a swimmer who could never make any team sport requiring hand-eye coordination. She now feels comfortable pitching, and catching, and making baskets. Finally, she no longer gets car sick. Vision Therapy is the greatest." (read more...)

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