When I was applying to optometry school, I heard about vision therapy through a doctor I was shadowing and instantly was entranced with the idea of a therapeutic approach to vision care. I watched children take an active role in improving their vision by performing various exercises that ranged from computer programs to walking along a balance beam, and I thought that vision therapy would be something I would want to explore with my patients someday. I promised myself that when I got to school that I would try to learn as much about it as I could, although as an alternative approach to optometry, it’s still relatively rare.
The summer before I left for NECO, about a year after my shadowing experience, I was motivated to revisit the practice where I learned about vision therapy–as a patient this time. When I was seven, I was diagnosed with a right intermittent exotropic strabismus. If you haven’t started optometry school yet, essentially this means that my right eye will sometimes turn outwards, especially when I’m tired, and only my left eye will be fixating on what I’m trying to see. Then I will see double, and I can move my right eye back in to fixate as well. I had surgery to correct this when I was twelve, and for a long time after that I rarely experienced any symptoms; but during college, I began to get headaches more and more frequently, and started noticing more double vision later at night and after I’d been studying for long periods of time. I wasn’t sure if my headaches were connected to the strabismus or if I was just prone to headaches. I remembered my experience shadowing an optometrist and vision therapist and thought there was a good chance that the headaches had something to do with my vision. Visiting the optometrist again to talk about my own vision, I was told that most likely I was right. I was able to start a type of vision therapy, light therapy, based on the exam, where I was given a blue-green light and instructed to look at it for twenty minutes a day in the darkness.
When I got to NECO, I started listening for opportunities to find out more about vision therapy. Through the College of Optometrists in Vision Development club, I heard about an opportunity to visit Dr. Loewenstein’s practice, where he practices vision therapy on both children and adults. Along with a few other NECO students, I visited the practice a few months ago and was intrigued by the different methods of therapy that Dr. Loewenstein spoke about. I am extremely interested in working with children as an optometrist, and vision therapy offers an interactive way to do that. The type of vision therapy Dr. Loewenstein practices especially gets children off of a chair immediately and has them moving around, coordinating their body movements with their vision. He will have his patients perform certain tasks while timing their movements with a metronome, or coordinate their hands and feet while hitting a swinging ball on a string. I was able to try one of the therapy techniques, the Brock string method, where the patient holds one end of a long string attached to a wall up to the level of his or her head. The string has three beads along it at different intervals: red, yellow, and green. The patients are asked to focus on one bead at a time, reporting the appearance of the rest of the string as they do so. The patients will see the parts of the string that they are not focusing on as double or single, and are asked to change fixation at various points during the exercise. I found it challenging to switch fixation and to keep the denoted target clear, and also to adequately describe whether I saw one or two strings, since one had the illusion of disappearing. I was glad to be able to attempt this type of therapy, however, and we were also able to fill out vision questionnaires during the visit that Dr. Loewenstein gives to his patients.
During my time at NECO, I want to keep pursuing opportunities to observe or learn more about vision therapy, not only to see if it can be applied to my strabismus, but to learn about how I might incorporate it into how I practice optometry. Its methods may be unconventional, but I find the use of unconventional techniques for vision extremely interesting.
Until next time,