Exploring Vision Therapy

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,

Emmy

In the middle of Midterms, but it’s almost Spring Break!

It’s midterms week at NECO, and so far I’ve taken three of my five midterms: Principles and Practices of Optometry (or PPO, as we call it), Anatomy and Physiology, and Neuroanatomy. Studying for midterms can get very intense, and I’m definitely looking forward to spring break after I take my last two exams, Optics and Etiology of Diabetes and Glaucoma. Two more exams and three more days of studying and coffee to go!

Although most people are leaving the city for spring break, I decided I wanted to stay in Boston so that I can explore the area more. It’s hard to believe I’ve already been here for seven months; I’ve already seen a lot of Boston, but there are still a lot of “essential” Boston things I need to accomplish. Over break, I’m looking forward to exploring the North End more and experiencing some of the amazing Italian food I’ve heard about; taking advantage of the weather that will (hopefully) be in the fifties and going for a run on the Esplanade, which I haven’t done since the fall; going to Chinatown for the first time; finding a farmer’s market nearby; and potentially exploring Cambridge, which I’ve only seen briefly. I’m definitely not going to be able to accomplish everything on my Boston bucket list in a week (going to a Red Sox game will have to wait for baseball season, and I know there are a lot of things I probably haven’t even heard about yet) but I can at least make a dent in it.

I love that Boston is made up of several different neighborhoods; it makes the city multidimensional and an extremely fun place to live. A lot of my favorite things in Boston so far are right in Back Bay, like the Esplanade, which runs along the Charles River and is a great place to walk or run, and Newbury Street, which has so many interesting stores, restaurants, and especially lots of delicious frozen yogurt places. A few weeks ago I went to the top of the Prudential Center and was able to see the city right when the sun was setting. I was actually able to point out landmarks from up there, and I found NECO and my apartment building, which made me feel I was better at getting around Boston than I thought, at least from an aerial perspective.

In addition to spending my break enjoying Boston, I’m also going to be finishing a project during spring break for my Vision Health Care class. The project involves analyzing a community where you could expect to one day practice optometry; I chose my hometown of Buffalo, New York, and the greater Buffalo area. Our purpose is to analyze the community’s population and eye care needs using research and interviews with two optometrists in the area. I’m looking forward to finding out more about my community through my research, and it definitely makes me think about where I’ll be practicing someday, even though that’s still a long way off. I hope everyone has a great spring break!