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Vision Therapy

Podcast Episode #17: Vision and Learning with Wendy Taylor, M. Ed

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Welcome to The Bright Eyes Podcast: Advice for Healthy Vision for All Ages. Your hosts are Dr. Nate Bonilla-Warford & Dr. Beth Knighton, residency-trained optometrist that provide eye exams for glasses and contacts, and specialty services including vision therapy, myopia control, orthokeratology, and sports vision training. Their mission to empower patients by providing the best in friendly, professional, and individualized eye care.

In this episode, Dr. Nate talks about vision and learning with Wendy Taylor from Learning Essentials.

Cross posted from the IEP Pro Tips Podcast.

You can listen in the player below or read the transcript. The show is available via Stitcher, iTunes, and the webplayer below. You can find all previous episodes here. If you have any questions or suggestions for future episodes, please email office@BrightEyesTampa.com.

 

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Full Transcript:

[00:00:10.040] – Intro

Welcome to The Bright Eyes podcast: advice for healthy vision for all ages. Your host are Dr. Nate Bonilla- Warford and Dr. Beth Knighton, two optometrist who really see “eye to eye”. They can help you get perspective of the latest visual scientific evidence for improving your vision and helping you “keep your eye on the ball”. We have real facts and (aqueous) humor without making “spectacles of ourselves.” And don’t worry, the jokes don’t get any “cornea”.

[00:00:39.150] – Dr. Nate

From Rainy Tampa Bay, Florida. It’s The Bright Eyes podcast. You might be able to hear the thunder in the background. This is episode number 17, I’m Dr. Nate Bonilla-Warford, and today’s episode is a special one. It is all about vision and learning. This episode is actually being cross posted from the podcast IEP Essentials Pro Tips with Windy Taylor. Wendy is the executive director of Learning Essentials an online resource for parents with a mission to understand and meet the educational needs of each child by creating a playbook for learning.

[00:01:16.870] – Dr. Nate

Learning Essentials incorporates one on one tutoring, interactive brain camps, informative workshops, and creative professional development programs to promote learning success for students. I really enjoyed this conversation. Wendy is very knowledgeable. She’s got her Masters in Education and she contacted me via Instagram about being a guest on her wonderful podcast that is packed with information about IEPs special population students, College readiness, and so much more. We talked about how important vision is for learning things parents need to know and about vision therapy. So without further Ado, here is our discussion.

[00:02:05.140] – IEP Essentials Intro

Hello and welcome to IEP Essentials Pro Tips Podcast brought to you by Learning Essentials. Learning Essentials offer special education-based tutoring in your home by state certified educators with advanced degrees in all areas of special education. IEP Essentials Pro Tips Podcast bring professionals together to educate and empower families navigating special education needs in the IEP driver.

[00:02:32.120] – Wendy Taylor

Welcome to IEP Essentials Pro Tips Podcast. I am your host, Wendy Taylor, to follow us on social, you can find us on Instagram at Learning Essentials. Today, we’re talking about empowerment through vision with Dr. Nate. Dr. Nate received his doctorate of optometry from Illinois College of Optometry, located in Chicago, Illinois, In 2004. The following year, he completed a residency program specializing in pediatric and binocular vision at the Illinois College of Optometry. During his Optometric internship, he studied development division in Denver, Colorado, in contact lenses and Ocular disease in Chicago, Illinois.

[00:03:17.400] – Wendy Taylor

Owing to his passion for improving the vision of children, Dr. Nate has published articles on such topics as the use of vision therapy to improve reading skills, and has lectured to optometry students and paraprofessionals, as well as the general public on visual care of children, the importance of vision in personal development and options for controlling nearsightedness. Dr. Nate was always smart as a student in Florida public schools but was a slow reader and standardized test were intimidating. He always had to work very hard in high school and at University of Florida, when it came to courses at the Illinois College of Optometry, he failed a class because he could not perform the eye exam techniques. One of his faculty members suspected that the root cause was that he had a functional vision problem. This was identified and treated and passed the course! Dr. Nate fell in love with functional vision and made it his life goal to help as many people of all ages as possible. He now practices in Tampa, Florida, at his practices Bright Eyes, Family vision Care and Bright Eyes kids. Welcome, Dr. Nate, and thank you so much for joining us.

[00:04:30.760] – Dr. Nate

Thank you, Wendy. I’m really honored to be invited, and I’m excited about our conversation.

[00:04:37.280] – Wendy Taylor

Absolutely. Let’s dive right in. So can you just tell me what is vision therapy? There’s a lot out there on the topic, but I would love to hear from an expert such as yourself of what vision therapy is, right.

[00:04:49.820] – Dr. Nate

So vision therapy is a little bit of a catch all term for anything that we can do as professionals to help empower patients to take control of their own visual system. So it’s basically kind of like being an eye coach where we teach children of all different abilities how to increase their awareness of visual perception, how to increase their fine motor visual skill, how to basically use their eyes better to improve their quality of life and meet their goals. And sometimes that is more centered around at academic success.

[00:05:37.520] – Dr. Nate

Sometimes it’s more centered around their quality of life and comfort if they’re either having headaches or other vision and type related problems, or sometimes it’s more to do with sports, competitiveness and achievement. So it’s a series of activities that are individualized and programmed to help individuals meet their goals.

[00:06:02.290] – Wendy Taylor

Does it involve more the physical or a cognitive approach?

[00:06:06.880] – Dr. Nate

Well, like almost everything that I’m probably going to say when we’re talking about patients, it absolutely depends on the individual patient and their diagnosis. A lot of it is physical or at least rooted in physical because of the visual system. The way our eyes learn to perform is really rooted in movement and development. And so a lot of the type of stimulation that kids get as infants, when we’re talking about tummy time and crawling and lots of bilateral activities and stimulation, all of that kind of gross motor and body awareness sort of sets the tone for visual fine motor skill, which in turn affects the visual perceptual skill. So it sort of depends on where the patient is on that continuum. So if they’re really, really having problems with tracking or what I would call ocular motor dysfunction, then. And we spend a whole lot of time on gross motor body awareness and then work towards eye movement. Fine control, if they’re fine movement control and their visual focusing, et cetera, is really good, but they do have visual information processing or perceptual deficits, then it’s a lot less body movement and a lot more worksheets and cognitive kind of skill development. So it just really depends on the patient.

[00:07:48.440] – Wendy Taylor

If the focus was kind of more school readiness reading that impacts in the classroom, can you walk me through what a session would look like?

[00:07:58.560] – Dr. Nate

Sure. So if I can set the scene just briefly, very many of our patients do not have isolated visual dysfunction or isolated vision problems. Vision is just sort of one piece of a big puzzle of the complex nature of patients. So many any of our patients have gone through sort of a sequence in their life, maybe around two or 3. They might have had some speech therapy, maybe a little bit older. They might have had some OT. And then as they’re sort of getting ready for school readiness, and especially around the ages of seven and eight, if their vision isn’t really quite performing as well as they need to for or the type of academic demands copying from the board, sustained reading, especially nowadays. There’s so much technology both in the classroom and at home, not even counting the e learners, but even the ones who are in classrooms. So technology base these days. So that’s sort of like our bread and butter most common patient. Of course, there’s differences. So for that kind of patient, a typical session would look like this. They would have one therapist that’s pretty much through with them the whole program to develop a very close relationship with that patient. And the therapists really get to know the ins and outs of their lives and kind of what they’re going through. So they would sort of get kind of warmed up and sort of socialize a little bit. They would usually take their shoes off, and then they would kind of go over. Okay. How did you do with the activities that we assigned you at home? Although we do sessions for 45 minutes once a week, the real benefit of the therapy is the fact that they do about 15 minutes, five days a week at home, because that gives them ownership of what they’re doing at whatever skill level they’re at. It could be very, very low.

[00:10:00.000] – Dr. Nate

The fact that this is something that they are doing and they are making connections means it’s not something that we are doing to them. They don’t just show up, and we infuse them with vision therapy. We’re teaching them skills that they then can practice. That review of what they’ve done at home is absolutely critical for each individual session. Then we take those sessions and those skills that they’ve been working on, and we increase the difficulty a tiny bit, just enough to where your audience? I’m sure it’s very familiar with this, but it’s all about finding that sweet spot for individual patients too easy, and it’s boring or it’s insulting, even if it’s way too easy, too hard. And then it’s just, like, frustrating, and they hate it. So you got to challenge them just enough. And that’s really where vision therapists really shine is just really knowing is every patient is different and every day is different. They could be not us left. Well, or they could have a change in medication. I mean, there’s just so many different variables.

[00:10:59.480] – Wendy Taylor

So sounds like the classroom.

[00:11:01.060] – Dr. Nate

Yeah, absolutely. It’s literally it’s like an informal classroom, and we vary it a lot. There’s an acronym we use called Love, and it’s called Lots of Variety in Everything. So we work on individual skills, but in so many different ways that the patient and their brain never gets bored because we’re constantly trying to stimulate them in a variety of ways. And then we prep them to send that home, and then they work on it at home.

[00:11:31.010] – Wendy Taylor

It’s so true in terms of finding that sweet spot. And then we say that as a special agent and educators in general, just trying to find that sweet spot. So the kids aren’t bored, but they’re not frustrated and shut down. And it is that delicate balance and dance, for sure. How our vision issues diagnosed beyond a simple vision test, kids get a vision test just their basic intro. And then how when would a parent know that something deeper has happened?

[00:11:57.780] – Dr. Nate

So that’s a fantastic question. And I want to say one tiny caveat, and that is where it absolutely never shows up. Almost never is in any sort of vision screening at either a pediatrician’s office or a school screening, because those aren’t even designed to pick up those kinds of problems. Those screenings are designed specifically to pick up kids who are near sided or myopic the kids who are having trouble seeing the board. Well, the reason why that is silly, in my professional opinion, is the kids who are near sighted, the ones who are bookworms, the ones who are myopic, they tend to, on average, be advanced performers like those are the ones who are doing really well.

[00:12:41.750] – Dr. Nate

It’s the ones who are farsighted or have functional vision problems, who pass all the screenings but are Super struggling when it comes to reading development and other issues. And so right off the bat, screenings don’t count. Just get that out there. Now, the second thing is for most people can see. Our listeners can see, but I can see you are wearing glasses. So the chances are really good that you’ve had an eye exam at some point in your life. And the purposes of that are primarily number one, to make sure your eyes are healthy and if not to treat it, figure it out what’s going on. And to make sure that you can see 20/20 at distance in year. And that’s pretty much all it is, and it’s pretty fast, and it’s pretty efficient because most people that is a certain model. That makes a lot of sense. Doctors know it. Patients know it everything just sort of works. What I’m talking about for these sorts of evaluations, I like to call it a visual stress test. It’s like a treadmill test for cardio patients, except for it’s for the visual system. So it’s not necessarily can you see 20/20 that’s necessary, but not sufficient for school readiness. But it’s all about… When we ask your eyes to work, how well do they work, and how well are they able to sustain extended hard work? Because it’s one thing, if kids eyes can do it for 15 seconds in the exam chair, boom, your eyes can move. Your eyes can focus. Great. You’re all good. It’s another thing if they can do it for two hours or eight hours. And Here’s the key thing, as I’m going to say over and over and over again, every child is different.

 

[00:14:25.700] – Dr. Nate

Every person is different. So when some people are challenged visually, some people’s eyes just shut down. They just shut off. They’re just like, no, I’m not doing this. I’m done. I’m checking out. Some people go into, like, way over drive. They have, like a hair trigger, everything just like, absolutely maxes out in red lines. And they also can’t function, but they present with different symptoms. There’s other people who go into sort of like, for lack of a better word for the audience, sort of like denial, meaning they just sort of like they have all of these problems, but their brain filters all of them out, and they perform terribly on exams, but they don’t present with the same kind of symptoms because they just are sort of checked out from their vision entirely. So these exams are longer and they’re all a lot more about observation. How are they doing these different things? When I ask them to look at something up close, are they holding it Super close? Are they getting really, really tense? Is their breathing getting, like, Super shallow, or do they just look at it and be like, Yeah, I can see it. Now. We also have very specific tools. We have flashlights called retinoscopes and all of these other fancy things, which allows me, as a developmental optometrist to look and see where they are focusing.

[00:15:51.430] – Dr. Nate

And this is absolutely key so I really kind of want to talk about this for a few seconds. There are lots and lots of times where children of all ages, but especially patients who have different types of developmental disabilities look at something, say it’s a paper in their hand, and they think they are looking at it. But their eyes, because of their poor, fine motor control, their eyes are actually focused either far away or about a foot or two behind it. And I can see that with my flashlight. I know literally where they’re focusing. Or Conversely, they could be looking at the board, and they think they’re looking at the board, but their eyes are still focused on the page. So it’s all blurry and frustrating for them, even though they can see 20/20 and their eyes are healthy. So there’s lots of different ways that we evaluate that sort of autofocus system. And I talked about eye tracking a little bit. That’s the most intuitive for parents, because if they can see that their kids eyes are just not pointing where they need to, if they’re just kind of like all over the place, people kind of intuitively understand that.

[00:16:56.810] – Dr. Nate

And then the last part that I’ll mention is the way the eyes work together, depth perception. If both of you eyes are pointing at the same place, they’re sending the same information to the brain. The brain can process that spatial awareness, and we have ways to evaluate that. So the whole process is like, depending on the patient, like, an hour. I mean, it’s a lot of work. And I always ask parents when I talk to them afterwards, how was your kid after when you got in the car and you went home? Because a lot of kids, well, they’re eager to please. They’re great, great, great kids. So they hold it together in here and they work and they do everything I ask, and they smile and they’re Super sweet and they’re great. And they get in the car and they absolutely fall apart because it is so difficult. They have headaches, they’re exhausted. And if you just watch them, it doesn’t seem like any of this is difficult because they’re just sitting in the chair looking around like it’s not like I’m asking them to do push ups, but it’s so hard for them to coordinate this much effort. And I wouldn’t know it because they’re so good at asking it and being delightful that it’s only when they leave. And the parents say, like, Yeah, he was like toast.

[00:18:06.730] – Wendy Taylor

it’s fascinating to me, this whole conversation, we could speak many hours on this topic. Absolutely. And that’s why I’m so excited to have you here and just thinking about my special education lens. Right. So you have parents as being in a classroom and then now doing the support that I do through educational therapy, an IEP coaching. You have parents say something’s happening, and you’re absolutely right. You mentioned the kids have had maybe speech or T or P parents are just trying to figure out something is happening, something’s going on, and that fatigue is so real and agreeing with what you’re saying in terms of you have these kids, they’re in class.

[00:18:50.770] – Wendy Taylor

I’m just thinking of what you’re explaining as you’re doing your process. But I see these kids in class and they’re lovely and working so hard, but then they’re so fatigued and they fall apart and and it’s trying to figure out what is happening. How would a parent know? How would a teacher now to refer to a visual exam? What would that be called? What are they looking for? What are they asking for? Because I’m sure this is not something like a neuropsych is not going to pick up on this or what.

[00:19:22.220] – Dr. Nate

Well, yes and no. Where the neuropsych evaluation may pick up on. It is the non verbal section, because there’s definitely only some visual processing and spatial awareness things that happen during that evaluation. And the challenge that I see parents having with that specifically is the neuropsych evaluation is great, and I encourage it frequently, so I don’t want anything I’m saying to sound anything other than positive, but the frustration the parents sometimes have is okay. They do poorly and the non verbal section and there are some accommodations, but there often isn’t, like a next step, like, okay, so how do we improve this situation?

[00:20:15.220] – Dr. Nate

And I don’t know. I know some, but I don’t know all of them. I don’t even know a lot of school psychologists or pediatric psychologists to have that conversation a lot. But anyway, that’s one way. It’s not the most common way, but it’s the most common way. There are some very classic tail tail signs, for example, headaches if the child never wakes up with a headache, but often gets a headache in the afternoon, especially if it’s pretty highly correlated with visual work, especially like up close work, either tablet or screen work, and then it kind of goes away when they’re done, especially if it starts in the forehead and maybe sort of goes around to the temples.

[00:21:06.940] – Speaker 1

Not always. There’s a zillion reasons for headaches, but vision is a big one. You know, if they’re doing a lot of rubbing their eyes, not when they’re tired, because everybody does that when they’re tired. But I mean, just like, in general, that’s a red flag. But honestly, I want to say two things about this, if kids just look like they are just not able to kind of do the work, if they sort of start off strong, and then 10 minutes later, they sort of drift out. This is where it absolutely looks like to parents, not to give dad the bad rap because I’m a dad, but to dad, it it can look like they’re just being lazy and even to teachers, and honestly, even to excellent special Ed teachers. If you don’t realize how hard. These kids have to work. It can just sort of appear like they’re just kind of not interested. Like they’re just not applying themselves, even though they’re doing their very, very, very best. Quick caveat, I’ll just say is that little window before they kind of lose confidence. Like at first they’re working really hard and they’re into it, and then eventually they sort of like, Oh, maybe I am just dumb. Like, maybe I just shouldn’t expect myself to do this. Like catching them before then is like, absolutely critical. But that’s a whole other thing. So I would say any of those are key. Now I will say this and you can put a link in the show notes. I think you will. But there’s an organization called College of Optometrists in Vision Development. Cod org is their website, and they have a symptoms checklist that has been very well studied and vetted. They have normative data and what you can do, you can use it in two different ways. One, you can just sort of look through the checklist and see. I wonder how much this sort of its my child. Now, the younger they are, the more they’re going to Act like immature people because they are. So you have to take that into account. But you can also click on the buttons and get a number. And then there are doctors there that the website can kind of connect you with on one of them, but there’s tons of them. Then you can see if you really need a a thorough pediatric evaluation.

[00:23:28.450] – Wendy Taylor

What an excellent resource. Thank you for sharing that. I absolutely put that in our show notes. Does vision therapy have the ability to permanently fix issues, or does it provide strategies to help children overcome the obstacles? So in other words, does vision therapy provide more of a cure or treatment?

[00:23:43.480] – Dr. Nate

So like everything, it depends. So I like to break it this way. This is not true in the very most literal sense, but I like to break it down this way to parents, because I think most parents understand this. It depends if they have more of a hardware problem or software problem. So if it’s a software problem, meaning their brain just never quite calibrated their eyes, they think they’re moving to from one word to another, but they’re actually moving three words down. And so they’re skipping, and then there’s gaps. But they do it so often that their brain sort of filters it out and think that that’s just how you read, then that’s the type of problem that by improving their awareness, by calibrating their eyes. When I move this much, it looks like this, and it feels like this. And with enough practice, I can not only do it, but I can do it over a period of time, and I can develop my stamina. And then eventually I can do it while I multi tasking and I can do it long problem solving, and I can even do it while the teacher is talking. And I’m really thinking about a thought, but I’m still copying from the board at the same time, all of that is happening. So that is an absolute permanent fix. Similarly, with the auto focus issue, if they can’t copy from the board because it’s just too blurry, they can see the board perfectly fine. But then they look down at their page and then they look up at the board, and then it’s blurry because they focused on their page. Those problems are totally fixable. We fix them. Then we give them some maintenance therapy afterwards, and then they come back. Three months later, we quantify all of the exam tests. We confirm, Yes, you’re exactly as good as you. You’re need to be your exactly average or above average because you’ve sustained it for three months. It’s assumed that unless if you have some sort of event which we can also talk about, then you’re done, you’re fixed. If it’s a hardware problem. Meaning they either have a physical issue with the muscles of their eyes the way they were developed, or they have, like an actual either congenital or developmental genetic condition with the way their brain processes information, then it’s not going to be a fix. It’s going to be adaptive. It’s going to be. How can we help you live with this? So it minimizes adverse effects to your quality of life? And I’ll say one more thing about that, which applies to all of our patients, is just as important as developing skills. Is developing good habits because they’re not going to be our patients for the rest of their life. They’re going to move way. They’re going to eventually go high school are going to go somewhere else. Different things are going to happen.

[00:26:26.830] – Dr. Nate

So the more we can teach them good visual habits to reduce eye strain and reduce the types of problems that they are likely to develop, then the better it is for them in the long term. And I spend a lot of time talking about “the race.” . To me, the race is… Okay. Like, life is stressful, and school is stressful. And even video games are stressful visually. And all of that stress is not great for us, visually speaking. Meaning we develop bad habits. We adopt for posture, we develop all of these issues. And so all of that is going to create problems also through just natural development from living because we’re smart and our kids are amazing, they’re going to slowly improve. The question is, which is going to grow more. Is there a natural development going to outstrip the rate of problems that they’re going to have? A school gets more demanding, and they have to go from reading individual pages to chapter books or not. And so the whole point about vision therapy is to make sure that they win that race. It all boils down to just that, or at least not make sure, but give them every possible advantage they can to win that race.

[00:27:42.180] – Wendy Taylor

Are there certain vision conditions linked to academic difficulties?

[00:27:46.120] – Dr. Nate

Yes. So there’s a couple of different ways to talk about this. There was a paper done by one of my all time favorite optometrist vision scientists from Ohio, and what he did is he had gone through, I don’t know, hundreds of students who had IEPs and then did very thorough, like visual evaluations and kind of correlated that with just sort of like a pool of, like, normal or neurotypical kids. And there were some interesting findings there, because definitely the kids who were in the IEP needed glasses more often, especially for far sightedness or hyperopia, the word would be used.

[00:28:33.450] – Dr. Nate

They also had more challenges with amblyopia and Prisms, what most people would call lazy eye. We don’t say lazy eye, but that just basically means the eyes aren’t working together. They may not be aligned in one, I may dominate the other. So absolutely. Those types of conditions appear significantly more frequently in the IEP population than in sort of the mainstream population. So that’s just sort of kind of one way to look at it. But on an individual basis. Yes. When children have a lot of these, quote, software problems because it just makes it a lot more work for them, it doesn’t mean that they can’t read.

[00:29:21.290] – Dr. Nate

It doesn’t mean that they never learned to read properly. But if their eyes aren’t really calibrated for tracking and they make so many mistakes when they’re reading, that they have to kind of go back and reread it so dramatically increases how much time they need and how much fatigue they experience when they read. And there’s basically correlates to that to the auto focusing system. The word optometrist use is accommodation, but never use that word because it means totally different things to you and everybody listening to this. So I use auto focus instead of that word, even though that’s the word. So when we write reports, we’re really careful to try to distinguish the two. So those are exactly the type of problems that we look for. But one more thing, and that is there’s a whole other group of people who have problems, and they’re not really necessarily the people who would be listening to this podcast because those are the academic overachievers. Those are the ones who are, like, gifted, straight as Super motivated. And then what they do is they wind up through overuse and stress at an older age, more like high school instead of Elementary school, creating a whole set of other developmental problems.

[00:30:44.850] – Dr. Nate

We don’t need to get into the details of that. But my point is that also affects school work, because if you get headaches so quickly and you just can’t even get your homework done when you’re used to getting straight A’s, that’s devastating for high achieving kids because they work so hard to get it done. It’s missed forever. They fall through the cracks because nobody knows how hard they’re working, because to everybody, they’re smiling and they’re polite and they’re getting straight A’s and they’re also playing sports, and they’re also learning violin. You know what I mean? So why would they possibly be having any problems, but they just can’t hold it together forever. So anyway, that’s a different group of people, but they’re a group that sometimes has a lot of problems.

[00:31:31.160] – Wendy Taylor

What are the more common learning related vision disorders?

[00:31:34.980] – Dr. Nate

Mostly what I’ve been talking about are the physiological or functional kind of mechanical things, like the brain sends signals to the muscles. Do the eye muscles have sufficient fine motor skills to kind of do what they need to do? But there’s a whole separate category, visual information processing or perceptual visual perceptual skill. And this does sometimes come up in neuropsych reports. And it very often comes up in occupational therapist evaluations. And this is less about, like I said, how the eye muscles work. But it’s more about, for lack of a better word, like how visually overwhelmed kids get, because there’s probably lots of parents and professionals who would be listening to this who are familiar with the kid who on a flash card will get the word every time 10 out of 10 times. Totally, totally get it. But then you put that exact same word in a small paragraph, and then all of a sudden they’re just like, Oh, my gosh, I have no idea. Now I have to either try to sound it out or I have to I have to, like, recall, or I just skip it all together because or the most common of all is I just guess I see the first letter is B. And so I’m just going to throw in any word that begins with B, you know what I mean? And so kind of what they may be having a problem with is visual figure ground, meaning they can see the whole thing, but they have a block or a delay in being able to pull out the most relevant thing at that moment. And when you’re reading, the most relevant thing changes every second because you’re going from word to word to word to word, and it just becomes so completely overwhelming. That is really, really difficult. Visual memory is another one, and that’s pretty intuitive to people. Some people just have a very hard time looking at something and sort of like making a picture of it in their mind and then being able to recall it later.

[00:33:37.920] – Dr. Nate

Most people sort of think intuitively get that. Another part of it is visual closure. So that’s taking a bunch of individual things and making one mental object out of it. So if you see three dots, just three dots, you can look at it and sort of like, Oh, that’s a triangle. And it could be a triangle and different. And then your mind doesn’t have to work as hard because you just sort of remember triangle instead of three separate things, there’s a kind of a famous that’s famous to me, optical illusion, which when you first look at it, looks like random rectangles, just sort of screw in about. But then when you put it together, it says Love, because you can sort of see the individual blocks, and then you can see, like in the contrast, actually, the space in between all those spells out. Love, this visuals closure skill is absolutely important for learning to read because the whole well, I mean, I’m not a reading specialist, and I don’t claim to be. But if you look at a word, especially one that’s long, it’s like seven letters long. And what you physically see in your mind are a lot of lines with sticks and crosses and little loops. And then you have to look at each one individually, but you don’t visually group it into one object, which is a word. It makes it much harder. So those are all types of things that we would test for. And then we would help patients with. And then we would re test with the idea that as they develop these visual skills, they would become more proficient at reading. So just to be Super clear, I don’t ever promise anything, because these patients very often have other challenges. But if we can solve part of these problems, then all of the other resources and everything that you are so fantastic about and all the people in the system, all of that just makes their job easier. And it makes it less frustrating for the patient. And they do feel empowered because they’re like, Oh, look, this is a tiny piece of it that I absolutely learned how to control myself. And I have all these skills, and I have this little tool belt or I have more tools to put in my tool belt. And so that’s kind of how that fits together.

[00:36:01.640] – Wendy Taylor

It certainly sounds that vision therapy can definitely help kiddos with their academic success. How often? And I’m sure it depends on the individual patient client. How often will they participate in vision therapy? So they come to you and they do the process. And then what does that? So a segment look like.

[00:36:23.020] – Dr. Nate

So it highly, highly depends. The patients who are referred to us from a psychologist or an occupational therapist or another another optometrist. They are very, very often kind of in a growth mindset where they, like, understand like, Oh, this is like another piece of the puzzle. And so this is something that we can do that makes sense. And the good news is unlike a lot of other sort of developmental type, therapies I mean, because occupational therapy, which is the closest analog to what I do, is so broad that can go on for years because there’s always sort of a next stage where they could do more. But this is a lot more defined. So this is usually like it’s not a trivial amount of time, but it’s more like six months. It’s like, okay, we’re going to do this for a short amount of time. It’s going to pay off long term. So the patients who kind of come in that way very, very, very often they will do it. And if they can’t do it because they travel from long distances nowadays, we can do it online. It’s not quite the same, but we’ve adapted really well. And so we can do a lot of it online, and that helps. One of the downsides is most of the medical insurance plans cover our kind of service correlate, if at all. And so that is an absolute kind of barrier for lots of patients. And so we kind of have systems to where we sort of make it as accessible as possible because everything is individualized. There’s ways that we can see patients once a month instead of once a week, and we can give them a lot more, like, information that they can do on their own. We can prescribe other kind of short term things. Or one of my favorite things to do is if they’re already in occupational therapy and they’re young and they don’t have extra business amblyopia, but they might have, like, an Ocular motor problem is then just kind of work with their OT, like, OTs are fantastic. Like, I can sort of tell them, Hey, if you include these sorts of things into what you’re already doing, and I’ll say come back in six months, and we’ll sort of see one of the things that I don’t know the history necessarily.

[00:38:53.910] – Dr. Nate

But unlike speech, that this doesn’t exist in schools at all. There are teachers for the visually impaired, you know, there’s, like, visual assistants, but not not this exact thing. And so that’s a big kind of barrier for a lot of patients. And then one more thing is if patients just kind of come in and parents don’t know any of this, and they think the absolute worst case scenario is that their child is going to be prescribed glasses, and that’s all they know. And if I’m their first stop because they haven’t explored all of those other things we talked about, then it is so overwhelming that they just they need time to process it. They just need they just need time and resources. And so I say, Hey, Let’s go to COVD. Look at the information here. So another information come back in six months. We’ll sort of regroup talk to your pediatrician or whatever resource you have currently, because it’s just too much for them. The conversation we’re having right now is they’re just not ready for it.

[00:40:03.180] – Wendy Taylor

Yeah, that’s a lot of information to absorb, especially if you’re coming in thinking you’re getting glasses, and then you get a whole other spectrum of information. I love that you collaborate with OTs. You mentioned that do you ever collaborate with schools in terms of kiddos with their IP school support accommodations? Is there any kind of overlap or any way that people could overlap as a school to kind of better serve students? That maybe cost could be a barrier or just in general, to better serve a population in need?

[00:40:39.120] – Dr. Nate

Yes and no, as much as absolutely possible. Every single report that we write based on functional visual evaluation has a whole page of educational accommodations. And that’s honestly true. Whether they’re in a public school system or whether they home school because they still have the same the same needs, they’re just sort of implemented differently. And so we encourage all of our patients to give that part of the report to parents, especially when it’s time to get ready for their IEP. We very, very often will write letters to kind of update on their present level of visual performance and sort of how they’ve improved or how they haven’t. And in my in my experience, this is just my experience, but individual teachers are amazing at implementing things. The system isn’t always so amazing, but that’s just my experience. Now, beyond that, not really. I practice in Florida, and in general, the school system is so under stress that they are not really actively looking for more things to think about. We try to coordinate with the school nurses as much as we can so that they’re aware we haven’t made a ton of progress in that specific Department. But individual teachers are amazing.

[00:42:18.650] – Wendy Taylor

So my question is how functional vision problems and short attention spans, how are they related? We kind of touched on that in the beginning of our conversation when we started. But how are they related?

[00:42:33.900] – Dr. Nate

Again, This is, like, Super fascinating. So there’s been some scientific research into the degree to which visual attention being able to look at something for a sustained period of time and mental attention, being able to pay attention to something for a sustained period of time. And they’re absolutely not the same thing, but there is a very high degree of overlap in general. And when you help a child improve either one of those things, kind of both of them tend to improve, like they’re so interrelated that you can’t affect one without the other. So that’s sort of the Foundation for the whole thing. But when it comes down to individual actions, is this sort of my favorite way to think about this? Because most people have never, ever they would have no reason to ever think about this, but two different parts. One, there’s some other research that says that when kids, not just kids, adults when they have poor eye movement control, tracking, ocular, motor function, like we’ve been talking about, they have a very hard time decoupling separating when they are moving their eyes and looking at the world versus their staying still. And the world is moving. Their brain has a really hard time knowing the difference. So if our patients, in addition to all of the other problems, they have also never totally certain whether the world’s moving around them or whether they’re moving or something else is happening. That’s really kind of unsettling. And so they’re often distracted by that. And then way that that specifically will happen is this happens all the time? Say, I’m like looking at you were doing this over some, and I want to kind of go over and shift my attention to look at my picture on the Zoom. But because my eyes aren’t calibrated, I go a little bit too far. I kind of overshoot. And now I’m looking at my microphone. Well, that can feel to a patient, especially one who’s got attention issues or ADHD. Like, the microphone just appeared out of nowhere and inserted itself into my awareness. And so now you are like ancient history. And I am, like, all into this microphone because it’s, like, shiny. I’m no longer listening to what’s going on, because all of a sudden this is like, right there. And that would have never happened if the eye movements were calibrated accurately. Now there’s all kinds of other things going on, but that interference. I mean, it happens all day, every day for these kids. It just happens. It’s just, like, kind of watching TV. And then somebody is just, like, beaming in every 30 seconds, like a whole different program. It’s exhausting for them. That’s exhausting.

[00:45:44.580] – Wendy Taylor

Yes, 100% exhausting. As a parent, can my child receive special education services for a functional vision issue?

[00:45:54.520] – Dr. Nate

Well, kind of like I said, I mean, like, school based occupational therapists can be amazing at this. It really depends on the issue. If it is ocular motor, they’re fantastic at that. If it’s like, perceptual, they’re fantastic at that. If it’s some of the other things. Like I said, where you really need tools and lenses and training, that’s kind of more difficult for them. Usually usually not always. But usually when we write these reports and we write these letters and we write these recommendations, they kind of are already identified.

[00:46:33.190] – Dr. Nate

And we are providing more ammo and more recommendations for accommodations. By the time they get to us, it’s rare. It’s not impossible that we’re like the very first ones who say, look, this child needs some additional assistance, attention, and this is what we recommend. So we definitely will advocate as best we can for the children. But just sort of due to the nature of human development, you know, where their skills are at, it’s usually not until a little bit later to where vision really becomes critical now, of course. I mean, I think vision is critical from, like, you know, six months. But in terms of being identified, that’s kind of how it tends to go.

[00:47:20.280] – Wendy Taylor

Do you typically see an age range where kiddos are being identified?

[00:47:24.160] – Dr. Nate

Well, it depends. There are certain conditions, like crossed eyes, which I would call estropi, which, like, moms and grandparents, like, see, and they freak out about appropriately. And so we see them really, really early. And so if they have additional problems and those are all caught real early. But a lot of times it’s really not until nine or 10, you know, unless of somebody like you who’s, like, really in tune with these children. And they’re like, no, you really got to have their their eyes checked. I mean, it honestly takes it takes somebody to have had this sort of knowledge to be like, Yeah, you just got to just make sure that that’s fine. And sometimes it’s totally fine. And they say, like, you’re all good. Just keep plugging away. You’re gonna be fine. But, you know, sometimes it’s not that way.

[00:48:21.320] – Wendy Taylor

I hope from this podcast, somebody is getting some additional information and insight and and we’ll be able to help. Absolutely.

[00:48:32.800] – Dr. Nate

This is one of the biggest paradoxes of my life, and I’m just going to say it and you can react to it. What I find is that the best, most dynamic, most wonderful, patient, student loving teachers have the worst classrooms for visual attention because they cram every single surface with something that’s fascinating. The walls I go into classroom sometimes, and the whiteboard is like three quarters covered with amazing things. And they have this tiny little piece that they write on there’s, like aquariums, and then there’s, like, tactile sensory stuff in the back. And it’s impossible for kids to not all kids, but for a lot of kids, it’s just impossible to pay attention in that environment. And it’s just a paradox because those are the best teachers, so you don’t want to discourage them. It’s just very hard. I don’t know. What do you think about that?

[00:49:33.220] – Wendy Taylor

I think it’s very true. Very true, I think. Dr. Nate, if you teleported to the past my classrooms, that’s exactly what you would have seen. And I’ve taught kindergarten all the way up to post secondary, and it didn’t matter what the age was. I had it all happening.

[00:49:51.440] – Dr. Nate

Yes.

[00:49:54.720] – Wendy Taylor

What are some accommodations that you list in your report that perhaps somebody that may not have access to your knowledge could say, Oh, that’s something I could implement.

[0050:04.740] – Dr. Nate

Right. So right off the bat, there is like, the very kind of no brainer things, like preferential seating. If it’s hard for them to switch from the board to the desk, then if they’re closer, then there’s going to be fewer visual distractions and everything’s going to look bigger and it’s just going to be easier. So that’s obvious. Also, I will very, very often prescribe glasses and then they should just be used. But then again, that’s, like, obvious to everybody. Ergonomics, makes a giant difference. So we will very often recommend or issue slant boards. Now, when I was a kid, our desks were all at a slight angle and that would promote good posture. And it would sort of help kids stay at the right distance. Desks aren’t like that. I mean, my kids are 11 and 13, and they’ve never had basically, like, an ergonomic desk. And now someone has a computer built right in to his desk, and it’s very challenging. So we will issue, like I said, plant boards very often. They will take those to school, and they will become part of their work surface. And that sort of helps. One thing that sometimes creative teachers will do is they will take a sheet of paper and to be environmentally friendly, they will put it on two pieces of paper or sometimes even four. They’ll shrink it down so it fits. But then the font gets impossibly small, even for average mainstream kids. But for somebody who’s got an auto focusing problem, it becomes impossible. So we make sure that they don’t use anything that’s less than, like, roughly 14 point on something like that, but not too small.

[00:51:42.650] – Dr. Nate

It becomes difficult for earlier ages. We encourage using their finger to keep their place until they feel like they no longer need to. They probably won’t need to do that forever. But a lot of teachers will and discourage that because they want them to learn how to use their eyes independently, which is a reasonable thing. But if they’re just not ready for it, then you’re mostly just kind of frustrating with them. You can also use either, like, a bookmark or what we call a letter box to isolate individual words or sentences. And that sort of cuts down on that visual information overload there’s a certain thing. It’s called the Harmon distance, but we often call it the elbow distance. And basically what that means is if you make a fist and put it under your chin, you shouldn’t hold anything visual closer than elbow distance. And as you get taller, that ratio stays roughly the same. And that’s been validated a whole bunch of times, so that that reduces long term like eyestrain and improve performance. But if you watch kids, I mean, they will get within, like, inches or sometimes even centimeters to the page, and that just causes lots of problems.

[00:53:00.220] – Speaker 1

So we just want teachers to know that they should kind of encourage that sort of posture. Not that that’s possible to really fix that sort of, because that’s like a really long, deep seated habit. So sort of be aware of that. And then, of course, depending on the diagnosis, extra time for assignments and testing and time for additional breaks, you know, that’s in my experience, that’s gotten harder and harder to to get even when it’s appropriate. But we absolutely requested because it’s program functional vision problems.

[00:53:37.630] – Wendy Taylor

Are they related more to the eye or the brain?

[00:53:39.940] – Dr. Nate

So this is great because functional vision problems are the brain and coordination and sensory integration and those sorts of things. Now, the other thing that I mentioned earlier, when we’re talking about what I would call low vision. But what a lot of people would call a teacher for the visually Imperator, like a vision teacher, like, those are people who are partially blind or have some sort of visual limitation, and that’s from a disease or from a developmental anomaly. So if they don’t physically have the structure to be able to see either clearly or to see fully, they might have a restricted field of vision, or they might have other reduced contrast. Or there’s a zillion different things. That’s a hardware problem, and that’s their eye.

[00:54:31.500] – Wendy Taylor

Everything else that we talked about is their brain as we’re kind of winding down our conversation today. And again, this has been so incredible. And just what a pleasure and honor to have you with me today. What should I have asked that I didn’t know enough to ask.

[00:54:48.080] – Dr. Nate

So this is something that is very, very challenging for parents, because I will go through the whole exam findings and I’ll say, your child has 2,020 Visio. They’re not nearside, they’re not farsighted, they don’t have a SIGNIS. Everything is great about how their eyes are healthy and they can see really well. And then in the very next sentence, I’ll say, and I’m going to prescribe these glasses for your child, and it is such a disconnect that now I’m a little bit more savvy than that, and I try to explain it ahead of time. But the glasses that we will often prescribe has nothing at all to do with seeing more clearly. Their eyes see plenty high res. That’s totally fine. The glasses are designed for many of our patients that we’re talking about these sorts of students to do some of the work for their eyes. So they have more stamina and they can work longer without having the sort of symptoms or their performance is better. And like my glasses, because I’m like I’ve got a life sentence, like, I wear glasses all the time, and I will for the rest of my life.

[00:55:57.470] – Dr. Nate

These glasses are very often somewhat temporary. They may only use them for a year or two. And then, as their visual skills improve, they may not really need them or certainly not need them as much. They might need them for standardized testing, but they don’t necessarily need them for 15 minutes of homework. But it’s just so important for parents to be aware that we do prescribe glasses for lots of other reasons other than just improving clarity. And nobody knows.

[00:56:30.530] – Wendy Taylor

Thanks for sharing that. It’s fascinating, and it’s great to know. My final question for us is always, if you had a Billboard with one tip for parents, what would it be and why?

[00:56:41.720] – Dr. Nate

Right. And I thought about this a lot, because a lot of times I have very limited time to sort of talk to parents. And this relates Similarly to kind of what I was just saying. But vision is more than 20/20. I ask parents like, what do you think 20/20 is and they’ll be like, it’s perfect vision. It’s like everything there is. But in reality, it only takes us, like, five seconds to measure. Do they have 20/20 vision? Yes, they can read those letters. Great. But it’s so much more than that. It’s not just that your eyes can see, it’s that they can see easily and comfortably. And it starts at infancy where vision is movement. Vision is coordination. Vision is gross motor skills and fine motor skills. And all of the systems have to have to work together. And that’s why every single patient I see, even if they’re normal and every single way, middle of the Bell curve and every single possible way, I say. And it’s really important to go outside and play.

[00:57:43.740] – Speaker 1

I joke sometimes about, like, I’m going to start prescribing dogs because if they have dogs and they have to play with them and they’ve got to take them outside and they’ve got to go for walks and their eyes have to do all of these different things. And it’s very difficult to be on an iPad or a phone while you’re paying attention to your to your dog. And that’s because our visual systems grow and develop through movement and interaction. It’s way, way more than just 20/20. So that’s my billboard.

[00:58:15.380] – Wendy Taylor

Excellent final advice. I love it. And thank you again for this tremendous conversation. And I’m excited to have our listeners digest it. And I’m sure some are furiously taking notes as they’re listening to this and to kind of go on and help support kiddos in the future. So I really appreciate your time today.

[00:58:35.060] – Dr. Nate

Well, it’s an honor to be here. I enjoyed it so much. You do so much fantastic work for both parents and professional. I mean, it’s just really important, and I’m happy to do it.

[00:58:49.440] – Wendy Taylor

Thank you.

[00:58:50.950] – IEP Essentials Outro

Thank you for joining us today for our IEP Essentials Protip podcast. To hear more protests and find additional IEP Essential, including our IEP webinar, please visit www.LearningEssentialsEdu.com.

[00:59:09.060] – Dr. Nate

So I hope you enjoyed that as much as I did. Of course, I will put the links to Wendy Learning Essentials and the IEP Pro Tips podcast in the show. Notes, Thank you for listening. If you have questions, comments or suggestions about how we can improve our podcast, you can email us at office at Bright Eyes Tampa, com until next time. Stay safe out there.

[00:59:35.410] – Outro

Brought to you by Bright Eyes Family Vision Care and Bright Eyes kids. Find previous episodes and more detailed information at Bright Eyes, Tampa com. Creative Commons Copyright attribution Noncommercial use. The only purpose of this podcast is to educate and to inform. It is no substitute for professional care by a doctor experienced in the area you require. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. Please consult your position for diagnosis and treatment.

Intro/outro music: Lucas Warford of Three For Silver.

E-learning Without Eyestrain: Guide for Visual Health For Students During the COVID-19 Pandemic

TL;DR: If your child is e-learning, be proactive to help prevent vision problems. If your child appears to be having screen-related eye fatigue, see your optometrist first and discuss it – your child may have underlying problems made worse by excessive screen time.

(Downloadable PDF of this guide can be found here.)

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Credit: Sandra Schoen

There is one topic that comes up over and over in the exam room right now and that is school. Let’s face it, school is challenging this year for everyone – students, parents, teachers, administrators, and everyone who knows any of these people. Every child’s case is unique and they need to do what is best for them. I get a lot of questions about vision specifically from parents whose children are e-learning.

I know this well, because not only do I help my patients every day, I have two e-learners of my own: Nora, an 8th grader, and Javier, a 5th grader. As a family, we are experiencing this right now!

E-learning can be the most visually stressful type of education because it is a set schedule of screen use for a large portion of the day, every day. In a classroom setting, there is a lot moving around and looking up at the board and at friends to provide visual novelty. In a Virtual School and homeschool setting, the schedule can be much more flexible to allow for visual breaks. Teachers are working as hard as they can right now, but they are not children’s vision experts.

Based on my knowledge of children’s vision and the research I have done, I list some helpful guidelines below to ensure that your children can get the most out of E-learning this fall, without as much eyestrain.

Why is this important?

For many years, Optometrists have helped office workers who suffered from Computer Vision Syndrome (CVS), a collection of eye and vision problems related to excessive computer use. It was originally thought that CVS was an adult problem, but now research has shown that children can (and do!) experience this problem, too. This can be compounded by the increased screen time and the general stress of e-learning during the COVID-19 pandemic.

Common symptoms from long-term computer use are:

  • Eyestrain
  • Headaches
  • Blurred vision
  • Dry eyes
  • Neck and shoulder pain

It is not hard to imagine how any or all of these can make learning difficult for a child who has to be in front of a computer or laptop most of the week.

What can you do?

1. Have The Right Set up

image

Nora’s Workstation

My personal preference for my children is that their workstations are in public areas of the house, like the living room and dining room. This has several advantages. One is that we can easily check on them and help them if needed. Another is that it is a psychological distinction of their “work area” from their “personal area.” Also, it is just nice to see our kids during the day. 🙂

  • Selecting a screen – Bigger is better! The larger the screen, the easier it is to focus on details.
  • Screen settings – Often selecting 110% or 125% magnification helps. Also, white print on black background can be more comfortable.
  • Position the screen – Position the center of screen straight ahead so head doesn’t need to tilt back or to side. Position screen further back on the desk. Allow for at least Elbow Distance from the eyes to screen.
  • Chairs – should be firm with back support.
  • Foot rest – If the child’s feet can’t touch the ground, a foot rest can stabilize them.
  • Lighting – You don’t want it to be too dark or too bright. Being near a window is great for natural light, as long as the direct sun is not shining in the child’s eyes or directly on the screen.
  • Water – Designate a place for a water bottle or cup so kids stay hydrated.
  • Clutter – Keeping the environment clear of visual distraction can help your child focused on class content.

Here is a cute comic about setting up a work station for kids.

 

2. Posture

We all know that it can be difficult to get kids to maintain any particular position, specifically if they are little. However, showing them the proper posture and reminding them often can go a long way to helping them stay comfortable during work.

Here are recommendations for efficient posture for kids at the computer.

  • Their back should be against the chair for support.
  • The chair seat should not compress behind the knees and cut off circulation.
  • Their feet should rest firmly on a floor or footrest (no dangling)
  • The head should be balanced on neck (not tilted back or too far forwards)
  • The upper arms close to body and relaxed
  • The elbow should angle >90° (forearm below horizontal)
  • The wrist should be neutral (not flexed)

(Adapted from Workstation Ergonomics Guidelines for Computer Use by Children.)

Here is an illustration from the American Optometric Association: Body Posture AdobeStock 144114992

3. Do Children Need Computer Glasses?

For adults like me who have “joined the club”, we need glasses to see small print up close. Children, however, have more visual focusing ability so they don’t usually complain of not being able to see the screen. However, many children do have functional issues and benefit from wearing glasses at the computer.

Some of these conditions are:

  • Refractive problems – Conditions such as farsightedness (hyperopia) and astigmatism can make it more difficult to see the screen. Even a low prescription can cause a child to have headaches if they are not wearing eyeglasses.
  • Focusing problems – If children’s eyes do not focus accurately on the screen, glasses can help make it easier. Having glasses can make the difference between working comfortably and headaches and blurry vision.
  • Rapid Fatigue – Some children can see the screen clearly for the first 15 or 20 minutes then start to lose interest because they can’t sustain focus on it.
  • Convergence problems – Some children have issues where their eyes either tend to over-converge (tend to turn in) or under-converge (don’t turn in enough). In both instances having the right glasses helps keep the image of the screen clear and single and makes reading easier.
  • Specialized prescriptions – Some children have unique vision problems and require alternate prescriptions such as prism or bifocals, these should definitely be taken into account.

 

4. What About Blue Light?!?

image (1)

Javier’s Workstation

Blue light is a very popular topic in 2020. As I tell patients, it really is the Wild West right now when it comes to blue light protection and companies can say just about anything to sell their lenses. We need more scientific study in this area about which frequencies of light matter, how much filtering is needed, and what are the effects. But after following the research for years, I can say these things:

  • There is very little reason to think that light from computers and devices is going to cause permanent eye disease. (UV light from the sun is a much, much greater concern and that is why we recommend UV-blocking sunglasses for all ages.)
  • Blue light can interfere with circadian rhythm and sleep cycles. There absolutely is evidence that blue light exposure especially at night will affect sleep . The best bet is no screen use a couple of hours before bedtime. But if that is not possible, then blue light protection in glasses, as well as night-mode device settings, can help.
  • There is a lot of anecdotal evidence that patients have less eyestrain and fatigue by limiting the scatter of blue light. The only people who seems to dislike blue light filters are people who need to see colors extremely precisely, such as a digital designer.

In short, I do not believe that every single person requires blue light blocking glasses. I think it can help some people feel more comfortable. If your child appears to be having screen-related fatigue see your optometrist first and discuss it – there may be other visual problems that should be addressed first.

For many patients (including children) a low prescription to reduce fatigue, as well as blue light filter and anti-glare treatment, can be the best combination for reducing eyestrain in front of the computer. Buying a blue light filter is only one part of reducing visual eyestrain. At Bright Eyes and most optometry offices, we can custom make the best glasses for your child!

5. Taking Breaks.

If using digital devices is the problem, then stopping using them is part of the solution. Optometrists refer to proper working distance and taking breaks as “visual hygiene” – like dental hygiene but for your visual comfort. Keep in mind, looking away from the computer only to check messages on a phone doesn’t really count as a visual break! The important thing to remember is that breaking up long sessions into shorter sessions helps a lot to release tension in the eyes. There are some suggestions that are helpful.break time

  • Before classes start – Do a few deep blinks and eye stretches (we often call these Eye Yoga)
  • 20/20/20 Rule – Every twenty minutes, look 20 feet away for 20 seconds This lets the focus of the eyes relax.
  • 1/5 Rule – Every hour take at least a 5 minute break and move around. This wakes these eyes, body, and brain up, especially if they go outside (see #6).

I know that you do not have perfect control of your children’s schedule, but by setting reminders you can try to develop these habits. (See Dr. Beth’s video below.)

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6. Getting Outdoors!

What is even better than looking out a window? Actually getting outside and moving around. Children’s brains (and mood!) function better with some good old physical activity. When I am at home with my e-learning kids, I make a point of scheduling a time for us all to go for a run together, but this is not always possible (darn rain!). Even if they can’t exercise, just being outdoors is great for them. The change of scenery will help break up the routine.

Even if it just a short walk of the dog, or just standing in the yard or back porch, there are big visual benefits. First, the eyes get to fully relax when they look very far away. Instead of the space of just 5 or 10 feet in the room, outside we can 100 or 1000 feet away. Second, the natural light contains the full spectrum of light frequencies. Also, we tend to blink a lot more when we are outside moving around than we are just looking at a screen “in the zone” of e-learning. This keeps the eyes moist and comfortable. And there is a lot of research that shows that taking young children outside is one of the best ways to reduce the chances of them becoming myopic (nearsighted).

Of course, if you are outside in sun, wear sunglasses to protect the eyes from UV light!

 

7. When To Check With Your Children’s Eye Doctor.

Extensive computer use more difficult for all patients, but some children are at greater risk. Here are some situations when you should schedule an eye and vision evaluation for your child who is e-learning:

  • Pre-existing visual problems – If your child has on-going visual dysfunction, definitely have an evaluation and discuss all the options to limit the visual stress of e-learning.
  • Symptoms – Any symptoms of fatigue or eyestrain should be evaluated.
  • Overdue – Many patients are overdue for visits due to offices being closed in the spring. Children’s vision can change extremely rapidly, so we recommend annual exams for children in school. This is especially true if they are e-learning.

I want to highlight one specific symptom – blurry vision when looking far away. This can happen for several reasons but there are 2 important reasons to consider:

  1. Recently developed myopia (AKA nearsightedness).
  2. Eyestrain up-close is causing a focusing spasm (a red flag)

Both of these are on the rise around the world generally due to increased screen time and decreased outdoor time. Both of them have management options that can reduce future problems, including good habits, glasses, and vision therapy. Make sure you discuss this with your child’s eye doctor at their appointment.

Conclusion

And that’s it. I know it was kind of long, but it is important. As different as it is from classroom education, e-learning can be be very effective. And it certainly is beneficial in social distancing and keeping everyone safer from COVID-19. With the information above you can help make sure that e-learning does not cause vision problems as well.

Good luck this year! We are cheering for you. If we can help in any way, please reach out at brighteyestampa.com or (813) 792-0637.

-Dr. Nate

 

 

Binocular Evaluation Testing Information

Because the Binocular Vision Evaluation is somewhat different that a standard eye exam, we have created a document to help you understand the different parts of the test, what they look like, and what we hope to learn from them.

You can download the document here​ to review ahead of time or during the evaluation. ​We have found that this helps parents understand much more about the testing that their child is experiencing.

Let us know if you have any questions.

-Dr. Nate and Dr. BethCapture

Vision Therapy and COVID-19 (updated)

Bright Eyes Family and Bright Eye Kids are now closed to all but eye emergency visits. We plan to reopen for vision therapy sessions as soon as the CDC and Florida Governor Ron DeSantis allow it.

 

Question: Do patients keep doing vision therapy if my child can’t come into the office?

Answer: This question will be answered on a case-by-case basis – contact your therapist!

To all of our patients and families enrolled in vision therapy, Like you, my family is adapting to life at home. My children are doing virtual school and taking online guitar and cello lessons. We have friends that are doing online taekwondo training. That is just how it is for a little while, but we don’t need to let it take control of our lives.

With schoolwork and leisure being held on digital devices during this time, helping our patients with visual symptoms is now more important than ever. Fortunately, Bright Eyes staff have experience doing online “remote vision therapy” – we have helped patients in different states and even different countries. There is no reason to lose momentum during this time. If your therapist has not already, we will be reaching out to you soon to discuss how we will proceed in your individual case. If there is anything we can do to help you, please let me know.

If a patient or family member actually contracts coronavirus, they may be too sick to do therapy or assist their child with therapy. If your family is in self-quarantine but the patient feels well, we recommend you continue home therapy activities and contact your therapist – we can email you ideas and variations! In the event that Bright Eyes must close for a period of time, we may offer remote therapy sessions on a case-by-case basis. (While remote therapy sessions are not the ideal way for patients to learn in the long term, we do not want patients to lose momentum, or to take an extended time to complete therapy, if possible.)

If you have any questions or concerns, please reach out to us! We will remain vigilant, constantly monitoring the CDC’s standards, as well as city and state government advisories, and will openly communicate with you as the situation progresses. We care about our patients and staff, and will continue to work hard to keep everyone safe and healthy! Thank you for trusting us with your family’s vision!

– Dr. Nate, Dr. Beth and the Bright Eyes Family

Can Neuro-Optometric Rehabilitation Help Stroke Patients With Vision Problems?

senior woman with middle aged womanIf a loved one recently suffered a stroke and is still struggling with the after-effects, you will want to do everything in your power to help them quickly recover. Unfortunately, it can be painstaking to find the right treatment for their specific needs.

The first thing to keep in mind is this: a single treatment is not going to cure everything. Instead, combining a set of complementary therapies promises optimal results. Read on to find out how neuro-optometric rehabilitation plays an important role in the recovery process from a stroke.

How Does a Stroke Affect Vision

A stroke occurs when the blood flow to the brain (or a section of it) is interrupted. In other types of strokes, a blood vessel in the brain bursts causing major damage in the area. Depending on where in the brain the stroke occurs, it affects different body functions.

Because visual information is processed through the visual cortex of the brain, any brain damage may also affect vision-related processes and quality of vision. Such visual defects are not always obvious and frequently overlooked in initial evaluations following a stroke.

Try to help the stroke victim identify any of the following symptoms:

  • Blurred vision (even over short periods)
  • Sensitivity to light (photophobia)
  • Reduction or loss of visual field
  • Headaches when engaged in visual tasks
  • Reading difficulty
  • Difficulties with eye movements

If any of these symptoms are present, a thorough assessment by a neuro-optometrist is needed.

Why Consult a Neuro-Optometrist?

A regular eye exam by an optometrist checks for eye diseases and visual acuity. A functional eye exam by a neuro-optometrist takes a completely different approach. The goal is to identify neurological vision-related issues and address the types of vision loss caused by a stroke.

About one-third of post-stroke patients experience one or more of these conditions:

  • Loss of visual field – Part of the person’s visual field disappears. In many cases, they will see only the right or the left half of it.
  • Lack of control over eye movements – When the eye nerves are damaged, the eyes may not move as desired or move involuntarily, causing eye turn (strabismus), double vision (diplopia), or other similar issues.
  • Constant, unsteady eye movement (nystagmus) – A continuous fidgety jiggle of the eye, which can move up and down, sideways or in a circle.
  • Visual neglect – When the person is not aware of or does not respond to something he/she sees. There is nothing wrong with the eyes themselves, but the brain does not interpret the images it receives.
  • Agnosia – Often people have trouble recognizing familiar objects and even faces. The cause is similar to visual neglect.

It is easy to see how these affect the overall behavior of a person. At the same time, many may mistake their lack of orientation, bumping into things and/or ignoring people for a problem unrelated to vision.

senior woman eye exam 640Choosing the Right Neuro-Optometrist for a Stroke Patient

An exam by qualified professionals will provide clarity into the situation, so make sure to choose an optometry practice that includes a neuro optometrist with extensive training and experience in neuro-optometric rehabilitation such as Bright Eyes Family Vision Care's Vision Therapy Center.

The therapy may include prism lenses to shift images into the visual field or join the images in case of double vision. Exercises to train the brain to manage vision and compensate for vision loss are also part of the therapy.

Your loved one deserves optimal healing, and to ensure this, rehabilitative vision therapy should be part of the overall treatment plan. If he or she is already undergoing physical or occupational therapy, consider adding neuro-optometric rehabilitation for a more holistic approach and better results.

How Successful Is Neuro-Optometric Rehabilitation Therapy?

Vision therapy will help improve the condition of your family member or friend. The speed and extent at which the patient will recover depend on the severity of the condition. Having said that, keep in mind each person is unique and reacts differently to the same treatment.

Neuro-optometric rehabilitation therapy is not a cure, but it will enhance visual skills and quality of life for the person you care for.

When vision is dysfunctional, so is everything else. Getting one’s vision back on track can greatly enhance daily function and quality of life. Help your loved one get his/her life back, contact Bright Eyes Family Vision Care's Vision Therapy Center today.

Serving patients in Tampa, Westchase, Town 'N' Country, University, and throughout Florida.

Resources:

https://noravisionrehab.org/patients-caregivers/about-brain-injuries-vision/stroke-and-vision

https://www.stroke.org/en/about-stroke/effects-of-stroke/physical-effects-of-stroke/physical-impact/visual-disturbances

https://noravisionrehab.org/patients-caregivers/conditions-treated-by-neuro-optometric-rehabilitation

https://noravisionrehab.org/patients-caregivers/what-is-neuro-optometric-rehabilitation

https://strokefoundation.org.au/About-Stroke/Help-after-stroke/Stroke-resources-and-fact-sheets/Vision-loss-after-stroke-fact-sheet

3 Reasons Why You Should Kickstart the New Year With Vision Therapy

holidays mug

It’s that time of year again when we sit down with a pumpkin spice latte in hand and think of a resolution we can take upon ourselves for the new year. Here at [tokensname=’SpCenterVT’], we believe that the best resolutions are the ones that positively impact other areas of our lives and enhance our overall quality of life. Vision therapy offers just that! This therapy is made up of a series of customized visual exercises designed to develop or regain visual processing skills.

Vision Therapy is highly effective in treating:

  • Amblyopia, (or “lazy eye”)
  • Strabismus, (or “eye-turn”)
  • Eye movement disorders
  • Focusing disorders
  • Binocular vision problems
  • Vision, balance, and memory problems associated with brain injury

Even those with 20/20 eyesight can benefit from vision therapy because perfect eyesight doesn’t mean perfect vision. Below are the ways in which vision therapy will help you kick-off the new year.

Improve Existing Vision Skills

You’re good at what you do, be it at work, school or sports. But can you do better? By training the eyes and brain to work in unison, you increase your potential for greater performance. Not only will you be more efficient, but performing tasks will become more enjoyable. This especially applies to school-aged children, as their brains are still in rapid development. Vision therapy effectively enables the brain to correctly process information for optimal academic success.

Learn New Skills With Ease

Many people make it their resolution to learn a new skill in the upcoming year but an underlying vision problem can interfere with that. Since learning is 80% visual, vision therapy offers an excellent opportunity to gear up for success! Undiagnosed or untreated vision problems related to convergence and focus can cause memory and reading problems and hinder learning. Dr. Knighton and Dr. Bonilla-Warford will use an array of tools, such as prisms, specialized lenses, filters, balance beams, and computerized visual activities to train the eye-brain connection and help you learn more efficiently in almost any area that requires vision.

Gain The Confidence You Crave

Whether you’re a pro-athlete or a 4th grader struggling to read, improved vision skills will boost your confidence. This confidence will surely trickle into other areas of your life leading to increased self-esteem.

Start 2020 by empowering yourself or your child with vision therapy. Call Bright Eyes Family Vision Care's Vision Therapy Center to book your appointment today.

Bright Eyes Family Vision Care's Vision Therapy Center serves patients in Tampa, Westchase, Town 'N' Country, and University, and throughout Florida.

Podcast Episode #14: Adam Cegielski From Eyecarrot on Binovi

Welcome to The Bright Eyes Podcast: Advice for Healthy Vision for All Ages. Your hosts are Dr. Nate Bonilla-Warford & Dr. Beth Knighton, residency-trained optometrist that provide eye exams for glasses and contacts, and specialty services including vision therapy, myopia control, orthokeratology, and sports vision training. Their mission to empower patients by providing the best in friendly, professional, and individualized eye care.

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In this episode, Dr. Nate talks with Adam Cegielski From Eyecarrot about Binovi and Binovi Touch.

You can listen in the player below or read the transcript. The show is available via Stitcher, Google Play, iTunes, and the webplayer below. You can find all previous episodes here. If you have any questions or suggestions for future episodes, please email office@BrightEyesTampa.com.


Full Transcript:

Intro: 00:10 Welcome to the Bright Eyes Podcast, advice for healthy vision for all ages. Your hosts are Dr. Nathan Bonilla-Warford and Dr Beth Knighton, residency trained optometrist providing eye care to all ages with exams or glasses and contacts and specialty services including vision therapy, Myopia control, orthokeratology and sports vision training. Their mission is to empower patients by providing the best in friendly, professional and individualized eye care

Dr. Nate: 00:39 From St. Petersburg beach in Florida. This is the bright eyes podcast. My name is Dr. Nate Bonilla-Warford and I am here with Adam Cegielski. Adam is the CEO of a company called Eye Carrot and I’m so excited about this because I’ve wanted to do this for almost a year. I’ve been talking and emailing with Adam for a very long time. I’m a big believer in what he does and what his company does and I’ve wanted to get him on this podcast for a long time and it just finally happened that we are in the same room and we can, we can get it done. So how are you doing today, Adam?

Adam: 01:13 Oh, I’m doing great. Dr Nate. Thanks for having me.

Dr.nate: 01:16 Yeah, so this is, so this is really good. So we are here at the college of optometrists and Vision Development, Florida study group. This is an annual meeting that, happens in the summer and the doctors that provide vision therapy and are specialized in children’s vision a get together and we all take turns lecturing and sharing thoughts and cases and , you know, it, it’s, it’s a great meeting. Now you were able to come last year or when the meeting was in Miami you, had an opportunity to interact with some of the doctors and so it’s nice that you’re here and I think that you’re enjoying it because you are from Canada. Yeah. You know, coming down to Florida is not all bad.

Adam: 02:01 No, it’s absolutely great. It’s my second time here. I’ve actually been to Florida three times now because of the COVD annual meeting we had in Jacksonville and it’s not exactly cold right now in Toronto. We are escaping a bit of a heatwave.

Dr. Nate: 02:15 So our office, bright eyes kids was one of the first offices in the United States to have Binovi, which is the product that you guys make and I found out about it before you even really launched and I was very interested in the benefits that this could have for our patients, who do vision therapy. So why don’t you just very briefly introduce our listeners to what the Binovi system is and the different parts of it. And then we’ll go on from there.

Adam: 02:43 Oh, okay. Thanks. Dr. Nate. so really this whole started with my personal experience with vision therapy and my son’s rehabilitation back in Toronto and we had a great doctor help us achieve the goals of vision therapy and got through 40 weeks of therapy. But we had that experience of binders and papers and notes and as a, as a technology futurist or whatever we call ourselves. I and my partner Sam said, listen there’s, a better way to deliver therapy. We think and doing that, we, we sort of unveiled the idea that this should be delivered smoothly through a mobile app with videos with content and we built the Binovi platform, not really a product we built software and hardware that delivers a modern comprehensive experience that, that really maximizes what you get out of in-office therapy and gives you the tools you need at home to be able to do really good homebased therapy.

logo binovi finalAdam: 03:42 So, so the Binovi platform is really a mobile platform that allows the doctor and the therapy teams to deliver home based activities through one to two minute videos that really explain, you know, the way to do these activities which are complex, which are difficult. And that platform was launched and you were one of the first people to even talk to us before we even went live, and so we’ve now launched that software. We’ve launched some hardware and we’re at a spot where I can come back to this meeting and have the confidence of, of, you know, customers that are actually enjoying the product and using it.

Dr. Nate: 04:20 So, you know, I was very interested in what you guys are doing because like you said, vision therapy is very, very powerful, but it’s difficult if you’ve got these binders, these sheets of paper with instructions and you know, in, in our experience. And I think that this is pretty true for, for a lot of offices. The person who’s providing the home therapy is not always the person who brings the patient. There might be a grandma who’s bringing them because mom and dad are work

Dr. Nate: 04:51 Or we’ll live in split households. There’s different things going on. And so communication with the people who are assisting the patient at home, has always been been a challenge and it’s something that we’ve always tried to improve upon by, giving them a manual at home with instructions and those have links to YouTube videos and we’ve tried to make sure that everybody understands the process. But when I saw what you guys were doing, I said, Aha, this is this is a modern way to do this. And that’s why I was, I was on board,

Dr. Nate: 05:28 So what have other doctors told you about their experience with taking it live.

Adam: 05:36 Well, you made a really good point about sending materials home youtube links and you’re not the first person to have this idea. You know, we’ve had many, many doctors across the United States say they had the exact same idea, but obviously the development work to put this all together is, is extensive and took a lot of time and effort and money. Um, but doctors have, you know, have been waiting for some sort of a platform like this to come live. Obviously there’s a lot of different doctors in the United States, a lot of different ways to do therapy. and we’ve, we’ve obviously embraced as much and as many of the ideas as we can from, from all the different people using our software. But for the most part we’ve had really good experiences.

Binovi Touch in action.

Adam: 06:15 You’ve had some doctors that have said, listen, I haven’t done home therapy and years just because of the difficulties you’re explaining right now. And, uh, we live in a different world than we did five, 10 years ago. We have Netflix, we have these video delivery platforms, um, that are such a big part of our lives. And, uh, and really we’re, we’re now at a spot where, the cost of hosting video and the cost of doing these things is at a spot where it is suddenly scaleable. It is realistic. And you know, there are 2.7 billion people with smartphones, I think in the world at this point, maybe closer to 3 billion people. So naturally, video and compression of, of content and compression of data put us into a spot where we can do this. And doctors are absolutely loving the platform. Therapists are loving the platform. And most importantly, when we have a short term window where the, where the APP is not functioning, we realized its value when we have all these patients contacting us saying, I can’t live without this. I need this. Where is the APP? So we’ve had all sorts of really good feedback. And, you know, we’re, we’re in a really good spot right now

Dr. Nate: 07:24 So at our office we see vision therapy, you know, essentially as, as teaching learning and just like my son takes a cello lessons, he has to have both the instruction from an expert, but he also just needs time to practice. That’s that skill and he needs to know what to practice and, and so Binovi does a fantastic job of keeping the patients and the parents up to date on what they’re supposed to be doing. And there’s a checklist that patients and parents know what, what to do. There is a chat feature. So if parents or providers at home, there’s a chat feature, so whoever’s helping the patient at home can interact with the therapist right away and give them some information, that is really helpful. And um, what we like is we can actually see when patients are doing the therapy because patients who practice things get better at them in, you know, in my experience. And so that’s been really helpful.

Adam: 08:29 Yeah. And I’ll give you an example in Canada and a cold winter, we’re doing therapy. Uh, my wife goes to therapy with the doctor and, and my son, they come home, we eat dinner. Therapy’s, usually the last thing on our list to do and of course the binders in the car and it’s snowing outside and you get the binder, no I’ll get the binder and it becomes a a bit of a chore. And ultimately, you know, compliance is a big factor in how healthcare technology is really changing our, our medical landscape and knowing that we’re actually doing this homework, knowing that we’re actually logging into the APP as a clinician. I think it’s very powerful.

Dr. Nate: 09:07 So why don’t you tell us a little bit about what you’re doing right now and where, Eye Care and Binovi are headed in the future.

Adam: 09:14 Okay. So as of right now, the binovi platform has been out for about a year. We have doctors in basically four continents around the world that are using the software. And we’ve completed our first video library. We’re extending the content now to add more educational content through some of our doctors. We have developed a tool that’s been around since I think 1974 called the Wayne Saccadic fixator and we’ve released, I think the seventh version of that now as the Binovi touch. So that is a device that is used in the vision therapy clinics with doctors that actually gives you that, uh, in office Rehab, in that office training. That device is now launched to about 100 clinics across the United States, Canada. And, um, and, and we’ve, really we spent two years working in developing this tool. We’ve probably done about 25 different prototypes. We’ve got an early feedback.

Adam: 10:11 We’ve tried to keep it as true to its original version that was loved and used across thousands of locations around the world. Most importantly now it gives the doctors in the therapy teams simplicity of using the IPAD. It gives the children and the patients using this fantastic experience where they can actually engage with modern tools, too complete therapy and obviously most importantly capture patient data profile data. That ties back to these, to these patients so you can measure progress, not just what you’re doing at home, but in the clinic. Now we’re starting to capture that in clinic data, tie it to the patient experience and obviously share with the parents. You know, that progress has happened week after week.

Dr. Nate: 10:55 And that data that you’re collecting from the Binovi touch, which is modeled after one of the most beloved vision therapy instruments of all time. tell us a little bit about some of the other population, some of the other people you’re working with. This is some pretty exciting stuff.

Adam: 11:11 Yeah. You know, this device has been used with professional athletes across the world. Recently we’ve worked with, an individual named Bryce Salvatore who was captain of the New Jersey Devils. He’s using it in, in his New Jersey training facilities with, with kids and trying to promote the importance of what could be done for vision performance. We have championship mma fighters and boxers and soccer players and football players that absolutely love the device and, Rehab hospitals that are using it on stroke patients and a wide range of utilities essentially.

Dr. Nate: 11:49 So, we’re gonna wrap up here because our meeting’s about to start. But anyhow any last few words you want to mention to our listeners,

Adam: 11:56 Just listen. Just go and do that homework. Log into your APP. Hopefully Binovi is giving you a really good experience that multiplies the benefits of what you’re getting from the doctors and therapy teams you’re working with.

Dr. Nate: 12:08 All right, well thank you Adam. we’ve been wanting to do this for for a very long time. We’ve been together at meetings but just didn’t have our schedules line up so I’m thrilled that we were able to do this to everybody who’s listening. Thanks so much. If you ever have questions, you can reach us at office at BrightEyesTampa.com. And, I hope you have a good time and stay dry. Avoid the rain!

Outro: 12:32 Brought to you by Bright Eyes Family Vision Care and Bright Eyes Kids. Find previous episodes and more detailed information at BrightEyesTampa.com Creative Commons, copyright attribution, non-commercial use. The only purpose of this podcast is to educate and to inform. It is no substitute for professional care by a doctor experienced in the area you require. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. Please consult your physician for diagnosis country.

 

Intro/outro music: Lucas Warford of Three For Silver.

Podcast Episode #8: Vision Therapy with Edna Moore

Welcome to The Bright Eyes Podcast: Advice for Healthy Vision for All Ages. Your hosts are Dr. Nate Bonilla-Warford & Dr. Beth Knighton, residency-trained optometrist that provide eye exams for glasses and contacts, and specialty services including vision therapy, myopia control, orthokeratology, and sports vision training. Their mission to empower patients by providing the best in friendly, professional, and individualized eye care.

In this episode, Dr. Nate talks with Bright Eyes Family Vision Care vision therapist, Edna Moore about what vision therapy is and what it is like to be a vision therapist.

** See the related episode about how vision and performance – #3 VISION LEADS.

The Full transcript:

Intro 00:00 Welcome to the bright eyes podcast, advice for healthy vision for all ages. Your hosts are Dr. Nate Bonilla- Warford and Dr Beth Knighton, residency trained optometrist providing eye care to all ages with exams for glasses and contacts and specialty services including vision therapy, Myopia control orthokeratology and sports vision training. Their mission is to empower patients by providing the best in friendly, professional, and individualized care.

Dr. Nate: 00:41 From the endless summer of Tampa, Florida this is the bright eyes podcast. My name is Dr Nate and I have our first special guest on the podcast. This is episode number eight and I am joined by Ed More. How are you doing, Edna?

Edna: 01:00 I’m doing great. How are you?

Dr. Nate: 01:02 I am super fantastic as always. So, Edna is our lead vision therapist at bright eyes. How, how many years have you been with us?

Edna: 01:02 Over eight years Dr. Nate.

Dr. Nate: 01:19 That is what I thought it seems like forever.

Edna: 01:25 No, it just seems like yesterday, actually it’s gone by a lot faster than what you would think eight years is.

Dr. Nate: 01:30 It’s been wonderful. It has been, and so for those who are not familiar with what vision therapy is, vision therapy really is a program of therapeutic activities that’s designed to improve some aspect of visual skill and that could be somebody who’s a child who either gets headaches or is having difficulty because their eyes don’t move or focus or it could be somebody who’s had some trauma or a brain injury or concussion and they are having double vision and that’s difficult for them. So it could be any of those types of things. Edna sees all different types of patients. And can you describe a little bit about what a day in the life of a vision therapist is?

Edna: 02:27 Sure. Actually, it’s a fun day. Each patient is different and when they come in, they are ready to get started. My job is to not only make it fun but also make it productive. So, we have a list of activities that the doctor has prescribed for the patient specifically during that forty to forty five minute session. And it’s my job to make it fun so that their eyes and their brain can learn quickly. Without thinking that these activities are going to be boring or that it’s hard to do, it’s fun to be able to create ways to show the patient that it can be done. A lot of these patients come in and they’ve already been frustrated with some of the things that they’ve had to do, whether it’s reading or not being able to see clearly, things like that to, being able to go through these different activities and then be able to do at the end. So a day in the life of the therapist is always changing. It’s challenging, but it’s also rewarding and it’s fun.

Dr. Nate: 03:42 Now you had some experience with vision therapy, before you came to work her as a vision therapist, can you tell us a little bit about that?

Edna: 03:47 Yes, my second child, he was ten and at school was hit with a soccer ball, by accident and he fell on the ground and hit his head and for, a number of months, his visual system, I didn’t know what was going on, but his, um, he started experiencing double vision, headaches, vomiting, and I had to, get him from school almost every day we didn’t realize what was going on. He didn’t have a concussion, he didn’t have whiplash, but, he kept telling me that, mom, I’m having double vision on and off, I’m having trouble balancing, I’m having trouble walking, I’m dizzy all the time, so through a battery of tests and getting MRIs, things like that, really all the different conventional ways of testing for these particular symptoms came up negative.

Edna: 04:42 It was only through a remark from a dean at USF had just mentioned in passing that maybe we should try seeing a vision therapist, a doctor who specialized in vision therapy. And that particular doctor had found out that just by doing a number of simple tests with his eyes that he had his center, was shifted to the right. So if you asked him to walk in the center of the hallway, he was actually a walking on the right side of the hallway. So through vision therapy, he went three times a week, about one hour a day and, , he also wore prisms in his glasses. Um, and for about three months we did that. And, after three months I was happy to see that I had my child back. He no longer experience double vision. His headaches were gone. He was no longer dizzy when he walked.

Edna: 05:45 It was as if this was a miracle cure or, but, I had no idea what this was. I did not know what they did with him in that room, but I know that experience as a mother when your child is going through headaches every day and it changes his life it changes the parents life too and and to see a child needlessly suffer like that and not be able to help him, I was relieved and elated that these symptoms had all disappeared and was resolved through vision therapy. So that was my, experience with vision therapy.

Dr. Nate: 06:23 I always love to hear that story because I had my own experience with vision therapy, which I’ll share on a different podcast, but I know that it helps you to be a better therapist when you understand what the patient and the parents are are going through. What do you think patients and parents think of the vision therapy program

Edna: 06:49 After they’re done with vision therapy, I’ve had both patients and parents make comments like “if it wasn’t for vision therapy, he wouldn’t be as confident as he is now”. “He’s doing activities that, before vision therapy, he would not have chosen to even try. Now my child is trying. I’ve had,, patients who hated reading, did not enjoy reading and didn’t understand why her other friends loved reading books where she found it very hard and not enjoyable. And after vision therapy, she’s now reading 400 page books and her mother says she’s just devouring the books left and right because she’s found that reading is now effortlessly.

Dr. Nate: 07:39 Some people, when they think about therapy, they think about physical therapy which might have happened after a surgery or some sort of injury and they don’t always have positive associations with that kind of therapy. What do you say to a parent or a patient who might feel like this is gonna be like that?

Edna: 08:00 I think that, if parents are unsure about vision therapy, it may mean that they don’t quite understand what’s going to take place and so, um, to explain it to a patient or a parent it’s like a sports or taking lessons for music. You come into the office or you go see your coach or you’re going to go to practice and you learn new skills and then you’re gonna go home and you practice, those skills so that you can improve upon them and then you come back the next week and, show your instructor or to learn new skills to build upon that. And that’s what vision therapy is. So as not some type of program where you wouldn’t understand the concepts. So I try to compare it to things that they already know about , if a child is in sports, you know, the child understands that, yeah, they go every week to practice, to learn new skills and then they, it’s to them to go home and practice. And the parents understand that to whether they’ve a learn to play an instrument or play sports. They understand and recognize the importance of that. And so that’s what vision therapy is. It’s as simple as that.

Dr. Nate: 08:00 Think most patients think it’s fun at least some of the time?

Edna: 09:13 Yes. I have heard often whether it’s my coworkers outside the office, outside the vision therapy room rather with the door closed, they can still hear us laughing. They don’t know what’s going on. They hear is clapping. They hear us saying that’s a great job. I hear children, laughing, you know, they mainly comment. They wonder why what’s going on in that room. Sounds like there’s a party going on. So, , a lot of times it is, we do have a lot of fun and sometimes we think some of these things are silly, but uh, there’s a lot of learning and um, a lot of improvement going on. , in these four walls.

Dr. Nate: 09:51 Does that mean they don’t have to put in any effort or work?

Edna: 09:55 No, I’m on the contrary. It just means that their focus is not so much on how hard it is, but the more fun they have, it just makes everything easier for them.

Dr. Nate: 10:07 Want me to put you on the spot?

Edna: 10:07 Sure. Why not?

Dr. Nate: 10:11 Of all the different types of patients that we see, what do you think is your favorite kind?

Edna: 10:17 That’s hard to say. I think the most memorable ones are the adults who have gone through a lot in their life and then all of a sudden something happens and then they are unable to function. They cannot drive, they cannot walk, they cannot ride a bicycle. Something happens and a life stops, for them until they come see us. And then through vision therapy and through practicing on their own, which these are highly motivated adults, their progress is so much quicker and I get to see from where they were, their tragedy or their traumatic experience changed your life, to now seeing them successfully be able to do the things that they enjoy that they couldn’t before they came to see us. So I think that’s, to me is the most rewarding.

Dr. Nate: 11:14 Anything else you want to tell people about vision, therapy, things you’ve learned over the last eight years?

Edna: 11:20 No. Two patients are alike and it’s , again, very rewarding to see that, especially me being here for this long now that I, enjoy seeing past patients who have completed vision therapy and has seen now, where they are in life. When I have seen patients who are six, seven, and eight, and now six years later they’re getting ready to drive or they’re getting ready to, you know, embark on different experiences. It’s just really cool to see sort of these little, what I call a “little, you know, chickens coming back to the hen house”, and showing off what they can do now. And their parents are beaming with pride in saying if it wasn’t for vision therapy, they are, they wouldn’t be. You know who they are today.

Dr. Nate: 12:12 All right, well thank you Edna for being our very first guests. You did a wonderful job. Several episodes of the brightest podcast are all going to be about vision therapy and I’m really looking forward to those episodes so everyone, stay tuned. You can always contact us at office@brighteyestampa.com. See you next time.

Outro: 12:35 Brought to you by bright eyes, family vision care, and bright eyes kids. Find previous episodes and more detailed information at http://Brighteyestampa.com, creative Commons, copyright attribution, non-commercial use. The only purpose of this podcast is to educate and to inform. It is no substitute for professional care by a doctor experienced in the area you require. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. Please consult your physician for diagnosis and treatment.

Intro/outro music: Lucas Warford of Three For Silver.

Dr. Beth and Dr. Nate lecture in Miami

This weekend, Dr. Nate, Dr. Beth and vision therapists took a trip to Miami Beach to attend the 6th Annual Florida COVD Study Group. Dr. Nate is one of the founding members of the group and usually goes each summer to listen, lecture, and discuss the very latest treatments for patients.

The talks were very good. Bob Orsillo, OD spoke about about sports vision enhancement. Dr. John Kuluz from Miami Children’s Neurology Dept spoke about sports-related concussion. Dr. Matthew Kay, South Florida’s leading neuro-ophthalmologist, spoke about double vision.

Dr. Beth and Dr. Nate gave a 2 hour Prezi called “Amblyopia and Strabismus Therapy Treatment with Virtual Reality“. It was an interactive discussion of our use of Vivid Vision, the Oculus Rift-based VR vision therapy tool. It was created to bring immersive new technology to long-standing principles of vision therapy. You can read more about Vivid Vision here.

After hours there was swimming, food and drinks, and more discussion about vision therapy. 🙂

The meeting was sponsored by Eyecarrot. They the company behind, Binovi, the new vision therapy tracking technology that we are using at Bright Eyes.

Here are a few pictures from the meeting:

01 Vivid Vision in action02

2017 Spring Newsletter:New Hours, Sales, Giveaway, Ortho-K, VR & more!

 

Hello, Bright Eyes Patients! Welcome to our first email update of 2017. We have so much to tell you that we’ll get right to it:

Not One But Two Spring Events

Spring EventsSpring has sprung and we have 2 big events coming up! The first is our Spring Eyewear Show on Wednesday, April 26 from 4 to 8pm. This is a trunk show of all the Banana Republic and Smith Optics eyeglasses, including sunglasses. Win a FREE pair of prescription sunglasses from Smith! The second is the Spring Cleaning Sale Monday April 24 through Friday, April 28. The doctors are away at a conference most of the week, but both offices will be open – all eyeglasses and sunglasses on sale! Read more here.

Hours Reminder

Our Westchase office has new hours: Monday, Tuesday and Thursday 9am-5pm. Wednesday is still 12-8pm, Friday 8:30am-4:30pm and Saturday 9am-2pm. See all the details here.

Big News about Ortho-K!

We have been getting more requests than ever about Ortho-K, the overnight contact lenses that allows for clear, glasses-free vision. You might have seen Dr. Nate on the news! You can read about Dr. Nate’s daughter’s own experience with Orthok-K and also read more about the process here. Treehouse Eyes is an office in Washington DC that specializes in myopia control, and they did a story on Dr. Nate’s daughter.

VR Home Therapy is Live

We are one of the first eye doctors to offer Vivid Vision Virtual Reality Vision Therapytreatment for amblyopia and strabismus, but we are now able to offer this treatment as part of a home Vision Therapy program. This is a game-changer for patients both children and adults. If you are interested, call us at 813-792-0637.

Updated Website

You may have noticed that we’ve been hard at work on our website BrightEyesTampa.com, especially pages on Myopia Control, Ortho-k, Vivid Vision and others. Check it out!

Other topics of interest from our blog

We’ve covered some important topics such as Top 10 For Screentime, Women’s Eye Health & Safety Month, Cleaning Your Glasses, The Importance Blue Light, & Eye Color.

Reviews

Finally, we want to say that we are very thankful for all the Yelp and Google reviews. Most people find us through online reviews or word-of-mouth, and as a small business, we appreciate it! If you haven’t left a review, it would mean a lot if you did.

Thanks and have a great spring! 🙂

-Dr. Nate

Bright Eyes Family and Bright Eyes Kids

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Read this Important Information About COVID-19 and Bright Eyes!