A Cross-Section of VT Consultations


In many of our blog posts I’ve addressed challenges that we face in clinical practice that divert patients from obtaining the help they need to develop the full extent of their visual abilities.  Yet whenever these challenges seem to be getting you down, as Dick Van Dyke reminded us in Bye Bye Birdie, just put on a happy face!  We have an extensive intake process that is conducted over the phone when a patient first calls our office, whether referred by another doctor, other professionals, or the various forms of self-referral such as through social media.  My office manager batches them weekly and gives them to me for review so that I can stay on top of things.  In turn I will add any comments to the patient’s computer file with my thoughts either prior to the evaluation, or any way along the process including after my consultation with the patient and/or family.  Looking over my batch from this past week reminded me of the diversity of our VT patient population.  Here is a cross-section of the “top ten”:

1) AJ, a 13 year old who is home-schooled and is struggling with reading.  He was referred to us by another O.D. who felt AJ’s issues were beyond what he could manage.

2) Yosef is a 7 year old whose mother used to be a patient of ours before she married.  He’s struggling in school and has been diagnosed by a neuropsych as having ADD who recommended that his pediatrician put the child on meds.  His teacher did an informal vision screening and felt he had issues for which VT may be of benefit.

3) Rose, who’s 76 years old, is the grandmother of a boy who recently underwent VT in our office.  She has double vision issues and has seen several  ophthalmologists who don’t seem to be able to help her.

4) Emily, an 11 year-old twin, was observed by her mom to be closing one eye at times.  Her regular eye doctor gave her glasses, but when they started to see her eye drift referred her to a strabismus surgeon.  He recommended surgery and said there was no other option.  A friend of the family, who’s an O.D., came over the house last weekend, took a quick look, and said they need to see me.

5) Josh is a 6 year-old who saw an ophthalmologist last year.  He said there was an eye muscle problem but since Josh still had stereovision there was no need to do anything.  They went to India, where mom is from, and while there had took him for an exam and was told he needed glasses and to do eye exercises.  When they related that to the M.D. he said they could see a certified orthoptist if they’d like.  They checked around and found we were the office to see.

6) Allen is a 48 year-old physician who experiences motion sickness.  He saw an O.D. who tried prisms with him, but was making little progress.  He’s a camp doctor, and an O.D. familiar with our practice who has a child there was chatting with him and said he needs to come to our office for a consultation.

7) Jane works in the brain injury field and when at Nyack Hospital years ago had referred patients to us who were helped significantly.  Her mother lives in Florida and began experiencing double vision, particularly “in the periphery”.  Her ophthalmologist though it was caused by anti-depressant medication.  Jane isn’t buying it and wants us to evaluate her mom.

8) Kaylee is a four month old whose dad noticed her left eye turning in.  He wants an opinion about any alternative to eye muscle surgery.

9) Jim, an O.D. who I think of like my son, referred a 9 year-old, Natalie, who by history performs very inconsistently on standardized educational tests.  He detected convergence insufficiency, grasping what Dr. Fortenbacher has written about extensively, and referred her to my office.

10) Leah is a 3 year old whose mom is a P.T.  She received a flier on an upcoming seminar that I’ll be doing and thought of her daughter who has mobility issues.  Other therapists thought Leah might have vision problems, so mother will be bringing her in to be evaluated.

– Leonard J. Press, O.D., FCOVD, FAAO

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