Dr. Paul Karpecki is a widely regarded continuing education lecturer in Optometry, who was one of the first practitioners in the country to establish a practice dedicated primarily to “Dry Eye”. He co-authored a nice CE article on the subject, which pointed out the potentially lucrative nature of dry eye practices. When Paul Karpecki speaks, people listen – and for good reason. He is knowledgeable, insightful, well-reasoned, and well-spoken. I’ve had the pleasure of chatting with Paul on the lecture circuit and participating in some think-tanks with him.
I was therefore intrigued when my old buddy, Dr. Brian Berliner, emailed me to ask what I thought about Stereo-Optical’s new Opt-Align system. I hadn’t heard of it before, but then again I missed going to Vision Expo this year where the company unveiled the product. When I visited the website I was surprised to see Paul Karpecki’s visage front and center, and even more so when I listened to the content of the video. I normally don’t associate Dr. Karpecki with functional vision problems, but have a look and listen to this well-done video:
“I heard about opt-align actually from an ophthalmologist named Vance Thompson who is discussing on a conference call we were all on that he’d had this incredible success on a series of post-refractive surgery patients who had significant dry eye type symptoms, and the success wasn’t related to dry eye treatment itself, it was actually related to eye alignment, and he introduced me to an individual named Dr. Jeff Krall. What was fascinating about that – and in trusting Vance and knowing him for alot of years I knew there was something to this, but what really convinced me was one day when Dr. Krall visited my practice he told me to line up about 10 patients who I’d been treating with significant symptoms ranging from headaches to irritation late in the day to grittiness to sandy-type eyes, and because I have a very large dry eye practice it was easy to line up those patients. They all seemed to test normally but all had these symptoms. And he spent a day with me going through each patient and tested their alignment, incorporated the opt-align, was able to diagnose the proprioception and the alignment issues and amazingly solved all of their problems. And these patients were ecstatic. Some were crying, a big guy was hugging him, it was an incredible response! I was convinced after the second patient, but by the 7th or 8th I was amazed.”
I’m going to answer Brian’s question, though I’ll have to do it in another blog piece. Going through Dr. Karpecki’s video prompted enough thoughts for this one. Take particular note of several things:
1) When it comes to ocular disease treatment, the most-respected gurus are often influenced not by prospective double blind studies, but by the opinions of colleagues they trust, and by anecdotal evidence. We’ve discussed this before in the context of the disingenuousness of those who dismiss VT because of a supposed lack of research.
2) As you listen to the entire video, note how Dr. Karpecki is intrigued by the overlap in signs and symptoms of dry eye with functional vision problems, particularly those influenced by the proprioceptive system. As I listened to him, I was reminded that this isn’t the first time Dr. Karpecki has discovered principles of optometric vision therapy through post-surgical and disease portals.
– Leonard J. Press, O.D., FCOVD, FAAO
The VisionHelp Blog 
Len,
Thank you for showing how this new technology has been developed to help doctors identify their patients with binocular vision problems that impedes their near-vision activities like reading and computers. Hopefully more eye doctors, optometrists and ophthalmologists, will see how important it is to their patients of all ages to identify these problems and manage appropriately.
The concept of this new technology is that the patient with a binocular vision problem can have symptoms that mimics the eye- strain felt by those with dry eyes. And, when identified, the new computer helps identify the reading-glasses prescription that will help relieve those symptoms. In our practice we always consider the appropriate application of lenses and/or prism to facilitate the best support for our patient. Now with advanced technology more doctors should find this easier to do as well.
Agreed, Dan. I have no experience with Opt-Align, and $15,000 seems like a steep price tag for combining a fixation disparity and TIB test, but if it helps authorities like Paul Karpecki get the word out to look beneath the ocular surface, I’m all for it!
Keep an open mind. Narrow minded people learn very little from life experience.
And of course, the width of one’s mind is relative to the observer, and that on which one is passing judgment.