Pediatrician Becomes Vision Therapy Believer

This article was originally written by Dr Cathy Wittman on her blog, wittmanvision.com. You can view the original post here.

I started a Pinterest board about Vision Therapy last year, and it has gained followers quickly. If you have never used Pinterest, it is a way to save web pages from the internet similar to, but much more fun than, “bookmarks” or “favorites” in your web browser. Instead of saving the web pages as titles or links in a drop down, you save the webpages as “pins” using a photo.

On Christmas Eve last year, I received an intriguing facebook message from a pediatrician. She told me the story about how her son completed a vision therapy program one year ago. One of the most compelling statements that she wrote was, “His dev opt saved his life and our family.” She went on to write that two years ago “life was hell”. Her son had been diagnosed with intermittent accommodative esotropia, amblyopia, ADD, and severe vestibular processing problems. He was seeing a pediatric psychiatrist, and the situation was dire. She was worried that he would have to be hospitalized for his behavioral issues. Their family has an amazing story.

I asked her if I could interview her for a blog post. I created this blog with their story as my motivation. She and her husband, a radiologist, have seen how vision therapy can change lives. It is important to share stories like this one because vision therapy is effective.

Dr. Wittman: Dr. Jennings, thank you so much for allowing me to interview you about your son, Zach. When did you first hear about vision therapy, and as a pediatrician (and wife of a radiologist), what were your initial thoughts?

Dr. Jennings:  In December of 2010, we had taken Zach to see a specialist for AD/HD in New York.  On the flight home, a stranger sat in the aisle with Zach and me.  He was very nice, and we chatted about our trip and the reason for going to New York.  He had a website link that he thought might be useful to me, and asked for my email.  A month later, he emailed me a link to a news story about convergence insufficiency and wondered if vision therapy might be helpful to Zach.  I watched the news story and found many similarities between the child in the story with CI and Zach, however, Zach’s problem was convergence excess.  I did not understand convergence problems or vision therapy or how it could help.  I asked our ophthalmologist who had seen Zach since age 5 ½ for his opinion.  He said that I should read the statement by the AAO and the AAP that came out in 2009.  He did not think it would be helpful and thought it would be costly, so he recommended that I not take Zach to a developmental optometrist.  Initially, I agreed, and I did not schedule Zach an appointment.  I reread the statement.  Then I picked up Zach from school and saw his frustration, and I thought about convergence insufficiency and convergence excess.  I reasoned that they were really the same problem, just different degrees of eyes not converging in the same location.  Why could vision therapy help convergence insufficiency but not convergence excess?  Did those who said it did not work really know what they were talking about?  I hoped that there was something out there that could help my son.  I called the closest clinic and asked how much a developmental vision exam was? I decided that I would rather spend the money and later think I had wasted it than to not spend it and always wonder if I had missed an opportunity to help my son.

At Zach’s developmental vision appointment, first I was told that he needed bifocals.  I was surprised by this, as nobody had ever checked his near vision by having him read letters in the near range.  I had never questioned this before because I trusted the ophthalmologist and felt that Zach was getting the best care he could get.  He had had some testing done using cards that were held near, such as the binocular vision assessment using 3D glasses to look at an image of a fly and some other images of various animals with one of four projecting outward that he was supposed to identify.  In the past, the thoughts were that he had been able to see the 3D images, though he never got every one of them correct.  He had not had that type of testing done in at least 3 or 4 years.  After his vision exam and refraction, he went to a room with a computer and 3D glasses and did a program by Home Therapy Solutions called BVA.  I know they tested his accommodation, saccadic movements, and pursuits, but I don’t really remember much about that part.  The first part they did was the phoria test which required Zach to look at a blue circle and a red plus while wearing the red/blue glasses.  His left eye could see the circle, and his right eye saw the plus.  The circle was fixed, and the plus could be moved with a remote control.  He was instructed to move the plus so that it directly overlaid the circle, like crosshairs on a gun.  The circle had little white marks on it where the plus would fit.  When Zach saw the plus as on top of the circle, the plus was actually located several inches to the left of the circle because his eyes were crossed.  Suddenly, as I realized what he saw and how different it was from what he was supposed to see, I began to understand my son.  It was a very emotional appointment for me.  I do not remember much else because as he was being tested, I kept remembering different things that had happened in the past and wondered if these things were related to his vision.  For example, he had never shown any interest in any sport that involved a ball.  He could not catch a ball if his life had depended upon it.  A week earlier he had been trying to flip a coin and catch it in the air.  He had a huge meltdown after he became frustrated because he could never catch it.  At age 3 Zach had begun sounding out words and trying to read, but by kindergarten, he had no interest in reading.  He was the kind of kid who wanted to know everything there was to know about a topic of interest, yet he had no interest in reading that information for himself at age 7.  When his teacher tested his reading ability at the beginning of 2ndgrade, she found his level to be 6 months into 3rd grade.  She thought he was lazy and unmotivated.  Suddenly, I realized that when he looked at books, he was seeing double and everything was out of focus.  Forcing himself to read was like making him lift 20 pound weights with his eyeballs.  No wonder he was frustrated!  I did not know anything about vision therapy, however, I did understand that nobody had ever done testing on my child that had revealed so much information to me before.  I hoped it would help and was willing to do whatever it took on my part to support my child as he did therapy.  At that point, I just trusted that the doctor who had actually identified significant problems might know something about how to fix them.

My plan was to read everything I could so that I could understand therapy and understand why I needed to do what was asked of me as a parent.  First I read Jillian’s Story, by Robin Benoit.  I was amazed by the outcome Jillian had with vision therapy, and I saw many similarities in what Jillian had experienced and what my son was experiencing.  This book gave me hope for my son.

Next I read Fixing My Gaze, by Sue Barry, PhD, about how she acquired 3D vision for the first time at age 48.  This book was fascinating and explained so many things about vision that I had never thought about before.  After reading these two books, I understood enough to know that I had to do whatever it took to get Zach to do what Dr. Boyles and Candice, Zach’s vision therapist, instructed us to do for homework each week.

When the bifocals arrived, Zach put them on and looked at a book.  “Mama!  This book has LETTERS in it!!” he yelled excitedly.

“What did they used to look like?” I asked, with tears in my eyes as I began to really understand his 3 years of struggle.

“They used to look like hairy gray blobs,” he told me.  Hairy gray blobs.  He could read hairy gray blobs a year and a half above his grade level.  I wondered what his reading level would have been if he had been able to see the letters well from the kindergarten?

At this point, some people might ask how he ever learned the alphabet in the first place.  When he was a baby, I had purchased a set of foam letters about 3 inches tall for use in the bathtub.  During bath time, his dad would play with 4 or 5 letters with him until he knew the names of them.  Then he would trade them for 4 or 5 different letters.  When he was first diagnosed with vision problems at age 2 ½, his visual acuity was tested the first time using the adult Snellen chart after the ophthalmologist had switched his screen to the large letter E and Zach had identified it.