VT Works

For the benefit of our readers who may be meeting you for the first time, can you share how you found your way into vision therapy and what drew you to this profession?

My journey into vision therapy actually began as a patient. When I was 9 years old I started vision therapy, by the time I finished when I was 11 years old, I told my optometrist that I would be a vision therapist one day. Many members of my family have benefitted from vision therapy. The whole experience changed how I interacted with the world. 

I followed the steps that I was advised to take, became an optician and contact lens fitter and worked in the optical field. Then my brother found an ad entitled “Wanted: Vision Therapy Assistant” . He knew that was my goal and gave me the article. Within two weeks I was working in VT at the Center for Vision Development Optometry Inc. with Dr. Derek Tong. 

You’ve been part of the Center for Vision Development Optometry in Pasadena since 2005. What has it meant to grow professionally within one practice over such a long period of time?

I am grateful for the opportunity to have been part of the Center for Vision Development since 2005. It’s been an incredible ride. When I first interviewed with Dr. Derek Tong in 2005, I asked him if being a vision therapist was a job or a career? He answered me with, “we will make it a career.” Both Dr. Tong and I value professional growth and education. I have been able to consistently attend many forms of continuing education. I try to read as much as I can from our in-office library and attend online events when I can. Early on, Dr. Tong encouraged me to synthesize the information into three to five actionable points for each lecture that could be applied to my patients. That mindset sits with me to this day. I will forever be grateful to Dr. Tong for his mentorship.

It’s said that you need 10,000 hours to become an expert at something. In vision therapy, that number is probably exponentially larger! The information we need in order to execute our craft is equivalent to a well stocked and ever changing library. The variety of patients that I see has me traversing that mental library many times over within a single work day. At times, I will reread some old notebooks, or even my COVT OBQ’s, and marvel at how far I have come. My journey in VT has truly become a career. 

You personally benefited from vision therapy as a child. How has that experience shaped the way you connect with patients and families today?

I personally experienced many of the diagnoses that we see today. As a child, I went from not being able to hit a ball or catch a ball, not being able to read or write; to playing sports with ease and enjoying reading. I am living evidence that VT works. I had two different therapists along my journey: one who made me feel safe, engaged, and understood and one who I didn’t look forward to seeing. I still remember some of the sessions with the “fun eye lady” she inspired me and helped me succeed. That contrast shaped how I work with patients and families today. 

I have been on both sides of the desk. I know what it is like to dread coming to VT and look forward to VT. I know what it is like to avoid doing home practice because it’s boring and uncomfortable and to be motivated to try something difficult because I saw the possible payoff. I know what it’s like to have a family member who has had a stroke, strabismus, amblyopia, severe developmental delay. All of whom have had a significant improvement in quality of life due to vision therapy. Meeting people where they are is one of my favorite parts of this craft. Part of that is having the empathy and willingness to sit in their experience for a bit. One of the lessons I learned early on was to set up the circumstances for success. I am not “doing” anything to a person, I am making the environment opportune for them to “do” VT to themselves. When I entered this field, I promised myself that I would work hard to be the “fun eye lady,” the one who made the patients feel safe; who understands the visual system so well that I can make every encounter meaningful for the person I am working with. That is a commitment I make to show up for my patients and the VT community.

You earned your COVT certification in 2007 and now serve as a mentor for others pursuing certification. What do you believe makes the certification process so important for the profession?

Certification is so important to the longevity and credibility of this profession. Certification provides assurance that a therapist has at minimum: a baseline of knowledge, follows established care guidelines, a commitment to continuing education, and provides the latest most up-to-date care possible while adhering to professional and ethical standards. A goal of mine is to elevate this process to a new height with every person I mentor. What we do is so much more than eye exercises. Vision therapists are not simply another piece of equipment in the VT room. What we do is specialized, medical treatment under the direction of an optometrist; we are affecting brain tissue and influencing development. Certification helps ensure that the therapist has the knowledge, clinical experience and advanced training necessary to deliver safe, effective, evidence-based, personalized vision therapy for each patient. 

Certification creates unity amongst VT providers and vision therapists so that patients and referral sources have confidence that the standard of care is consistent, whether they are seeing me in California or one of my colleagues in another part of the country or even the other side of the world. Certification is one step towards that professional confidence, continuity of care and credibility. I know many talented vision therapists who have not yet pursued certification, I encourage anyone considering it, or optometrists considering fellowship, to seriously consider going through the process. The growth you will experience as a candidate is extremely fulfilling.

As a mentor in the COVT process, what patterns do you notice in therapists who grow into confident, effective clinicians?

They share a few common traits from the start: curiosity, enthusiasm, drive, cognitive flexibility and a desire to help others. One of the biggest outstanding markers of therapists who are confident and effective is understanding and demonstrating the why of what we do, not just the how. When a candidate can clearly articulate why they do a procedure, the clinical reasoning for their decisions, I feel confident that they really “get” vision therapy. 

My grandma used to say; To be good at something you love you have to be the three H’s: Humble, Hungry and Honest. I interpret her words to mean. 

Humble, because every patient will teach you something. You have to get out of our own way to make vision therapy about the patient. It is the growth mindset of seeing the potential in others to heal and creating opportunity for their visual systems to grow. 

Hungry, because the best therapists are never satisfied with what they already know. They are desiring to learn more and more about the visual system and its intimate connection to the whole body.

Honest, because mistakes and mix-ups will happen. What we can control is the way we respond to them and how we model our regulated state. Patients will ask us questions that are out of our depth. Will you say: “That’s a good question. I don’t know the answer yet, let me write it down, talk with the doctor, and get back to you?”

You’ve been recognized with both the Lora McGraw Award and COVD’s COVT of the Year honor. What do those recognitions represent to you personally and professionally?

I am honored to have even been considered for these awards. Sitting in company with those who have won them before me, and will win them after me, is incredibly meaningful. I did not have the opportunity to know Lora McGraw, I have read her words and I have listened to audio recordings of her teaching. Lora set a standard of excellence in our field. She was known for being compassionate, committed and relentlessly focused on potential in her patients.  There is a saying from Dr. Don Getz regarding Lora McGraw that makes me pause, he said of Lora; “She did not have the disadvantage of an optometric education, and, consequently, did not know that certain things were impossible.” Mindsight.  To have received this award has been motivating, each time I see it on the wall I am reminded that a group of vision therapists saw those “Lora-like” qualities in me. My core belief is that nothing is impossible; our vision, our mind, our bodies, and our brains can heal. 

The COVT of the year award was unexpected. I’ve been told that I am the youngest to have ever received this honor and knowing that my peers nominated me for this award makes it especially meaningful. To be recognized by my colleagues that I so deeply respect is both humbling and truly validating. Knowing that I am contributing to a field I love so much, in a meaningful way, is something that I will never take for granted.

Many people describe vision therapy as both a science and an art. How do you see those two elements intersecting in your day-to-day clinical work?

For me, the science and art of vision therapy are constantly and completely intertwined and each is dependent on each other and frankly necessary. It is what makes the work we do so impactful. 

Think of the science as similar to the foundation, structure and integrity of a house whereas the art is the furnishings, choices and life lived within the house. The patient gives us their anatomy, physiology, their unique experiences.  Science gives us lenses, prisms, filters, tints, neuroplasticity, sensory-integration, automaticity. The art is the human connection, the sense of safety, the psychology, the ability to meet each patient where they are and take them “where they ain’t.” (Thanks WC!). The more I learn about the science of VT, I am convinced that the visual system does not work in isolation. The brain, the eyes, the mind and the body are constantly working together and giving us clues as to how we can help a person in a more meaningful way. Tapping into this is how we unlock the potential of each patient.  

A few years back I wrote an article on the Art of Vision Therapy for the COVD journal. My goal was to encourage our profession to push beyond the “why” and “how” and really speak to the currency of each patient.  Every human we work with is different, no two patients are going to “decorate their house” the same way. Vision therapy benefits children, adults, those with injury and without, athletes and many more. My role is to set the pace, when to push versus to pivot, to simplify versus to complicate, be playful versus be direct. The art meets the science!  Jessi Stevenson and I will be talking about this at the 2026 OVDRA meeting in a pre-meeting course entitled Unloading Loading. I am excited to dive deeper on this topic with her.

You currently serve as the moderator of the Tuesday Think Tank. How did that role come about, and what value do you believe this weekly space provides for the VT community?

I have you to thank for the Tuesday Think Tank, Robert! You started this meeting during the pandemic to help vision therapists come together in a time where things were very uncertain. After a couple months, you were not able to keep it going and asked if I would take over, I said yes and haven’t looked back.  Nearly 6 years later, the Tuesday Think Tank is going strong. The structure of the meeting has evolved over the years. We started out just talking about what was on our minds, specifically about providing virtual care for our patients. Then we talked about specific pieces of equipment. Then, people started emailing me prompts to include. Now I receive multiple requests for topics and cases to be discussed each week and send out a weekly agenda that helps guide our discussion.

The Tuesday Think Tank has become a safe, judgement free space for vision therapists and optometrists to come together and share ideas and brainstorm; while learning together. There are regularly very new and seasoned participants engaging and exchanging ideas together from all around the world. The Tuesday Think Tank vault now has over 450 hours, and growing, of recorded conversations about vision therapy covering endless topics. Personally, moderating the Tuesday Think Tank is incredibly rewarding. I love teaching and sharing my knowledge about vision therapy while facilitating these conversations. My employer has generously helped me to facilitate these weekly meetings, in turn helping the broader VT community.

For anyone wanting more information about the Tuesday Think Tanks, you can email me julescovt@gmail.com.

For therapists early in their careers, or those still finding their voice, what advice would you offer based on your own journey?

Never stop learning. Attend every conference you can. Be curious about the brain and the mind. Become friends with your visual system. Find your inner Sherlock Holmes and hone your skills in the VT room. Stay active in organizations that champion vision therapy like OVDRA, OEPF and others. Mentor COVT candidates when you qualify, this is one of the best ways to constantly grow yourself. Don’t shy away from complex cases, these are the people you will remember in 20 years. They give you the opportunity to dig deep in the literature, have fortifying conversations with the optometrist you work with and experience the joy of seeing things click for the first time.  Work to understand the purpose of each VT procedure. Speak to the “currency” of the patient that you are working with. Learn and collaborate closely with your overseeing optometrist.  Please, do not forget to rest and recharge yourselves, we give and give constantly. It is essential that you care for yourself so as to continue doing the work you will love. Most importantly, enjoy the ride. The journey of growing in this career, connecting with patients, contributing to solving complex problems, and discovering what is possible in VT is one of the most rewarding experiences. 

After nearly two decades of clinical work, teaching, and mentorship, what does it mean to you now to be a vision therapist?

I love people. My role is no longer just clinical, it is deeply personal. Today, being a vision therapist means so much more to me than it did 21 years ago when I walked into my first interview. I help people unlock their potential. I change people’s lives. I guide and mentor. Sometimes, I am the first non-familial adult that a child trusts, and that is a heavy responsibility. I have shared tears of joy and pain with people who have invited me into their lives. I have the privilege of witnessing transformation in real time. 

Every day there are challenges, opportunities for learning, constant problem solving, critical thinking, two days are never the same. It is a work that I love, and for me, a love that is truly priceless. 

Closing Thoughts from Robert: A great thanks to my dear friend Jules Petteruto for taking the time to complete this interview. Aside from becoming an amazing Vision Therapist (she literally teaches me something every time we discuss patient care), she is an incredible human being. Having Jules as a professional colleague makes us all better at what we do, but having the privilege of calling her my friend has made me a better person, without a doubt. Please join me in thanking Jules for sharing her wonderful story and for her undying thirst for improving the lives of those around her. Wishing Jules Petteruto continued happiness and fulfillment, both in her work and in the countless lives she touches with her heart, wisdom, and unwavering dedication. Cheers!