Full Blog Archive
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HIPPA Guidelines Lifted
Per this morning’s press conference from the White House, HIPPA guidelines regarding tele-health have been temporarily waived: Under this Notice, covered health care providers may use popular applications that allow for video chats, including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype, to provide telehealth without risk that OCR might seek to… Read more
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Is It August Yet?
So here we are – sheltering in place. There was a time in my life I never imagined this could happen. Not in my hometown. Not here. Not in the place where I grew up. A place that, for me, carries something of a magical essence. And yet, here we are. Home. Staying as far… Read more
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Fist Fights and Toilet Paper…
I get it. This is serious. For the last few weeks, talk of COVID-19 has dominated the airwaves, lunchrooms, and travel plans. We’ve seen Italy close it’s borders, cruise ships hold hostage its patrons for weeks of quarantine, and we’ve even seen Costco completely run out water and toilet paper – the latter of which… Read more
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Inbox: VT Mailbag
Since I’ve been away from blogging, I have a few mailbags worth of questions in the queue. Let’s begin with these. Cheers! My son is 9 years old, has been in vision therapy about 3 months, and our therapist has him working mostly on primitive reflexes. A book I’m reading explains how reflex integration can… Read more
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Direction Over Perfection
If the decision was ever made to award indoctrination into the world of psychological treatment by proxy, my guess is most of us in the Vision Therapy room would at least qualify for consideration. Although few us could speak intelligently about the tactics of manipulation or influence a true psychologist may use, many in the… Read more
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Pencil Pushups – Valuable or Futile?
During a recent conversation, a trusted and learned optometry friend opined Pencil Pushups are a worthless activity and should be banished from the mind of everyone associated with Developmental Optometry. What’s more, continuing to administer Pencil Pushups in their traditional form would garner laughter from colleagues and outside professionals OK, maybe my rendition of the… Read more
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The Smell of Wine and Cheap Perfume…
The timeless American rock band, Journey, was formed in San Francisco in 1973 and many of its members, both past and present, still live in the city. One of Journey’s more popular songs, Lights, is seemingly an ode to the city by the bay, it’s spirit, it’s comfort and it’s energy. Although I have always… Read more
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A Milestone, A Homecoming, and Coffee
Just so you know, I set my alarm an hour earlier than normal to be sure I’d have enough time to finish this post this morning. It’s that important to me. As it just so happens, this is my 500th post on this blog; a milestone I share with pride, to be sure. I have… Read more
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Body Work Revisited…
My experience and training in Vision Therapy has mostly been a “build from the ground up” approach which attempts to address all levels of development in which vision is affected. In most cases our therapy programs begin with a body mapping assessment of the patient’s relationship with gravity. We ask the patient to perform activities… Read more
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Amblyopia Revisited…
Amblyopia is clinically defined as the difference in the best corrected acuity between the two eyes of two lines or more in Snellen Acuity. Amblyopia is also known as visual acuity poorer than 20/20 in the absence of underlying structural or pathological anomalies, but with at least one of it causes occurring before age six,… Read more
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Strabismus Revisited…
Strabismus is a visual condition in which the eyes are not directed toward the same object in space at the same time and, therefore, results in a decrement in the quality and quantity of visual information through both eyes. One eye may be deviated inward towards the nose (esotropia) or outwards away from the nose… Read more
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Prism Revisited…
Prisms play a valuable role in the success of Vision Therapy. Since prisms are considered to be a medical device, their use should always be monitored and guided by a Developmental Optometrist, or other qualified eye doctor. Prisms can be used in a variety of ways to enhance our Vision Therapy patient’s experience. Monocular prism… Read more
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Lenses Revisited…
Considering the physiological connection between accommodation and vergence, both plus and minus lenses can be used to strengthen accommodative vergence and fusional vergence, as well as increase the overall flexibility between the two systems. Plus lenses decrease the amount of accommodative demand (relax accommodation), thereby asking the patient to stimulate fusional convergence to maintain a… Read more
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Eye Movements Revisited…
Eye movements can be broken down into three of the following areas: fixations, pursuits, and saccades. Fixations, also known as a zero pursuit (or a pursuit standing still), are defined as the process, condition, or act of directing the eyes toward an object of regard, causing the object to be centered on the fovea. Both… Read more
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Binocularity Revisited…
By definition, binocularity is the ability to achieve function with two eyes at the same time, which is often measured in three or four degrees of fusion, depending on the respective visual model. First degree fusion consists of simultaneous perception with the ability to overlap, or “fuse” dissimilar targets. As an aside, some visual models… Read more
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Accommodation Revisited…
Accommodation is defined as the act of focusing the eyes to provide an image clear enough for interpretation. Accommodation also refers to the change in the power of the crystalline lens to bring an object into focus when stimulated by the presence of blur or proximity of the object. Vision Therapy should strive to help patients improve… Read more
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The Lanes of Heaven
Upon making the decision to begin writing this blog in 2012, my thoughts and motivations were fairly simple. I would write for myself, share my thoughts, my ideas, and utilize this medium as an outlet for recording the passions of the moment. At the time, I wasn’t really concerned with who read it, or even… Read more
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A Bad Haircut…
We’ve all been there. You head out on a Saturday afternoon to run a few errands, make a stop to get your hair cut, and BAM. Get home to look in the mirror and realize the person who cut your hair had a rather aggressive interpretation for “just a little off the top” and now… Read more
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My Living Legend…
As a passionate Vision Therapist I really have only one serious goal…I want to be just like Linda Sanet. I first encountered Linda at an OEPF sponsored event in San Jose, CA in 2000, where she was teaching a weekend course. At the time, I had been working with patients less than a year and… Read more
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Welcome To Holland
In recent years, there’s been a definitive push towards “patient first” language, acknowledging the person before referring to their affliction. For instance, the strabismus patient has become the patient with strabismus, or the TBI patient has become my patient with a brain injury, or even better, my 4 o’clock Vision Therapy patient has become “Johnny”. The push… Read more
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From What If to Pixie Dust
It’s been said the “what ifs” will kill you. What if in college I had made that goal to win the soccer game? What if she had just looked to her left once more before stepping off the curb? What if just 10 more people had voted? The idea behind not asking “what if?” seems to… Read more
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Remembering Danielle Chason
Since completing my certification (COVT) in 2008, my estimation is I’ve mentored close to thirty other Vision Therapists through the process. All them have been hard workers, all of them have been memorable, and all of them made it through. Aside from the academic completion, the best part for me has always been and will… Read more
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Easily Transported
My best friend in high school, who we will call Mark, was an African American boy whose father was a Rabbi. His father’s immediate family had converted to Judaism a generation or two prior and Mark’s father felt his calling from within his faith. His dad, who we lovingly referred to as “the preacher”, was… Read more
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A Stupid Problem
At this time next year, I will have already surpassed the anniversary of my twentieth year in the land of Developmental Optometry. The the bulk of that time, minus a two year stint working with P.A.V.E., was spent in direct patient care in the Vision Therapy room. There have been several memorable patients, several poignant… Read more
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Developmental Testing – Part 1 – The Snapshot
Over the last few weeks, several people have reached out to me with questions about the information behind and the importance of the visual perceptual testing most Developmental Optometry offices offer. Although the level of questions received vary from beginner to fairly in depth, the need for understanding is evident. I am in no way… Read more
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Ties That Bind
If you’ve opened up this post looking for some nominal amount of Vision Therapy wisdom, I’ll kindly save you the trouble in the first sentence by alerting that is not what lies ahead. While those ideas are always fun to share, it’s just not where my heart is this morning. Instead, my sentimental side has… Read more
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Incredible and Indelible
There are very few things in life which truly make sense to me. I mean, I understand why the sun rises in the east, why gravity is a law, and why baseball is considered the greatest sport ever, but beyond those, the water becomes murky. Take the universe’s fascination with the Kardashian’s, why the DMV has… Read more
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Sad News…
Shared by James Smith, COVT. Please consider helping this family during this horrible time. It was a great shock to all of us at Washington Vision Therapy Center to hear that our Office Manager in our Tri-Cities offices was tragically killed this weekend. See the story here. Stephanie was the heartbeat of our clinic. … Read more
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Inbox: My VT Mailbag
Last July/August I had cataract surgery. I am pleased with improved vision and clarity. However, I ended up with double (distant) vision. My P.T. recommended I see Tom Headline. I’d like to know if you would recommend I see my eye surgeon first and if he does not have a solution, ask him for a… Read more
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Happy Left Handers’ Day!
My mom is a lefty. My sister is a lefty. My daughter is a lefty. My former boss is a lefty. Together, I’m sure they’re conspiring to celebrate National Left Handers today – and every August 13. Lucky them. These people in my life are also quick to point out three of our previous four presidents have been… Read more
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winds of change…
My mom used to carry a wooden cooking spoon in her purse, which she affectionately named “Jimmy” after Jimmy Hoffa. Later in life, I’ve learned the idea of the spoon was never to become physical; rather, just to maintain the illusion over our young adolescent minds that Jimmy would and could enforce her parenting wishes… Read more
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just listen…
I’m the first to admit my propensity to become fascinated with the peculiar, bizarre, and eccentric. I’ve never really figured out why, although I suspect my growing up in San Francisco is widely responsible. I’m drawn to people who are different, unusual, quirky, and perhaps even surprising. Throw in a little kindness and integrity and you’ve got… Read more
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riding the wave…
Anyone who has been around Vision Therapy for a decent period of time may be familiar with the idea of offering rehabilitative care to patients with Traumatic Brain Injuries. Helping patients to re-organize their visual inputs and balance their visual stimuli a lot of times can improve their quality of life post-injury. Just as every… Read more
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No One Fights Alone…
There are some people who will never ask for help; it’s just not in their genetic makeup. My Vision Therapist friend Robin Vreeland has always been one of those people. She is strong, proud, determined, and through her entire ordeal with colon cancer, has complained very little. She rolls with every punch, jumps every hurdle,… Read more
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A Different Tomorrow…
There are moments when I’m really into Vision Therapy, be it helping an adult recover from a Traumatic Brain Injury, or helping a third grader find her way through some accommodative exercise, or even finding some group to speak to in hopes of enticing them with the wonders our profession has to offer. Working with… Read more
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Size Matters…
There’s been a lot of chatter lately on the therapists’ email forum about vectograms; the do’s, the don’t’s, the how’s and why’s. I’ve written many times of my affection for the activity, and it always gives me an ounce or two of excitement to learn something new from those seeking new paths to success with… Read more
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Nick Foles – A Perry and Baskett Routine
To hearken a favorite melody from Journey, some boys in Philadelphia didn’t stop believin’. Having watched their favorite sons of the gridiron manage a full 60 minutes of hearty competition while emerging victorious, the repetitive thud you heard late last night was surely the sound of close to 2 million inhabitants of the City of… Read more
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Vectograms – A Clear and Single World – Part 2
Perhaps more than any other activity we walk our patients through, vectograms are the quintessential interpretive process. Quite naturally, patients look for what they perceive as the correct, or the “how it’s supposed to look ” answer, as we strive to keep them in the process of visual exploration. Embracing this as therapists is, in… Read more
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Vectograms – A Clear and Single World – Part 1
If we were to ask 100 therapists which activity gives them the greatest amount of trouble, my bet is the vast majority of them would name the vectograms. While I don’t pretend to be an expert, I certainly have been forced to think and re-think them on enough occasions, that I’m comfortable offering my opinion. The… Read more
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Inbox: My VT Mailbag
About a month ago, I reached out to a few friends around Developmental Optometry and asked them to have patients, or perspective patients, submit questions to be answered online in a mailbag format. Here are a few of them. My son has been in VT for close to six weeks and most of what we’ve… Read more
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When ‘Perfect Storms’ Pass
There are moments in life when we are given pause. Maybe talking to a child about a difficult topic or helping a friend through a tough situation, maybe even working through challenging moment on our own could all be reasons why. It’s one of those moments in life which has always fascinated me. Something external… Read more
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Hernias and Candles
The world can be unkind. Get used to it. In the not so distant past, an article came up on my screen detailing the inequities of online reviews with respect to the medical profession. The idea was, and surely still is, practitioners, be they involved directly or indirectly with a patient, should be immune to… Read more
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Eyes On The Ball
Someone asked me recently if my blog is still active, to which I promised them it is, explaining my heart and mind are just channeled elsewhere for a bit. My passion and pride still remain on these pages though, and although I’m not currently as prolific as in the past, there are days where something… Read more
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Small Deposits – Part One
Sometime last year, I watched an interview with Chesley “Sully” Sullenberger, who was, of course, the captain of of the US Airways Flight 1549 which landed in the Hudson River in January 2009. Captain Sullenberger noted during the interview how he felt as if each of his previous flights, totaling some 42,000 hours, allowed him to… Read more
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To VT Or Not To VT – The Final Act – Part 3
Just so we’re absolutely clear, I don’t think deciding against Vision Therapy for financial reasons makes you a bad person. Quite the contrary, in fact. If you travel far enough in the process to be told Vision Therapy is needed, you honestly have my complete admiration – even if you decide to take a pass. If… Read more
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To VT or Not To VT – The Root of All Evil – Part 2
For the love of money is the root of all evil; which while some coveted after, they have erred from the faith, and pierced themselves through many sorrows. ~ Timothy 6:10 There are many reasons patients and their families choose against enrolling in Vision Therapy, and although a few are tough to swallow from my… Read more
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To VT or Not to VT? – Falling On The Sword – Part 1
Operating an office which accepts third party assignment (medical insurance) can be a bit challenging. On the one hand, there’s the patients who find us simply because we accept their insurance, and on the other, there’s the folks who leave because their insurance didn’t participate in the manner they would have liked. In the middle… Read more
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To VT or not to VT? – That Is The Question
There has been a lot of discussion lately, in the public forums I follow, regarding whether Vision Therapy is best for the many families to whom it’s been recommended. My sense is there are some common misconceptions, or perhaps misnomers, floating around and I’d like to offer an “insider’s perspective” on the subject. Before I do,… Read more
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Click and Spin
My son announced this morning he wants to “get spun” before school next week. I was instantly concerned. More on that in a minute. Read more
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Primitive Reflex Weekend!
Of all the things to forget to do… My doctor and I are hosting a seminar late next month. I meant to post it on here a few weeks ago and it just slipped my mind. Here’s the information for anyone interested! Read more
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A Full Circle Experience
Sometimes it’s funny how life comes full circle, isn’t it? I received an email this morning from a therapist I met in Jacksonville during last month’s Annual Meeting. It’s an email I, myself, have written hundreds of times to people I admire and trust; an email asking for help, guidance, and maybe even a little… Read more
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22 Reasons – My VT 201 Experience
Having the opportunity to teach an AC Course at COVD’s Annual Meeting is a pretty special experience. This was the third year in a row I’ve had such an honor, and somehow every experience has found a way to top it’s predecessor. In both 2016 and 2017 the AC Course “VT 201” has been on… Read more
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A Great Kickoff!!
When names like Dr. Len Press, Dr. Byne, and Dr. Noah Tannen begin talking about Developmental Optometry, it’s a good idea to sit up and pay attention. That’s what I do. But when they sit in the same room, and on the same stage no less, one should consider themselves privileged to be in the… Read more
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Visual Acuity and the Race Car Driver
The following article was written by my friend and former patient, Michael Johnson, a professional race car driver, and is shared here with permission. You can find the original article here. How do you do it? How do I do what? See things coming at you so quickly, and respond appropriately. Well, I don’t always respond… Read more
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Holding Steady In Houston
Houston is not a town I often refer to as near and dear. Quite the opposite, actually. I moved to Houston as a husband and father in April of 2007, and within three years, life had unraveled. My wife and I had split up and we were headed towards divorce, both attorneys (and eventually the judge) were… Read more
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Confirmation Bias
Confirmation bias is the notion of human beings’ tendency to search for, interpret, favor, and recall information in a way that confirms one’s preexisting beliefs or hypotheses, while giving disproportionately less consideration to alternative possibilities. This according to the guru’s of Wikipedia. One of my current patients is a commercial airline pilot with several years experience, who… Read more
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Managing the Red Flag
As Vision Therapists, we receive training in a vast array of topics from oculomotor activities, the relationship between accommodation and vergence, and most visual perceptual areas. In fact, therapists who complete a certification (COVT) are tested in these very areas and plus several more. The benefits to more training are fairly obvious, although one understated… Read more
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I want to SWING!
All of our patients are special. Your patients, my patients, and that doctor in Florida whose name I can never seem to remember has special patients, too. They come from all different backgrounds and different walks of life, all seeking help with their particular challenges, and one working just as hard as the next.… Read more
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20 Days
Hello All – just a quick update on my book project and campaign. My Kickstarter campaign is in full swing and continues to do well. I’ve got about $9500 to go with just under three weeks remaining. Thank you to everyone who has jumped on board either by wishing me well, sharing my campaign, and of… Read more
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Off The Schneid
For anyone unfamiliar with the phrase “getting off the schneid” (pronounced shnod), it’s a phrase common in sports to mark the end of a losing streak, or to signify a player or team’s first points. In certain golf formats, the term is common when a player scores their first points under head-to-head competition. In other sports,… Read more
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The Salty Side of ICD-10’s
Note: Given the current political climate, allow me to state off the top this is not a political post, so please do not respond as if it were. The challenges discussed below exist regardless of political affiliation, healthcare plan and coverage, or policies of the current or previous administrations. If the world were a perfect place, our… Read more
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Realistic Engagement
Have you heard the news? I am embarking on a book-writing journey and I am inviting all of you to join me in this adventure! My plan for this book is to attempt some realistic engagement with parents and patients who are investigating treatment options, or perhaps, have already found Vision Therapy and need help navigating… Read more
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My Next Step!
For a little more than four years now, I have been writing in this blog. My goal, initially, was fairly moderate; I needed an outlet for my ideas and had hoped a few people would read them. In fact, a month after starting, less than 10 people were actually following, and that was fine with me.… Read more
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Happy Hump Day
A close friend, and Vision Therapy graduate, asked me recently what I like most about my job. My answer was simple: The people. When that same friend asked me to identify one of the greatest difficulties and/or frustrations in my job, my answer was again: The people. If you work with people long enough, there will… Read more
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Special and Equal
It can be tough to find good in the world, especially of late. If we allow it, we can be bombarded by negative on top of negative on top of negative, all before our first sip of morning coffee. The lucky ones among us are able to filter out some or most of it an go about… Read more
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Auto-Correcting Humanity
I love my iPhone 6S. Not as much as I love freshly baked apple pie and remembering to put my pants on before leaving the house, but the 6S is probably a close third. It’s an interesting device in that it’s light, durable, dependable, and has one of the most solid operating systems of any phone I’ve… Read more
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The Tectonics of Learning – Regression and Progression
If you’ve never experienced an earthquake, take my word for it, they’re attention grabbers. One moment everything is calm, and the next moment usually without warning, the ground is shaking with a rumble like no other. Coming from California, I’ve experienced three major earthquakes in my lifetime, and countless aftershocks. Sometimes the damage is minor,… Read more
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Visual Processing – Part 4 – Do Something
These last several days I’ve been on a treasure hunt of sorts. My bounty, which I’m still not fully convinced I’ve discovered, is the best way to lay out this post. I’ve been looking for a way to write it without writing it, to detail an undetailed method, to demonstrate my thoughts absent the actual demonstration, to present a… Read more
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A Sit Down – with Patrick McDowell
For the benefit of our readers, can you explain how you are involved in Developmental Optometry? My final diagnosis was a Traumatic Brain Injury and damaged Left Optic Nerve. Vertigo, Marty Feldman eyes, nausea, Migraines, depression, and mood swings. I was in Vision Therapy for over 6 months. Can you help us understand… Read more
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Visual Processing – Part 3 – The Road Not Taken
The Road Not Taken Two roads diverged in a yellow wood, And sorry I could not travel both And be one traveler, long I stood, And looked down one as far as I could, To where it bent in the undergrowth; Then took the other, as just as fair, And having perhaps the better… Read more
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A Sit Down – with Daniel Wilson COVT
For the benefit of our readers, can detail how you are involved in Developmental Optometry? I am the Head Therapist and Director of Sports Vision Training at Austin Eye Gym in Austin, TX. I have been a vision therapist for 9 years now. How did you first discover Vision Therapy? I was going to college… Read more
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Visual Processing – Part Two – The Mechanism Without
In Part One, we looked at the visual processing mechanism and hopefully began to understand the importance of treating this area in our VT rooms. Our eyes gather the information, our brains processes the information, and with any luck, an appropriate response is created. This applies to reading a book, opening a door, catching a… Read more
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Visual Processing – Part One – The Mechanism Within
A question often posed in the Vision Therapy room involves an understanding of how a particular activity applies, or perhaps more directly stated, “what does this have to do with my eyes?”. Although genuine, the question identifies a chasm in understanding between eyeballs and brain – or to be a bit more cliche – between… Read more
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Remeasuring Success
Growing up along side a sibling with developmental delays certainly left a lasting impression in my life, and I’ve written of my younger brother’s struggles in previous posts. Although he was never diagnosed with more than a gross developmental delay, my hunch is by today’s standards, he would fall under a high functioning spectrum disorder.… Read more
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The Mighty Reinvention – Part One
There comes a time in everyone’s life when the bells of reinvention tend to ring. Call it midlife crisis, call it boredom, call it burn out; however you describe it, my thought is we all experience it at some point. Lately, this moment has been knocking on my door, and suddenly almost without warning, it… Read more
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The Great Shoplifter
It’s one thing to not have a good rapport with a patient, and it’s another thing entirely to have a patient openly admit they do not enjoy your company. Sadly, there are times when both occur simultaneously. It happens sometimes, and when it does, I usually laugh it off. In fact, some therapists may shy away… Read more
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The End of an Era – The Passing of Dr. Harry Wachs
Prologue: This is a post I wrote in March 2015. With the news of Dr. Wachs’ passing earlier this morning, I share it again in his honor. The first time I encountered Dr. Harry Wachs was not long before his 81st birthday. He, and his now late wife Ruth, had traveled to San Diego for Dr.… Read more
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Managing Your VT Room – Part 5 – Veni Vidi Vici
I didn’t want to write this segment, which is why it’s been a fair stretch between the last post and this one. Basically, I’ve just been putting it off. And just so we’re clear, my aversion to writing it really had nothing to do with what I was going to say, and everything to do with… Read more
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Managing Your VT Room – Part 4 – Failure Has To Be An Option
If there’s one area where most Vision Therapists fall short, me included, it’s probably in the “give yourself a break” arena. We all want to do well, we all want our patients to do well, we all want our sessions to go well, and all want our patients to feel good about VT when all… Read more
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Managing Your VT Room – Part 3 – Dump The Square Peg Mentality
When you stop to think about why some kids struggle, ultimately it’s because they cannot maintain an arbitrary level of proficiency which has been created based on several hundreds of students who came before. For example, third grade curriculums are often written based upon the success or failures of previous third graders. When you have… Read more
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Managing Your VT Room – Part 2 – Can You Hear Me Now?
A few years back, I enrolled in a Dale Carnegie class for leadership and public speaking. The class taught many important lessons, perhaps the most important of which was understanding how your own language sounds to others. I think so many of us get caught up in our routine questions, we sometimes don’t recognize it as part… Read more
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Managing Your VT Room – Part 1 – An Ounce Of Prevention
One question which seems to surface from time to time in my world revolves around managing VT sessions; or perhaps put a better way, strategizing a session from start to finish. Ideas, such as which activity to start with, which to end with, and how to transition from one to the next. Questions, like how… Read more
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Not My Circus, Not My Monkeys
It doesn’t take very long, and one certainly does not have to look very far, before coming across someone who has something negative to say about Vision Therapy. If you ever need proof, simply Google the words “Vision Therapy and (insert your favorite negative descriptor here)” and you’ll see for yourself. Or, if that doesn’t… Read more
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Compassion – With a Side of Steak and Salad
A common question thrown my way involves identifying doctors and therapists who practice Vision Therapy. I have my usual “pad answer”, which sounds something like referring folks to COVD’s Find a Doctor or OEPF’s Find an Optometrist. And most importantly, find an office that works best for you. Right, but where would you take your kid? Finding… Read more
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Poster Board 2016
For those Vision Therapists attending COVD’s Annual Meeting in St. Louis, here’s a fun idea! Read more
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Eyeball Tattoos
When I was young, my favorite uncle had a tattoo on his arm of a girl, who in her era, was probably considered scantily clad. By today’s standards, that very same girl in that very same outfit could probably join a convent. Times have changed. Being an “old navy guy”, the tattoo on his arm was all… Read more
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Revisiting BOP and BIM – Part 5: End of the Road
Vision Therapy is capable of rebuilding many relationships, none quite as important as the relationship between a child and the love of learning. No matter which path we choose, or which model of treatment we subscribe to, our ultimate goal in Developmental Optometry remains universal: We want to help. Building degrees of freedom between vergence and… Read more
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Revisiting BOP and BIM – Part 4: The Role of Vergence
If Degrees of Freedom are the proverbial plane ticket to visual paradise, then binocularity can easily be considered the pilot for our journey – without whom our flight would become nothing more than a heap of metal on the tarmac. Similar to the plane and pilot relationship, solid binocularity is needed to ensure degrees of… Read more
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Revisiting BOP and BIM – Part 3: The Role of Accommodation
Treating the beast that is the Accommodation/Vergence relationship can be daunting, but by breaking down the moving parts and gaining a finer understanding of how each area can be addressed, the beast shrinks significantly. Understanding the progression that leads into the BOP/BIM work from the accommodative side is half the battle, and is today’s focus,… Read more
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Revisiting BOP and BIM – Part 2
In Part One, we saw illustrations of what occurs when Base In targets are mixed with minus lenses, also known as BIM. Our goal in this process is to teach our patients how to stimulate accommodation, while relaxing vergence – which is one half the process of building Degrees of Freedom between the two systems.… Read more
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Revisiting BOP and BIM – Part 1
In my experiences training and mentoring newer Vision Therapists, one of the more difficult areas to grasp and fully understand is the relationship between Vergence and Accommodation. Not only the symbiosis and synchronicity between the two systems, but also the level at which we should strive to strengthen the systems both individually, and collectively, to… Read more
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a dark place…
It was fairly obvious that I’d made a mistake. My question had struck a nerve and there was no undoing it. In the fall of 2012, I moved from Houston to Austin to be closer to my children. Eighteen months post divorce, it finally donned on me that all of my residual anger needed to… Read more
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the power of one…
People will sometimes ask me how topics are chosen for my blog; or more specifically, why I choose to write about the interactions with patients and connections with families rather than more of the technical jargon of how activities are done. The truth is that my interests seem to ebb and flow, and at times… Read more
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penny wise and dollar foolish…
If anyone ever tells you there’s nothing to be gained by heeding the advice of those who have come before us, please remember this heartfelt suggestion: Turn around and walk away. At some point during my time working with Dr. Sanet, he had shared that we should always be careful who we speak to and… Read more
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a life changed…
Close to two years ago, I wrote a post entitled the little battlefields which told the story of my patient at the time, “T”. She had just finished first grade and during an initial session, told me her teacher essentially told her that her intelligence was inadequate for the first grade. Here’s an excerpt from that… Read more
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A New Appreciation – Part Two
When Dr. Len Press bestows his wisdom, it’s a pretty good idea to sit up and pay attention. That’s what I do. “Give me any clinical challenge, and it pales in comparison with practice management” ~ Dr. Leonard Press Presumably, he’s been there a few times, and knows my pain. As shared in Part One, I’ve spent… Read more
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A New Appreciation – Part One
There was a time not too long ago when it occurred to me that after 16+ years in Vision Therapy that my sense of “the business” of Developmental Optometry was pretty strong. Patients call. We offer them help. Vision Therapy programs begin and end. Everyone is happy. Brace yourself. It’s completely untrue. That is to… Read more

