Wishing all of our fathers and patients a happy Father’s Day!
Ockham’s Razor, the idea that a hypothesis with the fewest assumptions should be selected over hypotheses with many assumptions. This is a term I learned for the first time a few years ago in a psychology class, a term I never thought I’d use again. After a recent patient encounter while shadowing Dr. Weinberg the concept re-surfaced and the case was quite interesting to hear.
A young man came to our office not knowing why he was there. He had been to every type of doctor and therapist he could think of. He had been to the neurologist, he had been to ophthalmologists, he had been to the masseur and chiropractor. Not one had been able to “cure” him. He had been admitted into one hospital to rule out Rocky Mountain Spotted Fever. He was released with no signs of RMSF and all accompanying reports had come back negative. CT scans were performed which also returned negative results. The patient presented ongoing symptoms of blurry vision, headaches and neck muscle pain. These symptoms had been occurring for over a year at this point and he had been in and out of hospitals and therapy sessions ever since the onset. He stated the massages helped with the muscle pain. The blurry vision remained constant. His final stop and last hope for an answer was at a Developmental Optometrist.
Dr. Weinberg performed a thorough visual evaluation. The young man had nearly perfect vision at both far and near. A very slight eye turn was discussed, however a simple “in home” exercise was prescribed to alleviate this symptom. Sitting in the exam room and watching the interaction, a prognosis seemed a mystery. After careful study of the young mans near vision the doctor asked the patient what kind of work he did, then how much time he spends in front of the computer. The patient confessed that at one point in the past year there was a stretch where he had to sit and work in front of a computer for more than ten hours a day.
Mulling over the information gathered during the exam, the doctor hypothesized that this mystery ailment the patient suffered from was an extreme case of simple problem…Eye Strain. Dr. Weinberg explained how doing so much near work for so long puts stress on the eye. It takes a lot of energy for the eyes to fixate and stay focused at a near distance. The strain became so much that the body has over compensated to alleviate the eye strain. The overcompensation induced neck pain and headaches. Needless to say the patient was quite shocked to hear that this was the problem. After all he had seen a neurologist, an ophthalmologist, masseur and chiropractor. For all of his troubles, all that was needed was a new Rx for near work to relieve his eye strain. Ockham’s Razor!
Something I would like to point out from this exposé is the relationship that vision has with the brain and body. Just as this young mans eye strain caused neck pain and headaches, a person suffering from an acquired brain injury or other neurological insult may experience a visual midline shift as described by Dr. William Padula, OD, DPNAP, FAAO, FNORA. The patients (spinal) posture changes in accordance to the their visual orientation being off kilter, for example a lean to one side or the other. The case above as well visual midline shift syndrome from an acquired brain injury may seem to be the extremes, however think how a visual problem may affect a child’s behavior who is struggling due to a visual deficit. One problem leads to another then another and so on, causing a much larger problem than what it began as. Remember Ockham’s Razor and the law of parsimony because much of the time there is a much more succinct solution for a large number of problems.
Happy (belated) Mother’s day!
To all the moms out there, we know how hard you work. We see it every day in our office. We see mothers who come in and are doing everything in their power to see that their children are happy and healthy. We love it!
We know it’s a bit late, but we want to express our thanks and gratitude to all the mothers out there. This blog has been created to help many people, yet we know the vast majority of our readers are indeed concerned mothers. Those of you with children in vision therapy and those who are beginning to research the field, you’re on the right track!
We appreciate the schlepping back and forth between school and vision therapy, the hours spent assisting with homework and often dealing with your child’s frustration. It is our goal to help you find the answers and get the breakthrough you’re looking for in your child’s learning. We know it will pay off. Without you and your dedication we wouldn’t be able to help get your child on track. We wanted to take this time to thank you for everything that you do.
So mothers, this one is for you. Happy Mother’s Day!
Keep an eye out for upcoming post on the “why’s” of vision therapy as Dr. Weinberg will be discussing the links between vision and learning.
Working for a developmental optometrist it is inevitable that you will be asked the question,”what is vision therapy?” As an optometric technician it is our obligation to answer this daunting question. We all know the answer to the question, but for some reason there is a disconnect when explaining vision therapy to patients. Allow me to paint a familiar picture for you:
Our (fictitious) patient “Brittany” is referred by a local eye doctor. Brittany’s mother is so distraught she can’t keep it together in the office. She’s running a thousand errands that day, has three kids with her and now she’s been told her daughter is in need of vision therapy. Mom sends her three children to the play room and slides here iPhone out of her purse. She contemplates the term vision therapy but has no Idea what that means. She thinks to herself, “Google is my only friend.” Mom now studies what Google has told her, looks it over a few times to get a grasp of the concept and then peers over her phone to look at the optometric tech who is vigorously typing away at the computer.
“May I help you?” the tech asks sensing the question coming.
“Yes” the mother replies hesitantly. “The doctor told me Brittany needs some sort of therapy. What is that, is it like some sort of physical therapy?”
Their eyes meet and each seems just as puzzled as the other. The mother’s question is met with a low sigh as the optometric tech bites her lip while she conjures up the best response to the question. The tech musters up the courage to respond and replies with hesitation “yeah, it kind of is….but…there umm…there’s a lot of….well…no, not really”. After carefully rethinking her mumbled response the optometric tech comes back with a simple reply “it’s like exercising the eyes!”
Well, you can imagine what mom thought of that response. I have been in this situation before as an optometric technician, and believe me the problem has nothing to do with the competence of either party. Vision therapy is hugely complex and is not only difficult to comprehend but is equally daunting to explain. That is why I have asked Dr. Weinberg O.D. FCOVD to explain what vision therapy is for us. Keep a look out for Dr. Weinberg’s response in “what is vision part 2”.
In the mean time here are some helpful links:
Hello blogosphere, welcome to the official blog of Advanced Vision of Louisville! Through this blog we intend to share our appreciation for the art and science of visual rehabilitation and learning. The two are interwoven tighter than any known fabric and we would like to show you how. ThinkVision will feature interviews with developmental optometrist Dr. Daniel Weinberg O.D. FCOVD, insight from the vision therapists at Advanced Vision of Louisville, patient testimonials and much more! Future posts are already in the works so stay tuned.
“The more that you read, the more things you will know. The more that you learn, the more places you’ll go.”
-Dr. Seuss, I Can Read With My Eyes Shut.