Combining Sports Vision and Vision Therapy Has Helped Me Change Patients’ Lives

My work as a neuro-optometrist came about naturally. I grew up in Hawaii, which meant I spent a lot of time surfing, as well as playing just about every sport growing up. My wife was a member of the USA Olympic weight lifting team, and as a family, we’re always doing active, outdoors activities. 

While I didn’t have a formal vision therapy or sports vision rotation during optometry school, I found myself naturally gravitating to those kinds of courses, and in my professional life, the same has been true. I sought to find the intersection between sports vision and vision therapy, and neurology has always been something that’s interested me, so I worked to incorporate all of those into my practice today. 

Starting from Scratch
My experience with sports vision started in my garage. Granted, as a weight lifting coach, our garage was set up well to implement sports vision exercises and training. However, that was where things started for me. I had one of my friends bring their kid in, and we started doing sports vision drills on a regular basis, and as soon as he started seeing improvements, the circle grew. Word of mouth increased our reach, and I was able to grow the scope of our business. 

From there, I moved into an office that was located inside a 10,000-square-foot athletic training gym. I was working exclusively with athletes, helping them recover from concussions, implementing weight training, agility training, speed training, in addition to traditional sports vision and vision therapy exercises. 

In time, I was invited to speak at a conference with sports medicine doctors and athletic trainers, and I was able to soak up all of that knowledge from them, and also share with them what I had learned. That one conference turned into another and another, which eventually turned into working with the Carrick Institute, which focuses specifically on neuroscience and neurology. I became a faculty member of theirs and started teaching vision therapy courses for them remotely. That grew into consulting for professional sports teams, such as the Seattle Seahawks, and traveling to treat athletes and educate other health care professionals in the Netherlands, Germany, Barcelona, and more. My journey has been full of constant learning and growing, picking up new pearls along the way and incorporating them into my own practice. 

What Does This Look Like in Practice?
The patients I work with now cover a wide range of different cases and conditions. I get referrals from medical doctors, chiropractors, physical therapists, occupational therapists, neurologists — even dentists. We see everything from athletes recovering from concussions, to people struggling with vision problems or convergence insufficiencies, as well as traditional comprehensive eye exams. 

Our patients run the gamut of various conditions, and I’ve introduced integrative techniques to best suit all of my patients’ needs. When I first started in this field, I’d put every patient through all of the different tests and then have a separate appointment where we’d go through the results and lay out my treatment plan. Now, with vision-vestibular integration, I’m able to start my therapy right from the consultation. I can try different techniques on patients right off the bat, and sometimes they don’t even need the long-term therapy after that — they just needed that initial integration of their visual-vestibular systems. These systems control our balance, coordination, and visual acuity, so if one thing is off, it can create real issues for patients. Now, I can use these techniques to see what happens to the patient’s visual system when I stimulate the vestibular system, and vice versa. This allows me to determine where the issues are arising and what the patient needs to be focusing on in their therapy. Once we get these systems all working in tandem as they should be, the patient has much better outcomes. 

How Does Primary Eye Care Play into Specialty Services?
In addition to sports vision and vision therapy, I also see traditional primary eye care patients, and my specialty work certainly plays a role in my primary care patients. Spectacle rechecks is one area for which I most often use my specialty work with primary care patients. 

As optometrists, we’re used to patients coming in saying they’re having trouble with their current glasses. It’s our job to then figure out why they’re having difficulties with their glasses. We often think something is likely wrong with the patient’s prescription, but in reality, if you’re changing a prescription by 0.25D, or if the pupillary diameter is off by 1 mm, that shouldn’t affect the patient’s vision. 

However, if that patient has more integration of their senses, something that small can affect their vision. When our senses aren’t integrated properly, those minor changes can make vision blurry and start affecting other parts of their lives. To help identify those patients, I’ve started doing some of that integration therapy with my primary care patients, and a lot of times, we’re able to get them back into that same pair of glasses that was troubling them. I’ve also started testing all of my primary care patients’ balance, because that can also affect how you adapt to glasses or contacts. 

Changing Patients’ Lives
The most rewarding part of this work is playing a role in changing my patients’ lives. Usually, they end up in my office after years of dealing with these issues, because many people don’t think their issues are related to their vision. When you’re treating people who have had these struggles for years, whose lives have been impacted by these issues for years, it’s incredible to see the positive changes. Their whole face changes — they’re so much happier, they’re more open, and they’re more positive. To see that change happen — to give them part of their life back in some way — it’s incredible to see. 

In our profession, we often try to be perfect before trying something new. My biggest piece of advice would be to just be yourself and focus on what feels right for you and your practice. The right patients will be drawn to you if you stay true to yourself. Rather than be caught up in the fears, think about the positive impact you can have on your patients’ lives.