Offering Vision Therapy for Children

If you'd like to bring kids — and interesting cases — into your practice, this may be the right field for you.

By Harvey F. Mazer, OD, FCOVD, Weston, Fla.

FOR ME, practicing optometry would get a little boring without kids. My longest days are those straight stretches of exam after exam. My young patients add spontaneity to the day, as well as especially challenging work.

My optometric work with children has gone through several transformations, from a strictly pediatric practice to a general practice with a specialty in developmental vision for children and adults. I perform many general exams and contact lens fittings for children and adults, from toddlers to seniors, but I take on some of my most interesting cases through my vision therapy and developmental vision care specialty.

Experiencing Vision Therapy

Vision therapy and developmental vision care are challenging areas, particularly when treating children. Despite completing a residency in this area, I wasn't fully prepared for the realities of working with children who have hyperactivity and attention deficit problems. Despite the challenges inherent in this field, searching for a visual component to these problems to help find a solution is fascinating and rewarding work.

Educators, occupational therapists, psychologists or other optometrists refer many pediatric patients to me. These patients may have learning-related vision problems, such as difficulty with reading, concentration or motor skills. From a 5-year-old with dyslexia to an adult with a brain injury, patients can benefit significantly from vision therapy.

Vision therapy changes the lives of many children and their families. After 3 months of therapy, parents tell me their child can finally read, pay attention or catch a ball. It's very emotional for these families, who often weren't aware of their children's full potential.

Getting Started

If you're interested in offering vision therapy for children in your practice, the first step is, of course, education. This specialty also requires investments in your facility and your staff.

■ Education and training. Residencies are available in vision therapy and developmental vision care, but they're not absolutely necessary, and a large majority of doctors who practice in this modality don't complete one. Learning opportunities are available in many places, including optometry schools, fellowships, annual meetings and conventions and the College of Optometrists in Vision Development. Once you begin to practice vision therapy, it's essential to stay educated and current on the latest pathologies and treatments.

■ Changes to your facility. If you offer vision therapy, you'll need a dedicated physical area. In my practice, our therapy room holds all of our vision therapy equipment, and it's always set up for treatment. This is a significant amount of space to dedicate to a niche specialty, but it's an absolute necessity. In addition, whether you're doing routine exams for children or performing vision therapy, you'll need to be prepared to serve children in your optical area, which may mean additional stock and training for your staff. (See "Is Your Optical Area Ready for Kids?")

You may want to take a fresh look at your reception area, as well. Kids will be naturally drawn to the part of the room that appears to be the "kids' area," with toys, videos or other enticements. In a general practice, setting up a special area for children can help alert your adult patients who may wish to sit separately from the children. Some practices schedule children in blocks, which creates some breathing room between pediatric and adult patients. Also, block scheduling makes it easier to have specialized pediatric staff members on hand when they're most needed.

■ Staffing considerations. In my practice, six staff members are dedicated to vision therapy, and they receive specialized training once a month. We also have a trained occupational therapist, who specializes in neuro-optometric rehabilitation, on staff.

Education, dedicated staff and a therapy room require sizable investments of both time and money. My advice is to start small and focus first on building a patient base.

Building Your Specialty

In addition to learning about vision therapy, it's important from a business perspective to evaluate the availability of this therapy in your local area. In my community, I'm the only optometrist who offers vision therapy for children. We don't do any advertising. We get all of our patients through word of mouth, community efforts and referrals from other doctors, teachers and occupational therapists.

Community outreach at the Lion's club, churches and temples is important, but to get kids into the practice, you must be involved with the local schools and youth sports programs. You may not see referrals from these places for several months, and what may be a good referral source one year can dry up the next, so your efforts to build your patient base in this area will be ongoing.

The best way to make the most of referrals from optometrists, teachers and others is to maintain your professionalism at all times. Every time a professional refers a patient to me, I send a letter within a week acknowledging the referral and updating the referring physician about the patient's progress or outcome.

Finally, I've learned that testimonials from patients really stick with people. When a child is able to sit through class or play more easily with others, his family is deeply affected. On display at our front desk is a letter from a young mother who describes how vision therapy changed her daughter's life. The letter sparks conversations with patients in our practice who may be interested in learning about vision therapy or may tell their friends who have children who may need vision therapy.

In short, the same things that make vision therapy for kids fascinating for practitioners also help us grow our practices. nOD