A Sit Down – with Dr. Nancy Torgerson
This post appears as part of a series called Sit Down – candid conversations with real people detailing their journeys and experiences with Vision Therapy.
A Sit Down – with Dr. Nancy Torgerson
For the benefit of our readers, can you explain how you are involved in Developmental Optometry?
I have the joy of daily working with a team of optometrists, vision therapists and patient care coordinators who are passionate about people and making a difference in people’s lives. Our youngest in vision therapy has been 4 months old and oldest in their nineties. Even if I wished for a boring day, it couldn’t happen. From the 6-year-old skeptic last week, wearing a unabomber look-alike hoodie, that said, “Just what would be so great about having 3-D?” To today, when I asked a girl during her vision therapy progress evaluation if she liked reading, and she replied “I don’t like to read.” I was shocked. I thought she was doing so well in VT. She started laughing and said, “Dr. T, I don’t like to read; now I love to read! I am reading all the time.” To the adult with anomalous correspondence that called after her session, crying and saying, “Is this what depth perception looks like?” She was overwhelmed with her new sense of what the world looked like.
Can you tell us about your background and explain how you found Developmental Optometry?
I had never had an eye exam until I worked as a receptionist after my freshman year of college. I worked for a husband and wife team of optometrists in downtown Seattle. They were getting ready for retirement but Dr. B told me if she had to do it again, she would go into vision and learning. I thought, wow that is interesting. What in the world is vision and learning? Here is someone who after her whole career wants to help people in a different way, maybe I should check this out. I had been going to college for pre-med in New York and transferred to Pacific University. Back in the day, there weren’t many women in optometry and even before I had all the classes, I was asked to help in vision therapy with a girl who had been abused and would not see a male. The change in this little girl through vision therapy was amazing. She gained the ability to throw and catch a ball and read! I was hooked.
While at Pacific University, I learned that my fatigue when reading was due to a binocular dysfunction and I needed vision therapy. I had great grades and scholarships but had been a social nerd. I spent hours studying to keep up with school. Once you experience vision therapy personally, it is harder to let all the naysayer’s comments dissuade you from your passion. Dr. Bill and Diana Ludlam’s practice was close to the optometry school and I was able to work as a vision therapist for a time. What an invaluable experience. When I graduated from optometry school, it was my intention to buy a practice in Seattle when Dr. Ted Kadet asked me to fill in for him while on vacation. After the vacation he asked me to work in the practice overseeing vision therapy four days a week and doing exams one day a week. Heaven! What an opportunity. Linda Frost, a former teacher, was a vision therapist and she was passionate about learning and visual information processing. I shared my knowledge and she shared hers, and we learned together. After I left the practice, we studied together for certification in COVD. We met weekly at Cocoa’s Restaurant to study. At my first COVD meeting, I took my Fellowship Exam. That is crazy, and I would not suggest that to anyone. However, I was goal oriented and I wanted to be a part of Developmental Optometry.
A team of optometrists was referring to me and asked if I would set up a practice in their medical building. I started Alderwood Vision Therapy Center as the receptionist, vision therapist and optometrist. Yes, I had different phone voices for each. My dream was to help transform lives. It has led to endless adventures in being a part of many people’s lives. I got involved in the local and state optometric association. I was Chair of the Washington Board of Optometry. OEPF invited me to a leadership meeting and I got involved in Regional Clinical Seminars and was able to invite and learn from the greats. Dr. Gary Williams came out for one of those RCS’s and recommended that I get involved in COVD. COVD became extended family and with family comes opportunity to grow, learn and be involved. I have served on many a committee and as Chair of the International Examination and Certification Board and President of COVD. I have had the support of two wonderful study groups.
Your website shows that you periodically host Vision Education Workshops in your office. I’m wondering if you can tell us about these. What topics are covered and who can attend?
Every month to two months we host a Vision and Learning Educational workshop for anybody and everybody that wants to know about vision. We invite patients, parents, grandparents, tutors, teachers, principals, OTs, PTs, optometrists so that they feel and see what a vision problem might be like. Empathy can make a world of difference and bring understanding to questions like:
So… they aren’t just lazy?
They get visually tired?
They may not be able to write on the line because the line may not look like it does to you and me?
As a group we do hands-on, eyes-on activities. Wilma Schunke, a parent advocate, speaks about her family’s journey and how vision therapy made a difference. Wilma’s story highlights the frustration and guilt that parents carry when their child is not working to their potential. Some people would rather ask questions parent to parent. This way they can do both. I don’t have a traditional consultation, I invite all vision therapy patients/parents/ candidates to the workshop. The questions are lively and many times we have to pass around the Kleenex box as people share their stories. It is wonderful for the teachers to come so that they can see and feel what their student might be experiencing.
In last week’s interview, Dr. Thomas Lenart offered his perspective on the unique collaboration between a Pediatric Ophthalmologist and a Developmental Optometrist, namely himself and you. He also made several excellent points, some of which I’d like to ask for your perspective on. First, can you tell us how the collaboration initially began?
Years ago, Dr. Lenart called and asked me why OTs, PTs and speech therapists wanted their clients with special needs and those on the spectrum to see me instead of him. I found that such a refreshing attitude. That started a conversation that carries on to this day and hopefully for years to come. Dr. Lenart knows that patients are helped through vision therapy. Dr. Lenart was in the Peace Corp and a researcher before he became a pediatric ophthalmologist. He credits the person he bought his practice from, Dr. Howard Freedman, and optometrists, Rick London, Curt Baxstrom, Corey Manley and Karen Preston with his understanding and growth. We have co-managed over 250 patients together. We have discovered each other’s professional strengths and challenges, know that when we use the same word it can have very different meanings and the foundation of all of this is built knowing we want to really help people.
What’s your thought on Dr. Lenart’s idea that studies have already proven the efficacy of Vision Therapy and a person has the right to choose to accept or dismiss what the facts present?
No matter how much research there is, naysayers will exist. So we need to support continued research studies AND do our jobs well to help create success with each of our patients. Our patients’ stories give the research meaning and life.
I am very thankful for the studies that show the efficacy of Vision Therapy. But, no matter how many studies exist, it can be difficult for people to see the correlation of vision with everyday life skills. Our patients telling their individual stories can help create the difference.
When asked how parents should manage the divergent advice from Developmental Optometrist and a Pediatric Ophthalmologist, Dr. Lenart responded in part with: It is only when the Developmental Optometrist and Pediatric Ophthalmologist can talk openly and actually discuss the patient’s situation with delivering the best patient care in mind that a solution can be generated. Absent that, I think it is very difficult for parents to know what to do, quite frankly. – What are your thoughts on this?
I give my recommendation to parents and patients and I give them other options. I tell them that I am biased but would like for them to have all the information they need to make the best choice for their family member. The divergent advice between Developmental Optometry and Pediatric Ophthalmology is only a problem if it isn’t addressed with open communication.
One of my favorite points that Dr. Lenart made was “…we need to uncover and discover the efforts that achieve what we want…(and) put aside some of the questions that cause the most dissension between our fields and begin to look at where we agree and build on that…” – In your opinion, how can we begin to move the needle in that direction?
Put history behind us. We can get bogged down with pointing fingers and what is wrong with each of our professions or we can find the areas where we have mutual patients that need help and change the future. Personally, I think we need to get the collaborative efforts that are taking place in the literature. This blog is an example of how we as a profession can move the needle in the right direction.
In August of 2013, COVD published an article in which Dr. Bob Sornson was quoted as saying “It’s Time to Stop Arguing and Help Our Children”. His comment, in part, was directed at the naysayers of Vision Therapy and seems to have been an interesting prelude to your professional relationship with Dr. Lenart. Do you feel like we, as Developmental Optometry and Pediatric Ophthalmology, can somehow shift the paradigm and all work together?
We can shift the paradigm. It will take individual work all around the US/world. I think it has to happen one on one, locally. Dr. Lenart and I have been talking for about seven years and building trust and respect. It takes time and energy but most of all the mutual desire to give patient’s our best effort.
This October in San Diego you’ll be presenting with Dr. Lenart on the details of your wonderful collaboration. Can you give us a few tidbits of what we might be hearing?
Come hear excuses of why collaboration between Pediatric Ophthalmology and Developmental Optometry cannot work and see that it is possible. Hear a myriad of examples of co-management of care of patients with exotropia, esotropia, diplopia, acquired brain injury, thyroid ophthalmopathy with large angle ET, Duane’s syndrome, toddler with a brain tumor, ET with schizo-affective disorder and much more. It can help to remember that each of us see the other doctor’s problems. We usually don’t see each other’s successes because if the patient was doing well, why would they come to us? So we have to help our patients tell about their successes in order to educate other practitioners.
You’ve also recently opened a satellite office within Dr. Lenart’s practice, is that correct?
It is! Dr. Lenart and I spoke at SECO. We practiced our talk with our office team, then with optometrists in our community and he asked if we could present to his staff. When we gave the talk at his office it was in an administrative area that was a large open room. After a visit, Dr. Lenart asked me a question and I told him that I thought that room could be perfect for vision therapy. Coming from our office where every square inch is used to the max, it seemed ideal. He said, he had been wanting to ask us to have a satellite there for vision therapy but wasn’t sure how to ask. After calling some of our major referral sources to see their insights and Dr. Lenart making sure that his optometric referral sources were fine with this collaboration we started the satellite last September. Alderwood Vision Therapy in Redmond. Nine months later we had outgrown the space and now have expanded. It is vision therapy only with all administrative work and evaluations done in Lynnwood, our home base.
For readers out there hoping to duplicate this type of professional collaboration in their area, what advice would you offer?
Reach out, like Dr. Lynn Hellerstein, and invite your local Pediatric Ophthalmology groups to a joint dinner and go over patient cases. Do demonstrations. Show them your office and have them try the Sanet Vision Integrator. Have them trial the NVR. Create a path so that they can start referring the patients that are befuddling. Communicate via email and phone. What do you do with your other referral sources? How did you help them understand there is more than eyesight to vision? Don’t get bogged down with the professionals that don’t want anything to do with you. Look for those that could be open and start there.
We’ve covered a lot of territory here, and I thank you very much for your candid responses. I’d like to complete this interview with the same closing question posed to Dr. Lenart.
If we could gather all the Developmental Optometrists and all the Pediatric Ophthalmologists into one room with you as the keynote speaker, what message would you deliver?
I would love to deliver a Socratic message that was bursting with demonstrations and questions that would shift the way we perceive each other professionally, perceive our future of working together for the good of each of our patients and serve as a catalyst to bring about change. Our professions need to find common ground, as that is the key to connecting. The key may be asking, WHY we do what we do? Imagine all the possibilities, WHAT IF things were different? Then imagine HOW COULD WE together make a difference?
Based on a wonderful book, A More Beautiful Question, The Power of Inquiry to Spark Breakthrough Ideas by Warren Berger, I think that innovative questions can break down barriers. Developmental Optometry and Pediatric Ophthalmology together could help transform many MORE lives if we based our care on each individual patient’s need.
Some Closing Thoughts – A great thanks to my friend, Dr. Nancy Torgerson, for taking the time out for this interview. I first met Dr. Torgerson very early on in my Vision Therapy life and I was quickly convinced that she is one of the most positive, energetic, and loving people on the planet. Her unique collaboration with Dr. Lenart is just the latest proof positive of her dedication to her patients and her desire to make the world a better place, and for that, she has long been one of my personal VT heroes. She has always been and continues to be a huge supporter of mine and I absolutely think the world of her! Please join me in wishing Dr. Nancy Torgerson, her family and staff, the absolute best! 🙂