A Sit Down – with Dr. Carole Hong
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. Carole Hong
For the benefit of our readers, can you explain how you are involved in Developmental Optometry?
Currently, I am the sole proprietor of Family Vision Care and Vision Therapy in San Carlos, California. I am fortunate to have practiced at this location for almost 20 years and have worked with many caring and talented people. This practice has deep developmental optometric roots, as Stuart Mann, OD, FCOVD, joined his father Frank P. Mann, OD, after he graduated from Pacific University and started the vision therapy clinic we have here today.
I have the privilege of working daily with an exceptional team of vision therapists, a vision therapy coordinator (my husband), patient care coordinators, opticians, an office manager, an accounting manager (my mom) and optometric interns from SUNY State College of Optometry and Western University College of Optometry. Currently, my associate, Dr. Macson Lee, who also did a residency in vision therapy at SUNY, and I serve as adjunct clinical professors. We are honored to help young soon-to-be ODs learn about private practice and how to incorporate vision therapy and neuro-optometric visual rehabilitation in their future practices.
In addition, I served as Vice President and was on the Board of Directors for the College of Optometrist in Vision Development for almost 10 years, overseeing the Therapist and Membership Committees and the Academic Services Committee, which encompasses programs for students, externs, residents, faculty and administrators.
I have also been involved since its inception and continue to co-chair COVD’s Tour de Optometry Program, with past president Carol Scott. The tour program which is in its 10th year continues to send a board member or past president to each optometry school in the US and Canada once a year. The tour helps to educate and inform students, faculty, and administrators about the latest news and research, enlist feedback on programs for students and residents, as well as, provide a glimpse of the power that vision therapy and developmental vision care can have on patient’s lives.
What led you to Developmental Optometry?
Prior to attending Southern Californian College of Optometry, I gained valuable experience working in different optometric settings. First, I worked for my uncle, Dr. Gene Lee, who had a private practice in the San Francisco Mission District. Then I worked at the Fashion Island Mall for Dr. David Brewer and for Dr. Weyland Ng, who was in private practice and the Assistant Dean of Clinical Affairs at UC Berkeley School of Optometry.
I wanted to work with children, so I applied as a pre-optometry student to UC Berkeley’s health and medical apprenticeship program and had the privilege of working for Dr. Mann. I visited his office every week for a semester and later worked as an optometric assistant. I was able to see first hand the transformation in his pediatric patients. I saw how students went from struggling to having success in school after vision therapy and I was hooked!
From there I wanted to learn more and visited other optometric vision therapy practices every chance I got. I remember spending time at doctors Don Getz and Gary Etting’s office, being inspired by doctors Beth Ballinger, Bob Sanet, and Claude Valenti, and working for Dr. Charles McQuarrie with fellow SCCO students as therapy assistants.
I attended COVD’s annual meeting as a student every year, the Studt Practicums, and OEP seminars. I did my senior research project with Dr. Mike Rouse on Accommodative Facility (focus from near to far and vise versa) in presbyopes (people over 40 years of age) and spent time picking the brains of doctors Elizabeth Caloroso and Lou Hoffman. I visited the offices of doctors Lynn Hellerstein and Marcy Rose when I was on rotation at Omni Eye Services my 4th year in optometry school.
Then I did a residency at SUNY State College of Optometry in Vision Therapy and I was in heaven, learning from and working along side many talented doctors: Izzy Greenwald, Martin Birnbaum, Shelly Mozlin, Irwin Suchoff, Bob Byne, Jeff Cooper, Alan Cohen, Arny Sherman, Bob Duckman, Dave Fitzgerald, Joel Warshowsky, Sid Groffman, Harold Solan and Lenny Press to name a few. I loved it so much that I stayed on as Chief resident, overseeing the new residents, teaching students and helping to start the head trauma unit. Yes, I did a two-year residency!
Lastly, I worked part-time for Dr. Lenny Press in Fairlawn, NJ. I learned so much from Miriam and Len and am forever thankful for their mentorship and guidance. I remember using every mode of transportation to get there and back. I took the train, to a shuttle, to pick up a car on the way there and took a car to the ferry and finally took a taxi home to my little apartment on the upper west side. Many snow storms later, I decided to move back to California to teach at UC Berkeley’s School of Optometry while working for doctors Stuart Mann and Bradford Murray, and marrying the my best friend John. I then became a partners with Dr. Kris Stasko and we purchased Dr. Frank Mann’s practice. Developmental Optometry was with me from the start of my career and my passion continued to grow as I began my private practice endeavor almost 20 years ago!
Your practice, Family Vision Care, has been existence for quite some time and in fact, was previously owned by Dr. Frank Mann. Looking back, what advice would you offer to students or new optometrists that may be interested in buying into an existing practice which includes VT? When you were first starting out, did you ever consider opening your own “start-up” practice?
I knew that I wanted to have an office where families could go for all their vision care needs and of course, I wanted to have developmental vision and vision therapy at its core. I also always wanted to buy an existing practice as it made more sense to me than starting from scratch. I considered doing vision therapy only and opening a “start-up” practice, but could not part with the thought of not providing patients with primary vision care service.
I recommend that students or new graduates visit as many practices as they can. Accompany an optical lab representative as they make their rounds through out the city, so that you can get a feel of what practice setting you prefer. Make sure you get an externship or work at a vision therapy office, you are more likely to get a better understand how to incorporate vision therapy into a private practice and see if you have a passion for vision therapy. Including vision therapy in one’s practice takes work, but if you have the passion, it is the most rewarding part of one’s practice. There is no better feeling than to help turn someone’s life around or give them their life back in the case of our head injury patients.
I tell our interns that they should start their career with the intention to purchase or buy into the practice they are working at. Find a place that you want to live and offer the doctor you are interviewing with to help grow their practice. I enjoyed the challenge of bringing in new patients to the practices I worked in by giving in-services, meeting with potential referral sources and educating mothers clubs, teachers and other professionals about what we do.
Being a mom and a business owner takes a lot of skill, and probably even more energy. Now that your kids are growing up, can you describe how you’ve managed those two worlds simultaneously over the years?
It’s hard to believe that my oldest son Collin is 17 years old and a senior in high school. Come to think of it, Robert, you were his first vision therapist when he was just four years old! My two girls, Caitlyn and Camryn are 15 and almost 10.Caitlyn also did vision therapy when she was seven and this helped me to see things from the parent’s side. Doing home therapy is hard work! Camryn tells me that she wants to be an eye doctor and that I will need to wait 16 more years for her to graduate!
The hardest part about being a mom and a business owner is feeling guilty that you are not doing enough for both families – the one at home and the one at the office. I try to take one day at a time. I believe in working hard and playing hard. So during the week I tend to be very focused on work and on the weekends it’s all about the family and spending time with them. I hope that my children understand the value of working hard and grow up wanting to help others whether they are optometrists or not.
I have always said that it “Takes a Village!” and over the years I have been blessed to have a lot of great help both from my family and others in my professional life. My wonderfully dedicated staff who work hard to provide exceptional care and service, the great consultants that have helped over the years with everything from HR, marketing and practice management and the support from friends and colleagues I’ve met through COVD and our VisionHelp group have all helped to keep me sane.
In addition there are two special people that have been pillars of support, throughout my career. First, although we have been fortunate to have both sets of grandparents and many aunts and uncles help to care for and raise my children when they were young, I can’t thank my mom, Rose, enough. She has unequivocally supported me throughout my personal and professional life. She is someone who has amazing energy and someone I can always count on, whether it be to pick up one of our kids, order supplies, pick up food for the next office celebration, produce our monthly balance sheets as our office accounting manager or just be there to listen. My mom rocks!
Second, my husband John continues to be my true partner at home and at the office. In addition to becoming the house chef, grocery shopper, personal basketball and softball trainer, and chauffer, he works at Family Vision Care as our vision therapy coordinator. As a former vision therapy patient who had convergence insufficiency (CI), he has become passionate about what we do and sees his role as helping those who are in need of vision therapy to get the care they need. As you know, he had some big shoes to fill as he took over this position from your mom, Judy, who held that position for close to 10 years!
Switching gears now, the National Eye Institute recently funded a new study called the Convergence Insufficiency Treatment Trial – Attention and Reading Study which will further study the effectiveness of Vision Therapy on kids who have successfully completed a VT program. From your perspective, how important and exciting is this study?
This new phase of this research is very exciting and important. Keep in mind that the study’s Principal Investigator, Dr. Scheiman, originally spearhead the group as the CIRS – Convergence Insufficiency (CI) and Reading Study. It took almost 20 years for the group to first develop effective questionnaires and test procedures for CI, prove that office based therapy is the treatment of choice for CI, then that CI influences attention, and now to investigate its influence on reading.
In addition, while I see how effective vision therapy is on a daily basis and I am thrilled with the change and improvements in my patients who have reading and attention problems, I am most excited to see that this study will involve a multidisciplinary team. It will include the professions of optometry, ophthalmology, psychiatry, and education, in evaluating how this eye-teaming problem impacts a child’s attention and reading performance.
The original CITT study, which was published in 2008, did wonders for Developmental Optometry. Would you agree?
Absolutely agree! For many years our critics have claimed that we lack scientific evidence for office-based therapy. Of course, this was also a rationale for them to explain to parents why they, in the case of other eye care professionals, didn’t offer this treatment in their own practices. Now that the results of the CITT have become a gold standard of sorts, the onus is on our critics to explain why they don’t refer for office-based vision therapy.
Yet any paradigm shift occurs slowly, and the next step may be for pediatric ophthalmologists, such as Dr. Thomas Lenart who is presenting at this year’s COVD meeting with Dr. Nancy Torgerson, to help explain how we can better collaborate with other eye care practitioners in the best interests of our patients, as well as to promote the benefits of developmental optometry to the public.
There are many areas of developmental optometry beyond what the CITT addresses; nevertheless, this new study will lay the foundation for many professions to better understand just how superior in –office vision therapy is using evidence-based medicine.
It might interest your readers to know that we had parents come in to our office with a copy of the first CITT study in hand, asking us to help their child. I will look forward to increased public demand and helping to increase the number of providers of vision therapy in the future.
In your years of practice, have you found that vision affects attention?
Again, Absolutely! In fact here is an amazing story from one of our patients that helps to demonstrate that vision affects attention and reading.
***Discovering as an Adult the Life Changing Effects VT can have in Treating Symptoms of Convergence Insufficiency.***
Since I was a child, I struggled with visual symptoms that made reading difficult. Text often had a faint shadow trail that was especially noticeable when my eyes moved from line to line on a page. Copying notes from the board was also often exhausting, as I would lose my place when switching between the board and my notes. With the help of great teachers and my strong work ethic, I compensated for these obstacles and pursued a college and graduate education in the natural sciences.
Once in medical school, I was also evaluated for ADHD after having a difficult time keeping up with the large reading load. I was classified as having primarily inattentive ADHD. I was also diagnosed with dyslexia based on my slow reading speed.
I was prescribed a daily medication for ADHD (stimulants), which helped me focus for longer periods of time. During this time, I also participated in a program called Cogmed to improve my working memory and attention. Both ADHD medications and cognitive behavioral therapy improved my attention, but my visual symptoms while reading persisted.
I finally learned about vision therapy after visiting my optometrist and describing my symptoms of eye fatigue and strain after 20 minutes of reading or computer use. Through a series of tests, she found that I was not able to see certain pictures in 3D and that I had a difficult time turning my eyes inward to focus on a near point. I’m so very thankful that my primary care optometrist referred me to Family Vision Care for vision therapy.
After completing 3 months of office based vision therapy sessions and daily home exercises, my visual symptoms have significantly improved. I am now able to read for longer periods before my eyes fatigue. I also recently stopped taking my ADHD medications and based on the objective diagnostic program called the Quotient, my attentiveness is within normal limits and even better than when I was taking ADHD medications. Outside of school, I have also taken up visually intensive sports (such as basketball) and hobbies such as playing the piano.
My experience has taught me the importance of seeking a complete eye exam whenever learning issues such as ADHD or dyslexia are suspected. For example, symptoms of convergence insufficiency can especially worsen symptoms of inattentive ADHD. Although the ADHD medications were helpful throughout my vision therapy training, the long lasting effects of training my visual system are truly remarkable and life changing.
-2nd Year Med Student
Your passion for this field has taken you beyond your exam room. Can you tell us more about this?
Being on the COVD board and a part of VisionHelp has been nothing less than inspiring. With these two groups we are always “looking forward to great things to come,” as my friend and colleague Nancy Torgerson always says. Dru Grant, also a friend and a past president of COVD, often summed it up by saying how “volunteering as a board member, committee chair, or member of a committee does take a lot of time and commitment, but the rewards often multiplied and the people and lives that touch us along the way have always outweighed the effort.”
The VisionHelp Group has, and continues, to produce wonderful material to help educate the public. Is this part of the group’s mission?
Yes – we’re very pleased about the contributions we’ve been able to make to public and professional awareness through our blog, website and videos. We feel that collectively, as a cross-section of practices around the country with very similar practice management approaches that we promote excellence in vision therapy and can contribute materials that are beyond what any of us individually could or would produce. A pillar of the VisionHelp Group’s mission is public and professional awareness through projects to help end the senseless struggle of individuals, children and adults, who suffer from undetected vision problems.
One of our newest projects is to help train parents, coaches, athletic directors and primary care optometrists to use the King Devick Test for both baseline and sideline concussion testing. We will have a new website that is dedicated to concussion awareness and how the head injured can find help. We hope this will benefit colleagues and the public just as much as it can enhance our individual practices.
In writing this interview, I realized that since the COVT of the Year award was created in 2001 there have been only three male winners, and you have employed two of them. This fact confirmed what I already knew, that there must be something pretty special happening in your office. What are your thoughts here?
I would have to agree with you again! At Family Vision Care and Vision Therapy we have been very fortunate to have some wonderfully dedicated individuals who share our passion of helping patients and our profession. Our staff and therapists have each contributed to the special, almost magical, atmosphere of our office. The success stories that line the walls, the clamor of patients shuffling in and out and the happy ringing of our vision therapy graduate triangle all contribute to the feeling that this is a special place. But the fact of the matter is that what we do is not really different than any other vision therapy practice. We all have the ability to transform lives.
However, I have thought about how you and Tom Headline are alike. You both have a great sense of humor, are perceptive, empathetic, creative, inquisitive, patient, and kind. In addition, you are both gifted communicators and do so in a way that allows patients, parents, caregivers and colleagues alike to appreciate you. The two of you, as well as the other winners of the COVT award, have these qualities that make you outstanding therapist and allow you to go beyond the therapy room to contribute to our profession. I don’t think it’s more than a very lucky coincidence that I was able to employ both you and Tom, but I’m reminded by visitors who come on almost a weekly basis to observe our practice and vision therapy in action that we have something special going on here. It must be something about our magical address of 1234 Cherry Street!
Lastly, my very first VT patient, who was 11 years old at the time, has now returned as an adult and is working as a Vision Therapist in your office. Can you elaborate?
Maybe this is just another magical thing about how vision therapy changes lives. In addition to your first vision therapy patient, Jessica Bailey, I have two other former vision therapy patients who are either working at a colleague’s office as a therapist or interested in becoming a vision therapist.
I think that vision therapy graduates become inspired by how vision therapy improved their lives and they want to give that gift to others. Jessica definitely brings her experiences from when she was a therapy patient to help her patients through the process. Patients can sense her confidence even though she is relatively new therapist. Experiencing therapy as a patient is important for every therapist because these experiences can only help one to become better vision therapists.
Some Closing Thoughts – A very special thanks to my friend, and my very first “VT Boss”, Dr. Carole Hong for this interview. My journey in Vision Therapy began in November of 1999, in San Carlos, CA, with Dr. Hong and a great many others from her office. Although I moved away a few years later, Dr. Hong and I remain friends and I look forward to seeing her every year at the conferences we both attend. Dr. Hong started me on a journey within Developmental Optometry that is still being written, quite literally, and for that she is both directly and indirectly responsible for my meeting some of the finest friends, doctors, therapists and patients that one person could ever dream up. For me, there have been a small handful of people that have really had an impact on the trajectory of my VT life, and Dr. Hong is certainly one of them. Please join me in wishing Dr. Carole Hong, along with her family and staff, the absolute best! 🙂