let it burn…

First, let me begin with a disclaimer:

I’m a Vision Therapist.

I think Vision Therapy is awesome.

I have spent the last 15+ years of my life learning, tweaking, growing, absorbing, failing, adjusting, overcoming and pushing myself with the goal of providing the absolute best care my brain can produce. Fair to say it’s been my life.

Disclaimer number two:

I completely agree that Vision Therapy cannot fix everything.

Just so we’re clear from the outset, I have no problems with questions, doubts, or skepticism.  I welcome them, in fact.  The parents or patients who are considering Vision Therapy and want to know if it will work in their particular situation, how long it may take, what the potential outcomes may look like, and even if there’s a chance it won’t work are usually the cases which are most successful.  My theory on why this is true is simply because going in these folks have an open mind and are willing to listen. Their inquisitiveness is not to be shunned or shied away from. Rather, it is to be embraced as an opportunity to help someone understand their options and even the possibilities lay before theme. The goal is simple – help them make the most educated choice available as to what will work for them.  And if they decide that VT is not the best answer, that’s OK.

About nine or ten months ago, a potential VT patient came to our office for an exam and perceptual testing.  All went well, and as some parents are, mom and dad were skeptical during their consultation with our doctor.  Although there were several concerns which our doctor felt Vision Therapy could address, the parent’s ultimate decision was to not enroll their child in VT. Instead they chose Occupational Therapy – which was also recommended by our doctor – and secondly decided to enroll their third-grader into a local tutoring program. The thought then was that the extra academic help may be beneficial and the cost of tutoring was, and is, far less than Vision Therapy.  The parents were very kind and respectful in expressing their concerns and skepticism with Vision Therapy, ultimately reaching the conclusion that there was really nothing wrong with their daughter that a little ‘motivation and TLC’ couldn’t fix.

Fair enough.

As I mentioned above, when people feel they’ve found a better answer than the one we’re offering, we support them 100%. There are plenty of kids that really need our help and that’s where we focus. After all, our goal should always be the assist in finding the best quality of life possible, and if that is found through the services of another, we’ll do everything but put gas in their car to make sure they receive what they need.

About six weeks ago, the father of my aforementioned patient called our office, and since our receptionist was at lunch, I just happened to answer the phone. After exchanging pleasantries, dad told me that his daughter continued to struggle and in fact the pressure within their home was now worse.  He went on to explain that the expectations for improvement had risen because of the extra help, and the pressure was causing his daughter to fail even more so than before.  The OT was helping with some things, but still they felt there was something missing.  In reviewing his daughter’s visual profile over the phone, and discussing the potential benefits Vision Therapy may offer, this father stopped me and asked a very pointed question…

Why didn’t you (our office) try harder to talk me into this before?

The short answer was easy.

We did.

One father to another, I explained that our goal was and is always to provide the most comprehensive set of results we can, and then lay the options on the table. We try very hard to complete this task without sounding like salesman. We want them to make the best choice for their family.  In reality though, sometimes people are not ready to hear what we’re saying. Or perhaps, as in the case of these parents, they need to process their emotion and denial before they are able to see clearly enough to understand the gravity of the situation.  And sometimes, they just need to feel it.

“The last nine months have been horrible” he told me.

I explained to the dad that if we would have ‘pushed’ this family nine months ago into believing Vision Therapy was right for them, one of three outcomes would have occurred.  Two of them are bad:

  • They would have walked away feeling we were ‘too pushy’ and most likely dismissed VT altogether as a possibility
  • The would have halfheartedly started VT based on the doctor’s recommendation, realized at some point it’s not what they wanted, and left as unsuccessful patients
  • They would have been a success story.

“You needed to see if you could fix it another way” I explained. “That process of learning was necessary and it led you back to VT”.

Our job is to support the process of understanding what is best, and sometimes, that means leaving it alone until all other options have been exhausted.  In this case, the father had an interesting way of expressing it.

“You just needed to let it burn until we figured out the best way to douse our fire”.


And that’s probably not the metaphor I’ll be using in my next conversation with a parent, but his point is clear.

Vision Therapy is a process, start to finish. From helping people understand its benefits, to figuring out the best treatment options, to allowing parents and patients the space necessary to reach the best solution for their family, to helping the nine-year old girl sitting across from me understand the concept of direct matching with a few wooden blocks.

The day they call for an appointment the process begins for the entire family, and it doesn’t end, until they graduate.

Posted on February 25, 2015, in From My Perspective... and tagged , , . Bookmark the permalink. 8 Comments.

  1. Interesting how you posted this today. I also wanted to share something a parent wrote to me today….it’s not really relevant to your post but I feel in some ways it is.

    This mom started bringing her teenage son to me in December for an eye turn. They had been seeing an ophthalmologist in the past and was not happy with the case they received. They have been extremely encouraged by VT and have been seeing a lot of progress. However, there is still a significant eye turn. Yesterday was the annual visit to the ophthalmologist and while we knew we wouldn’t get support, the response was quite negative despite the improvements.

    I knew to expect this response but was extremely encouraged by this mom’s perspective. She wrote “We believe vision therapy is working and look forward to seeing more positive results. I have told Darren right from the very beginning, we have no control over the outcome from our efforts with vision therapy but the benefits from learning self discipline, the value of commitment and dedication will serve him well in the future even if we are unable to ‘totally’ correct his vision issues.”

    So I would like to respectfully disagree with your last sentence as your post shows the process starts even before they start vision therapy and continues well after graduation from therapy. And despite the ups and downs, what a wonderful process it is.

    Liked by 1 person

    • Robert Nurisio COVT

      Thanks, Dr. Yeung. If I’ve learned anything, it’s that we need to be positive about the things we can actually control. Celebrate your patient’s progress! We actually also agree with the start and end of the process reaching outside our programs. My hope was to illustrate that the process stretches far beyond the one hour per week we visit with our patients. Thanks for expanding on my point, and thanks for reading! 🙂


  2. Robert,
    Communication may be the biggest challenge. I hope that we all use your approach. Families need to make their own choices. It is personal and they need to have – or develop – confidence in what they are doing. Not too many years ago, many vision therapists (and doctors) were isolated. Your sharing helps a great deal.
    Gary J. Williams

    Liked by 1 person

    • Robert Nurisio COVT

      Thank you, Dr. Williams, for the very kind words. Having the opportunity to share my thoughts with so many wonderful colleagues has been a great gift in my life. Thanks for tuning in! 🙂


  3. Robert:

    I thought this was so well said that I printed it for my go-to file on really bad days, or days I need some inspiration. It’s a very valid way to look at helping parents and patients make decisions that work for them, and in helping them feel comfortable in reconsidering VT when the first decision didn’t work out as they wished.

    Liked by 1 person

    • Robert Nurisio COVT

      Thanks, Jenni. Truly we all want to save the world, and no matter how close we think we are to reaching that goal there is always that one situation that seems to knock us back to reality, and in a hurry! Thank you for the great compliment, and as always, thanks for reading! 🙂


  4. michaellievens

    That is under the assumption that parents will ever get there of course… 🙂


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