Just Another Sunday Morning…

When it comes to the epic battle that is vision care, it’s often been my contention that we should disengage from the turf war and focus on the positive changes being made all around Developmental Optometry.  After all, the time and energy spent being angered by other professions who claim that we have no basis for our success is time spent away from helping a patient become more successful.  In the words of one of my closest friends, “don’t allow your enemies to live rent free between your ears; be bigger than that, be better than that, be stronger than that.  See it for what it is and move on.”  It’s a mantra that I believe in whole-heartedly and most days it’s all the reminder I need that focusing on the things I can control is the best use of my time and energy.

Apparently, today is not one of those days.


soapboxThere was a conversation shared on social media recently from the perspective of a parent who has sought strabismus surgery for her child.  In the interest of anonymity I’m not going to re-post it here, but in a nutshell, after numerous surgeries which had not achieved the desired results the doctor seemed to rationalize the trifecta of unsuccessful operations by stating the growth and development of the child was suddenly a factor. That somehow fully correcting the eye turn surgically would be detrimental as the child grew. Huh?  Forgive me for saying so, but after three unsuccessful attempts at surgical repair, that explanation sounds mighty convenient.

Just so we’re clear, I’m not here to bash strabismus surgery, the surgeons, or anyone who entertains the surgical route.  In fact, some of the most successful treatment I’ve witnessed has involved the combination of strabismus surgery and vision therapy.  It’s why continued collaboration and communication between professions is so vital to improving overall care for our patients.

But let’s just be fair about one thing. A key element of the Hippocratic Oath is to ‘Do No Harm’, and for as much bad-mouthing as Vision Therapy endures in the face of a purported lack of evidence, how is it that multiple surgeries with results that fail to meet even meet a sliver of the desired outcome are beneficial? How is this ‘evidence of success’?

female I call

Vision Therapy has its limits; a point we can all agree on.  I’ve never contended otherwise.  It’s a treatment process which takes time and effort to retool and rebuild visual pathways which are either under-developed or impacted by neurological insult.  Because every human being is different, every goal is different, and every treatment plan is different, there are times when stitching a common thread through cases that lack common features becomes difficult.  I accept that, and in many ways, this fact is both the curse and the blessing of our profession.  It’s why I am so passionate, and it’s why hearing the deliberate manipulation of facts angers me so much.

Changing the rules of the game midway through your treatment to benefit your own success rate is nothing short of deceptive and harmful.  If the development of a child is important in planning surgical intervention, then let’s play fair. From the outset, lay all the cards on the table, where they belong.

The thud you’re about to hear is me jumping off my soapbox.  Rant completed. 😉


Posted on March 15, 2015, in From My Perspective.... Bookmark the permalink. 2 Comments.

  1. Hi Robert, I read the same post as you did and it made me very sad and very angry. Sad because the mom apparently still has confidence in the surgeon, and angry because the surgeon is blaming the person instead of the treatment.


    • Robert Nurisio COVT

      Completely agree, Linda. To go one step further, it angers me that the cards were not laid on the table from the beginning.


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