A Sit Down – with Dr. Steve Devick
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. Steve Devick
For the benefit of our readers, can you explain a bit of your background and how you are involved in Developmental Optometry?
I was inspired to pursue optometry after having had an extremely positive experience with my own optometrist as a kid growing up, Dr. Floyd Mizener, who despite having been retired for many years now, is still active in optometry causes and policy. I graduated from the Illinois College of Optometry and opened a new practice at the (also new) Good Samaritan Hospital Professional Building in Downers Grove, IL.
In 1976, you co-wrote a thesis project for graduate school which grew into something much larger and continues to have an impact to this very day. Can you explain?
Al King and I were classmates. Al, by the way went on to have a busy practice in North Dakota and is currently the Chairman of the National Board of Examiners in Optometry. In school we had just learned a lot about how complicated eye movement pathways were and we wanted to see if there was a relationship between the physical act of reading and reading ability. We developed a rapid number naming test which we thought was a task similar to the physical act of reading-we flipped a coin to decide if it would be the Devick-King Test or the King-Devick Test. I lost the coin flip (I thought) but now when Al isn’t in the lecture hall when I’m presenting, I just say that I’m “King Devick”. So I guess I really won that coin flip.
Back then my mother was a first grade teacher. Her school was K through 8th Grade and because this was before HIPPA laws, we were allowed to do a study of eye movements as they related to reading abilities. As far as we could tell, keeping in mind that there was no internet during those years, this was the first study that had correlated the physical act of reading to reading fluency. Even though this was an important study, I actually think that we got a “B” on it.
About seven years later, researchers from SUNY called and told me that they had repeated our testing protocol on more than 1000 New York students and gotten similar results. It soon became part of the New York State vision screening package and became well known.
For those readers who may not be familiar, can you briefly explain how the test is administered, and how what information it was intended to provide?
It’s a performance measure test of rapid number naming. Subjects are timed as they read numbers on three test cards that get progressively more difficult. Poorer performance has been correlated with oculomotor dysfunction and reading fluency ability.
Fast forward to 2009, you made an interesting connection between the findings of the King-Devick Test and concussions. Can you explain how you reached this conclusion, and what did you do with that information?
In 2009, Dr. Len Messner, who is the well-known director of the Illinois Eye Institute at ICO, and I were talking about an article that had been published in Brain Journal which had shown that in Post-Concussion Syndrome (a condition in which concussion symptoms last many months), 36 out of 36 subjects had defects in their eye movements. The King-Devick Test requires eye movements (saccadic, accommodative and convergence) in addition to other things like visual processing, language and attention functions.
Len and I met when I was on the Board of Trustees at ICO and I asked him who the best neuro-ophthalmologists in the country were and without hesitation he said Steve Galetta, MD and Laura Balcer, MD, MSCE at Penn. Those doctors agreed that it made sense to undertake two initial studies to see if the King-Devick Test could accurately screen for concussions at the sidelines or rink-side. Drs. Galetta and Balcer are now the Chairman and Vice-Chairman respectively at the notable NYU Langone School of Medical.
In 2010, researchers from the University of Pennsylvania Perlman School of Medicine published two studies involving the King-Devick Test. Can you elaborate?
The first study published in the prestigious American Academy of Neurology’s Journal Neurology in April of 2011 tested boxers and mixed martial arts fighters. The second study published in the peer reviewed worldwide Journal of the Neurological Sciences tested both male and female athletes in basketball and soccer in addition to football. Collectively they showed that the King-Devick Test could be used on the sidelines or rink-side as a quick, accurate and reliable test to screen for concussions by comparing the performance of athletes with suspected head trauma to their pre-injury baseline.
What is a ‘remove from play’ protocol?
A remove from play protocol is a sideline protocol which helps determine if an athlete has sustained a concussion and should be removed from play. Proper removal from play improves outcomes by correctly identifying injured athletes and initiating timely brain rest and recovery. It also prevents potential secondary head injuries, which can often lead to more prolonged recovery times, particularly when sustained with an unidentified primary head injury which can also have much more serious consequences such as second impact syndrome.
Can you detail some of the other modalities who have conducted studies on the use of the King Devick Test as a sideline concussion screener?
Since the first concussion study was published, elite peer reviewed medical journals and conferences which have shown that in addition to numerous other studies that prove the effectiveness of King-Devick Test as a sideline test for concussions, the test is an effective Quality of Life indicator in multiple sclerosis, Parkinson’s disease, ALS, and Alzheimer’s disease and is a predictor of functionality in hypoxia and extreme sleep deprivation.
One of the most interesting studies published about King-Devick Test was in the elite Journal Clinical Pediatrics in June 2014, which showed that K-D remediation software, an eye movement training program, vastly improved reading fluency in schools in a very short period of time. Teaching the physical act of reading in schools should be part of every school curriculum. A larger study is just getting under way in that regard with Mayo Clinic.
We know that this process of emphasizing the importance of the physicality of reading in schools will be validating for Developmental/Functional Optometry. We are proving with evidenced based science what many ODs have known for years.
The Journal of Optometry recently published an article detailing how your test is being used as a sideline concussion screening in college football. Are there any sports, at any level, where you’ve met resistance in the King-Devick Test being used as a concussion screener?
Yes it’s exciting to see a study of concussions and the King-Devick test published in an optometry journal. This is a first in an optometry journal after more than 50 articles (to date) had been published in peer reviewed journals of neurology, sports medicine, pediatrics and aerospace medicine (see www.kingdevicktest.com for references)
Additionally in January of 2015, for the first time in their 150 year history, the Mayo Clinic entered in to a contract with King-Devick Test so that in regards to concussion screening the test is now referred to as the King-Devick Test in Association with Mayo Clinic. According to US News and World Report, Mayo Clinic is the number one brand in hospitals and neurology (and many other segments) so this has been a real honor and great business development opportunity.
The NFL does not require teams to utilize King-Devick Test on their sidelines yet but we believe that that may happen in the future. We like to say that we don’t care so much about “millionaires playing for billionaires but what happens of Sunday afternoon, happens on Friday nights” in high school football so we hope that the NFL requires King-Devick Test on the sidelines soon. Some NFL teams already use it already.
What is “Head Games”?
Another company which I founded was a movie company, so we decided to film two full length films about concussions in sports. One called Head Games released in 2012 focused mostly on concussions in football, wrestling and boxing. It was produced and directed by Steve James who is the world’s most respected sports documentarian (He directed Hoop Dreams) and the film won too many awards to mention including Best Documentary by the Boston Film Festival and Sports Illustrated.
The second film, Head Games: The Global Concussion Crisis is more about international sports and has been well reviewed around the world. Both films are used as educational tools to raise awareness about concussions and their potential long term effects. More information is about these films is at www.headgamesthefilm.com
When preparing for this interview, I found article after article detailing your continued interest in changing the way concussions are managed on the ball fields and in professional arenas around the world. Considering your business success outside of optometry, where does your passion come from to make such a difference in the world of concussions?
We like to say it’s great to “do well while doing good.” The work we are doing at King-Devick Test is good for sports and other neurological conditions. It’s an optometrist founded test and should be very good for optometry.
I’ve been involved the founding of six start-up companies which accomplished Initial Public Offerings (IPOs) and became large companies including Platinum Technology, which in 1999 sold for more than any software company had ever sold for, and Blue Rhino, which was the world’s largest propane cylinder exchange. I think that King-Devick Test could be equally successful in the telemedicine/healthcare space.
After reading this, many parents may wonder if allowing their children to play sports is a good idea. If parents make an informed decision by understanding the risks beforehand, and taking necessary measures to should an injury occur, do you feel their children are safe?
My personal feeling is that there is mounting evidence that contact and collision sports should not be played until high school. In other words, kids could play flag football before age 14, like I did. I also think that heading the soccer ball should not be allowed until then as well. Hockey already has “no-check” leagues before age 14. With kids, waiting for brains to become more fully myelinated before contact sports, is likely best.
These are just my personal opinions. I didn’t participate in full contact football until high school and I enjoyed it immensely and was a good player. Even though I first started playing contact football as a freshman, by the time I was a senior I was honored as an “All Chicago Area” football player. So waiting until high school to start contact does not mean that you won’t end up excelling in a sport.
I also think that King-Devick Test results should be looked at every day after contact in practice or games. In a recently published rugby study, 44 out of 52 concussions were “un-witnessed” and were only found by checking all athletes after every game with King-Devick Test.
On a personal note, I read that in 2012 you were the World Natural Power-lifting Federation bench press champion. That’s pretty incredible! What does a title like that involve?
I’m retired from competition weight lifting, and I only participated in weight lifting events in which participants were tested for performance enhancing drugs. I placed second nationally in bench press for men over 40 initially-the Masters I Division. Ten years later I placed in the top 5 nationally for guys in the Masters II Division. More recently I won the national bench press event for men in the Maters III Division.
I find all of the things that are happening with King-Devick Test these days, way more fun than banging weight around in my gym. 🙂
Some Closing Thoughts – A great thanks to Dr. Steve Devick for taking the time out for this interview. Clearly his passion for helping others shines through as he continues to promote safety and provide education for those engaged in sports. Please join me in wishing Dr. Steve Devick the absolute best! 🙂