June 20, 2013

That was the day this all started.

At the beginning of her Vision Therapy program, our VT staff was 1/4 of its current size and our entire staff numbered four, two of our three person admin staff had not yet applied in our office, and our database conversion of January 2014 was still in the early planning stages.  Her family has seen witnessed our staff more than triple in size, they’ve watched us expand our services by opening a second office, they’ve been privy to our own personal growth through marriages, birth of children, and buying homes. They’ve even seen the space transform, as not long after she began in our Vision Therapy program we moved walls, added doors, and lathered it all with a fresh coat of paint.  When she started, she was 13 years old and would have given her right arm to not do therapy. She hated her visits, she hated the activities, and she hated the homework. Pretty sure she hated me too.  Her diagnosis was complicated, and to hear her talk about her life it became obvious that her eyes truly were her windows to the world, however broken.  She complained of headaches, double vision, clumsiness, intermittent blur, inaccurate spatial maps, triplopia (seeing triple), and the occasional inopportune and unplanned meeting of her face with the concrete. No wonder she was angry.

If there’s one motto of my life that I’m most proud of, it’s to judge no one. That is to say I work very hard to not let my preconceived notions or personal prejudices from past experiences interfere with my approach with patients, or even now people I meet. Some may say it’s a sign of apathy. Quite the contrary.  It’s an active process of accepting everyone for who and what they are.  This skill came in handy with this young lady – many times.  Her world was messed up, largely due to her eyes and she was angry about it.  It wasn’t mine to judge, but I received her message, loud and clear.

Upon completion of her initial exam, our doctor diagnosed her with an 8 diopter right esotropia, amblyopia with best correction sitting at 20/200, eccentric fixation, suspected onset of anomalous correspondence based on reported symptoms and zero stereopsis. For as many times as I’ve used the “with strabismus, the world may not look the same minute to minute” reasoning, here it was sitting across the table from me. Her visual world was a mess, glasses helped only marginally, and our friends with the surgical approach advised that since she her measurements were already within their margin for error, surgery was not an option.  She was at the end of her visual rope and she knew it. No wonder she was so angry.  Her initial Vision Therapy stands out in my mind, not for what it was but for what it wasn’t.  She attended with her dad, they argued about why she was even VT for nearly the entire hour, and I sat quietly on the other side of the table, interjecting where possible. Her therapy program has been long and has required her therapists verbally go toe to toe with her on many occasions. She’s argued, cussed, thrown things, cried, laughed, and even tried to give up a few times which her parents disallowed. She’s shown up angry, sat in the corner with her arms folded and refused to participate, and even locked herself in the office bathroom once or twice. Still, we pushed forward.  As her therapy program progressed, her visual conditions improved – slowly. Anyone familiar with a small angle esotropia with an accompanying challenges might concur, it’s a slower moving process.  We worked, we battled, we kept pushing forward.  An MIT here, a little Lustre there, throw in a lot of accommodative work with some gross fusion activities and we may just have a VT program for this young lady. Oh, and bring your own boxing gloves because you can bet dollars to donuts she’ll have hers. This has been her program since June of 2013.

Over the last two months, we’ve witnessed significant changes.  Aside from recently turning 16 years old, she smiles, she’s happy, she engages willingly, her appearance has changed, her clothes have changed, she even has a boyfriend. Last week, our receptionist summoned me out of a VT session by reporting a patient was crying in the reception area and wanted to talk to me. After momentarily handing off my patient to another therapist, I discovered our longest active Vision Therapy patient currently in our program crying at the door. She was arm in arm with her dad and he was matching her tear for tear.

“What’s wrong?”

I invited them into one of our empty VT rooms and they handed me a piece of paper – it was a printed copy of our electronic exam records.  She had just finished her latest progress check and measured 20/20 in both eyes and achieved 20 arc seconds of stereopsis.  She hugged me once, twice, then a few more times and broke into the biggest smile I’ve ever seen on her face. After her dad offered his own round of hugs, he told me that they were taking the copy of her exam home to put in a frame. He extended his arm for a handshake…

“You saved her life. No question in my mind”.

I had no words.

A very wise lady once told me that some patients will give us far more than we could ever give them. You have no idea.

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Posted on January 6, 2016, in From My Perspective.... Bookmark the permalink. Leave a comment.

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