Podcast: Play in new window | Download
Subscribe: Apple Podcasts | Google Podcasts | Spotify | Amazon Music | Android | RSS
In this enlightening conversation, Dr. Darryl Glover, sits down with Dr. Brenda Montecalvo, to explore the transformative world of vision therapy. Their discussion spans the fundamentals of vision therapy, the personal journey of a seasoned optometrist, the identification and treatment of various visual disorders, and practical strategies for implementing vision therapy in primary care. Dr. Glover and Dr. Montecalvo delve into how vision therapy can elevate optometric practice, offering insights into its definition, the ideal candidates for treatment, and the integration of simple, yet effective, vision therapy exercises into routine care.
This comprehensive dialogue is not only a masterclass for optometrists looking to enhance their practice but also a beacon for anyone interested in the profound impact of vision therapy on learning, life, and overall well-being.
What is Covered
Who is Dr. Brenda Montecalvo?
Dr. Darryl Glover:
Optometrist, vision coach, game changer. Today, we’ll elevate your practice by diving into everything related to vision therapy. Are you ready to take your practice to the next level? I’m thrilled to introduce my colleague, Dr. Brenda Montecalvo.
Dr. Brenda, could you share your story with us? Tell us about your background, where you studied and practice, and include an interesting fun fact.
Dr. Brenda Montecalvo:
Absolutely. My journey into optometry started quite early, as my mother practiced optometry for nearly 80 years, beginning in 1945. Her passion for the eye care field was infectious, which she passed down to me and now to my daughter, who is also an optometrist.
Dr. Darryl Glover:
Incredible.
Dr. Brenda Montecalvo:
Yes, my mother’s practice was located in our home, so I began adjusting glasses at 12 and was involved in many aspects of optometric practice early on. My mother was a pioneer in practice management and marketing, having been a student of Dale Carnegie and possessing photos with him. She was deeply committed to spreading awareness about the significance of vision therapy in everyone’s lives. Whenever I enter my exam room, I challenge myself to find ways to improve my vision and, by extension, my life. I view vision as fundamentally intertwined with learning, life, and business.
I graduated in 1985 from Pacific University College of Optometry, and since then, I’ve worked in various settings, including corporate and alongside an ophthalmologist. Despite the challenges, I’ve always aimed to integrate vision therapy into my practice, emphasizing the importance of primary care optometry in offering comprehensive care, whether through direct services or collaboration.
What is Vision Therapy?
Dr. Darryl Glover:
Let’s dive into the essentials. You’ve provided a solid overview of how we can engage with our patients and address minor issues in the exam room. Now, let’s get back to basics and define vision therapy. I believe establishing a clear understanding of this concept is crucial before we dive deeper into our discussion.
Dr. Brenda Montecalvo:
Vision therapy involves diagnosing and treating a wide range of visual disorders, including binocular vision disorders and visual perceptual difficulties. It utilizes lenses, prisms, and various procedures and activities to develop visual skills, enhancing the visual system’s efficiency for the tasks an individual needs to perform. Vision therapy is comprehensive, incorporating tools like light therapy, while also considering diet, health, breathing, and posture to support a healthy visual system.
Identifying Candidates for Vision Therapy
Dr. Darryl Glover:
I appreciate the clarity of your explanation. Now, who would you say is the ideal candidate for vision therapy? Are we talking about children, teenagers, adults, or seniors? Essentially, who benefits most from vision therapy services?
Dr. Brenda Montecalvo:
The ideal candidates are those whose visual skills are not at the required level to succeed in their desired activities. Vision therapy is applicable across all ages, from six months to 99 years. Whether a patient is recovering from a stroke or facing challenges in daily tasks, they are likely a good candidate for vision therapy if their visual system hampers their ability to thrive.
Vision Therapy Practical Steps and Chairside Strategies
Dr. Darryl Glover:
Understanding that, what practical steps can I, as an optometrist looking to learn more about vision therapy, take to support my patients? Moreover, how can I ensure a smooth transition when referring patients to a specialist like you, so they feel informed and ready for what lies ahead in their treatment journey?
Dr. Brenda Montecalvo:
Thank you for that question. To address it broadly, I categorize our patient groups into three main areas: learning-related issues, brain injuries, and strabismus and amblyopia. Strabismus refers to a turned eye, and amblyopia, often called “lazy eye,” is when an eye doesn’t see well even with correction. We focus on these three primary categories, with optometrists typically proficient at identifying strabismus and amblyopia.
For learning-related issues, we delve into why a student may not be performing well academically. Brain injuries are usually apparent through case history. Chairside, if a patient isn’t ready for a full program, we focus on the visual motor system, which involves 12 extraocular muscles and the ciliary muscles, totaling 14 muscles that need to work in harmony to convey messages to the brain. This system is highly innervated, with a one-to-one nerve-to-muscle ratio, the highest of any muscle in the body.
Improving these muscles’ coordination can significantly enhance visual function. Key exercises include practicing fixation to keep the eye on target, tracking objects, and aligning spatial perception across the XYZ axis over time. We aim to synchronize visual, auditory, and kinesthetic maps to improve overall coordination. Simple activities, like capping a pen, can help align these maps and are particularly beneficial for individuals with brain injuries or those struggling in sports due to poor tracking abilities.
To support this, we can teach staff to conduct simple procedures chairside and schedule progress evaluations every four weeks. Preliminary testing, such as binocular vision tests, allows us to quickly assess improvements without extensive testing, maximizing efficiency in a primary care practice. I aim to equip optometrists with strategies that enhance patient care without compromising valuable chair time.
