Optometric Vision Therapy (OVT). This essential specialty of optometry sets us apart from our colleagues in ophthalmology and has changed the lives of countless patients. As students, many of us dreamed of helping children and adults improve their quality of life by teaching them how to use their vision more efficiently. As a preceptor for externs from the Illinois College of Optometry, I am always encouraged to see the enthusiasm our students have as they work with us to serve our patients in our all-OVT practice.
But something happens to that enthusiasm after graduation. Perhaps it’s the realization that many hours of additional training and experience are necessary to provide a high level of care in this complex specialty. Perhaps it’s the exhaustion that comes with the transition from being a student to being a skilled clinician. These may or not be true for you, but I have to believe that a big reason why most newly graduated optometrists don’t offer OVT in their practice stems from the misconception that they have to offer treatment for all disorders of functional vision.
This past fall, at the behest of one of our colleagues in primary care, my mentor Dr. Kellye Knueppel and I began a journey to bring OVT back into the practices of primary care optometrists in Wisconsin. With the help of some of the best primary care optometrists in the nation, we have begun an initiative that we call the Wisconsin Convergence Insufficiency Project. The mission of this project is to provide the education and tools necessary to empower and support optometrists in the diagnosis and treatment of Convergence Insufficiency, the most prevalent disorder of binocular vision.
Convergence Insufficiency is the place to start with OVT
According to the AOA’s recently released Evidence-Based Guideline – Comprehensive Pediatric Eye and Vision Examination, up to 8.3% of children have Convergence Insufficiency (CI). This makes it the most prevalent disorder of binocular vision and one of the most prevalent vision problems at large.
The beauty of CI is in the simplicity of the diagnostic battery and the profound effect that initial treatment can have on a patient’s quality of life. If a new clinician is inspired to add OVT to their list of services that they offer to their patients, chairside treatment of CI is the absolute best place to start. By starting with one of the easiest functional vision problems to diagnose and treat, a clinician can quickly gain confidence in their skills and immediately improve the quality of life of their patients.
Start simple, start strong
Eight years after my graduation, I have attended many hours of continuing education in OVT. From the COVD Annual Meeting to our local OEPF Congress and everything in between, I have been privy to many conversations between successful OVT ODs and new graduates looking to add OVT to their practices. One piece of advice that I consistently hear is to start simple.
No one starts out getting a constant esotrope to see in three dimensions for the first time. Rather, the best cases to start with are the ones that you feel confident treating. In my next piece, I will begin laying out a simple, systematic approach to the diagnosis and chairside treatment of CI. In my opinion, there is no better place to start when adding OVT to your practice.