Every Optometrist should have a favorite Occupational Therapist

ODs and OTs…how i joined the team

It was my luck to find a job at a forward thinking optometry practice that wanted an occupational therapist on-site to provide low vision services (training on devices, home modification, etc). But the occupational therapy scope quickly moved to reading problems, visual motor integration, handwriting and “visual processing” problems.  I had to quickly learn about eye movements, convergence and focusing problems that our ODs were finding. I learned about the Convergence Insufficiency Treatment trial and the prevalence of eye movement problems affecting the functional outcomes of pediatric OT patients. I attended NORA training levels one and two. I even got learn about performance vision training as part of the High Performance Vision Associates.

The results were amazing. When the practice changed ownership, I continued my practice as part of an outpatient pediatric therapy clinic working with other PTs OTs and and SLPs.

Helping more Children

The OD that I worked with continues sending me patients, only now, every child is seen regardless of insurance ( a problem in the OD clinic). I frequently spend 6-8 hours a day of direct patient contact on vision patients. Now with a complete therapy clinic, the scope had expanded to managing the strength and postural problems, as well as the sensory problems often associated with children that have eye movement problems.  We are adding vision rehab to traditional pediatric occupational therapy

And the optometrist that refers to me? He is also very busy, as his reputation for performing complete eye exams on special needs children and finding problems other ODs did not, made him the “go to guy” in our community.

Why partner with an OT?

Every optometrist should have an OT that they can refer patients. As OTs, our education includes standardized testing for fine and gross motor defects, learning the developmental sequence from birth to old age and kinesiology and movement. We treat sensory problems and use reliable and valid tools to identify these problems. We are already treating the children with eye movement problems and doing the best we can. We know a part of the puzzle is missing.

Training needed

The OD may have to spend some time with the occupational therapist teaching about convergence and the near vision system and the most efficient way to treat these things. The course I present teaches the basic skills for this and I have taught about 700 therapists so far.  You, as an OD, will quickly find a receptive therapist as we recognize that vision is standing in the way of our kiddos progress, but we do not know how to fix. In return, a rewarding symbiotic relationship can begin that benefits all involved. Mostly, it benefits the children that need these important interventions to be more accessible .

Learn More

Learn more about this subject in a live course presented by Robert.  Its now available as a webinar too!! Hosted by PESI Education

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Vision Resources for Occupational Therapist

Vision Rehab Resources for Occupational Therapists

It has been my pleasure to share information with OT students, PTs, SLPs and anyone else that will listen. It is my belief that information should be free and accessible to all. It is very exciting working in a unique OT area where there is so much to share.

Where can an occupational therapist learn more about vision rehab??

My first course was Mary Warren’s Vision Processing Impairment . This teaches the basics of eye movement assessment, visual field treatment and puts it in a nice functional context. It was a great course that got me much more aware of the visual problems neurological patients face and how to fix them.

If Mary Warren is the OT reaching towards optometry, Mitchell Scheiman is the optometrist reaching out to OTs. His courses and books are specifically teaching OD skills to OTs. I refer to this book frequently and it needs to be on more OT’s shelves.

Dr Scheiman also teaches a two day course for therapists that discusses the mechanics of vision the first day and interventions on the second. He is also on the faculty of Salus University’s post professional OTD program in Vision Rehabilitation.

There is also the course that I teach for PESI Education on assessment and treatment of binocular vision disorders.

Vision Rehab articles that are important for OT’s

Here are some of my favorite journal articles.

The Convergence Insufficiency Trial is important. It proves that that in-office treatment of convergence insufficiency works.

A systematic review of what works for treating visual field defects.   

The website of the Neuro Optometric Rehab Association is a great resource for information on treating the visual problems of stroke TBI and concussion.

For the EI therapists, here is a nice piece on the development of the visual system in infants.

The Journal of Behavioral Optometry and Optometry and Visual Performance are located at the Optometry Extension Program Foundation website. Complete article are available. There is a great bookstore too!

Vision Rehab and Occupational Therapy websites

Eyecanlearn.com has great activities.

Hartchartdecoding has a fun saccade activity.

Michigan Tracking is a tracking/Saccades task.

Learning Works for Kids is a great website that has search engine to find apps that address specific skills a for specific ages .

LittleBearSees.org offers great information about cortical visual impairment for therapists and parents alike.

Who cares about eyes anyway?

As one discovers more about vision it becomes obvious that as OTs we must be evaluating vision better. Eye movement accuracy affects balance, academic performance and overall development and it can be improved.

Visual processing, balance, gross motor development and reading cannot be successfully treated while a child has poor eye movements! It is like testing for sensation while a patient has gloves on.

Learn More

Learn more about this subject in a live course presented by Robert.  Its now available as a webinar too!! Hosted by PESI Education

About the Author