Vision Training for the Primary Care Practice. Lawrence D Lampert OD, FCOVD Yamato Rd. #120. Boca Raton Fl

Size: px

Start display at page:

Download "Vision Training for the Primary Care Practice. Lawrence D Lampert OD, FCOVD Yamato Rd. #120. Boca Raton Fl"

Phoebe Owens
5 years ago
Views:

1 Vision Training for the Primary Care Practice Lawrence D Lampert OD, FCOVD 9874 Yamato Rd. #120 Boca Raton Fl Drlampert@aol.com This course will enable the primary care practitioner to identify and treat vision therapy candidates in his or her practice in the areas of binocular vision, sports vision, and vision rehabilitation. Course Learning Objectives To recognize who may benefit from vision training and other functional interventions Review of testing procedures Review of treatment procedures and gradients of difficulty Know when to refer for more extensive workup and treatment Why should we do VT? My past fear of strabismus cases How we treat amblyopia Being a cook or a chef ADDITIONAL TESTING Phorias 1. Phoropter Setup 2. Values distance and near NPC 1. Wand 2. Red/Green.tap side of head Worth 4 dot 1. Red on dominant eye Vergences 1. Setup

2 Fused Cross Cylinder PRA NRA BINOCULAR VISION AND LEARNING Pick your cases Convergence Insufficiency Treat binocular vision not dyslexia or learning disabilities Probe for symptoms 1. Skipping or substituting small words words they know 2. Demo diplopia and blur 3. Momentary blur going back and forth to the board 4. Aesthenopic complaints 5. Decreased comprehension 6. Reading ability..knows words but misses in paragraphs eyes can t navigate through print 7. 3D movies NPC 1. Repeated NPC 2. NPC with red/green Phorias 1. Values 2. Exo 3. Eso Vergences 1. Values 2. Supression 3. Demonstrate what is seen PRA NRA Stereo 1. Recording performance 2. With shake King Devick Tracking problems.ambient/focal processing Plus at near Yoked Prism 1. Ball catch 2. TOP test Vision Training basic skills

3 1. Accomodation flippers 2. Hart Charts 3. Vectograms 4. Prisms- rotatable 5. Brock string 6. HTS computer program 7. Gemstone computer program 8. EyePerformance computer program Sports Vision Training Model of Sports Vision Training: Awareness, Tips, Drills.Be a Vision Coach AWARENESS: How to test for and make athlete aware of his own visual system by testing for eye dominance, phorias, vergences, and accommodation Eye Dominance- demo Phorias- phoropter, cover test, stable versus fluctuating Vergences- phoropter, flippers 12 BI/ 12 BO near 6 BI/ BO dist. 12 cycles/ min Accomodation- +/ flippers. 12 cycles/ min, 14 b Worth 4 dot- red filter over dominant eye Tony Fernandez Stereo testing- with and without shake Brock String The Zone

4 TIPS: Information for a same sided versus cross dominant athlete, what phorias predict, information on vergences, focal and ambient visual processing, and how to apply this information to golf, tennis, ball sports, shooting, etc. How to access The Zone. Eye Dominance Dominant eye processes milliseconds faster and use line of sight for localization. Baseball- open stance. Dominant eye on pitcher s release zone. Doug Jennings Tennis- cross dom explained pro s difficulties. Dom eye blocked by nose and he had high phoria Golf- position over putt, plumb bob with dominant eye Shooting- cross dominant failures qualifying on range, policeman s story Phoria- cover test and phoropter Eso- miss short PGA pros (14 of 15), ball sports- swing early Exo- miss long PGA pros ( 8 of 12), ball sports-swing late Unstable- Val Skinner and Patty Jordan Walk eyes along green to judge dist. Vergences- test in phoropter and flippers for jumps Base Out ranges Base In ranges Weak and/ or out of balance Accomodation- McCouch story Anthony story The Zone Focal/ Ambient Processing- Periph 25% faster and 20 % balancing (reduce squinting with lenses) and zone Peripheral Expansion

5 The Big Zen story Body Alarm Reaction- opposite of zone, tunnel vision, law enforcement- Doug Jennings Vision is the dominant sense Other Tips Factoring time into putting equation Spot putting and using your putter as an alignment tool Using logo on ball as alignment tool Pitch takes 4 tenths of a second to reach the plate. You have 2 tenths of a second to decide to swing. Make the target smaller Tape and mirror techniques to make sure eyes are directly over the line of the putt Reduce eye movements and use periphery- basketball, cycling, running, diving, tennis Keep your eyes on the ball and be aware of the periphery SVT PROCEDURES: How to improve strength, flexibility, stamina of the athletes visual system using lens flippers, prism flippers, and a vectogram. Information on The Zone and procedures to access it through the visual system VISUAL SKILLS TRAINING Plus/ Minus Flippers- trombone if can t clear Prism Flippers Brock String Vectograms Quoits- build ranges BI/ BO/ BI..Qadry Spirangle- Zone trainier Peripheral expansion- batting bean bags tossed from side while walking on a balance beam to a metronome. Peripheral Expansion Chart

6 Computer based training- HTS, Vizualedge, EyePerformance Sportsvision Magazine, SVS section of the AOA, Pro s Edge Eye protection: Appropriate lens choices for the athlete. Eye protection. Fixed tint vs photochromics and polarized vs non polarized. Like photochromics polarized or non polarized. Varying lighting conditions Golf and ski- non pol Water sports- pol Cyclists Garmin Transitions team- Multiple sets of lenses replaced by one pair photochromics Aging athlete. By age 60 the pupil IS 20% smaller and you need 3x more light for specific tasks. Also light and dark adaptation takes longer. Case Studies: DJ- Batted 200 in US. After VT went to Japan. 17 hits out of 21 at bats, Tied consecutive home run record, MVP, billboards Qadry- on bubble with Ravens record receptions and yardage, superbowl ring, ESPN announcer Three High School Kids- 118 pts increase in batting avg, HR ev 48 at batts - HR ev 9.5 at batts. All drafted into the pros Patty Jordan- fluctuating phorias and low fusional ranges. Tony Fernandez- Low fusional ranges and central suppression. Batting average 278. Went to 321the season after SVT. 2 nd season after SVT led both leagues batting over 400 for first half of season VISION REHABILITATION Visual Midline Shift Syndrome

7 My first case Post Traumatic Vision Syndrome 1. Binasal occlusion Falls Past Pointing aka Targeting Hospital Visits 1. Rotatable yoked prisms 2. Red/Green bin vision eval 3. Visual field loss Confrontation, blind field stim, penlight stim 4. Doctored ordered consults.retinal specialist does not refract, endodontist does not fill teeth 5. Spot Patching for diplopia.cases 6. Ambient/Focal processing Procedures and gradients 1. Hart Charts 2. Stick in straw 3. Red/green wand 4. Tracking and scanning 5. Computer programs with tachistiscope Neuro Optometric Rehabilitation Association Questions Thank you

Lawrence D Lampert OD FCOVD Yamato Road, Suite 120. Boca Raton, FL

Lawrence D Lampert OD FCOVD Yamato Road, Suite 120. Boca Raton, FL Lawrence D Lampert OD FCOVD 9874 Yamato Road, Suite 120 Boca Raton, FL 33434 561 479 1411 Drlampert@aol.com VISUAL SKILLS TRAINING FOR LAW ENFORCEMENT, RISK MANAGEMENT AND SPORTS LAW ENFORCEMENT AND RISK