What sparked your interest in optometry?
When I was in grade school, maybe fourth or fifth grade, I remember speaking to my mom about wanting to be a doctor, but being a bit squeamish about blood. When she told me I could be a doctor, without having to deal with blood or emergency rooms, it really stuck with me for some reason.
And even in my little yearbook from grade school, I wrote down that I wanted to be an optometrist. I mean, I misspelled it, but anyway that’s what I wrote for my dream job when I grew up!
What led you to specialize in so many different fields within optometry?
So, long story here…
When I went into optometry school, one of my instructors was into vision therapy, and I really fell in love with the subject. With vision therapy, it’s not just about vision. You’re dealing with the whole human being. You’re dealing with the brain, the perception of the world around you. And it was really fascinating for me, working with patients who suffered from amblyopia and strabismus. It was interesting to see the different ways we can manipulate the visual space to be able to get the subject and the patient to be comfortable.
I also did an internship at Walter Reed Army Hospital, where we got a really good background in ocular disease and I started at SUNY as a researcher. While I was there I was also able to write a textbook and teach an amblyopia course for a number of years.
Eventually, I decided I really missed seeing patients, so I went into practice working for an ophthalmologist, where I would do vision therapy on evenings and weekends. Soon after that, I opened up my own practice and I was seeing patients at the same time I was teaching the amblyopia course at SUNY.
But with my research background, my practice eventually got approached by a sponsor, Johnson and Johnson, who wanted to create a Spectacle Lens for Presbyopia. We had computerized our records early on, so we had all our prescriptions and patient data on hand. So, we got into research and founded the Institute for Vision Research.
So that’s how I’ve been able to specialize in so many different fields, do research and see patients!
Do you find having so many specialties helps you better serve your patients?
Yeah, absolutely. So many parts of optometry are intricately intertwined. I realized that while studying and teaching at SUNY. Contact lenses, ocular diseases, low vision, infant vision, you name it. So often, addressing only one piece of the eye care puzzle sells the patient short.
To really do right by the patient, you have to check for eye disease first, and then you have to be able to get the two eyes to see as best as you can. That often involves contact lenses or glasses. Then you have to put the two eyes together and work with the technology you have at hand. With many specialty cases, like with strabismus or amblyopia, you’re really rebuilding the whole visual system.
I had to become an expert contact lens fitter because most of the strabismus and amblyopia cases I had needed contact lenses on top of any other treatments in order to be successful. And I needed to become very good at recognizing signs of disease, because very often somebody thinks that it’s just a lazy eye when it’s really a larger underlying issue.
What is your ideal patient, and how do you deal with more complicated eye care cases?
I like the difficult cases. The patient says, “I have this issue, whatever it is, I’ve tried this, I’ve tried this. It doesn’t work.” I want the patient to be honest. I don’t want them to just say yes to everything I say, because then I can’t really help them. I have to be able to know when something’s not right.
I use visuals all the time with my patients, so I’m continuously showing them pictures, cartoons, of the eye and then their own eye that I’ve taken images of. I want them to really understand what their eye is doing, why it’s doing it, and what that means for their treatment options. So, for instance, if they have a dry eye issue, I’ll make sure they know the three, four, or five different types of dry eyes and why we’re doing what we’re doing and how that affects their contact lens fit and how that affects the fact that maybe their eyes are not working together, etc.
What would you say motivates you to come into the office every day?
Honestly, it’s just something in my gut. If I can’t figure something out with a patient, it bugs me the whole day, the whole weekend. In 42 years I’ve never had a boring day in optometry because there’s always something there that I haven’t figured out yet. I haven’t finished it. I haven’t quite pulled it off.
And I also love helping people. I had a 30 year old who is wearing glasses, is legally blind and can only function wearing scleral contact lenses. I was able to get it to the point where she could wear her lenses all day long, and is able to function at a high level, even despite her poor vision. If that doesn’t motivate you, what will?
It’s one thing if somebody is 85 and you get them to see a little bit better. But in lots of cases, we’re talking about young people who are totally dependent on the specialty contact lenses that we fit or the special prism glasses that we give them or the special treatment for dry eye. So, I’m really passionate about that.