In my private practice that specializes in vision therapy, the majority (about 70%) of our patients find their way to my care from a direct referral from another doctor or rehabilitation professional. Yet there are a significant number of patients, (often children) who are referred by a parent of a past patient who recognizes behaviors in a child that looks like what their own child struggled with before coming to see us for vision therapy.

This represents about a third of our practice that come to us directly because of a parent, teacher or friend who saw behaviors or recognized the problems described by the other parent. That means many children somewhat serendipitously find their way to our care because of a thoughtful  “goodwill ambassador” past patient or friend.

This group of patients are typically the kids with vision related learning problems. There can be a variety of clinically presenting conditions but some of the more common diagnoses are convergence insufficiency, accommodative dysfunction or oculomotor dysfunction or a combination of all three.They may also have a visual processing problem resulting in letter reversals, difficulty with visual memory and/or hand-eye coordination.

When a child has a vision related learning problem, it is also interesting to note that the diagnosis is typically very obvious as I will demonstrate to the parent directly their child’s trouble with the sample visual test  and then let the parent see for themselves usually how effortless the test is if they have normal abilities. Once we establish the diagnosis and determine that this child has a vision problem that can be effectively treated, there is typically a three part response by the child’s parents.

First there is a sense of relief that finally  a visual explanation has been found that answers why their child has struggled and it is not because their child was “not smart enough” or “not trying hard enough” and they are not “bad parents”.

Second  there is a feeling of hope for their child’s future because the solution I present just makes sense. We provide the “best practice” delivery of care, doctor supervised office-based vision therapy that is a proven and effective treatment and I have a solid track record of 30 years experience in this specialty.

Thirdly the parents then experience a momentary feeling of regret and disappointment (sometimes anger) that their previous eye care professional who saw their child did not not recognize the problem in the first place. As a result of overlooking their child’s vision problem their child had to deal with often years of frustration and emotional side effects. It is this group of parents who will ask me, “Dr. Fortenbacher, why did our child’s previous eye doctor not tell us about this problem with our child’s vision?” Often I can not honestly say why with certainty, but try to emphasize the positive, we can leave the past behind and move forward now to solve the problem.

However now I’m pleased to have a better response to this question. Thanks to my friend and colleague, Dr. Leonard Press who has written 3 wonderful articles on The VisionHelp Blog there is now an answer to  the proverbial question, “Why did our other eye doctor not tell us about this problem?” The answer can be found in CATS WHO SUCCEED.




Dan L. Fortenbacher, O.D., FCOVD