Today’s guest blogger is Dr. Nancy Torgerson.  Dr. Torgerson practices in Lynnwood, Washington (metro Seattle).  She is optometry’s “Energizer Bunny.”  She is a past president of the College of Optometrists in Vision Development and continues to write, speak, advocate, research and educate.

It never ceases to amaze me, what power lenses and prisms have in the vision therapy process.  The therapeutic application of prisms and lenses must be done under the guidance of a doctor….  BUT observations from the whole team (doctor, therapist, parent and child) will help to guide the process.  For example, if positive changes are noted by the parent or therapist, I can modify the treatment plan to incorporate more activities that use those combinations of lenses and/or prisms.  Ultimately, this collaborative approach results in more meaningful long term outcomes for the patient.

Lenses and prisms can have profound impact on a person’s visual perception.  Most people think about lenses in particular as a tool to focus light on the retina and eliminate blurry vision.  But lenses and prisms have many other effects.  They make objects appear bigger or smaller; they can move images up, down, left, right, in and out; they make objects appear to move when we move; they can alter the perceptions of color and contrast.  By changing the power and the orientation of the lenses and prisms, these changes can be overwhelming or just noticeable. The lenses and prisms cause the patient to adapt, to respond in a different way to changes in visual input.  I always observe the person’s ability to do a task with and without the lenses and/or prisms.  The value of the lenses becomes obvious if the person changes their behavior.  These are some of the behaviors  that often change as a result of wearing lenses and/or prisms:

  • Posture
  • Visual awareness
  • Spatial localization
  • Increase of decrease in sensory seeking behaviors
  • Gait
  • Organization
  • Eye contact with people or objects
  • Mood and facial expressions
  • Fine motor skills (such as writing)
  • Gross motor skills (such as catching a ball)

Dr. Mel Kaplan was key in introducing me to the power of prism glasses.  Initially I used the prisms only for those on the autism spectrum.  Many behaviors typically associated with autism, such as hand flapping and rocking, subsided.  I also noted improvements in many behaviors.   The ability to perform fine motor tasks such as writing, being able to walk more confidently and enhanced eye contact were a few of the many changes that I observed in the exam room.  By continuing to work with lenses and prisms and changing the power and base orientation I found that these changes not only happened for those on the autism spectrum but for many other patients.

I have learned so much about the use of lenses and prisms from my patients.  The team approach (doctor, vision therapist, parent and child) provides me with input concerning all sorts of tasks and behaviors in the exam room and the therapy room, at school and at home. I often discover that changes in the therapy room that seem minimal have greater impact in other aspects of the patient’s life.  Children seem more confident in school and on the playground.  Adults feel more comfortable driving or participating at a meeting. As Dr. Kaplan wrote, “By viewing the behaviors of your patients as clues, and allowing these clues to guide you to the correct treatment of your patients’ visual deficits, you will discover that you can free these individuals to see there once frightening world in  new and exciting way.”

Be sure to read How Vision Therapy is Saving Stella’s Toes.  Dr. Torgerson is Stella’s developmental optometrist.  Stella’s mom has written this powerful description of the impact of prism glasses and vision therapy on Stella’s behaviors in and out of the therapy room.

* Dr. Mel Kaplan practices in Tarrytown, N.Y.  He is the author of the book, Seeing Through New Eyes.