Iris Stern, MD FACP
1440 East 29th
Street
Brooklyn, NY 11210
May 1, 2001
In my role as internist/geriatrician I am
often approached by patients who want to take herbal products. There are also
those who seek alternative treatment modalities. Deciding how one advises these
patients is often difficult. Our training as physicians has not provided us
with sufficient background to evaluate and draw conclusions on the efficacy of
these approaches to dealing with patients’ problems. However, when the medical
literature reviews these products or new treatment modalities I try to become as
knowledgeable as possible. This allows me to give intelligent advice to my
patients.
In my role as a parent I have been thrown on
the other side of the consultant’s desk. My six year old was diagnosed with
anisometropic amblyopia two months after his 5th birthday. His
condition was identified by my ophthalmologist who then referred me to the
pediatric sub-specialist. The pediatric ophthalmologist informed me that my
son’s visual acuity of 20/200 in his left eye may or may not improve. In fact,
I was told the prognosis was poor and we would start therapy with eye glasses.
We proceeded subsequently to patching his "good" eye. His vision was
gaining little ground. No mention of vision therapy was made.
I pursued vision therapy after an educator
made me aware of it. I went to an optometrist skilled in vision therapy and was
given a list of at home exercises to work on with my son. His vision started to
improve. When a better level of visual acuity was reached we started in-office
therapy. This not only helps strengthen the weak eye, but improves the other
aspects of the amblyopia syndrome. It helps train the child to use binocular
vision (to use the weaker eye when the stronger eye is not patched). He is now
at 20/40 with glasses.
Amblyopia is the most common cause of
monocular blindness in children. Shouldn’t our ophthalmic and pediatric
societies be advocating for early screening. Once the diagnosis is made should
we not offer our patients everything possible to treat this condition? If our
ophthalmologists are not familiar with vision therapy, isn’t it time to educate
them? If it was your child at risk wouldn’t you want all doors to be opened to
help avoid the consequences?
Iris Stern, MD