My Journey into Vision Therapy in Australia

Vision Therapy is one of the core contents of optometry practice, this speciality of optometry is gaining lots of importance in India. Our alumnus from BLSO, Swathi Vemula (BLSO, 2009) feels fortunate to have gained invaluable experience in this field in Australia. In a series of articles starting from this month she will take us through her journey into Vision Therapy and also introduces to different Vision Therapy procedures.

Swathi Vemula offering her services

Having worked as an optometrist in India and moving to Australia, it took two months for me to make up my mind to look for Optometry Assistant jobs in Sydney (to practise as an optometrist in Australia, one needs to either do the entire Bachelors in Optometry program or give competency exams conducted by Optometry Council of Australia and New Zealand (OCANZ) and apply for a registration with Optometry Board of Australia (OBA). My plan was to first work as an optometry assistant, while I simultaneously prepare for the local Optometry registration exams so that when I clear them, I can start practicing optometry. 

Hunt for jobs

Within a week of job hunt in Sydney, I came across this interesting advert that said they were looking for an optom assistant to work for a “behavioural optometry“ practice. I vaguely remember studying about behavioural optometry during my studentship and it quickly struck me that it was not an area I was strong in. However, I was very keen to apply for the as it could be an opportunity to learn. With some apprehension, I ended up applying for this job, as it was just 5 clicks away from home. Such a convenience is a luxury in this city. Luckily I

 secured the job as my employer was convinced that being an optometrist from a reputable organisation, I could do much more than pre testing and dispensing spectacles. Least was I anticipating that she had special plans for me. 

At the new job

I started work after brief training. First up, I was asked to do a pre test for one of the patients in a separate clinic. This huge room had gadgets that I had never seen in my life before. I didn’t even know if they were used in Optometry and for a second I wondered if my boss had another business! I was given a list of tests that I would have to perform on this patient and to my sunshine I was happy within that I know all of them as I scrolled my eyes down. I still remember that I had this moment of pride. The moment when I thought that if you graduate from BLSO, you are the “know it all” practitioner. The pride of knowing them all changed to panic when I saw the last test on the list, which read, “Howell’s distance and near phoria”. I never knew that this test was used for subjective measurement of phoria as we were taught other ways to do this at BLSO. I felt nervous to ask my boss what this test was. She smiled and asked me to do everything that I knew on that list. At the end of the visit, she came into my room and told me to read about this test so that I could do it next time. That was the day when my learning in Australia began. Precisely from my first day onwards, I kept that learning curve growing. I delved really deep into concepts of binocular vision, orthoptics and eventually discovered the huge ocean of an exciting science called Vision Therapy. 

So what is Vision Therapy?

We know that a significant amount of learning happens through vision. Patients with conditions like convergence and accommodative anomalies, strabismus, amblyopia and autism, go through difficulty  in using both their eyes together. This results in a significant reduction in brisk and smooth processing of visual information leading to an affect on learning capabilities. Vision therapy allows training such individuals to use their brain and eyes for betterment of eye movements and visual learning.  It is like a workout regime tailor- made for each person to reach specific goals. This involves training the person using a series of orthoptic exercises that falls into orthoptic vision therapy as well as a series of other exercises to improve visual memory, attention and concentration that falls into behavioural vision therapy.  I kept reading books to improve my knowledge in this area and eventually upon a couple of instances when I had an opportunity to discuss these concepts with my employer, she realised my interests were slowly inclining towards vision therapy. She started letting me be an observer during her vision therapy sessions. She then made me attend training workshops and conferences related to vision therapy to make sure I reached the Australian standards. I was then promoted as a Vision Therapist. 

Training oculomotor skills

Training accommodation

Now, offering Vision Therapy services is my daily routine

The same gadgets in my clinic that I once thought were props used in some alien movie are now my favourite toys. I render vision therapy services to about 12 to 15 patients every week. The vision therapy program I give my patients typically goes on for three months and in some cases might be as long as one year. It includes training activities using aperture rule, prism flips, Marsden ball, flippers, brock string, tranaglyphs and vectograms etc. Each patient is given an in-office vision therapy session for about 45 minutes to one hour, every week and also 15 to 20 minutes of at-home vision therapy exercises, every day, not less than five times a week through out the period of therapy. The patient is advised to continue exercises on a regular basis, to avoid relapse post therapy. The strategy and approach is decided at the beginning of therapy itself depending on the diagnosis made by the optometrist. Details of the actual therapy program will be discussed in my subsequent articles after this very brief introduction to my journey into vision therapy. 

Swathi Vemula completed her graduation from BLSO in 2009. After graduating, she worked as consultant optometrist at GKB Opticals, Hyderabad for three years. She then moved to Australia in 2013 to join her significant other half. In pursuit of better career prospects, she joined Eyecare Kids in Sydney, Australia. Eyecare Kids is an optometry practice offers services with special focus on child’s vision and learning. Swathi’s love for binocular vision and the fact that she finds immense satisfaction in working with kids is what turned her into a Vision Therapist. For the last 2 years she enjoys her role as a Vision Therapist at Eyecare Kids. 

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