We would like to share something that we suspect you might not have ever heard about before but think you will find very interesting and hopefully useful. Since 1995, Dr. Debby Feinberg has been working on a new approach to treating patients not normally seen by optometrists – those with headache, nausea, dizziness, gait imbalance, neck and shoulder pain, anxiety, persistent post-concussive symptoms as well as reading and learning problems. This year, in her persistence and passion for creating a way to help those who suffer from these symptoms, and after caring for more than 10,000 of these patients, she has won the Theia Award of Excellence in Innovation for creating the optometric subspecialty of NeuroVisual Medicine. 

It turns out many who suffering have one thing in common – a subtle heterophoria (almost always vertical) that is not identified with current associated and dissociated phoria tests, which responds to treatment with micro-prism lenses with prism power as small as 0.25 diopters. The patients typically see an immediate improvement in their symptoms of 50% (during the initial exam), and about 80% when they complete the process. These are the same people who, for years were treated by a host of other doctors, and really did not improve with other treatments, therapies, or medications. These are our medical colleagues’ most challenging patients – a population that would really be appreciative of some assistance.

This new optometric paradigm is called NeuroVisual Medicine (NVM – www.Vision-Specialists.com), and it has transformed several practices into a unique niche specialty practice. Our office is open Monday through Friday, with no evening or weekend hours. The patients are the most interesting and complicated cases, and when screened properly (using a specially designed questionnaire) almost all can be helped. Due to the complex nature of these patients, the initial exam lasts about 90 minutes – only 6-8 patients are seen per day, which is financially viable because the capture rate is 70-80%, and second pair sales is over 30%. Many NVM colleagues have set up this part of their practice as a cash pay paradigm. Some offices practicing NVM no longer perform standard optometric exams and don’t have to work with vision insurance.

NeuroVisual Medicine will enrich your life in several ways including:

1. Having the ability to spend enough time with the patient to really know them and get to the bottom of their problem and help them feel better and live the life they were meant to live.

2. Interacting with medical colleagues – neurologists, ENT’s, PM&R’s, pediatricians, primary care doctors, psychiatrists/psychologists, PT’s and OT’s, speech and language specialists, reading specialists, etc. – working together as a team to get our mutual patient better.

3. Interacting with NeuroVisual Medicine colleagues. To date, there are over 20 other optometrists trained in NeuroVisual Medicine across the US and Australia (www.NVMInstitute.org). It can be very rewarding to work with them on their thought-provoking cases.

4. Expanding the optometric “pie” – the patients being seen would not normally present to an optometrist or ophthalmologist as their chief complaint isn’t visual (blurred vision, diplopia, etc.). However, NeuroVisual Medicine specialists are seeing these patients for a medical problem.

For this work to be taken seriously, the necessary academic foundation must be created – this work has been presented through lecture at AOA, poster at AAO, and peer-reviewed articles:

Though these articles were written about TBI patients, the information in this is extrapolatable to all our patients, TBI or not. There have also been multiple lectures and presentations nationally and internationally outside of the optometric space, including neurology, ENT, psychology, PT/OT and TBI on this subspecialty. 

It is getting more difficult for the traditional optometrist to make a good living and have a good quality of life. NeuroVisual Medicine has provided several practices the opportunity to accomplish both. In these most challenging times, this is something you should know about.