Taking a Good Look at Family Eyecare Associates

LOOK OUT FOR YOUR EYES

As you begin making your resolution to be healthier this new year, don’t leave out two of the most important parts of your body: your eyes. With the demands that are put on our eyes every day, it is essential to take care of them and even exercise them to strengthen them and possibly improve your vision.  In the past, people were hunters, farmers and gatherers. They were used to looking over far distances to seek prey and other possible sources of food. But now we live in a 2D world, where....

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SENSORY INTEGRATION IMPORTANT FOR BALANCE

What happened the last time you went on the Mad Tea Party ride at DisneyWorld? Did you enjoy yourself initially, but as the ride went on, did you start to feel sick and disoriented? When you closed your eyes, however, you probably felt much better. And you were immensely glad when the ride ended and you could get your bearings again.

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VISION THERAPY AND ACQUIRED BRAIN INJURY

The eye is amazing. Did you know more than 1.9 million fibers come from the eye into the brain? Each of those fibers creates its own pathway to the brain and has its own distinct function. So when someone has a stroke or other acquired brain injury (ABI), vision is often affected.  ABIs include concussions suffered in severe sports-related hits or a car accident, as well as cerebral or vascular strokes. An ABI can affect both neurological pathways in the eye, the focal or parvocellular pathway, which....

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accurate shifting of the eyes along a line of print or from book to desk to blackboard and back. The exam will also evaluate problems such as cataracts, glaucoma, hypertension and diabetes.


In addition to general eyecare, there is a clinic that continues the work Dr. Graebe and his team are doing. The Children’s Vision and Learning Center (CVLC) offers unique Neuro-Visual Perceptual Therapy (NVPT) programs for children and adults who are having difficulty reading and thus are underachieving at school and in the workplace. Thanks to these NVPT programs that target learning- related vision problems, including many who have been diagnosed with ADHD, ADD and dyslexia, children average more than a three year performance improvement in 30 weeks. The programs can benefit adults as well. It’s all about changing the input into the brain.


“We’re making new pathways in the brain,” Dr. Graebe said. “Once patients improve these pathways, they will stay with them forever.”


This happens because about 70 percent of all the pathways in the brain are involved in vision, directly or indirectly.


“The function of the eye is to send information to the brain,” Dr. Graebe said. “If we improve your efficiency with your vision system, we’ve improved 70 percent of the input that goes to your brain for the rest of your life. We also work sensory integration. There are all sorts of sensory input coming to the brain and it all needs to be in agreement.”


Dr. Graebe says vision and eye-sight are not the same thing.


“Vision involves how our eyes, brain and body interact – so many different things from balance to spatial awareness and even our sleep cycles,” he explained. “Eyesight is [measured by] the acuity chart, but vision is sending information to the brain.”


Two neurological pathways lead from the eye to the brain. Dr. Graebe says the parvo cellular or “focal” path is the part of the vision system that answers the “what is it” question. He says the magnocellular focal is the “ambient” path that’s in the background.


“The ambient pathway deals more with the ‘where is it’ question,” he said. “It has to do with balance and spatial awareness. The ambient pathway will always fire first and tell the focal path what to look for.”


He says many attentional problems may occur because these pathways are not working properly.


“It’s just overwhelming,” he said. “People get sensory overload. We see this with the autistic spectrum. Those patients are always in what I call focal lock. The No.1 sign of autism is the person won’t make eye contact and it’s because they’re in focal lock.”


Dr. Graebe often prescribes therapeutic ambient prisms for autistic patients.


“The prism bends light so it just changes the distribution of light on the retina,” he said. “The theory that makes the most sense is that if the ambient and focal paths are out of sync, a prism changes the timing.”


Dr. Graebe is enthusiastic about behavioral optometry.


“My personal passion is kids with reading and school-related issues,” he said. “That’s why I get out of bed in the morning. I really do consider it my personal ministry. I can make a bigger change in someone’s life with this than with anything else I’ve run across.


“It’s such a shame that people get these labels: ‘I guess I’m just not very good at reading’ or ‘I guess I’m dyslexic or ADD,’ where in reality, so many of those times it’s just you’re having visual skills deficits that are totally fixable,” he added. “You put this artificial ceiling on your capabilities, and that’s the part that breaks my heart.”


Seeing dramatic results is encouraging. “My goal for these kids is keeping these doors open so their vision won’t be a limiting factor on what they do professionally or personally,” Dr. Graebe said. “People say, ‘I wish I had known about you five or 10 years ago’ or ‘I wish I had had you for my kids.’”


A wide variety of visual services are available at FEA and CVLC, including:


•  contact lenses, including bifocal and disposable astigmatism lenses with fitting and follow-up;

•  treatment for binocular vision conditions such as amblyopia (lazy eye); convergence insufficiency    (near vision disorder); diplopia (double vision); lack of stereopsis (two-eyed depth perception); and    strabismus (cross-eyed, wandering eye and eye turns);

•  visual rehabilitation for patients with traumatic brain injury (TBI); and

•  Orthokeratology, also known as corneal molding – a non- surgical alternative to (LASIK).    


Orthokeratology patients wear rigid lenses that are designed to reshape the cornea while they are sleeping. “When you wake up the cornea is the shape it’s supposed to be and you can see all day without glasses or contacts,” Dr. Graebe said. “There’s no need for an operation.” Some visual conditions that cannot be treated adequately just with glasses, contact lenses and/or patching are best resolved through a program of NVPT. This is an individualized, supervised treatment program designed to correct visual-motor and/or perceptual cognitive deficiencies.


Vision therapy is essentially physical therapy for the eyes and brain. It includes training and rehabilitation of the eye-brain connections involved in vision. VT is directed toward resolving visual problems that interfere with learning. It can improve visual function so the student is better equipped to benefit from educational instruction. It helps both children and adults who have been diagnosed with learning-related vision problems, attention deficit disorders, dyslexia and learning disabilities. It helps patients develop normal coordination between the two eyes and improve binocular vision. When the eyes work together effectively, reading, sports, depth perception and eye contact are enhanced. VT helps people who play sports by improving eye-hand coordination, visual reaction time, peripheral vision, eye focusing, eye tracking, eye teaming and visualization skills. The eye muscle training benefits of vision therapy are medically proven.


“There’s some great science behind this,” Dr. Graebe said. “It’s so amazing when you really understand what happens and some of the changes you can make with VT.


VT procedures are designed to enhance the brain’s ability to control eye alignment, eye tracking, teaming and focusing abilities, eye movements and/or visual processing. The therapy utilizes specialized computer and optical devises such as therapeutic lenses, prisms and filters. The patient’s visual skills are reinforced and made automatic through repetition and by integrating them with motor and cognitive skills, avoiding the need for surgery.


“I’m not against surgery of any kind, but to me, that should always be the last resort, not the first line of defense, because you’re still not treating the real root cause of the problem; you’re just worrying about the smoke and ignoring the fire,” Dr. Graebe said.


FEA also treats many stress-related visual problems. Graebe says our 21st-century lifestyles demand more from our vision than ever before.


“We have so many computers and phones and all this other stuff , we’re spending much more time in a 2D world,” Dr. Graebe said.


Excessive computer use or close work can sometimes induce headaches and visual difficulties that can be effectively treated with corrective lenses and vision therapy. When you are sitting and talking to someone, you blink about 22 times a minute. When you sit staring at a computer screen, the eyes blink about seven times a minute. The blue light emitted from computer screens suppresses melatonin, and chronic blue light has been shown to cause macular degeneration. Dry eyes are another problem that stems from computer use.


“From a visual development perspective, there are a lot of reasons not to do a bunch of computer work, but that’s the world we live in,” Dr. Graebe said.


He offers advice for doing near work with computers. “Follow the 20-20 rule,” he said. “After every 20 minutes of reading or doing close work, look 20 feet away for 20 seconds. You’re relaxing the pointing muscles; you’re relaxing the focusing muscles.


Dr. Graebe spends from 15 to 20 hours a week reading about and studying VT.


“I’m board certified and I have a national certification,” he said. “I am very passionate about this. Good therapy can truly change lives.

Family Eyecare Associates (FEA) in Versailles works with people of all ages and situations, from seniors with balance difficulties to children with learning- related vision disabilities. In business for 25 years, FEA’s goal is to develop a lifelong relationship with you and your family, as both patients and friends. FEA sets its sights on maximizing your visual performance and preserving your eye health, now and in the future.


Working alongside Dr. Rick Graebe, O.D., FCOVD, are Dr. Regina Callihan, O.D., and Dr. Rebecca Swartzentruber, O.D. Dr. Graebe said he always knew he wanted to have a career in medicine, but he wasn’t sure what health-related specialty he would pursue until, at age 17, he tried on his girlfriend’s glasses. He was astonished to realize he could see much better.


“I saw what I was missing,” he said. “The right door opened at the right time. Optometry was the only career path that I’ve ever really chosen.”


Dr. Callihan joined FEA in 2004. Her specialty includes primary care optometry as well as vision therapy and low vision. Dr. Swartzentruber, who came on board in June, brings a great deal of knowledge about primary eye care and vision therapy to the practice. Everyone on staff at FEA realizes there is more to eye health than just having 20/20 vision. The measurement of 20/20 simply means you can clearly see a certain

TAKING A GOOD LOOK AT FAMILY EYECARE ASSOCIATES

letter on the standard Snellen eye chart that is equivalent to what a person with normal vision should be able to see at 20 feet. You can see 20/20 and still have functional problems.


Eye health means getting regular checkups; wearing your prescribed corrective lenses or contacts; and protecting your eyes from the sun’s harmful UV rays. It encompasses visual efficiency and the ability to process visual information effortlessly. At FEA, a comprehensive vision exam evaluates visual skills, including visual acuity at close distances, which is vital to reading and computer use; eye teaming skills to make sure your eyes work in sync; eye focusing skills; and eye movement skills. A weakness in eye teaming skills can cause difficulties such as convergence insufficiency, a disorder that interferes with a person’s ability to see, read and work at near close distances.


Rapid, automatic eye focus adjustment is critical to learning, reading, writing, sports and other activities. Deficiencies can cause visual fatigue, reduced reading comprehension and/or an avoidance of close work or certain activities. Eye movement skills are essential for reading because they involve the quick,

DR. RICK GRAEBE

Dr. Graebe received both his B.S degree in Visual Science and Doctorate of Optometry from Indiana University. He is a Behavioral Optometrist and learning expert. He has been in private practice here in the Bluegrass area for the past 32 years.

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