Zephen's Vision Therapy Experience with Dr. Sara Morrow

Child psychologist Dr. Sara Morrow describes how she discovered vision therapy and the success her son, Zephen has had over the course of the past three and a half years. She describes how he has gained alignment of his eyes and emerging depth perception.  
Zephen’s diagnoses from the developmental optometrist at age 10 were as follows: 

• Alternating exotropia (both eyes could turn outward, a form a strabismus) 
• Vertical strabismus of left eye 
• Vertical heterophoria (a vertical misalignment of the eyes that, a type of binocular vision dysfunction) 
• Supression of binocular vision 
• Fusion with defective stereopsis (inability for his brain to fuse together the images from his two eyes) 
• Fourth nerve palsy (tilting his head to turn his right eye forward, an accommodation to see better) 
• Spasm of accommodation, (both eyes, trouble adjusting eye muscles transitioning from near to far) 

Dr. Morrow's YouTube channel: https://www.youtube.com/@rootcauseofhappiness 

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Transcript

Denise: Welcome today to the Healing Our Sight podcast. I'm your host, Denise Allen. I'm so happy to present my guest today. I have with me Dr. Sarah Morrow and she is a clinical psychologist specializing in child and family optimal mental health. She's been working in pediatric mental health for over 20 years, providing therapy services to children and teens with significant mental health difficulties. Sarah is also the mother to two teenage sons. Her 14-year-old son was diagnosed with strabismus when he was 18 months old. At age 10, her son began vision therapy and has been able to achieve significant treatment progress in overcoming his visual disability. So welcome today, Sarah.

Dr. Sarah: Thank you so much for having me, Denise. I'm really happy to be with you and be part of your wonderful podcast. Thanks for the invitation.

Denise: Oh, I'm so, so happy that you're willing to share your story. It's harder than people might think for me to find people who are actually willing to put it out there. You'd think everyone would be so happy, right?

Dr. Sarah: Yeah, I think, you know, for me I just have this passion to help increase public awareness about the, the field of vision therapy because it's just not very well known about and I think there's so much that can be accomplished with exercises and a therapist to guide you through restructuring your vision. And so, I just tell everybody I can. So, when and I had the invitation to talk with you, I just couldn't wait to share our story and hope to inspire some other families out there.

Denise: I'm so glad. So, tell us a little bit about Zephen's diagnosis and how that came to, to pass that you found vision therapy after all of those years.

Dr. Sarah: Yeah. So, my son Zephen seemingly had very aligned eyes as an infant. So, I've gone back and looked at all his baby pictures, and his eyes were perfectly aligned and teeming and seeming had, you know, central focus with his eyes aligned and we don't quite know what happened. Although listening to some of your other guests, I have been curious about just genetics and the fact that strabismus does seem to have some heritability and run in families. And my mother-in-law, my husband's mom, she has a strabismus, you know, just one of her eyes can, can move out of alignment and so we don't know if it just showed up over time. The other possibility is when he was 16 months old, he had a fall. He just fell really hard and hit his face on the floor and he nearly bit through his tongue. And, and that was our focus was he had this like really nasty gouge where his teeth like, wounded his tongue. And there were no other concerns. We didn't see signs of concussion or anything else of concern, just the wound on his tongue. But it was very shortly after that that seemingly out of nowhere, he would turn and look up and over and his left eye would be completely gone. Like, you could barely see the iris of his left eye when he would turn to look to the left and up. And so of course, that was pretty frightening at first. Like, what is this? We really didn't have a clue. And right away went into the pediatrician. She referred us to the best pediatric ophthalmologist in our area. And so, he was only about 19 months old when we started seeing an ophthalmologist to follow him. He was originally diagnosed with kind of a. It said not quite strabismus. So, the diagnosis got worse, it seems like over time. He was diagnosed at 19 months old with isolated right inferior oblique overreaction without other evidence of strabismus and a right superior oblique palsy, which was flicking off and on. Hypotropia is what she called it. So, I did get the medical diagnoses just to be accurate. And essentially what I was under the impression of at the time was that he had kind of like weak muscles in his left eye. That was the best I could understand what we were hearing. You get all these big medical terms. These are words I've never heard of before. I still don't totally know the words. I have to look them up to, to make sure I understand what that means. And what they recommended was that we start patching his right eye so his left eye would have to be exercised. So, I really started from this thinking that he just had kind of a muscular weakness in his left eye and that if we made his body use the left eye, that those muscles would get stronger. And what happened was we patched for over a year, maybe a year and a half, and then we started seeing his right eye wander. And so, then the ophthalmologist said, well, we best stop patching because we don't want the right eye getting worse. And so, we didn't really have anything else presented to us as an option at that time. They wanted to do surgery. And the ophthalmologist, you know, that's what she does. She is a medical doctor, eye surgeon, so she does this probably all the time. And the recommendation was we should do surgery while he's still really young because of self-esteem. So, the worry was as he went into School age, that he would be teased because kids might notice, you know, that his eyes would get wonky and misaligned. And so, she really put kind of a time frame on it, like we should do surgery by age 7, maybe 8, but you really don't want to wait long. And I would challenge her and say, what is the likely success of the surgery? And it was iffy, like there was not a guarantee. She could not confidently tell me, like, it will definitely help. It was like, it'll probably help some. And probably in good fortune. I had a niece, not biologically related, a niece through marriage, who had gone through many, many eye surgeries. And it seemed like each surgery made things worse for her. So, in trying to affix her eye, there had been some nerve damage to her eyelid. And so, then she had more of a droopy eyelid. And it's seemingly her surgeries had really failed or at least not led to improvements that seemed worthwhile for the cost and pain, pain and fear of going through eyeball surgery. It's, you know, kind of a scary thought, right, to have your eyes surgically cut into your eye muscles. And so, because the outcome was, you know, iffy, it might help, it might not. And my other question to the doctor was, will it improve his vision if we do surgery? Right? And she said, no, not really. It really would just make his eye mechanically stay more affixed in a central location. And so, it wouldn't look as obvious to other people that he has this eye issue. And we hope it would help his self-esteem. So, what I did in that situation, what my husband and I decided was Zephan was old enough to be part of the conversation. You know, it's not like dental care where you ask your child if they want a dental filling. You know, this is like his body, it's his eyes, it's his self-esteem. And so, we would talk with him, you know, we'd go to see the ophthalmologist, she would push again, he should have surgery. We would have a conversation as a family. And Zephen as a little boy, honestly, he had no self-consciousness that was obvious about his eyes. He could look in the mirror and do like chameleon eye tricks. And he thought that was pretty cool because no one else could do chameleon eyes. You know, like he had a very unique little party trick that, you know, he thought was kind of funny. And you know, thankfully, I think he just had really kind friends in our circle, and he never had been teased or bullied about his Vision or the way his eyes looked. And he consistently said he didn't want to have surgery. You know, I'm sure there was some fear about it, but also, he just said, if it's not going to help me see better, I don't see the point.

Denise: Yeah.

Dr. Sarah: And so, I just felt that it was not a deadline. I just didn't really believe that we had to do this by age 7 or 8. I really felt that if he were to reach a point and he wanted to do the surgery on the muscles, we would support him immediately. And I felt like that that door wouldn't close completely. Like maybe the outcome would be better if we did it really young, but that we could turn to that route ultimately if he decided that's what he wanted for himself and he didn't at that time. So that was kind of where we started was, you know, thinking of this as a mechanical issue patching for quite a while and then really feeling like all we could do was monitor and there was no other option presented to us. Yeah.

Denise: Which is frustrating to us now that we know something different.

Dr. Sarah: Right, right. Yeah.

Denise: So, at this point, you hadn't been told about vision therapy and…

Dr. Sarah:I had never even heard of the field of vision therapy. It had never been presented to us as a possibility, an option. I didn't even know it existed. Yeah.

Denise: Which is common. Right. How did you find out about vision therapy then?

Dr. Sarah: Yeah. So ironically. So, I'm a pediatric psychologist, so I work with children and families in mental health. And I started a therapeutic yoga program and was offering classes for children and middle school age and teenagers. And there's a chiropractor in town who has like a developmental therapy program. And so, she does kind of mind body exercises, you know, trying to coordinate gross motor with mental activities, coordination, different sides of the body while doing mental tasks. And she often works with children that have like autism and ADHD and are kind of like what we call neuro typical children that have, you know, some behavioral, some emotional, some learning struggles. And she's developed a really innovative program that combines different types of therapies and really helps these kids kind of exercise their brain. And she reached out to me because she was actually wanting to know about my therapeutic yoga classes. And so, she invited me to come to her clinic and just chat about my work and her work and how she might refer some of her kiddos to my yoga program. And in talking with her, I just had this nagging thought, like, I wonder if she could help my son. You know, like I just thought, like, you know, Zephen is interesting because he really functions really well across the board. Like, he loved to read. He learned very easily, very emotionally, just a resilient, like, easygoing person. But he had these quirky little things that I always wondered about. So, for example, spatial awareness. So not really noticing, like, when we're walking on a trail or a sidewalk that someone's coming towards us, and the thing to do is to time that to get over on the side and get out of someone's way. And Zephen seemed to be totally oblivious to that oncoming traffic and the need to move over and accommodate other people's space. And we would kind of get frustrated with him. Like, hey, you have to pay attention. You know, like, that's important that you have be aware of what's going on around you.

Denise: And we assume people have spatial awareness because.

Dr. Sarah: Right.

Denise: If you have it, everyone should have the same kind of awareness. Right?

Dr. Sarah: So, mind you, at this point, I had. Had never been explained to me ever, that he had no depth perception and no 3D vision.

Denise: Okay.

Dr. Sarah: And no binocular vision capacity. I did not know that until he was 10 years old. So, he was nine at the time. And this chiropractor and I were chatting, and I just kept thinking, like, I wonder if this would help him. Zephen also just kind of struggled with gross motor coordination, but we also sort of attributed that to him just being a really tall, lanky kid. He's just, like, really tall. He's always had big feet, big hands, and he just kind of seemed a little clumsy as a little boy. And we would just kind of, like, laugh it off, you know, Again, I just was not thinking about the neurology behind this. I just, you know, thought, oh, he's just growing into his big, tall body, you know. He also totally avoided sports, so anything with balls flying through space or Frisbees, he just was like, nope, not interested in that. And we, you know, try to encourage him to try things out, but he just was, like, zero interest in sports. And clearly, he struggled to, like, catch a ball. Like, it was really hard for him to catch a ball. So, we just kind of thought, oh, he's just not a sporty guy, you know, Again, like, not comprehending what his visual experience was of moving objects flying towards him and unable to gauge timing because he had no depth perception. So, we were so. I feel, like, so slow. Like, I look back and think, how was I oblivious to understanding the neurology he was living with at the time and how that Impacted him. But again, I had sought out professional guidance. We were working with what we were told, you know, was the best specialist in our city. I just thought he had an eye muscle problem. I did not understand his visual perception of the world at all. And so, this chiropractor completely changed our lives. Her dad was a developmental optometrist.

Denise: Oh, wow.

Dr. Sarah: So, she had grown up with a dad. He must have been very, like, one of the pioneers in the field, I would guess. I mean, we're talking maybe 40 years ago he was doing this work. 

Denise: Yeah.

Dr. Sarah: I mean, 40 years later, still no one has heard of vision therapy. You know, her dad was really early on in this field, so she was aware as a child growing up about vision therapy and developmental therapies. And she ended up going down the chiropractic path but integrating these different developmental therapies into her chiropractic services. And so, I did have her assess my son and try her program for a little while. And she said to me, at some point, she said, has he always turned his right eye forward? And I said, I don't know. Like, I actually was unaware that he had this very significant movement of his head, turning the right eye forward. I just thought, oh, he does that when he's really concentrating. But I never, like, questioned it. And she looked at me and she said, Sarah, what we're seeing with his eyes tell us there's something going on in his brain.

Denise: Yeah.

Dr. Sarah: And that was like, the biggest light bulb moment for me, probably in my whole parenting journey. Like, honestly, that's a vivid memory. I'll never forget this moment in time where this woman looked me in the eye and said, this is neurological. 

Denise: Right. And no one's aware of those kinds of things, honestly.

Dr. Sarah: Well, you'd think a child psychologist might be

Denise: that it's missed. Those things are missed by doctors of all kinds. I've heard of medical doctors not catching them, you know, pediatricians.  It's across the board an issue. It's not noticed at any level.

Dr. Sarah: Right, And I'm fully educated in learning disabilities. Right. So, dyslexia, you know, auditory processing disorders, sensory integration disorders, all the neurodevelopmental disorders. And yet I knew almost nothing about the visual perceptual system based in the brain. Right.

And so, it's this weird kind of blind spot in mental health. And, you know, frankly, that's where I'm at in my career is realizing what a disservice we have done by fragmenting the healthcare system. So, we don't tend to work in Interdisciplinary teams. And I think we are letting children down in not having different professionals that have studied different pieces of the brain come together to integrate what we all know and help that child's whole brain develop to their optimal potential.

Denise: And so not just children, though. I have to throw this in because here I am. And I took advantage of the neuroplasticity principle for myself. Right?

My brain was not unable to learn how to see in 3D, and that's why I could do it at age 54 when I'm not seven.

Dr. Sarah: Right, right, totally. Yeah. So, imagine if you had gotten that exercise, you know, those tools and techniques to help your brain, you know, rewire the visual cortex earlier. Certainly, we do have neuroplasticity across the whole lifespan, but we have a slowly lowering ceiling of our neurological potential with age. And so, I really, you know, had I understood the root cause of why his eye was out of alignment and what that meant on a brain level, I would have been working with him in such a different way.

Denise: Right.

Dr. Sarah: And I would have been researching and just looking up, like, YouTube videos for, like, pointers and exercises to do at home. And so, you know, at age nine, we had this huge light bulb moment of me finally understanding that this was brain based, not muscular. And I'm like, oh, well, neurodevelopment is my thing. Like, this is something I understand now. I didn't have the vocab for all these eye disorder terms they gave me. I did not understand how to work with the musculature of the eyes, But I sure understood what the brain would need to grow the circuitry it didn't have. For whatever reason, whether that's genetic predisposition he has, whether he suffered an injury to the back of his brain when he had his big fall, whatever the cause, he was lacking neural structure. And that requires repetition after repetition, after repetition to teach the brain what it needs and slowly grow the neural pathways he didn't have. So that changed our lives. So, what I realized then was even though this chiropractor's program was really neat, he was not really her typical patient, right? He didn't have much measurable they could improve on. You know, he didn't have full blown autism or something where, like, we would see, like, major behavioral and emotional dysregulation be able to improve, or he didn't have learning struggles, or we would see that improve. What he needed was a vision therapy specialist. Right. And so, then I got online and looked up developmental optometrists, and the closest one is 45 minutes away from us. And we make that drive every other week. And we have done for almost four years, three and a half years. And we right away called and got on their wait list for him to become a patient there. So, he was 10 when we started with the developmental optometrist. They did a very in-depth assessment. I want to say they assessed him two or three hours over two different appointments and gave us an 11-page detailed report. 

Denise: That's amazing. 

Dr. Sarah: So let me contrast that to ophthalmology, right. Where ophthalmology is like 15 minutes, you're in that room with her and she's, you know, tracking his eyes and looking through her, you know, assessment equipment she has. And then like, okay, see you in a year. Yeah, see you in a year, you should do surgery. See you in a year. I never once got a report written from them, ever. I had no comprehension of what really was going on with him. The root cause. I would ask, what is his diagnosis? But again, those were words I didn't have vocabulary for to really understand. And there was no treatment plan.

Denise: Right.

Dr. Sarah: There wasn't a treatment plan, only surgery for his self-esteem. And so contrast that to this developmental optometrist who could not have been more thorough in looking at every possible thing to do with his visual function and writing this 11-page report of all the different tests he did, what they found, what percentiles he felon, and then treatment recommendations. And what I really, really appreciated and where I built trust with this doctor was he said, I know I can help Zephen with eye teaming and get his, his eyes to look more aligned. We can work on the aesthetics for sure. So that was more of strengthening the weaker eye, practicing his eyes tracking together using patching, but really strategically very different patching with exercises. Right. And he said, I know we can help aesthetically with vision therapy. And he said, had you done the eye surgery, we would have less potential to achieve good outcomes in that regard. So yeah, so that was really. He was, the developmental optometrist was really grateful that we had delayed surgery.

Denise: Yeah.

Dr. Sarah: And not that he said you shouldn't ever do it, but it was the fact that it's really good to do therapy first and see what we can achieve that way. And if we can't achieve what you need, then surgery.

Denise: Yeah.

Dr. Sarah: Right. So had we done surgery when he was say three or four years old, there would be artificial fixing of his eye muscles or shortening of the muscles to where now he actually has limited range in a sense. To work with that eye would be somewhat limited. Because the surgery would have just changed the organic natural structure of his eye. And so, the developmental optometrist said, it's good that you delayed because there's no limitation, really, to see where therapy can go. And if it doesn't get you where you need to be, then of course, surgery is still an option down the road. 

You know, I felt very anxious, defying the recommendations of an ophthalmologist, you know, to tell an MD, I'm turning you down on your recommended surgery. And I had to tell her that every year. Right, sorry, we're going to pass. We'll talk it over, we'll think about it, but we're probably delaying. You know, it's hard to defy a doctor and not just do as you're told. I think, you know, It's hard to be an empowered patient in the medical system. And I just, you know, to be validated by the developmental optometrist to say, like, it's okay that you waited. And actually, now that you're in therapy, it's probably okay. It's probably a benefit that you didn't surgically alter his eye yet. Right. So he was able to tell us that he thought he could definitely help his eye teaming and the aesthetics of how his eyes present as far as getting them to look more aligned. But he's the first doctor to tell me, he said, so basically, here's his long list of diagnoses, but basically what's going on is your son has 20/20 vision in both eyes, but his brain only uses one eye at a time. So, his brain was suppressing one eye or the other. His brain would sometimes suppress his more dominant right eye, but he never was seeing the world, or very rarely could see the world with any binocular vision at all. And so, he was essentially, over time, it was getting worse because he was having atrophy.

Denise: Wow.

Dr. Sarah: So as his brain is turning off the left visual field, he was actually, you know, losing capacity to use that left eye. And one thing aesthetically that was very clear was that by age 9 or 10, he had kind of almost as if he'd had a mini stroke, like, I mean, pretty subtle. But his left eye was slightly lower than his right. His left side of his face looked somewhat less developed than his right. And it was truly just his brain was not using his left eye, left visual field, those muscles equally. And so, yeah, so we started this journey and he said, we can help the aesthetics. And the doctor said, but I don't know. And I can't promise you that we can address the lack of binocular vision and therefore the lack of depth perception and 3D vision. He said, I won't tell you that's impossible. He said, it is possible, but it is much harder to wire the brain to obtain depth perception and 3D vision. He said, we can work on the musculature and the eye teaming, and his eyes will definitely look better. But I can't tell you where we'll get with our depth perception 3D vision goals. He said, those take more time, it's more difficult, and I won't make false promises, you know, which I really appreciated. I always want to know, like, I want realistic outcomes so I can make an informed decision. Right. And so, I thought, I thought he was so respectful to us as parents. To validate like this is significant, you know, your son has a very significant situation. I know we can help with that self-esteem piece, the aesthetics piece, but really getting his vision to, to have, you know, functional depth perception is a lofty goal and will take a of time. So, we were all in though, right? We're like, well, gosh, you know, in lieu of surgery, we're absolutely, you know, on board with doing therapy and seeing if we can get him to a place that surgery would have given him, but more naturally, right? to where, like, he's actually building up that left eye, not just surgically affixing it. So, you know, we were very committed to diving into vision therapy at that place and seeing where he could get, at least with the aesthetic school of having his eye be strengthened and have it team with his right eye better.

Denise: Right. Which you wouldn't have necessarily gained aesthetically if you had done the surgery route.

Dr. Sarah: Well, yeah, it was possible, right? It was like it might make his eye look more normal and it might not. Right.

Denise: Right. But the function was not something they promised when with this.

Dr. Sarah: No, it was a guaranteed, guaranteed not functional benefit is really. I mean, it was not to help his vision. It was just to help him look more typical so that he would have better social confidence. Really is what the, the ophthalmologist was offering, which did matter, you know. And I'm curious, you know, if he had been a little girl in this society where beauty is such a, you know, our symbol of worth as a woman in this society is often around beauty. And I wonder if he was a little girl, if he would have felt differently. I also wonder if he had been bullied or teased about his eye, if he would have been More compelled to want to do surgery, but he emphatically didn't want it. The outcome was questionable. Certainly, it was going to cost a lot. You know, we're self-employed, so we, you know, have only catastrophic health insurance. And so, we knew surgery would cost quite a lot and therapy costs a lot too, but it's more of a cost spread out over time. So, we just decided therapy was the thing to focus our efforts on and see where it could go for him. Yeah.

Denise: Right, let's go through the diagnosis because I think there have been a few places I've seen people asking about specific things like that. And so, it's helpful to say, oh, he had all of them, not just a couple, right?

Dr. Sarah:Yeah. So, this is at 10 years old, the report from his assessment from the developmental optometrist. So, the first diagnosis was alternating exotropia. And that means that both of his eyes could turn outward and that's a form of strabismus. He also had left eye vertical strabismus. So that means his left eye would be slightly lower than his right. He had vertical heterophoria, which is a vertical misalignment of the eyes. And that is a type of binocular vision dysfunction. So again, if one eye is low, he's not getting binocular fusion. So, he also had suppression of binocular vision, meaning his brain was suppressing one eye at a time. So, he only had monocular vision regardless of which eye. He wasn't having combined binocular vision. He had fusion with defective stereopsis. So that meant it was an inability for his brain to fuse together the images from his two eyes. So even if you could get both his eyes pointing in the same spot, his brain wasn't fusing those images together. So Zephen was also diagnosed with fourth nerve palsy. And that was the tilting of his head, turning his right eye forward, which is an accommodation his brain would make to actually see better. And then his last diagnosis was called spasm of accommodation. And that was trouble adjusting his eye muscles to transition from focusing near-to-far. And so, a lot of exercises we did early on were called fizzy dip, and that was looking at two objects and looking at the near one, the far one, the near one, the far one. So, we did a lot of fizzy dips, and we did a lot of tracking. So having him, you know, look over here at this object and then we would switch and look it to another object. So, I was doing lots of therapy with him at home with tracking and doing near far focus. We started doing a lot of Brock string work. And that meant in the beginning that he could only do the Brock string with his right eye forward. That accommodation was necessary. And then we tried to get him to start moving his head towards center and eventually moving his head with the left eye forward. And so, it took a long time, but we did a lot of Brock string work and then also a lot of Marsden ball, which is this ball that you hang from the ceiling. And you start with kind of gross motor tapping hand by hand and then fist and fist and fingertip and pencil eraser. So, trying to get more and more accurate, kind of moving target, you know, hand, eye, hand, eye coordination, touching this moving ball. So those were a lot of the early things we did. And it just kept expanding from there. The therapies we've done.

Denise: So, you did the Marsden ball at home then?

Dr. Sarah: Yeah, yep. So, we got the backpack full of all his gear, and it had the red-green glasses, the 3D vision glasses, Brock string, the Marsden ball. And then we would use different tracking objects, just like colorful pens, you know. So, I have like a red pen and a blue pen. And he would track those? Yeah. And then there's also transparency sheets he works with to try to do convergence and divergence with his eyes. So, we've just used like lots and lots of different tools and they'll just keep mixing it up. And usually what we were doing was five days a week of homework, about 15 to 30 minutes. But I would say we averaged about 20 minutes of homework a day. And the treatment goal or the treatment plan, I should say, was the optometrist recommended 56 to, to 72 vision therapy appointments. But he said we'll probably need to break that into two different kind of chunks of treatment, two different stages because of burnout. It was kind of like, I think if we do the first maybe, you know, 32 or, you know, 40 therapies, we can work on that teaming and the more aesthetic school of having his eyes look aligned. But the optometrist kind of thought that's hard. It's hard for a 10-year-old to do 40 therapy appointments. And chances are you guys will need a break, But I'd love for you to come back and do stage two. And that's where we can hope, like fingers crossed, to make some headway in depth perception and 3D vision. Usually, vision therapy is once a week for 45 minutes. They we have an hour. So Zephen does 45 minutes of therapy one on one with the therapist. I come in for the last 15 minutes to talk about progress and homework and kind of my support role, you know, for him at home, how I'm going to support his homework over the next week. This was In January of 2020, when we started vision therapy. So, we did all of, like, eight or nine appointments. And then Covid started. 

Denise: that’s so hard.

Dr. Sarah: And, yeah, so we were like, we finally found our specialist. We're finally into therapy. Like, we're pretty, like, got the ball rolling with motivation and a plan, and then everybody, everything shut down. And so, they tried to do telehealth vision therapy with us for probably six sessions. And it really just is not a format that works with vision therapy. You really need your therapist right there with you. There’re all these props. You know, we're using all these tools and props. And we were trying to kind of wing that at home through the laptop. And I mean, just really wasn't working. And so, we decided out of anything we were willing to continue to risk, you know, Covid exposure for it was vision therapy. But they agreed to let us just come every other week. And so, it was because of Covid we were able to reduce frequency. They normally would not recommend that, but because of the health crisis, they agreed to just say every other week. And I actually, in retrospect, look back and think that was a bit of a blessing, because what that means is that. That we've been taking a marathon approach versus a sprint, and we have found that we can sustain that level of commitment. 

Denise: Okay

Dr. Sarah: So, we're now at, I believe, like, 85 consecutive therapy appointments over three and a half years.

Denise: So, you didn't even take a break then, right?

Dr. Sarah: No, so we never have taken a break. So, we kind of just. Just pursued, you know, moving forward. And we, you know, there wasn't a stage two. We've just persevered and stuck with vision therapy. I think the optometrist is always surprised that Zephen is willing to continue. Like, he's anticipating burnout every time we go see him. And. And I won't lie, like, there has been ups and downs of Zephen's emotional resilience, dealing with the burden of homework and therapy appointments. You know, how I manage that, Denise, is I have just always tried to make that and feel empowered in the journey he's on. You know, it's. It's his body, it's his vision, it's his struggle to overcome. And I just have always supported him leading the charge. You know, it's up to him how we navigate this, for the most part. My role is paying for therapy and driving him there every other week, you know, for you, five minutes each way and a reminder every day about homework. I just check in with him. Of course, when we started, I was doing homework with him, more hands on because he needed, you know, the, the person holding the objects up or, you know, giving him feedback. But now at 14, he's almost 100% independent with his vision therapy. And so, he even has an alarm set to remind him every day to try to not skip therapy. So that's just our, increases our chances he'll remember. If it's nearing dinner time, I'll just check in with him like, hey, did you get therapy done today? If he's burned out and he has a reaction of like, oh, I forgot, oh, you know, and I can just see the, the, you know, the burden of thinking about doing those 20 minutes of homework. Then occasionally I'll just say, hey, you can take a day off. You know, like taking a day off is not going to make or break your therapy outcomes, you know, and I'd much rather him feel less burdened, less frustrated and take a slow, steady approach than have any conflict over it whatsoever. I just really tell him like, if you need to take a break, take a break for a long time. If we missed a homework day during the week, we would try to do a catch up on the weekend. And I don't really do that anymore. Like Monday through Friday, Friday are our therapy opportunities, you know, and if he needs to skip a day, he skips a day. And then I would say over the winter he was just kind of not looking forward to therapy appointments. And we started having the conversation like, do you think you're done? You know, do you think you're just ready to take the progress you've made and kind of call it? And he said, I don't know, like he's really like unsure, you know, if he wants to continue ongoing. So, the goals are, is he coping? Like, is he not getting too burned out? If he can handle it, we're going to keep going. And then the other assessment is, is there any measurable progress? Because the doctor's been very honest that he will probably hit a ceiling where we just don't see much more gain. And the very first ceiling he hit was our last assessment. So, every, so we assess with the optometrist every eight therapies. So, because we do every other week, it's roughly every four months. And every single assessment for three years he had measurable progress. Just, I mean, I should say really small gains, right? It's like he's just inching in the right direction, not seeing his ability forward, but there was always measurable gain. And I think whenever Zephan could get feedback to say, hey, you only could see, you know, two of those. Last time you saw six of them. This time, when they're doing some of those 3D, like the blue- red rings you look at, they used to be he could do zero, then he sort of could get the first two, and they get harder as you go. Well, now I can see like eight or 10 of those. And so, I think just him getting feedback to say, hey, you did make progress. You could do a little bit more this time. It seems to, like, recharge his motivation batteries, you know, when he gets that feedback. So, this last reassessment we did, he had kind of just the same outcome as the last assessment and had plateaued. And then Zephen said, well, I think I've been slacking on my homework. So, you know, at this age, like, I'm not micromanaging, you know, I'm just really respecting. I'm reminding him, but really he's more independent with the homework. And so, the doctor said, well, do you think you're done or you want to take a break? And. And so Zephen and I talked it over, and he said, I do think I was skipping more days and maybe instead of doing five minutes of each exercise, was doing like two or three minutes and, like, calling it good. You know, he had just kind of taken some shortcuts. That's just kind of, you know, burnout. Just.

Denise: Yeah, we would expect that to happen after this length of time.

Dr. Sarah: It's hard. I mean, well, and you think about, like, if you have an injury and you do physical therapy, it's really motivating when you're in pain because your body reminds you, like, do your PT or whatever. But when you don't have noticeable, you know, struggles or. Or discomfort or limitation, it's really hard to feel like, why do I have to do this all the time? And, you know, Zephen is lucky in that he never had any major symptomology other than some gross motor spatial awareness stuff and avoiding sports, you know, but otherwise, he's never had headaches, double vision, blurry vision, trouble reading, fatigue with reading, learning, just, you know, disability or struggles. Like, he never had any of those outward difficulties. He was very fortunate. And so, I think sometimes it's hard for him to know that he has made progress because it's just like such a very, very slow transition of functional vision that he. You can't. I mean, if we could turn off his progress and go back to how he saw the world four years ago, maybe it would be obvious to him. But it's so little over time, you know, it's hard for him to feel the benefits of therapy and how he's living life. Life. So anyway, he decided. So, at our last assessment after therapy, number 80 is when we reassess every eight visits, we decided, I said, would you be willing to just push yourself to do all your homework? You know, let's get back on the homework commitment and push yourself a little harder this next four months when we reassess after therapy number 88, if you've still plateaued, that will give us confidence to know if maybe it's time for you to graduate. Denise: Right, 

Dr. Sarah: Right. But if he pushes himself and commits to doing all the homework and he's made another step forward, we have more functional progress. Next assessment. You know, he's still committed. He still wants to maximize his outcomes. So, we'll see. We'll see where that is in another month or two. And so we might be about ready to graduate and we'll, you know, we're just curious to see where it goes for him. 

Denise: Yeah. Awesome. So do you feel like your background as a psychologist has. Has been helpful to you as you've navigated this journey?

Dr. Sarah: I mean, I wouldn't have thought so early on. You know, it's again, that fragmented healthcare system of, like, well, I don't know, eyes. You know, eyeballs are not my part of my body that I know how to work with. Right. And this, this blind spot, I had to realize that his visual, you know, issues were neurologically based. And so, once that became clear to me, then it really, you know, kind of lit me up to pursue understanding this more. And so, reading more about brain development around other areas, not mental health. Right. So, I've read books by some chiropractors and body work experts, vision experts, and just trying to really educate myself more to understand what we're doing and why and kind of the root cause. Right. What's going on at root cause in his brain. So, I do feel like probably just understanding neuroplasticity and really understanding that a marathon approach is probably ideal. Right. That the slow but steady endless repetitions is really where the progress would come from. Like, if we had crammed 80 therapy sessions into one year, that would not give him the same outcome as 80 therapy sessions daily, 20 minutes of homework over four years, like, the potential to rewire the brain with a slow but steady repetition program. You know, that's helpful for me to understand. Like, it will take time and consistency. 

Denise: Yeah. 

Dr. Sarah: And so that is helpful. I think it's also helpful for me to help Zef and understand why we're doing this. So, here's a good example. So, two years into therapy, we had really made huge goals with his eye teaming and aesthetics, and the strabismus was drastically reduced, but we still had no 3D vision at all. And his therapist recommended a program called HTS, which is home therapy system. And so, what we were stuck on is Zephen would go to therapy, but only every other week. Part of the therapy was doing what's called randot. And they have this, you know, high-def TV screen, and it has a square made up of random dots. I assume that's what randot probably stands for. So, it's a square made up of random dots. Dots kind of stuck together. When you put on 3D glasses, then you see an image pop out at you. A 3D image will come forward, and your job is to say, is it up, down, right, or left? So, to identify the location of the 3D image coming toward you. Well, Zephen had zero perception of that. He did not see any square within the square. Nothing looked forward or back for him. It was just random dots, thoughts. And he would try to do this in therapy. It would be a strikeout every time. Just nothing there for him. And his therapist said, you know, I think if he did HTS at home, like, he would have chance to work on this five days a week, you know, at home. He's like, it's probably not as good the home program compared to our technology, but it would give him chance to practice. So, we signed up to use HTS and it was like six minutes on two different randot tasks. And Zephen is looking at the computer screen like, why am I doing this for six minutes? Like, I have. There's nothing for me, like, zero. Like, I cannot see anything. And what we realized was like, okay, six minutes of that is tedious. Like, that's frustrating and too much. And so I think we reduced it to like a two-minute goal. Can you just. And I'd say, Zephin, you just want to keep staring at that image. Just stare at the image. I'm like, I know it feels pointless, but your brain is struggling to perceive something new. And slowly, if we keep trying this over and over and over and over and over and over again, maybe your brain will start to perceive depth in there. And Denise, that was one of our just beautiful, shining moments. Was probably three months after starting HTS, I went in at the end of his therapy appointment, and his therapist said he saw randot today.

Denise: That's awesome.

Dr. Sarah: Yeah. I mean, it just, like, makes you want to 

Denise: so emotional 

Dr. Sarah: It just. Yeah, it is. It was so. I mean, like, I’m like hugging the therapist. Excuse me. You know, And Zephen's kind of like, well, it's not that big a deal. And I'm like, it is a big deal. It is a huge deal. I said, said, you have been working so hard, like, five days a week, staring at the computer screen, like, wondering, like, why do I have to stare at all these random dots, you know? And I said, you are wiring your brain to have 3D vision, and it's happening.

Denise: Yeah.

Dr. Sarah: So that was like, a big, just huge breakthrough moment for us. And. And I'll tell you, like, he does not have normal 3D vision still. You know, like, that is still slowly emerging. But there is an assessment they do on depth perception, and essentially, when he was 10, he had none. Like, it's like these. I don't even know there's numbers on a scale of functional depth and how high, you know, how well depth perception can get. Well, he had zero. Like, he was like, not even on that chart. And then you can notch up a little bit and have a tiny bit of depth perception, but there's a threshold you cross in which they. To consider you having functional depth perception. And he has far surpassed that mark now.

Denise: Great.

Dr. Sarah: Yeah. So. So that is huge. And for me, I'll tell you honestly, Denise, what's driven my commitment as his mom is thinking about him driving a car. Denise: Yeah. 

Dr. Sarah: So, you know, he's 14. Within a couple years, we're going to be embarking on driving a car at 60 miles an hour, flying down the road. And that's worrisome. I mean, I realize people out there are driving that have strabismus or even only have one eye. I know that it is possible, but I only can imagine that his risks are going to diminish and his safety capacity will improve the more depth perception that he gains. And so, I just always think about that, and I just want to. I just want to know we did everything possible to help him be safe out there.

Denise: Yeah.

Dr. Sarah: You know, not just for his own safety, but for everyone else on the road with him. You know, it's like you can harm someone else if you cause an accident. And I just feel compelled to know that we just totally committed to doing whatever we could for him. Yeah. And I, and I should say developmentally, as a psychologist, another driving piece is understanding how the brain wires over time. So, I wish I had known about vision therapy when he was, you know, maybe four or five years old. It would have been nice. But the fact that we became aware and started therapy before age 12 is really valuable. So, until about age 12, the brain is kind of building kind of scaffolding, you know, like a broad potential for brain structure. But around age 12 is when the brain starts pruning. So, whatever you're not using then in neurological structure, the brain will actually start pruning away those neuronal pathways to make room to expand into expertise for the things your brain does use. It's kind of like why learning foreign language is much easier in childhood and then is much, much more slow and difficult into adulthood and has a different ceiling. It's hard to become fluent in a foreign language as an adult, but a young child can easily become fluent in multiple languages. And so, his optometrist had said, you know, probably would have been nice if you had started therapy maybe around age 8, he said, but it's really hard to do therapy with like 4 and 5-year-old little kiddos. You know, he said, we do try and we do some stuff, but it's such hard work, it's boring, it's tedious. They have limited attention or willingness to do the work. And he said, you know, you know, would have been nice if you started a little bit younger, but we're good, like starting at 10 is good. And so I just have always felt like we got in soon enough, you know, to kind of maximize, giving his brain opportunity to want to continue to build the neural structure in his visual cortex and that will just enhance his capacity to have, you know, a higher ceiling as far as where his vision potential can end up. So, that helps me a little bit, you know, knowing a little bit more about brain development, knowing emotionally how best to prevent his burnout and keep him motivated. So, I think that helps a little bit just like that I've tried to navigate this strategically so that he has a voice, he feels empowered, there's a little bit of flexibility, like there is sort of expectation, but it's not rigid and it's not ever going to lead to conflict or punishment if he's not doing the work. I just try to keep it as positive and low stress for him as possible while keeping the consistency there. Checking in every day, little reminder, little encouragement. But when I'm sensing burnout, giving him like a little break and then seeing if he can re-motivate himself. Because I really do not believe a parent could force this on their child and have much treatment success because it would just be a daily struggle, I think you teach piano, is that right?

Denise: I do, yeah.

Dr. Sarah: So, it makes me think about how many families I've worked with where the parents fight with their kids to practice their piano stuff every day.

Denise: Yeah.

Dr. Sarah: And, and there's anger and conflict and no TV until you do your piano, you know, And I think as a parent, it's a losing battle to try to force your child to find motivation for something thing they really need their intrinsic motivation driving them with the sense of personal value to them. Right. And so, I've tried to, I guess, be intentional in helping Zephen want this for himself and find his tolerance point so that it's sustainable and doesn't, you know, lead to worse self-esteem. I don't want any sense of failure for him. I just want him to think about the marathon, you know, slow and steady approach forward, him having a voice to set boundaries when he needs a break. I also encourage him to give feedback to his therapist, you know, so I don't want to be speaking for him if he has a complaint about therapy. I always tell him like, hey, you should let your therapist know about that and troubleshoot with them or find out, you know, what your other options are or, you know, just, just I really want him to have a voice and learn how to advocate for himself. So, you know, probably some of that parenting is, you know, because of the work I do and understanding kiddos and behavior. But yeah, you know, what's shocking to me is that I was so blind to understanding, you know, that this was neurology and that I could have been working with him in a different way and I should have been studying this, this from a brain-based perspective early on. And I really just didn't understand why my son had a vision problem or what. I felt totally disempowered. I did not think I could help him. And nobody else was offering us help.

Denise: Right.

Dr. Sarah: I felt very powerless, you know, like this is just kind of, you know, a disability and like how it's going to be for him.

Denise: And we’re told that all the time. Right. That, that's my story with my daughter too.

Dr. Sarah: Yeah.

Denise: The doctor all the time. I mean, I didn't take her to an ophthalmologist because I didn't see surgery as an option for her anyway. Right. But the optometrist would always tell me she was fine. Told me I was fine too, actually, you know.

Dr. Sarah: Yeah. So even within the medical profession and of ophthalmology, optometry, like regular optometry, a lot of those professionals don't have an awareness, I should say. Oh, go ahead.

Denise: Well, they, they profess to have an awareness sometimes. The doctor that I did go to said he had a background in vision therapy and that we didn't need it.

Dr. Sarah: Oh, interesting. Oh, interesting.

Denise: That was appalling to me too.

Dr. Sarah: Yeah. So I was, you know, able to talk with his ophthalmologist down the road once we had started vision therapy. And I asked her, I said, I'm curious, like, why you never recommended therapy for him. You know, had I known that was an option, I really would have liked to have started that younger. And her response was just, well, oh, yeah, I've heard of it. But the outcomes are sort of iffy. You know, therapy may or may not help and it's expensive. And, and my feeling was, well, first of all, don't make financial decisions for my family because, like, we're going to decide how best to spend our health care dollars. Right. And it's not like surgery is free. Right. So, she wasn't worried about cost when surgery was the push. And it is true we have spent a lot of money on therapy, but again, it's spread out over, you know, over time. As far as budgeting, you know, we've been able to spread reducing therapy every other week, but extending the, the long-term plan and then whether or not it's effective, I felt like, well, shouldn't we be given the opportunity to try?

Denise: Yeah.

Dr. Sarah: Because without being able to try therapy, there's a guaranteed you're, you're not going to progress. You know, if anything, Zephen's situation was getting progressively worse because again, the brain is neglecting neural structure. It needs to be exercising. But to have a better monocular view of the world, it's suppressing the, the left eye, typically because it was not getting a fused image. Right. So, the brain's trying to navigate kind of scrambled data coming in.

Denise: Right.

Dr. Sarah: And the brain's response to that is just to shut down one eye. It's way better to have one monocular clear view than a distorted binocular view that's not fused together correctly. So, I would not doubt that therapy is not effective a lot of the time because people don't do the homework and commit long enough term to build the neural structure they need. I think every therapist from every field has that experience, right? So, if you talk to a speech therapist or occupational or physical therapist, they'll say all, okay, mental health therapy, same thing. It's really hard to do the work at home every day like you need to. And so, I would not doubt that a lot of people might try vision therapy, do their 45-minute session, not do any of the homework, and just not see a payoff. You know, I'm sure that that is possible for people, but what if we were willing to do the work and put in the time and financially prioritize the therapy in our healthcare budget? And what we have achieved for Zephen is. It's priceless. I mean, it just. It's really priceless. You know, it's. So, here's another just beautiful moment for me as a mom through all this. So, my kiddo has avoided sports his whole life, right? 

Denise: right

Dr. Sarah: We've done other things. Let me just say, if your kiddo doesn't like ball sports, we have done a lot of swimming, jiu jitsu, parkour, like, other things, you know, just kind of hiking, you know, like, we just try to make sure he has other, like, exercise and physical outlets that don't involve balls flying through space at him. Right. But, essentially, my kiddo, he's 14. He had never swung a baseball bat ever. Like, I. When I realized this, I went, oh, we probably should have at least tried that, you know, like giving him a chance. But as a little boy, at least, he probably would have been uncomfortable and just avoidant. And my guess is he would have had zero success if he tried to hit a ball with a bat. Like, ping pong was really hard for him. You know, just timing, that was so hard. So, we were at a graduation barbecue, literally like two weeks ago, and there's this big group of people at this family barbecue. He doesn't know very many of them at all. And we're at a park and there's a pickup game of softball. And he got out there, and I'm like, looking at my friend going, he's never played baseball in his life, like, ever. And I was nervous. I'm like, this is a big deal. And I had this mom fear. Like, this could be really embarrassing for him, like, that he can't hit the ball, right? So let me tell you, he had no, like, his form. Like, people were like, you can't stand on home plate. You have to stand, like, to the side of home plate. You don't face the pitcher. You turn to the side. I mean, he had to get like, just basic coaching. And that's where I felt some parent failure. But he got in position and Denise, he hit the ball three times. So, he had two  fouls. But he made contact. He made contact. It was just slightly outside of third base. So, two foul balls. He hit the ball and got to first base.

Denise: Nice.

Dr. Sarah: I need, as, you know, and for everyone else watching, they're probably thinking, like, boy, that kid's not very good at baseball. And I'm sitting there going like, this is like winning a gold medal, you know, like, he not only had. Okay, talk about self-esteem and self-confidence, he not only had the courage to give it a go in front of a big audience of people.

Denise: Right.

Dr. Sarah: But he made contact bat to boss. And not just once on fluke, but three times at his first up to bat.

Denise: Nice.

Dr. Sarah: And got on base, you know, and it didn't take 20 strikes before that happened. It was like, I think he had one strike, two fouls, and got on base, the, you know, the third hit. And that's like, for me, just priceless again, because had we not done vision therapy, I'm not sure he would ever have been willing to participate in a group activity like that. And he would be sidelined, right. Like, he would be sitting on the sideline watching other people having joy and feeling limited.

Denise: Yeah.

Dr. Sarah: And I was just so proud of him, you know, like, just like, oh, my gosh, like, I can't even believe he's willing to get up there and try. I'm really nervous for him. And he totally succeeded, you know.  It just. It's very heartwarming. And like, I just want to go tell his optometrist, you know, and his therapist, like, you guys, we had a big breakthrough, you know, because they're always so sincerely joyful for his progress and they've just been so supportive of him over these years. We've been really, really lucky to feel so well cared for by his vision therapy team. Yeah. So, yeah. Yeah.

Denise: Well, I like to tell people, and I think this may be something that I take as a motto or a tagline or something like that, but I read so often people say vision therapy didn't work for me. I tried it, it didn't work. Right. And I. And I think, well, either you didn't do it long enough or like you said, maybe they didn't do what they were supposed to at home or a combination of the two. Right. And honestly, vision therapy didn't work for me either. . .Until it did. Right. And when it did, it took figuring out what we needed to do. Right. Which for me was a bunch of therapy, surgery, and some more therapy. And if I had been less against surgery, maybe we could have made that happen faster, I don't know. But it had to happen the way it did, for a lot of reasons, I feel like. Right, But. And I'm okay with that, but my daughter, who was my carbon copy, only needed the vision therapy.

Dr. Sarah: Wonderful.

Denise: So, you know, it. And it can look different for everyone, right? It will look different for everyone because everyone has a different diagnosis.

Dr. Sarah: Right.

Denise: And everyone has a different situation, different ages and different. Whatever. Different doctor, even. I mean, sometimes it's finding a different doctor, but there's still a solution out there.

Dr. Sarah: Yeah. And I would say, yeah, if one vision therapy specialist can't help you, you might see there's another one. Because there are seemingly countless different activities and therapies they use. Right. So, I'm always amazed, like, oh, like we haven't used this piece of equipment before, and we haven't had this chance to practice 3D vision in this way yet. I mean, they have such a broad toolkit. And I'm sure, just like any therapy field, each person has their preferred tools and preferred techniques to use. But someone else might have a new strategy or something like the HTS computer program, you know, where they might offer you the right tool for your situation. And it's a really diverse field. The same with mental health therapy. If you go to mental health therapy and you don't get good results or good care and you don't make the progress you need, shop around and keep trying, because we all have a limited toolkit from a vast knowledge base, and you just got to find your right fit of provider and they can hopefully meet your personal needs. Another step that Zephen did, I should mention, that was, I think, very helpful for him. He had 20/20 vision at age 10, and so they didn't recommend glasses. But when he grew a whole bunch, you know, going through puberty, he got just slightly nearsighted. So, he can still see just fine without glasses, but he was just a bit nearsighted, as tends to happen, you know, as we grow into our adult body. And so that kind of gave us the option to now start wearing glasses. And he started with prisms. And so, the prisms, because he has the vertical strabismus, right. So, his eye tends to go up or down out of alignment. The prisms essentially force his eyes to pull vertically into alignment. So, one prism is above the lens, the other One's below the lens, and it pulls his eyes into central vision. And so that, I feel like, is a passive therapy for him. The. The prisms are kind of all day, every day, helping his brain resist that vertical strabismus.

Denise: Okay.

Dr. Sarah: And so, I think that was also helpful. And then the goal is to reduce the amount of prism he has over time. And within one year, we dropped his prism from a six to a five or maybe from a five to a four. I can't remember. I think a five to a four. And then that's kind of plateaued. Like, he still needs about a level four prism, but there's a chance and a hope over time that he will continue to need less kind of, you know, support through prisms, that his brain will continue to be able to hold that vertical alignment better without needing prisms. 

Denise: Yeah

Dr. Sarah: So, we've just had so many pieces of the puzzle come together, you know, from first of all, learning this was neurological to doing lots of, kind of, kind of like physical therapy for the eyes, right? So, all of the teaming, tracking Brock string, the fizz dip, near and far exercises, practicing convergence. Right? So, getting his eyes to. To converge into, like, crossing your eyes. So, it was a lot of mechanical work. And then moving into prisms to help with the strabismus vertical alignment. The HTS program, I really think helped him be able to start getting 3D vision in depth in a different way. And we're just keeping on forward with, you know, just. Just pushing his ceiling as high as we can, you know, and. And I think, you know, chances are maybe we're time limited at this point with ongoing therapy. He might go back in adulthood, though, right? So, I think it's feasible that he can keep working at home on his own, which I, you know, I don't know. I heard in one of your interviews that some people regress, right? They have made gains with therapy, and if they don't keep doing some work at home, they might have some regression. So that's feasible. We don't know, you know, how well he will sustain all of his progress. I'm very excited to learn about the, what you showcased, the virtual reality EqualEyes software that looks fascinating to me. And I'm wondering if, when we do decide, you know, we're kind of done with ongoing therapy, if Zephen would be willing to do some of that VR, you know, therapy on his own. You know, it seems like you could build into your weekly regimen, like two or three times a week. I play some of these vision games you know, just to keep challenging the brain. And it sounds like that man's experience is that he, in his 50s, is also getting progressively improved 3D vision, you know, through his own software he developed. And so, I'm really excited to learn about that for potential mainstream maintenance therapy for Zef. Yeah.

Denise: Yeah, there are a lot of options out there. And I think most of the people who I've talked to who did, especially if they've done it later in life, maybe not so much with the kids, but just need a little support to. stay where they are or to make more gains. Because it wasn't programmed in at the very beginning.. Right. So, like, for me, I have to do things ongoing to remind myself how I'm supposed to be seeing. So, yeah, I think it's reasonable. And I. Yeah, honestly, I think a lot of people negate the effect that they can have on their vision by being proactive about it.

Dr. Sarah: Right.

Denise: You know, we say, oh, I'm gonna need reading glasses.

Dr. Sarah: Right?

Denise: Yeah, I don't believe that for a second. And so that's why I do things on an ongoing basis to relax my eyes and encourage them to not need reading.

Dr. Sarah: Yes. So here I am in my mid-40s, and everyone is like, oh, I need reading glasses. Oh, I. I'm. You know, I'll go to a restaurant with my girlfriends, and they're like, oh, I'm really, like, noticing I can't, like, see in. In poor lighting like I used to. And I'm so aware, like, I'm doing my own vision exercises to prevent that, hopefully. So doing the focus as far away as I can when I'm outside and then focus really close up in front of my face and just do full range of motion with my eyes. And, yeah, I think just. Just, you know, again, why don't we know about this possibility? You know, we talk about it's so important to exercise as you age and, you know, like, these different things, but we don't talk about the eyes and our choices available to keep our eyes healthy and our vision strong. And, yeah, you don't need a disability to benefit from a lot of these activities. I think they're just really wonderful things for everyone to work on. So, yeah, the more I learn, I'm just, you know, I'm truly excited about the field of developmental optometry. I try to let people know, you know, if they're having headaches when they read or, I know a few adults that have strabismus and have never gotten any help at all and typically they don't care to drive because driving is so scary. And so, I just try to spread the word and encourage people to at least get an assessment done and learn some home activities you can do. Even if you don't want to do therapy, they can probably give you exercises in couple appointments and you can just keep working on those on your own time. So, I think, you know, it should be more in the public dialogue about vision, health and across. Not just in childhood like you said, but really across the lifespan. And yeah, it just seems to be kind of a blind spot. Spot in the public awareness and discourse around taking charge of our health and taking care of our bodies and. Yeah.

Denise: Yeah, well, thank you for helping me raise awareness today.

Dr. Sarah: Oh, it's such a pleasure. Yeah. I just, I feel just so incredibly grateful. You know, we're just so incredibly grateful that we've found a person who could point us in the right direction. And then we found our specialist to hold our hand through this journey, and you know, just, it's been worth every penny and every minute of hard work because number one, aesthetically, nobody would chat with my son and realize what he's been through. His eyes look perfectly aligned almost all the time. I think just as his mom, I'm the only one who ever might catch like, you know, just a slight misalignment and he can correct it. Like if I can point out to him, he can self-adjust now, but you know, socially, his self-confidence, his self-esteem, his facial symmetry, certainly he has much improved depth perception, you know, emerging capacity for 3D vision. I mean, the list of successes and important progress he's made over these years is life changing. I really feel it's life changing. And not just beyond safe driving of a car, but how he views himself as a person. His self-awareness, his ability to talk face to face with somebody and sustain eye contact. You know, there were things that were difficult for him, and I just feel it's totally changed his life having this huge privilege of being able to in a sustainable way overcome a disability he had. Yeah. So. And I think I can almost say that-- a disability he had.

Denise: Yeah.

Dr. Sarah: You know, and that's, that's, that's a big deal. So.

Denise: Yeah. Yeah. Thank you so much.

Dr. Sarah: I'm so grateful for your podcast. And now that I know about it, I will be telling everybody they should be listening and subscribing. I'll be spreading the word too, because I think what you're doing is such an important public service, Denise, you know, and if we don't know it exists, we can't get the help. Right? And had it not been for that chiropractor giving me that one moment of understanding the root cause for my son, this is his brain, right. If it had not been for her, I can only imagine what a different place my son would be in entering adulthood. Social self-confidence, needing to get a driver's license. I mean, I just have incredible gratitude to her and to you. Because if someone stumbles across this information, it could be their light bulb moment, you know, and it could put them on a path to healing. And I just think it's beautiful what you're doing. So, thank you so much. I really appreciate the invitation to be part of it.

Denise: Great. I'm just thrilled that we were able to do this today. And we'll go ahead and end today and I'll put in the notes the things that we, some of the things we talked about. And I wanted to also let people know that you do have a YouTube channel. And now that wasn't any part of what we were going to talk about today, but there are some, you know, things on your YouTube channel that people would be able to access as far as mental health.

Dr. Sarah: Mental health, yeah, thanks for mentioning. Always try to. Again, a little plug is great just to get the word out, but yeah. So, I'm a, you know, child psychologist and my awareness became very clear over the last couple years that there is an absolute epidemic unfolding in pediatric mental health. There is a concerning shortage of providers. It's very, very hard to find effective child mental health therapy. There are so few psychologists, and I do think counselors can do really good supportive work. But, you know, when we're talking about kiddos with autism spectrum ADHD, severe anxiety disorders, obsessive compulsive disorder, major mood disorders, you know, like it's, it's neurology. Okay. Like, we need people that can really help train parents to understand how to get their child's brain and nervous system to rewind care and therapeutic parenting. So not just loving your kiddo, but really being strategic in how you parent. And then I also study kind of functional nutrition. So how important it is to understand your biochemistry so that you can be, again, more empowered to reduce inflammation, have essential nutrients, have healthy fats to support your brains. So, all these things that, again, when I was in Graduate School 20 years ago, it wasn't talked about. And yet we have all this science now, and it's really hard to find providers that will give you all the pieces of the puzzle. That come together that lead to resilience and optimal mental health. And if you can find a provider, it's still unaffordable for so many people. So just like vision therapy is expensive, well, mental health therapy can be financially out of reach for so many families. And so, I did start a YouTube channel just about six months ago, and it's called Root Cause of Happiness. And that title comes from everything that I'm passionate about, that it's not that you're broken and you have a mental health disorder. There is root cause and there's a path to healing. And I just passionately believe that healing is within reach for just about everybody if they have the right knowledge, the right tools, and can get the guidance to implement the changes they need in their own lives. And again, it might take time. And we have to be patient on any healing journey, but there's so much science now to really show how we can heal the body and change biochemistry and rewire patterns in the brain, change nervous system function. So, yeah, so thank you for the mention. But, yeah, Root Cause of Happiness on YouTube with Dr. Sarah Morrow. And I'm just slowly trying to produce lectures as I have time. I think I have about 20 posted now. And it's just, it's my offering. It's a way for me to feel that I am offering my knowledge, my services to as many people as possible, and especially the people that either can't find a provider or can't afford care. So, thank you for the mention.

Denise: Yeah, it's awesome.  I think everyone will want to check that out as well.

Dr. Sarah: Thank you so much, Denise.

Denise: Thank you. And we'll see you another time.

Dr. Sarah: Thank you. I appreciate the invitation today. It was lovely talking to you.

Denise: Thank you for listening to the Healing Our Sight podcast. I'd love to hear from you. If you like this episode, please share it. And please join our Facebook community at Healing our site to leave suggestions or comments. Have a great day.