As I move forward through Optometry school, I am finding that many students (as well as faculty) have created this dichotomy within the profession: It is either ocular disease or vision rehabilitation. I challenge you to think outside of that… from the vision rehabilitation side, the options are endless. Here are just a few:
Total VT: This practice is the type of practice that has created this dichotomy. Your time is spent doing evaluations, vision training, and the follow up visits. With that, less time will be spent doing primary care, ocular disease, contact lens fittings, etc… Often this type works well in a partnership, as your partner can manage the rest of the practice population. The decision is yours to treat all aspects of vision rehabilitation or become specialized in a branch of it.
Just Basic VT: A great alternative if you have many different interests when it comes to practicing. This type of set up will allow you to practice a full scope of Optometry, but if you find a basic binocular/accommodation problem (e.g. CI, AI) you are able to treat it! Perhaps one day a week could be set-up as the ‘Vision Rehabilitative Day.” If a more complicated case comes on, you refer to the nearest O.D. that handles those types of patients.
Referral: Perhaps the most common (and most important!), you refer patients who you suspect to have a visual issue. This allows our patients to get the best care they can.
Sports VT: If sports are your thing, this could be the option for you! Here you get the chance to work with athletes training and enhancing their skills specific for the sport they play. The vision therapy is not your average, run of the mill Michigan Tracking training, but rather working on skills that include timing, dynamic visual acuity, eye-hand coordination, and peripheral awareness. How you set this up in your practice is up to you: you can specialize totally in this therapy or make it a small branch of your practice.
Head Trauma: This is sort of a ‘hot topic’ right now with the shift in attention to things such as soldiers coming back from war with visual issues, effects of concussions, and stroke victims. Although this is a difficult population to work with, it may be the most rewarding. This sort of therapy is not always conventional; often it requires thinking on your feet and modifying exercises for each individual patient. As with Sports VT you can incorporate this into a practice however you see fit.
The beauty of Optometry is you practice the way you want, tailored to what to suits your interests. Vision rehabilitation may not be your cup of tea, but remember it should not be something that you should write off completely. There are so many opportunities and outlets (these are just a few!) within this specialty that you really can make it what you want. The financial benefits take the backseat to knowing you are helping people function better, doing things that they would have never tried before.