This is just the begining.

What an exciting week this has been! As I sit in the airport, waiting to head back home to Michigan, I reflect on everything that has brought me to the moment I had last night…

Last night was the COVD 2018 Induction Banquet, where I, along with many other wonderful therapists, officially became a Certified Optometric Vision Therapist. It was a wonderful moment, and the perfect way to end a great trip surrounded by fantastic like-minded individuals in the field I am so passionate about. COVD (The College of Optometry in Vision Development) is so much like a big family that although I attended this annual meeting alone, I didn’t feel alone. We stood on stage, received medals, recited an oath, and shook the hand of quite literally everyone in the room (our cheeks hurt from smiling by the end)!

I have always been passionate about helping people, especially children, so when the opportunity to change lives as a vision therapist came to me, I lept at the chance. Then when the opportunity to start the certification process came, I knew I wanted to do that as well. The road to becoming a COVT is quite intensive. I attended seminars, studied A LOT, wrote 9 papers, passed both a written exam and oral interview, and of course kept up on patient care. While it is a lot of hard work, the process helped me to gain more in depth knowledge of many areas of vision therapy. Personally I love learning, so while the task seemed somewhat daunting at times, I can say that I definitely enjoyed it, and I am very thankful to Dr. Jacobi for both allowing and helping me to achieve this certification.

As with any seminar that I have attended, from my first one with Dr. John Abbondanza (whom I got to visit with last night!), to those this week, I have learned some great new techniques that I will bring back home to the therapy room, as well as enjoying new (and old) connections with some wonderful people in the field. Congratulations to all of my fellow new COVTs, as well as the new Drs of COVD.

Achieving this certification is not the finish is just the begining. ūüôā


How young is too young for VT?


Sometimes¬†people are surprised to hear that we work with adults who benefit greatly from vision therapy. Stroke patients, adults with eye turns and other vision difficulties have seen much improvement through a vision therapy program. We also work with children of all ages; even infants and toddlers. Not all offices work with children of these ages, and different doctors and therapists have¬†varying specialties, but we have¬†extensive experience with people of all ages –¬†from infants through¬†adults.

This is not to say that there aren’t factors that go into deciding if vision therapy is right for the patient. There are many things to consider, and we want to be sure the individual patient will see improvement in whatever symptoms he or she is having. The lovely little one¬†working hard in the picture above¬†is Olivia, and she was just 2 years old when she started coming to us for regularly scheduled vision therapy sessions.¬†Because of her maturity, diagnosis, and strong support system at home, Dr. Jacobi prescribed a therapy program in which she comes every 3 months to see him as¬†well as a vision therapy session,¬†then she¬†works with mom and dad¬†on her new vision therapy activities at home for 3 months before returning. This was a better approach for her personally, as opposed to our more typical weekly therapy sessions.

Thanks to neuroplasticity, we know that vision therapy helps people of all ages, but generally the sooner we address vision issues, the easier things will be for the patient. Infants and preschoolers have a visual system that is still in a formative stage, so vision therapy at this time can be greatly beneficial (Take Olivia, and Nadia from our previous blog post, for example).

Detecting and correcting vision problems when your child is young ensures they do not encounter unnecessary difficulties and labels throughout their schooling. Unfortunately, basic eye exams usually only test for 20/20 eyesight, and do not test any other areas of vision function, which are essential for learning. Undetected vision problems can cause significant difficulty for a child in an academic setting. As a child progresses through the higher grades, children with vision disorders often fall further and further behind their peers, continually requiring academic intervention and support services in order to achieve.

Many visual skills are essential for early learning, including scanning and eye/hand coordination (cutting, coloring, pasting, learning to write), depth perception (catching and throwing balls, spatial judgments, coordination, sports), visual memory (remembering colors, numbers, letters etc), and visual-spatial orientation (writing letters and numbers the correct way). Please see our preschool vision checklist below for more examples.

Just as all of our vision therapy programs are highly individualized to each patient, the same can be said for our work with infants and preschoolers. We would not do the same exact activity with a 2 year old that we would with an 80 year old, even though the visual diagnosis and/or symptoms may be similar. We know that children learn through play, so a lot of vision therapy for young children involves games that help to develop the visual skills that are lacking. This may include tracking, fixation, crossing the midline, left/right concepts, binocularity, fine and gross motor, and much more. That is why it’s important to see a developmental optometrist and vision therapist with experience in whatever area of expertise you are looking for…and with children especially, you can’t be afraid to have FUN!


Preschool Vision Checklist


From flat to 3d!

This sweet little girl is Nadia and she is 4 years old. When Nadia first came to us, she was unable to see in 3d and had poor depth perception, even at the lowest level. This was because Nadia had an eye turn, and her two eyes were not working well together in order to give her accurate and efficient binocular vision. Nadia’s parents brought her to see our Dr. Jacobi, who prescribed a 9 month vision therapy program (NO SURGERY!) in order to help her two eyes work better together and eliminate her eye turn. Her lovely parents bring her once a week for therapy with the vision therapist, and do their prescribed activities at home.

Nadia is progressing¬†very well. She¬†is not even halfway through her program, and when we tested her randot stereo today, she was able to do each section without issue!! This means that not only is she seeing 3d, but she is coordinating her eyes together at the finest level of detail in order to appreciate depth perception and 3d!¬†This is so exciting and we are so proud of you, Nadia! Keep up the hard work! ūüôā


Congratulations Grace!(:

grace piepho

Grace graduated our vision therapy program today! Both Grace and her mom have been such a pleasure to work with weekly throughout Grace’s therapy program. They were dedicated,¬†worked hard on the¬†home activities as prescribed, and there have been wonderful improvements! Grace came to us with debilitating headaches, motion sickness, anxiety regarding school and homework was taking 5 hours to complete with help. Now Grace is feeling much better, no more headaches, she has all A’s and B’s, and she is easily completing homework by herself in around 30 minutes! On her post VT evaluation Grace scored far above average on all of the perceptual testing that was quite tricky for her before VT.

Here is her mom’s testimonial: ” The VT program has been such a blessing for grace. It has released so much anxiety and worry for her in regards to her schoolwork. She is very capable of completing her schoolwork now without any additional help. She feels very confident in herself and it has reflected itself in her grades. Before VT Grace‚Äôs life was exhausting. School was extremely challenging and created so much anxiety for her. School was not a place she wanted to be because she couldn‚Äôt be successful, even though she knew she was smart. We all knew she was smart! After a year of VT a whole new world was opened up for Grace. The more therapy she did, the easier and more enjoyable school became. Her true potential was able to shine and schoolwork became easy. The anxiety was gone and a more relaxed and confident child emerged. She has maintained the honor role at school this past year and continues to show progress in all areas of academics!‚ÄĚ

Congratulations Grace, we are so proud of you!

“My brain is freaking out right now!”

Smith, NathanMeet Nate. He is a super sweet, smart 8 year old currently in a 6 month therapy program for Convergence Insufficiency. Here, you see him working with prisms on the walking rail. Prism lenses are a key component of vision therapy programs and are considered a medical device. They should only be used under the guidance of a qualified doctor.

A prism causes light to bend toward the base, which changes the location at which light falls on the retina. This causes a shift in the space the patient is viewing. Nate is wearing yolked prisms Рthere is a prism over each eye; both turned in the same direction (up, down, left, right). The first step of a yolked prism activity deals with awareness. I want to see if the patient is aware of the shift in space, and in what direction. Nate was very observant, and quickly told me which way things appeared to have shifted as soon as I turned the direction of the prisms. His visual awareness has grown a great deal in the last few weeks of therapy.

If you look closely, you can see the thicker part of the prism he is wearing is on his right, which means everything he is seeing appears to be shifted to the left.¬†This can make it quite¬†difficult to balance on a beam! As he tried to walk across the beam,¬†Nate¬†exclaimed “My brain is freaking out right now!” Which is kind of the point. This was another observant statement, as he was very aware of the mismatch he felt between what he was seeing and what he felt as he was moving through space. This mismatch can feel quite disorienting at first, almost like you are on the tilt-a-whirl and about to fall over. Imagine the visual and spatial skills you would obtain once you are able to not only walk across a balance beam, but doing so while your entire view appears to be shifted. Nate has learned some new skills so far in his vision therapy program, and¬†with this activity¬†we are working on his spatial awareness and ability to adapt. Because the prisms throw his vision into a state of disequilibrium, he needs to adapt and match his motor input to his new visual input.

Nate worked hard on this activity. Though it took a few tries and changes to his posture and thought process, the smile on his face when he managed to successfully walk the entire length of the beam was just another example of the pride and sense of accomplishment vision therapy patients feel as they gain new skills and control through their individualized therapy program…and that’s what this is all about. Great job, Nate!


What’s the difference between an optometrist and an ophthalmologist?

1f8e64ab768cff20fb8a8ac8ccc0046aOphthalmologists are medical doctors (MDs) who specialize in the health of the eye. When they assess vision, it is a confirmation that the eye is healthy and there is no disease. Their main focus is on surgery.

Optometrists are vision specialists (ODs, optometric doctors) who help people maximize the functional aspects of vision. When they assess the medical aspects of eyecare, it is because healthy eyes allow for better vision (with each eye and with both eyes as a team). Their training usually addresses the art of providing comfortable lenses for seeing with two eyes. They are also trained in the diagnosis and management of eye conditions and diseases as well as systemic diseases impacting the eye. It is a broad scope of training, and depends on the specific doctor and his or her specialties.

Pediatric ophthalmologists do conduct surgery related to eye-teaming. Unfortunately, vision rehabilitation and visual processing skills are not part of their training, and their opinion of vision therapy varies from doctor to doctor. Opthamologists are generally surgery focused, as they are surgeons. Unfortunately, surgery only corrects the cosmetic issue with eyes, and not the neurological issues of vision disorders. This is why generally vision therapy is the best treatment for an eye turn, or in some cases of a very large turn, a combination of surgery and vision therapy.

Developmental¬†optometrists who specialize in vision therapy¬†(“VTODs” such as Dr. Jacobi) undergo a considerable amount of post-doctoral training to enhance their understanding of vision development, visual information processing, visual rehabilitation concepts and techniques.¬†Certifications for this¬†include university-accredited residency programs and Fellowships attained with various post-doc organizations¬†such as the COVD (College of Optometry and Vision Development),¬†where Dr. Jacobi received his certification.¬†¬†Continuing education is also an important aspect of such certification.

If you or your child are in need of a comprehensive eye and vision assessment, I suggest beginning with a developmental¬†optometrist, especially when¬†there are problems which interfere with the ability to read, learn, comprehend, or even to pay attention. Sometimes, a person can have a vision disorder without realizing it, and a developmental optometrist can implement things to correct it before it becomes¬† a bigger problem for the patient. Most optometrists assess sight at distance and don’t test vision, eye teaming and sight and vision¬†at near (where kids spend most of their day looking). When managing strabismus (eye turns) or amblyopia (lazy eye), I¬†again suggest¬†a VTOD for a more¬†complete rehabilitative approach.¬†In cases where the turn is so large that surgery is needed in addition to vision therapy, Dr. Jacobi will refer a patient to a trusted ophthalmologist for collaborative¬†care.

I hope this information is helpful to you! We understand that when you or your child is experiencing any difficulty, all of the information out there can be overwhelming and it is difficult to determine where to start. As with any profession, levels of expertise and competency will always vary based on individual experience and inspiration. At our office we specialize in contact lenses, dry eye, low vision and vision therapy. Dr. Jacobi is board certified with the COVD and has been working with children and adults with vision disorders for decades. We are passionate about what we do, and who we serve, and we would love to help more patients achieve the success they aspire to.

What if you saw letters like this?


Today¬†we discovered that¬†our patient sees any print within arms reach as though it is overlapped. And no one ever knew. She has had eye exams before, but her specific difficulties and diagnoses were not discovered until she came to see Dr. Jacobi for a comprehensive eye exam with a developmental optometrist. She sees 20/20 and her sight is fine, which is why other eye doctors did not diagnose her with any vision difficulties. But when she reads she has to pick which word makes more sense in the context and not surprisingly she HATES writing. I realized this when she couldn’t read anything with both eyes open within 12 inches of her face. With one eye covered, she can read the letters, but with both eyes open she would squint her eyes, tilt her head, close an eye…She said it looked blurry like black blobs… so I had her draw exactly what she saw. This is what she drew.

Can you imagine being a young child in a classroom trying to keep up when this is how things look?? And these kids are often labeled as lazy, ADD, etc. These are the kids who are quick to give up and say they can’t, who tell me they just want to be smart, who cry when¬†we tell they they are smart-we just need to help their eyes work better together. These are the moms that cry in the therapy room because they feel so bad they never knew. These are also the kids who learn during vision therapy that they can achieve great things- who gain confidence and success. The kids who make me fight back tears on their VT graduation day while mom cries and we discuss how far they’ve come. The good news is we can definitely change her life. This is why¬†we work so hard and this is why we¬†are so passionate about¬†what¬†we do!

Vision Therapy is truly life-changing. Kids often don’t know how to describe what they see, and they often think everyone sees that way. This is why it is so important to take your child to a developmental optometrist. If you are not in our area, go to and search for a board certified optometrist who is a fellow at the college of optometry in vision development.