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Let me take this opportunity to introduce myself, as I have already been impressed by the caring and passionate nature of the few of you I have met so far. My name is Heidi Wise, and I am an optometrist in Lincoln, Nebraska. I first met Ron Hruska a couple years ago. I have had the opportunity, since meeting him, to assist him and other PRI therapists to further progress their patients with visual modifications. But it wasn’t until earlier this year that I began to see the full impact that interdisciplinary integration, between optometry and PRI-based physical therapy, could really have on patients’ lives.
My optometric background has been varied, but for quite some time has focused on vision as it relates to the entire person. This approach considers their behavior, their ability to perform at their maximum potential at school, work, and in athletics, as well as how they function in their every day life. This isn’t what I thought I’d be doing when I began practicing! I graduated in 1998 from Southern College of Optometry and began practicing what is known as primary care optometry. This includes the prescribing of glasses and contacts, as well as diagnosis and treatment of eye disease. I began to notice after a few years that there were many children who did not possess the visual skills really necessary to excel at school with the amount of effort commensurate with their intelligence level. To make matters worse, these are not typically problems that glasses or contacts can fix. In 2003, I went into private practice to address this issue. There was a regional shortage of optometrists providing this type of care, which usually includes vision training, and I was frustrated with the lack of treatment options for these children.
After becoming experienced in this area of optometry, which is sometimes called “behavioral” optometry, I was asked to consider caring for patients who had experienced traumatic brain injuries or cerebral vascular incidents. I was fortunate enough to learn some of the basis of this type of care from another colleague, and soon realized this was not all that different from my work with children. The two categories were simply on opposite ends of a continuum, which included visual-motor skills as well as visual-perception skills. One group hadn’t had the fortune to develop the skills, and the other had possessed them to some degree, but those skills were compromised by an injury to the brain.
In 2005, I began providing care onsite, as well as at my office, to inpatients and outpatients of Madonna Rehabilitation Hospital in Lincoln, Nebraska. Each of these type of patients, whether it was a child or an adult with poor vision skills, such as a lazy eye, focusing problems affecting behavior, double vision, or problems interpreting their world visually after an injury, has given me a broad base of understanding the eye’s influence on the brain and vice versa.
Now, I am working with the Hruska Clinic therapists, seeing patients in tandem, to use vision and vision perception to change postural and movement patterns of patients who have not been successful in making or maintaining these PRI directed changes. I am learning a lot about PRI principles and techniques. The more patients we see, the more we are learning, together, the true potential of what can be accomplished through the visual system. It is a well-documented fact that 70-80% of all neural connections relate to vision, and that only 20% of those are concerned with our central vision, which provides our clarity. The 20% determines how far down we are able to read the letters on the eye test chart whether it’s with or without correction. The 80% that relate to treatment of PRI vision, frontal plane astigmatism, cyclo-torsion, curvature of the spine, dizziness, visual push or visual pull, myopic myokinematics, visual midline shifts, or other associated neuro-visual postural influences will be shared with you in the future.
In moving forward, we will share information with you, the PRI therapists, so that you may grow in your understanding just as we are. I gave the first in-service to the therapists at the Hruska Clinic last week and will continue to develop training materials with Ron for both PRI therapists and future optometric partners. I am looking forward with great anticipation to not only the Interdisciplinary Integration PRI course this spring but also to assisting PRI therapists in understanding the role vision can play in your treatment programs.
Check back often, as this site will be used to post recommended references to help you establish your knowledge base about PRI Vision. Also, any information that I, in conjunction with the therapists at the Hruska Clinic, feel is beneficial to you along the way will be added.
I look forward to working with you all as we embark on what will truly be an amazing journey!
-Dr. Heidi Wise