Vision therapy is a profitable specialty that brings families into your practice—to stay. Here are key steps to build that specialty. When your office offers vision therapy, you provide a vital service to your community. You also gain a niche with word-of-mouth referrals from patients whom you have helped and referrals built from colleagues as well as other professionals including: optometrists, occupational therapists, educational psychologists, speech and language pathologists, schools and teachers.
Potential for Significant Patient Volume
Studies show vision to be a major contributor to what children learn in a classroom. Therefore, undetected and untreated eye and vision disorders in children can significantly impact their schooling. According to the American Optometric Association, 1 in 4 children suffers from vision problems. Vision disorders, such as amblyopia and strabismus can not only result in vision loss, but in low self esteem. Children with disorders such as convergence insufficiency additionally may develop delayed reading and poorer outcomes in school. These staggering numbers mean that if optometrists are seeing children and families in their practice, then they are already seeing these visual difficulties. The question to ask yourself: Are the children in my practice being treated and managed to the highest standard of care?
Build Relationships with Local ODs
In addition to generating referrals, relationships with local ODs are necessary if you focus solely on vision therapy. Appropriate lenses and/or prisms are often an important part of vision therapy treatment. Contact lens fittings and medically based care is referred to a primary care OD.
Get Patient and Parent Buy-In
Patient compliance is a vital component to vision therapy. To get total patient and parent buy-in you must educate parent and child about the value of the therapy, including the goals you are all working toward. For example, you might explain how the difficulties the child is having in the classroom ties to the specific activities you plan to do in the office and the kind of improvement that can be expected. It helps to paint a picture of what the child’s classroom performance could look like if the goals you, the parent and child set are realized.
While it is not required before starting a vision therapy program, it is important to mention that COVD offers optometrists and vision therapists the opportunity to become certified in vision development and vision therapy. The Board certification process includes a rigorous evaluation of the eyecare professional’s knowledge and abilities in providing developmental and behavioral vision care for patients.
To Get Started: Educate Yourself
The most important investment you can make in a vision therapy practice is to attend seminars and catch up on the latest literature about VT. The College of Optometrists in Vision Development (COVD) and the Optometric Extension Program Foundation (OEPF) both have peer-reviewed journals and continuing education available. OEPF provides an excellent clinical curriculum. The first two courses will have any OD up and running on diagnosing and treating basic skills cases with a structured vision therapy program. You also can educate yourself by tapping the services of a practice management consultancy that specializes in vision therapy such as the one I used, Expansion Consultants.
Make Instrumentation Investment
The investment in instrumentation can be easy on a budget. Knowing the types of cases you will be treating will help dictate the instruments needed.
Charge Per-Visit Basis
The average treatment time is about six months, but patients can be in vision therapy anywhere from about three months up to a couple of years, depending on the severity of the problem. Parents are presented at the beginning of treatment with a summary of expected fees based on the estimated treatment time. Treatment time can vary based on a multitude of variables, including compliance, attendance, home life, and the developmental abilities of the child. Estimating treatment time becomes easier with experience.
Code for Vision Therapy–When Insurance Covers It
Currently, coverage for vision therapy is limited. In fact, there is not a procedure code that precisely describes the procedures performed in a typical vision therapy session. The closest code is the orthoptics code – 92065. Since there is no single code to describe vision therapy at this time, every doctor must decide how to best bill the session based on the procedures that were performed.
Prescribe What Patient Needs, Despite Limited Coverage
As optometric physicians, it is our job to recommend the most appropriate treatment for each patient. Often, doctors will try other options, such as pencil push-ups, before recommending the most appropriate treatment, because they are concerned the patient may not be able to afford it. But in many cases you are doing the patient a disservice by doing that because research has shown that the most effective treatment for binocular vision disorders, such as convergence insufficiency, includes office-based vision therapy with home reinforcement activities.