A new optometrist in Ammon does more than just prescribe glasses.
Dr. Daniel Nielson provides vision therapy and development, which can help with issues from double vision to post-concussion vision problems, for children and adults.
Nielson, 29, the sole practitioner at Idaho Vision Development Center in Ammon, doesn't have an optical, used to prescribe glasses, in his office and he doesn't do primary care. Instead, he provides vision therapy, or eye movement training.
"Glasses don’t help the way eyes move, so that’s what I do here with the vision therapy," he said. "I really help to train the eyes."
His practice focuses on three areas of vision therapy: vision and learning, concussion and brain injuries and slowing the progression of nearsightedness in children.
Nielson often works with children, although his practice isn't exclusively for children, because checking for vision problems and treating potential issues is important from a young age, he said.
A north Idaho native and graduate of the Southern College of Optometry in Memphis, Tenn., who recently completed his residency in Wichita, Kansas, Nielson moved to the Idaho Falls area with his wife and two young children to open his first practice.
During his residency, Nielson said he saw firsthand a young girl, who was struggling with reading in school due to double vision, have her life changed by therapy. That's when he decided to devote his career to developmental optometry and vision therapy.
"There’s a lot of vision problems that are often overlooked," Nielson said. "Whether a child may not be able to explain what’s going on or a child may have just had a screening in school and they think that their eyes are working fine, there’s a lot of people out there that are struggling that need our help and we can help them."
Nielson sees patients about once a week for three to six months or more, depending on the case.
Chantel Ercanbrack, 23, of Rexburg, had done about a half-dozen therapy sessions with Nielson in early December.
"I had this problem I think most of my life," she said. "I’ve known I had double vision. A lot of my eye doctors never told me I need prisms in my glasses or that I might need vision therapy. I knew I needed to take that next step."
Ercanbrack, a visual communication major at Brigham Young University-Idaho, said she struggles to see clearly when switching between digital screens at school, which, as a photographer and marketing student, happens a lot.
Her therapy exercises are meant to help Ercanbrack widen her focus.
During one visit, Nielson asked her to stand in front of a board — a Binovi Touch ("I just call it 'the beeper,'" Nielson said) — with dozens of lighted buttons. The patient focuses in the middle of the board and must press each button as it lights up. It's meant to help with eye tracking, or in Ercanbrack's case, peripheral awareness, a trait often lacking in people who experience double vision.
"She has a problem where she zeroes in and over-focuses," Nielson said. "I was doing an activity where she was having to hit the buttons on the outside, or the periphery, trying to help open her peripheral awareness."
Changeable settings on the Binovi Touch help with different vision issues, such as reading problems or even with stroke-related vision problems that affect specific areas of a patient's eyesight.
Another exercise in Nielson's office involves a computer program, a VTS4, that manipulates an image to strengthen a patient's eye teaming ability, or the skill that allows both eyes to work together. That exercise requires 3D glasses.
Low eye teaming ability often leads to double vision, when one eye attempts to do the work meant for both eyes.
"When someone has low eye teaming ability that’s when they start to see double and they can see the words move around," Nielson said. "As we strengthen those ranges, it’s actually strengthening that connection in the brain and strengthening that reserve for each person so that they can go longer without getting headaches and without seeing double."
Other exercises are more old-fashioned — a string with movable wooden beads suspended in front of the patient's eyes (the Brock String) or simply a piece of paper with various letters that patients must point to on command, while focusing on a point in the center.
"All these equipment and different games that I have, I learned about in my training," Nielson said. "There are different activities that I adapt and I modify and really tailor to the specific needs of the patient. Each eye doctor and vision therapist has their own ways of doing it but the principles and the techniques are all very similar."
Ercanbrack meets with Nielson once a week for vision exercises and the optometrist assigns homework, to reinforce concepts learned in the office, such as standing in front of a mirror and identifying reflected objects throughout the room.
Ercanbrack said she wants to make the most of her therapy, which is typically not covered by insurance.
"Not only is it a lot of money, it’s a one-time thing," she said. "I want to make sure it works."
Nielson stresses that vision is a learned process and that it takes time to train the eyes to move and work together to their full potential.
Ercanbrack said it's hard to tell whether the therapy is working this early in her therapy but she's going to keep at it.
"Dr. Nielson told me there’s going to be lots of ups and downs," Ercanbrack said. "There are moments during the session where it’s like ‘Oh, I can do that a little bit,’ but it’s not like I see a dramatic difference yet. I’ll just keep doing what I’m supposed to and hope that it’ll be fixed."
Nielson, whose office has been open since October, has just a few patients at the moment but he hopes to grow as more people learn about the benefits of vision therapy.
"It’s growing and it’s building and the more education we’re doing the more people are becoming aware of this and are seeking out treatment," he said. "It’s kind of fun to see that grow and build."