In a Q&A, Central New York optometrist Leonard Savedoff talks about child and teen vision care, eye exercises, common problems and more.
For over 30 years, Dr. Leonard Savedoff has offered patients the latest advances in the field of optometry. Currently, this can include anything from treating vision problems exacerbated by the demands of computer and handheld device use, to pediatric vision therapy. He was initially partnered with the late Dr. Jerome Weiss, who started the practice more than 70 years ago. With his current partner, Dr. David Ciccone, and Dr. Donna Konick, Savedoff treats thousands of patients each year between offices in downtown Syracuse and Manlius.
Savedoff is a New York City native who lives in Manlius with his wife, Susan; he is the father of three. Family Times recently caught up with Savedoff at the end of a typically full day. (This interview has been edited and condensed.)
Tell me a little about the origins of the practice.
Leonard Savedoff: Dr. Jerome Weiss started this practice almost 70 years ago. He took me on as an associate. He was aware of the importance of developmental vision care and there wasn’t a (local) doctor specializing in this. I went to the SUNY College of Optometry in Manhattan. It has one of the best programs in developmental vision care and rehabilitation the country, if not the world.
So, I came here and brought that aspect to this practice. I started out talking to school districts all around Central New York, with reading teachers, school psychologists, school nurses as well as more recently—getting more involved with professionals such as physical therapists and occupational therapists.
The work we do in developmental vision is evaluating the visual skills of children to see if their performance matches the age-expected performance for their chronological age. Some people don’t realize that, for example, tracking skills mature through age 14. So, it’s a problem if an 8-year-old is tracking like a 6-year-old.
What is involved in that kind of treatment?
LS: They are eye exercises that primarily provide, in a sense, a biofeedback—keeping in mind that the eye muscles are sometimes 100 times stronger than they have to be. It’s not weak muscles. Kids with these problems are not sending out the right signals from the brain to control these reflexes. They’re just not happening. It’s like having a symphony without a conductor. You can have a lot of great musicians, but they have to be brought together and integrated by a conductor.
Why is this not happening? Some of these skills are normally developed around the time of birth. If they don’t happen then, they don’t happen on their own. But if you make the patient aware of it through different activities and exercises—some of which are done on special computer programs—that is like a biofeedback to let the patient know what they are doing. Are they crossing their eyes? Are they diverging their eyes? Are they relaxing focus? Are they on target? Are they off target? When they get this feedback, they develop better control and accuracy.
With young children who have not developed those skills we are just enhancing them to where they should be, and in other cases, we help people to regain what they’ve lost. In our practice, we are very fortunate to enjoy a great relationship with Upstate’s concussion clinic. We see many patients who are having visual symptoms after a concussion. Most recently, we have been in the NCAA protocol for Syracuse University.
Is that an increasingly frequent issue?
LS: Yes. It used to be, “Why don’t you come and check this out?” Now, it’s a mandated policy. When someone is seeing double after a concussion, you have to have a protocol for getting that person the proper care. You can’t just go to your own eye doctor. A regular exam might indicate that the person is seeing 20/20, and everything’s fine. But some of these people I see, they’re having problems seeing double, getting headaches.
A lot of people don’t have effects from concussions. But, these days, I see a few people every day with concussions.
Are a lot of those patients kids with sports-related injuries?
LS: I saw a 12-year-old the other day, and I saw someone who was 17 yesterday. But I also see adults who are 80. I think it’s more common with teens and above. The reason is that the activities they are involved in have rougher play. Football, lacrosse and basketball—there are a lot of injuries related to those sports. It could be a lacrosse player taking a stick to the head, or a football player taking a late hit, getting smashed in the skull. Sometimes it’s the oddest injury. It could be someone standing still on a bike and they lose their balance and flip backward and hit their head.
What are some other common issues that come up with children these days?
LS: Everyone is very much aware of nearsightedness. One of the biggest problems actually with prescription issues is farsightedness, because kids who are farsighted can see clearly (close up) by focusing extra and harder to make up for their problem. But they are likely to get tired or get headaches from fatigue, or to start avoiding reading because it’s not really fun to focus twice as hard to read.
It’s kind of like an invisible problem. Without a full, complete eye exam by an eye doctor, you don’t know if you are missing things like that. If you have a huge amount of farsightedness, you’ll see poorly. But usually what is causing a lot of academic-based issues in school with reading and so on is uncorrected farsightedness. Kids are straining to focus and get fatigued, yet they still see 20/20. Glasses can help that problem.
At what age would you recommend that kids get their first full eye exam?
LS: Without any obvious problems, kids should certainly have a complete exam by the time they enter kindergarten or first grade. Let’s say there is a little farsightedness. If you didn’t correct it at 4 years old, it’s not going to have much of an impact on them. But if you’re not learning your letters and numbers right, and your penmanship is not right because your vision is blurred up close, that could become a problem in first and second grade.
Vision training has been getting a lot of publicity lately.
LS: I think that schools have become more aware of the impact of vision problems on reading and academics. Athletes are becoming more aware of this. Most professional athletic teams now have eye doctor consultants. Now, in the medical community people are more aware of treating head trauma, stroke, concussion, and brain surgery problems with vision therapy too.
In addition to that, physical and occupational therapy is so big now. These allied professions don’t overlap exactly, but we touch upon the same patients to the point where there are more professionals out there dealing with rehabilitation that are aware of what can be done with vision.
In our practice, because we deal with a lot of complex cases, we actually employ a team of a doctor and an occupational therapist. Between the field of occupational therapy and what we need to do in vision care, we meld the two together and have a very full ability to care for people. Some of these patients with vision problems are also having problems with hand-eye coordination, balance, and that’s where the occupational therapy comes in.