We’ve done a lot of Q&A posts here at Double Vision Blog, but this is our first interview with an eye doctor.  I’m pleased to introduce Dr. Kierstyn Napier-Dovorany, OD, FAAO, Associate Professor, Western University of Health Sciences, College of Optometry   I didn’t just choose a random eye doctor to interview.  This is “Kier”, a dear friend going all the way back to our days at Naperville North High School. I love that I can ask her anything eye-related and she will respond with experience, research, and honesty. She has even offered to do the same for our readers.  If you have questions for Dr. Kier, post them under comments or email questions to jenlandgraf@msn.com

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Q: Describe your work and how long you’ve been in this field.

A: I am an optometrist who works primarily in geriatrics and vision rehabilitation (aka, low vision). I’ve been working in vision rehabilitation for 8 years. Currently, I work at a university and I also teach the courses for vision rehabilitation and geriatrics, among others, and I do research investigating people with visual impairments and their balance.

Q: Why did you choose to pursue optometry?

A: I knew from a young age that I wanted to go into healthcare because I liked helping people and solving problems. I decided on optometry because it seemed like a good fit for me. I became interested in vision rehabilitation during optometry school because it is a unique and challenging field. I’m so glad that I chose this field because it is so rewarding. It completely fulfills my career desires from when I was a kid!

Q: What is the most challenging part of what you do?

A: The most challenging part of my job is helping patients who have not yet accepted their vision loss. These patients are still trying to regain vision that just won’t come back. Another similar challenge is reaching out to patients who are not aware of vision rehabilitation and are under the false impression that “there is nothing more that can be done.” These patients are typically older adults who have recently become visually impaired. It must be very frustrating for your vision to work in a certain way most of your life and then to have it suddenly change. My least challenging patients are often those who have had vision loss since childhood. They usually teach me something that I didn’t know: a new modification, a different use for a device, or how to use a smart phone as an all-in-one low vision device!

It’s nice to have a variety of patients that I see so that I can continue to learn the best way to work with patients with visual impairments.

Q: Is there anything that working at a low vision clinic taught you that you didn’t expect?

A: It taught me that I have a lot more patience than I thought I did. I’m generally a fast paced, hurried person. But I can spend hours with a patient evaluating their vision and solving their problems. I love the relationships that I develop with patients.

Q: What would you say to someone who does not want to return to the eye doctor b/c they’ve had a bad experience? (i.e. a doctor has pitied them, shown ignorance about their eye condition, etc)

A: Find a new doctor!!! It should never be acceptable to see a doctor that you don’t like. I, myself, have changed doctors because I didn’t like the way one treated me. Some eye doctors aren’t very comfortable with diseases that don’t have a clear treatment, which is usually the case for someone who has a visual impairment. Most low vision eye doctors would make a good new eye doctor. They are experienced with working with people with visual impairments; they know about a lot of rare eye conditions; they know how to empathize with patients and mirror their feelings; they truly want to help their patients get through life, not just to manage the disease; they don’t get frustrated when something fails, or a patient isn’t ready to face their vision loss, they just work through it. Ultimately, the patient-doctor relationship must be about mutual respect.

Q: What do you wish more eye specialists / doctors would tell their patients about losing vision?

A: I wish more eye doctors would consider the person behind the eyes. Losing vision is a significant factor in someone’s life-but it does not define a person. Losing vision is distressing-but rarely is it life threatening. Losing vision will cause significant changes to a lifestyle, but it does not limit the individuals potential. I have heard some terrible stories from patients. One that stands out is a mother of a girl with optic nerve hypoplasia from birth who was told when her child was an infant “well, at least you can hold her and love her”. I worked with this young lady when she was 18 years old to help prepare her for the elite college she was about to attend across the country. Thank goodness the mother saw and encouraged the potential of her daughter. Most eye doctors do care about their patients, but sometimes they just don’t know what they can offer to patients with visual impairment. I wish they would offer hope. Share stories of patients with similar conditions who go on living life. Give referrals to vision rehabilitation, mental health, orientation and mobility, etc. Be the advocate for the patient. Give hope for a happy and successful life.

 

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11 thoughts on “Ask the Eye Doctor

  1. Excellent interview Jenelle!

    Hello Dr. Kier, great open and honest interview. I really appreciated the comma at the end of the “there’s nothing more that can be done” spiel. I understand that doctors are trained to make people better and I wondered in the field of eye care why do you think that so many of them do not finish the sentence with …medically, however with low vision rehabilitation you can…? Since losing my vision I’ve talked with so many others who have similar experiences and it seems systemic. Could it be that since the percentage of individuals with sight loss that impacts day to day living is small, in relation to other disabilities, that this issue is overlooked?

    • Hi Stephanae! This issue is pervasive in the field of vision rehabiltation, and us low vision doctors have ideas about it, but don’t really know the answer. Some of it is training. A lot of older docs, especially ophthalmologists, didn’t have training in low vision. Many newer ophthalmologists don’t either, but it is beginning to be a required part of residency training for many, especially retina specialists. Optometrists have less of an excuse-low vision rehab has been part of the basic curriculum for many years. We try to spread the word, but I think what makes the most impact is when the patient reports back to their doctor with success stories from vision rehab. I always send a letter to all of the patients eye doctors (with permission) and even their primary care providers with the results of my low vision exams to help show other providers that there IS something that can be done!

  2. Thanks so much for doing this interview Dr. Kier! I loved your answers! I am curious how much coursework is required of general I doctors in the field who are not going into the specialty of low vision. It seems like more doctors would be able to offer their patients more help like you do if they were required to take several low vision courses. . I am grateful that there are doctors like you out there !

    • Your welcome, Joy, it was truly my pleasure. Optometrists, regardless of specialty practice, all have required low vision coursework, but it varies from school to school. Some ophthalmologists have required coursework, or clinical experience, in low vision to varying degrees. For some programs it may be rather lengthy, but for most it’s minimal (a single 1 hour lecture) or none.

  3. Dr. Kier makes several very important points. As a retired OD (due to my MS) I understand and appreciate her perspective. May I reiterate her statement about the importance of finding a doctor who regards his/her patient as a person? The disease or condition is just that; what matters is the person. Personal feelings, dignity, and quality of life. Nicely spoken. 😎

  4. Dr. Kier and Jenelle what a great interview! Kier such valuable points that you make and of course I think you are the best and smartest…and one who I have always and still look up to!

    I also love Dr. George’s remarks…”what matters is the person”! This is how ALL healthcare should be!

  5. What a great interview Dr. Kier and Jenelle. I love the concept of this blog, especially the idea of helping people through a blog. Jenelle, I loved your questions and Dr.Kier, your answers were terrific. I,also,really like the idea that a Dr.should always think of the patient as a person,not a disease. I love Dr.Kier and think she’s the best optometrist ever.

  6. My wife and I just moved to a new town, and we were curious about how to find the right eye doctor. It’s interesting that you say that you wanted to learn optometry to help older patients who can’t see. It would be nice to choose someone that cares that much about my vision in the end.

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