Article Date: 3/1/2011

The Power of Demonstration
lesson learned

The Power of Demonstration

Here's the secret to appearing smarter than the most brilliant minds.

Jack Runninger, O.D.

She was a 19-year-old local college student when I first examined her.

“Whenever my eyes are examined, I'm told there is nothing wrong and that I don't need glasses,” she said. “But I get eye-strain and headaches when I study for very long, and even when watching TV or a movie.”

I found only two minor problems from the examination, a slight eso fixation disparity and a quarter diopter myopia, O.S.

“Both problems are so minor I doubt they could be causing your difficulty,” I explained to her. “But let me demonstrate them to you.” With red-green I showed her that with her right eye, the letters on both sides of the chart were equally distinct, while with the left eye letters on the red side were clearer. When I held a −0.25 sphere before the left eye the letters became equally clear in red and green.

Then, with Polaroid lenses, I showed her how the top arrow on a fixation disparity chart deviated to the right. And that a one degree B.O. caused the arrows to be aligned.

The perfectionist

“You say the problem is minor and that you don't recommend correcting it,” she responded. “But I'm a perfectionist, and I'd like for it to be corrected to see if it might help.”

So I prescribed lenses for her: O.D. one degree B.O. prism, and O.S. −0.25 sphere.

Two weeks after dispensing, she phoned me and excitedly reported she was wearing the glasses constantly and no longer experienced eyestrain or headaches.

All in her head?

“Just psychological,” you say. Perhaps. But it's sort of like a dentist friend of mine who was offered a cup of coffee late one evening.

“I can't drink coffee in the evening, it keeps me awake,” he told her.

“Not really,” she said. “It's all in your head.”

“I don't care where it is,” he replied. “It still keeps me awake.”


15 years later

It was 15 years before I heard from her again. During that period, she had received her Ph.D. degree and was working in chemical research for a company that operated in New York City and Europe.

“I'm still wearing your glasses,” she phoned to tell me from New York, “even though they're terribly out of style. I've had my eyes examined four or five times in Europe and New York by supposedly top doctors. Every time they tell me I don't need glasses, but if I try going without them, I get headaches again. Not one of them was smart enough to pick up the problem you showed me.

“So I'd like to make an appointment for you to examine me again. I'll be visiting my parents in Alabama next month. It's 200 miles from your office, but it will be worth the long trip to come to someone who understands my problem.”

I hate to admit

Why was she convinced that I was smarter than “top doctors” in New York and Europe? Much as I hate to admit it, there's a slight chance it might not have been due to my admittedly brilliant mind. Any competent refractionist can certainly discover a quarter diopter of myopia and a one degree fixation disparity.

The secret was that I demonstrated the problem to her so that she could see and understand it. OM


Optometric Management, Issue: March 2011