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Q&A: Convergence insufficiency, neuroplasticity, and hanging upside down over a cliff

Optometry Times JournalVol. 10 No. 12
Volume 10
Issue 12

Meet Ingryd Lorenzana, OD, a neuro-optometrist and founder of Vision and Sensory Integration Institute, Schaumburg, Illinois. 

Where did you grow up?
I was born in Bogota, Columbia, and I came to the U.S. when I was 10, so I pretty much grew up in Chicago. My mom was a single mom. She was the oldest of 13 kids. After my grandmother was widowed, my mom had to quit middle school so she could go to work and raise her younger siblings.

How did your world change when you learned your convergence insufficiency could be treated?
I felt cheated. I didn’t understand why I had to suffer for so long because I didn’t get diagnosed until I was in optometry school. I struggled forever to read, and I was given the excuse that that I was a bad reader because English was my second language. The doctor who diagnosed me said, “Why aren’t you in jail?” People who have problems like me usually don’t make it as far academically as I had, and they usually have behavior problems or are dropouts-there is a high incidence of vision disorders in jails. My passion for vision therapy helped me get through optometry school, but once I was a doctor, I thought there has to be something more. That’s what led me to research and to develop the program that I now call CogniVision that focuses on training vision pathways in the brain instead of just training the eye and the eye muscles.

Related: Q&A: Casablanca, dry eye, and throwing axes

Why pediatrics?
I connect with kids. I see myself as their vision advocate. When I diagnose these vision problems in them, I’m the one who needs to make the case for them to their parents, to their teachers, and to their schools because they don’t know to speak up for themselves. They just think they’re in trouble. That’s what I lived, and that’s how I connect with them.

What keeps you in private practice instead of going into academia or industry?
I was in academia my first eight years. I taught at Illinois College of Optometry in the pediatrics clinic and then a year at Southern College of Optometry. I wanted private practice because I had more control over what choices I made professionally, and I could build stronger relationships with my patients. You do build relationships in academia, but because of the students the continuity of care isn’t as consistent. You may get a patient today, but then my colleague may get him next month for a follow-up. That’s what keeps me in private practice: the fact that I want to build stronger ongoing relationships with my patients.

What’s something that your colleagues don’t know about you?
I don’t tout my vision problems. I think it’s been more recently, and I’ve been struggling with if I should write a book to tell my story from a perspective of me as a patient. My colleagues are very respectful, and I don’t think they realize how hard I have had to work to get to where I am. If you’re someone who has it easier to absorb information visually, then you don’t experience the difficulty. Therefore, it’s harder for you to relate to others who do. I know a few of my colleagues are in this arena from their own vision problems, but more of them should be aware that these patients struggle.

How can vision therapy be a holistic treatment to improve patient quality of life?
I’ve learned it’s not about the eyes, it’s about the brain. The eyes are giving me signs of what’s going on in the brain. If a patient has an eye muscle imbalance, that tells me this is a brain that is not functioning at high performance. That ties into things psychologically; this might be a person who is under higher stress with less productivity. I read the eyes to let me know what’s going on in the brain.

How does neuroplasticity work in vision therapy?
The brain works by organizing the information that goes into it-90 percent of that information is through the eyes. The tissue in the eye is a direct extension of the brain. The retina is made up of the same types of cells as the brain. Other senses are external and made of a different component of tissue from outside of the brain. The eye and the brain are directly connected. That’s why when ODs see anything, whether it be functional or physically not in balance in the eye, that’s a direct sign of what’s going on in the brain as well.

What is CogniVision?
CogniVision is a brain-fitness program. Neuroscience tells us that best performing brains are those in which different neuron types-auditory, motor, visual-communicate with each other in a synchronized manner.  Because the vision pathways are the dominant sense of input into the brain, they become the dominant mode of training the brain. CogniVision uses these vision pathways to make sure the different neuron types communicate with each other in the brain in a harmonic way. My patients go through a program in my office for four to six months because I’m treating eye muscles and vision pathways simultaneously. I call CogniVision my fourth baby because I have three daughters. [Laughs]

What do you for downtime?
I love so much what I do that I don’t feel like I work. But I love dancing and music. I do yoga, and I do art with my younger daughter who is 10.

What’s your guilty pleasure food?
Food. [Laughs] I love to travel because I love trying different types of foods. There’s research that says chocolate gives you the oxytocin endorphin, which induces more neuroplasticity, so I do love chocolate. [Laughs]

Related: Q&A: Cornea, almost two residencies, and a Vietnamese hoagie

What’s something about optometry you’d like to change?
I wish my colleagues would look at it about the brain, not the eyes. If they saw it that way, they would see that we are in the best time to be an optometrist because society needs us, visual demands are greater than ever, and we are the ones who are best to treat these functional conditions to make people comfortable and happy. You could be an OD who focuses on nutrition and deal with macular degeneration and Alzheimer’s. Science is showing that patients who have macular degeneration are more likely to develop dementia and Alzheimer’s. As long as the brain is getting sensory input, it stays active. With macular degeneration, you’re losing the dominant mode of sensory input to the brain. I wish they would see it. It’s about the brain, not about the eyes.

Do you have any regrets?
I used to say I did, but now I don’t because I realize whether I’ve had challenging experiences or happy experiences, they have all shaped me to the person I am today.

What is the craziest thing you ever did?
Hanging upside down over a cliff in a vortex in Sedona, AZ. [Laughs] There are areas where supposedly the magnetic fields are higher, and you can see it because the trees grow in a spiral formation. I went hiking through Sedona, and in one of those areas I hung upside down over the cliff. I have always loved hanging upside down and watching the sky and my relationship of me on earth as the sky moves. Because this was a special place and that’s the thing I like to do, I thought, “Let me do the two hand-in-hand.” [Laughs]

Read more Q&A interviews by Vernon Trollinger

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