Patrick J. Pirotte, OD, FCOVD, Diplomate ABO: [email protected]
This post appears as part of a series called Sit Down – candid conversations with real people detailing their journeys and experiences with Vision Therapy. A Sit Down – with Dr. Pat Pirotte For the benefit of our readers, can you share your background and explain how you are involved in Developmental Optometry? I’m involved in developmental optometry in multiple ways. First, I am a board member of COVD. Second I have one of the original private practice residencies in pediatrics vision therapy and rehabilitation in the US. Third, I have had a large and prosperous pediatrics and vision therapy practice for almost 30 years. I went to Wichita State University and to Kansas University. I majored in piano performance at Wichita State University and human biology at Kansas University. I attended the Southern California College of optometry in Fullerton California. What led you to Developmental Optometry? I got involved with developmental optometry because of the of my own severe vision deficits that I suffered with as a child. I had a large angle esotropia by the time I was a year and a half old, I am moderately farsighted in both eyes, and I suffered with the severe effects of visually related learning problem which caused me to drop out of college ultimately with round-the-clock headaches. Fortunately, a wonderful woman, Dr. Dorthea McCoy, was able to restore my function to where I was able to attend graduate school and it seemed a natural outgrowth of these experiences to become a developmental optometrist. It is my understanding that you also serve as adjunct faculty in some pretty important places, correct? I do serve as adjunct faculty on at least five schools and colleges of optometry. I have now taken about 75 student externs into my office in the past 15 years. It has been a very joyful ride! How did your office become one of the first accredited private practice residencies in the country? I believe the reason our office was approached to start a private practice residency was through my acquaintance with Dr. W C Maples. Dr. Maples was and is a passionate supporter of developmental optometry and he knew of my passion and interest in education. These two things joined together for him to encourage me to investigate the program. Also, it was determined that we had sufficient patient flow to generate the large number of patient encounters that the resident is required to have in an accredited program. Can you were tell us how you were involved in the Kansas Study on Convergence Insufficiency and reading in third graders? I was intimately involved with the Kansas study on convergence insufficiency and reading. In fact, my office did the bulk of coordinating the study all the way through. At that time, I was the only practice in the state that had a full-time well-trained optometric vision therapist and she was able to devote lots of her time to guiding and teaching the other offices about how to do therapy techniques. Developmental Optometry is clearly is your passion, as evidenced both in your private practice and in your role in hosting externs. Can you share why both aspects have been important to you? The reason I have such a strong passion for developmental optometry is that I believe it brings a piece to the healthcare equation that is critical and that no other profession or part of our profession does as well. When you have suffered personally as I have with the effects of poor vision, you can see that if there were not pioneers such as Dr. McCoy, you would never have received any help at all. Also it’s a great joy to me at my time in my career to see my externs and residents graduate and succeed. The need for our care is almost infinite. And to have the new young generation embrace and advance this part of the profession is very satisfying. Your website reads that during the summertime you “present teacher re-certification workshops on the impact of vision to learning and classroom performance”. There are places that this type of message sadly is not well received. What’s your experience been? Yes, I do present teacher certification workshops on the impact of vision in the classroom. The didactic part of these courses is very well received by the teachers who take my course. Incidentally sometimes I also have school nurses and speech therapists and other professionals. Where the difficulty with this information not being well received typically occurs is when the students who take my class return to their school buildings. There is a lot of inertia in the US public school system. There’s also a lot of misinformation in the administrators and school bureaucracies. We must continue to work to root this out because there is also a tremendous passion and commitment inside the US public schools to help children to learn into advance. We really have to remind ourselves that one of the hallmarks of our work in the developmental optometry community is the depth and sophistication of our knowledge of the visual system. It’s very difficult for a person who is not educated inside of optometry to appreciate just how sophisticated and massive the visual system is in our brains. I truly believe that’s the source of the misunderstanding and the difficulties we have transmitting our messages. It is true that I have occasionally had people consider me to be controversial in what I teach. However, the science behind our model of vision which includes such marvelous concepts as neuro-plasticity, continues to advance. This can do nothing but improve our cause. Educating parents of the duration of treatment necessary for a successful Vision Therapy program seems to be crucial aspect of patient care. In extreme cases, Vision Therapy can take in excess of a year to reach a successful outcome and there is always the risk of parental frustration, which may result in early withdrawal from a program. How do you go about helping parents understand a successful program can take time? This is a great question. I think the answer to this problem is to have experience and/or a mentor who can help you with this and to give parents a realistic expectation. Let me give you an example; I occasionally treat a child with a large angle esotropia. It is true that large angle tropes are not typically going to be able to be managed and brought to full binocular status with vision therapy alone. I inform parents of this at the outset. I suggest to them that their child should have what I call the “ham sandwich” approach. The bread in the sandwich is vision therapy in the ham is surgery. We do preoperative vision therapy, do a surgery, and do post operative vision therapy. I would love to conduct a study with surgeons about this treatment modality. But my impression from doing it through my years in practice is that it has a very high prognosis rate. This is a case that’s an example of a relatively long treatment course and parents need to be warned in advance about what they can expect. So I don’t think that parental frustration will get very high if they have expectations which match the reality that they experience. It’s also true that you sometimes need to take a break during therapy. Children are people and they occasionally get so fatigued they simply need to rest. I use this a lot and it’s a very effective tool. Can you tell us about your work with head injury and stroke victims? We work extensively with head injury patients in our practice. We staff the three major rehabilitation hospitals in the Wichita area each week. We encounter between four and 600 patients per year that Have had head injuries and strokes. It’s a fantastic new area and one which I think is going to be very fruitful for the profession in the near future. COVD is a wonderful organization and one on whose board you currently serve. Can you tell us about your experience thus far, and explain what led you to seeking this position? I am a passionate member of COVD! It is a deep honor to serve on the board. The dedication, knowledge, and commitment that COVD board members have would stun you. The knowledge and cleverness and innovation would amaze you. It’s easy to love the organization because it is so well run and so without typical problems such as egos and turf battles which cause organizations to fail to meet their objectives. You also lecture for the AOA, correct? I actually have lectured for the AOA in the past including the rollout of the infant see program about 10 or 12 years ago when that occurred. I am not currently involved in any teaching through AOA but would be happy to do so if the opportunity presents itself. One of your fellow board members whose name we will not mention (it was Dr. Jenn Dattolo) shared with me that you are a huge Kansas Jayhawks fan. With March Madness rapidly approaching, what’s your prediction for the Big 12? Do you happen to have Bill Self’s number on your speed dial? I am a huge Jayhawks fan, it’s true. I feel like this year the Jayhawks may disappoint. The reason I feel this way is that Bill Self has a particularly challenging set of new young men who he’s trying to bring together and create a team. You may have noticed there have been some pretty embarrassing losses including a 32 point lost to Kentucky earlier in the season. One of the fun parts about the Jayhawks is that they do develop all season long. I won’t say never, but I’d be surprised if the Jayhawks make the elite eight. Some Closing Thoughts – A great thanks to Dr. Pirotte for taking the time out to complete this interview. Dr. Pirotte’s passion for Developmental Optometry, both in private practice and in the classroom, quickly become evident to anyone who gets to know him. In preparing for this post, I asked several people about Dr. Pirotte and all of them returned common sentiments about his wonderful dedication, incredible intelligence, and his extraordinary personable nature. All qualities that make his a great asset to Developmental Optometry and make me proud of this collaboration! Please join me in wishing Dr. Pat Pirotte, his patients and his family, the absolute best!