By Crain’s Detroit Author Jay Green
For years as a child and into adulthood, Elli Altman suffered from a medical condition she and nobody else seemed to understand – misaligned eyes.
Her teachers and mentors told her she was smart, but because she had problems with school studies and playing sports, they told her she was either lazy or unmotivated and would never succeed.
“I wanted to learn – learn everything under the sun – but it seemed mysteriously out of reach for me,” said Altman of West Bloomfield. “I could read individual words (was great at spelling them) but my eyes could not make their way across the printed page.”
“I tried every sport, even though I could not catch or hit a ball or determine exactly where the hurdle was so that I could clear it,” she said, recalling many bumps and bruises accumulated from trying athletics. “I knew I didn’t have great vision, but was always told that I did not need glasses.”
Early last year, when Altman was turning 60 and her vision getting worse – “I just could not control the use of my left eye. It felt like it was bobbling at the end of a slinky” – she found Bloomfield Hills-based Vision Specialists of Michigan.
Optometrist Debby Feinberg performed a simple test her father began to develop years ago and corrected Altman’s vision by fitting her with custom-made eyeglasses with a prismatic corrective lense.
“It turns out that my eyes are misaligned – both horizontally and vertically,” said Altman.
“There was a moment during the initial evaluation when, with goggle-like trial lenses tailored precisely for my eyes, I saw the world for the very first time as people with normal vision see the world,” Altman recalled.
“All I could think of was, ‘Oh. That’s it.’ Until that moment, I had no idea what normal vision looked like or felt like,” she said. “But, I can tell you this. It was glorious and I am going to remember that one moment forever.”
Feinberg’s road to vision misalignment specialist
Debby Feinberg began practicing optometry in Oakland County in 1983 after graduating from Illinois College of Optometry. She joined her father, Paul, now 89, at his practice, the former Mall Optical Center in Waterford.
Over the years, Feinberg began specializing more in the treatment of neurological conditions, including headache and dizziness, that have a visual cause.
Her pioneering work, which helped Altman, assessing patients and developing specially designed corrective lenses for the condition called binocular vision dysfunction, addresses a condition where the eyes are misaligned and can cause severe headaches, dizziness, anxiety and neck pain, said Mark Rosner, M.D., Feinberg’s husband and the practice’s business manager.
As her practice grew, Feinberg, 57, moved to Bloomfield Hills and renamed her practice Vision Specialists of Michigan. She now has four optometrists along with 25 employees.
“Before 1995, I had a typical optometrist practice. Now my practice is a little different,” said Feinberg. “I do 90-minute eye exams. I only see eight people per day. “Most of my patients get referred by medical doctors.”
In the mid-1980s, Feinberg noticed her brother-in-law, Arthur Rosner, an ear nose and throat specialist, had vision problems caused by eyestrain. He came in for an eye exam and she found he needed prismatic correction. It was her first patient to receive eyeglasses fitted with a prism lense.
“He was so happy it worked,” Feinberg said. “Years passed and I got a call from him in 1995. He told me he had patients who suffered from nausea and felt unbalanced. I discovered they had misalignment in their eyes. Once I leveled their vision with prisms, they felt better.”
Over the next nine years, Feinberg said she helped 500 patients with various misalignment symptoms. Word of mouth spread and soon she needed to expand her practice.
“I got calls from people who said, “How did you learn my secret,” and “When can I come in for an appointment,” Feinberg said. “The proper lenses can help these people.”
Randall Benson, M.D., a neurologist who specializes in traumatic brain injury, has referred dozens of patients, including former NFL players, to Vision Specialists over the years.
“I use Debby and Vision Specialists extensively because about 50 percent of the time my patients have binocular vision dysfunction caused by brain injury,” said Benson, who heads up Novi-based Center for Integrated Neurology and runs the non-profit Center for Neurological Studies.
“Many of them have gone years without any satisfactory diagnosis or treatment,” he said. “I have patients come from all over the country and Vision Specialists really are the leaders in our region and nationally, too.”
Benson, who said he is collaborating with Vision Specialists on clinical research on vision issues, said the combination of Vision Specialists experience in assessing and diagnosing the vision problem, and fitting the right prismatic corrective lense makes the practice his go-to referral.
Over the past 21 years, Feinberg has seen more than 7,000 patients. She gets more than 15 emails a day from people all over. She has co-written a book, “If Walls in My Exam Room Could Talk” with her husband Mark and Sherry Brantley and posts educational videos on her website.
Feinberg also has started a training program for other optometrists to teach them how to evaluate patients and manufacture the special prism lenses. And she has created a simple 25-question test to help practitioners determine if a patient’s eyes are misaligned.
“We have a lab to cut the lenses. The prism element is so critical. It bends the light both on the vertical and horizontal plane,” she said. “My goal is to move this service out of my office and into other states.”
Focus on child vision misalignment
Altman, who last July left her job of 20 years as admissions counselor at the Roeper School to accept a job as education liaison for the fast-growing optometry practice, said once Feinberg helped to cure her, she knew her next calling.
“As soon as I experienced my new vision with the new glasses, I declared that no child with misaligned eyes should ever go without these glasses,” said Altman. “I knew then that I wanted to work to promote this mission. I wore my glasses for about two months and then approached Dr. Debby about working for her to find the children with misaligned eyes. “
Feinberg said she has helped dozens of children with misalignment problems and hopes Altman can help spread the word to schools through her contacts.
Experts estimate 10 percent of the population has some form of misaligned eyes. Some children identified as having ADD/ADHD, or another learning disability, have problems with misaligned eyes.
Feinberg said it is very common for children to have misdiagnosis of ADD when they really have misaligned eyes.
“Even a small misalignment can become an enormous part of the problem,” she said. “A prismatic correction sometimes can help children.”
Feinberg said if two eyes are not coordinated, reading can be difficult and confusing.
“Words move around on the page, bump into each other. Kids can be distracted because of it,” said Feinberg, adding that one of her goals is to evaluate more children for these problems.
Altman said typical school eye exams sometimes miss how the eyes work together.
“A child may have 20/20 eyesight, yet have binocular vision dysfunction because the vision test looks at the acuity of each eye, not how they work together,” Altman said.