Dr. Pilar Vergara busts amblyopia and TBI treatment myths

In this episode, Dr. Pilar Vergara tells how she came to write the book Crossed and Lazy Eyes, Myths, Misconceptions and Truths. She shares that science backs up new ways to treat amblyopia and TBIs and how lives are changed as people receive appropriate treatement. 

Dr. Vergara is a true leader in behavioral optometry and vision development. Based in Albacete, Spain, she’s spent over 30 years helping people of all ages improve their visual function—from children struggling in school to adults recovering from brain injuries. Dr. Vergara is a global educator, author of several influential books on vision and learning, and the first Spaniard to be named a Fellow in multiple international optometry organizations. She brings a deep understanding of how vision impacts our lives and a passion for helping people see—not just with their eyes, but with their whole brain.

Dr. Vergara's website: https://pilarvergara.es

Access the book Crossed and Lazy Eyes, Myths, Misconceptions and Truths here: https://www.amazon.com/Crossed-lazy-eyes-misconceptions-truths-ebook/dp/B0854KX1Z4/ref=sr_1_1?crid=DI0JGKL6171F&dib=eyJ2IjoiMSJ9.TdGV_CLmwvfpoI4fuJG9AcBm5URe52X7s7d3DScnj1i7562qYGoTHKBeRWt9hsF2.-PzugOMoz-gyAgiKDOMzQQWYlZliSURVLJki1ebUzC8&dib_tag=se&keywords=crossed+%26+lazy+eyes&qid=1744956809&sprefix=crossed+%26+lazy+eye%2Caps%2C449&sr=8-1

Dr. Vergara's book: Tanta Inteligencia, tan poco rendimiento (available in Spanish on her website and Amazon/Spanish)

https://pilarvergara.es/libro-tanta-inteligencia-tan-poco-rendimiento/

English Testimonial on her website:

https://pilarvergara.es/a-beautiful-story-of-love-one-that-goes-far-beyond-optometry/

Brain Injury information on NORA website: https://noravisionrehab.org/patients-caregivers/about-brain-injuries-vision

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Transcript

Denise: This is the Healing Our Sight podcast where we discuss vision issues and healing strategies from the patient perspective. The goal of this podcast is to create an awareness of the diverse types of vision issues people experience, to highlight the types of help available, and to open a dialogue between patients to show we're not alone in our vision struggles. As a patient who gained 3D vision at age 54 through vision therapy combined with strabismus surgery, I feel uniquely qualified to offer a hopeful, balanced perspective on the possibilities. Please use the link in the show notes to send me a message and thanks for joining me today. 

Welcome to the Healing Our Sight podcast. I'm your host Denise Allen, and I'm so excited today to have my guest, Dr. Pilar Vergara, and I'm going to just go ahead and introduce a little bit about her. 

Pilar Vergara Jimenez received her degree in optometry from the University Complutense of Madrid in 1989. In 1993, she was awarded a Master of Optometry and Visual Training from the International Optometry Center COI, where she also taught for four years. Also in 1993, in collaboration with Dr. Pilar Plough, she provided vision therapy to Spain's Olympic Women's shooting team. Pilar was the first Spaniard to become a Fellow in the College of Optometrists and Vision Development COVD in the United States. She was a member of its International Examination and Certification Board, IECB from 2002 to 2007 and was the first international optometrist to hold this position. In 2015, she became a Fellow in the College of Syntonic Optometry, FCSO, and a Fellow of the Behavioral Optometry Academy foundation, FBOAF. Being again the first Spaniard to qualify for fellowship and I want to tell everybody here it takes a lot of advanced training to become certified with all these organizations. 

She's also the International Director of the Sana Vergara Institute, teaching behavioral optometry globally. She has lectured in 25 countries, co teaching with Robert Sannet and others. Pilar is the author of three books. The first book is entitled Tanta Intelligentsia tan poco rendimiento, which is translated as Is your child intelligent but underachieving? It's the first book in Spanish for parents and educators on the relationship between vision and learning problems and has also been translated into Portuguese. She's also written the first published book about strabismus in an amblyopia aimed at both professionals and the general public. The is entitled Crossed and Lazy Eyes, which has now been translated into English and Chinese. And her third book is entitled The Extraordinary Power of Vision:  100 Answers that can change your life and your child's life. Published in March of last year. It's only available in Spanish, unfortunately, so I'm anxious to get my hands on this in English at some point. She is well recognized and has received several prestigious awards for her excellence in behavioral optometry. 

She maintains a private clinical practice specializing in behavioral optometric care in Albacete, Spain. She specializes in vision development, amblyopia and strabismus, syntonic phototherapy and neurobehavioral vision therapy, especially for brain injuries. She has two lovely children, Natalia and Rodrigo. She defines herself as a lover of her optometric profession. 

So welcome today, Pilar.

Dr. Pilar Vergara: Oh, thank you. It's an honor to be here.

Denise: Now the honor is online. I've been looking forward to this for a very long time and I keep thinking, why did I wait so long? Because we met two years ago when I went.

Dr. Pilar Vergara: Yes. In the COVD meeting, I think.

Denise: Yes. When I went to the meeting in Toronto. And it was such a delight to be there and see you teaching with Robert Sanet. It and then you gave me a copy of your book, which I was thrilled to receive. I had just finished reading it the month prior in an ebook. And so having a physical copy was just a treat. And I love the fact that you debunked all the myths about vision in your book.

Dr. Pilar Vergara: Thank you. Thank you very much.

Denise: How. How did that book come into being?

Dr. Pilar Vergara: The. Which one? Lazy Eyes.

Denise: Yeah. Crossed and Lazy Eyes.

Dr. Pilar Vergara: Why I write it?

Denise: Yeah.

Dr. Pilar Vergara: It's an interesting question. I am this type of person that also is trying new things and if something don't like it, I don't like it. You know, I don't know how to say. And I felt very badly when I saw the little kids, or not so little with a patch, for years. For years. And I thought, shoot, it should be another way to treat this. Should be another way to treat this. And I was making my own experiments like a clinician because I'm first of all, I'm a clinician and I didn't want to share with anyone else because I thought maybe I was doing something wrong, you know, So I was. I didn't want to patch and even I didn't share with my dear mentor, Dr. Sanet. And that he is like my father at the beginning, because I thought, oh my God, how I tell him I'm doing this. And then I began reading some researchers that began going out like the problem in amblyopia and strabismus is in the brain, is a binocular competition. And my brain is blown. 

And I thought, wow, so it's clear to patch one eye is not the way I was thinking, thinking, thinking. And then I began to think, someone has to tell to everybody that there is another way to do it. But I realized also that there is not another way to do it, you know, because although the researchers were saying the problem in amblyopia is the binocular competition, and everybody was happy when I was in other countries in congresses and I speak with the optometrist. Oh, have you read this? Oh, yes, we are so happy. And I say, had you changed the way you treat the amblyopia? They didn't. They didn't. And then I understood why. I arrived at the moment, I understood why. And I understood that the reason was because although the researchers say that is the reason, they don't know how to do it because it doesn't mean that they have to train binocular. Only it is that the reason to have the problem is a binocular problem. But how I treated them that. So I began to do two things at the same time. 

I began to write a book and I began to keep with my experiments, you know, developing like a way to treat it. So I wrote my first draft. When I sit down with Dr. Szant, I share with him and he told me, you cannot publish this. I say, why? Because many people are going to be against. And I say, well, someone has to say what is happening with that? The treatment is completely old and people are suffering. And he said, why you? You know, why you? And I said, why not? So she told me, you are wrong, you are wrong, you have not to publish the book. So I was in unbalanced at the beginning, very in a crisis. I was working for a year then, but instead of saying, okay, I'm not going to publish, I keep working. So the second year we're working with my draft, I sit down Doctor Sanet again. And then I said, I'm sorry, I keep working with my draft. Here you have. So he read it and he said, I'm sorry, the same opinion, you cannot publish this. So we were in the same position again, you know.

Denise: Yeah.

Dr. Pilar Vergara: And my imbalance was bigger. I felt very badly and I didn't know what to do. But I was working for two years, and not only in the book, I also was working in my clinical experiments, you know, all. And after I have a crisis for I don't remember, one week, one month. I thought to keep working, but I want that Dr. Sanet tell me. Yes, I support you because for me it was very important in a professional way and in a personal way. So I. I spoke with him the third time and. Yes, the third time. And also I wanted his help.

Denise: Right.

Dr. Pilar Vergara: You know, because for me was not easy to organize some part of the book, especially the scientific part, because I'm so clinician. I. You know, that is. It's different, you know. So one day we were in the car. That is a truth anecdote about how the book was see the World. We were in a car in front of my old house in Madrid. And we were talking about this. He was saying, why you don't do it? Blah, blah, blah, blah, blah, blah. And then suddenly we saw one of my neighbors that was about maybe 10 years old or 9 years old that he was with his father, going down the steps, three steps with the father's hand, very strong and touching the steps with the foot like he was blind. . And the other hand was to the a holder. He was in my office before. So I knew that the visual acuity was less than 20/400.

Denise: Okay.

Dr. Pilar Vergara: Because he was in my office. But he didn't like my approach. And he come back to the ophthalmologist. And then the ophthalmologist patched the whole day.

Denise: Yeah.

Dr. Pilar Vergara: And he was like a blind boy.

Denise: Yeah.

Dr. Pilar Vergara: And in that moment, my tears began to go to my face. I remember very well. And Bob too. Bob (Robert Sanet) too. And then that day, in that moment, he said, I support your book.

Denise: Wow.

Dr. Pilar Vergara: That was like that. I'm going to support your book. You are right. Someone has to say to the world that there is a new way to treat that. And we don't have the only. If we only had this way that in the past. Okay. But we have new way. We have new research. We have. So that was the story. And because we have to go deeper, deeper, deeper to study to publish the book. That helped me and help Dr. Sanet too to begin developing a protocol to treat amblyopia that was alive for years. And we improve and change, but we start to organize the information because the book. Because we study a lot to publish the book.

Denise: Right. Wow, that is a powerful story. I totally. I'm with you. It's the whole thing. Who's going to do it if you don't do it? Right. When I decided to start my podcast, it was the same kind of a thing. There's no patients talking about what patients should be doing or how they can have success or what all the options are. You know, there was no podcast about it. And so I said, okay, it must be my job.

Dr. Pilar Vergara: Yeah, good for you and good for the world.

Denise: Well, hopefully at some point when more people can find it. Right. But I think that this is such an important book, and it's so clear how you explain everything. And there are so many great case studies in it of the people that have been helped by following the protocols that you've designed. And I love the part in there where you talk about all of the outdated treatments that people are still using. And I see them all the time when I'm on these strabismus support groups on Facebook. They'll be talking about, okay, how do I get my child to wear this patch? Should I use atropine drops? When do I go for surgery? Yep. And what about prisms? My eyes are eating the prisms, and they're not working anymore, and I need stronger ones. And then they'll say, should I try Botox? You know, and I just shake my head because it just makes me crazy.

Dr. Pilar Vergara: Yeah. But if there is not enough information, they don't have all the options. I always say, the power is the information. 

You know, every week, I have many, many patients with Strabismus. And they. All of them, or maybe 95%, they were first in the ophthalmologist. So they come to me to listen, a second opinion. And I said to them, my approach is completely different, and I'm going to evaluate your child, I'm going to explain everything and to answer all your questions. But I want you to be clear. You cannot be in both approaches at the same time. If you choose to follow the ophthalmologist approach, hey, patch, do the prescription, do surgery. But if you choose my approach, it's going to be without patching. It's going to be with my prescription that I do different, very different. And I'm not going to recommend to you surgery, and I'm going to recommend to you other tools. So, you have to choose. And it's not to put them against the wall. It's that I need them to understand that also in this type of things, there is more than one choice. And most of the people only know one choice. Patch and surgery. And I think it's unfair because then they cannot choose.

Denise: True. So are there any cases where you actually recommend that, say, an adult has surgery?

Dr. Pilar Vergara: Me, I never recommend it.

Denise: Okay.

Dr. Pilar Vergara: Because I. I don't Believe in the, you know, I. When. When both Dr. Sanet and I, we teach together, you know, in many countries, he always say, speak about that. And I say, well, it doesn't mean that you have not to recommend it. I don't recommend it because I don't believe that that is the solution, you understand?  So I cannot recommend something that I don't understand the approach. If the problem is in the brain for me is like when you. In Spanish, we have the letter R and we say carro. We say, I don't know jarron. You know, many children don't know how to put the tongue. And then they don't say this letter. And they go to a speech therapist, and the speech therapist teach them to do it. No one cut their tongue or anything in the tongue. They understand that it's the brain, that they don't know how to put the tongue. And it's the same with people who cannot walk because they have had an accident, you know, a traffic accident, for instance, and they're in a wheelchair because they cut the spinal, you know, and they understand that cutting the, the muscles in the legs, they're not going to walk again because the problem comes from the brain. So everybody understand that. 

And then I say, if most of the cases. 95%, not 100%. Okay, 95%, only 500 has a problem in the muscle that could be the group that maybe can be helped by surgery. Okay, the other. And I say, maybe the 95% is a problem in the knowledge how to. To. To organize the information in their brains to coordinate both eyes. How cutting the muscles are going to help the brain to organize this? It's aesthetic surgery. So if you understand that and you accepted that and you understand that is not related with function. I'm okay. I don't have any problem. Yeah, but the problem that I see is that the parents don't know what.

Denise: Yeah. Well. And I think if you're talking about a child, it, it feels a little different to me than for myself because I, I don't know if you're aware that I actually had a lot of vision therapy and then I had surgery and then I had more vision therapy. And that's the only way that I got to my result. 

Dr. Pilar Vergara: That is in my book also. I am. If,  you make the decision to do the surgery. Okay. Then I would say to you, okay, do VT first, do the, the surgery after and do VT after. Why? Because the surgery is going to work in the motor part and what happened with the sensorial part, now one is going to help so we can do that part.

Denise: Yeah, and that's why I did it that way, because Dr. Davies and I had done everything we possibly could in vision therapy for years, you know, and my eye would not straighten. It was just stuck where it was, you know. I couldn't get it to relax to where it needed to be so that I could do any of the activities. And right after my surgery, I was back the next week and I could do everything.

Dr. Pilar Vergara: Perfect. I think that, that I had some cases like that also. And I don't recommend the surgery, but they take the option at the end because they see that really we don't solve it. And when they take the option, then I explain that, okay, we have done surgery. VT now you take the option to do surgery, I'm going to be supporting you because it's your choice. And now we are going to do VT after, right?

Denise: Yeah, well, that was, that was the thing that worked for me. But you know, my daughter only needed vision therapy, so I would have not ever chosen it for her, you know?

Dr. Pilar Vergara: Yeah.

Denise: She did great with just vision therapy. So what do you say to the skeptics who tell you or who tells your patients even that they shouldn't do vision therapy because it doesn't work or it's just a placebo or something to that effect? What do you tell those people?

Dr. Pilar Vergara: Well, I see many of these people here also. And first, I'm old enough not to be fighting. When I was younger, I try to convince everybody about what I believe. So strong now, no, now I'm more calm. And then what I do is just to talk. Okay? Not just so no passion. No, no, no. I just talk and then I explain to them that there is research is very strong from about 15 or 20 years ago. It's not something that I make up, is not something that people make up. It's something that is there. And the scientific research is so very clear that the problem is in the brain. And that is no one can say it's not true because it's not one research, it's hundreds. I don't know how many. That is the first thing.

 Second they say, but if that is true, why most of the optometrists and ophthalmologists keep doing the same. And I say, oh, that is a very easy question. Because, yes, it's very easy. It's because to change anything in the planet, not vision needs time. Needs time. So if they have been doing. They have been using the patch for 300 years, I think that they are going to change in one month, one year, two years. No, that is not going to happen. That is not going to happen. And also, that is also very important to explain to them. An ophthalmologist is a doctor who have studied medicine. Okay. Their main goal is to treat eye health. Okay. And I'm very thankful to God and to the planet and to the universe and whatever that they assist because they are wonderful to treat our health. Eyes, you know, I have a reduced detachment in my eyes and I go every year. I'm very happy with my ophthalmologist. 

But there is a point like in strabismus that there is not a pathology. It's not. It's not when they count the muscles and then it's 95% of the cases. Most of them are a developmental strabismus you know. And they study diseases and they don't study the function. It's not their job. They don't study when they are at the university. So they have some tools to fix this type of problem. That is the surgery, the patches and the glasses. And they use what they have.

Denise: Yeah.

Dr. Pilar Vergara: And they understand what they understand. So is it because they are not smart? Of course not. Of course not. They are wonderful smart people. I don't understand how to do a surgery. I don't understand how to put drugs. Why? Because I don't study that. That means that I'm not smart? No, I consider a smart person. But I study different things. So what I study, I study the brain, the relation between vision and brain and other thing is all optometrists on the planet study this. The answer is no. And I always make the analogy with psychologists. I think it's very easy to understand comparing with optometrists, you know, all the psychologists are psychologists. All. And they study different approaches. You know, I did psychoanalysis with a psychologist for many years. I'm very happy. I recommend it. There are many different types of psychologists, you know, the Jungianos, psychoanalysis, behavioral, many, many types. And everybody understand that. 

So in optometry it's the same. You know, some optometrists who sell glasses or make refraction and do primary care with contact lenses and all these type of things. Others who are more involved in low vision, you know, and others that are more related developmental vision and neurofunctional vision. And I belong to this group, right. So this group is a minor group. We are few in Spain. No, in the world. In the world, right. Why? I don't know. I can make hypothesis, but I don't know. I think that this, something deeper. You have to study a lot. And you, you have to. To have enthusiasm, and to be okay, to be in crisis all your life, you know.  Because you are out of your comfort zone or your life. And you need a type of personality and it's not good or worse. I'm happy to have my colleagues who do low vision. I'm happy to have the primary care. I'm happy to have all.  

But I'm this type of people that I love to be studying every day. I love to go to a new course to understand new things. And when I began studying the brain related with vision, then my brain explodes. And I thought, wow, wow. 55% of the neurons belong to the visual system. Really? Are you kidding? No. I see researchers and also all the sounds in the brain are related with the brain, with the visual. What are you doing? What are you saying? And then I understood the power of our profession.

Denise: Yeah.

Dr. Pilar Vergara: And. Yes, the power of our profession. And I thought what I have to say. Thank you. Thank you, thank you, thank you. Every day in my life, you have this beautiful profession. Why? Because I can help so many people in a way that anyone (no one) else can do it. So I feel very, very fortunate.

Denise: Yeah, well. And I love that not only do you practice it, but you teach others all of the time how to improve their own practices.

Dr. Pilar Vergara: But that is very selfish. You know why? That's very selfish. Because if I, you know, if I only a clinician, I can help maybe in all my life, I don't know, 30,000 in, you know, 40,000, I don't know how many. But if I teach people, each one can help how many in this life. You understand?

Denise: Yeah.

Dr. Pilar Vergara: So I was teaching for 30 years in many countries, different countries. I was very fortunate to met Dr. Sanet  33 years ago, and to be with him for years. So when you are so close to Bruce Springsteen, I call him Bruce Springsteen, you know, a monster of optometry. And you learn and learn and learn. Not everybody has this opportunity. And I took the opportunity to keep sharing what I learned from him. And not only like a professional, also like a person.

Denise: Nice. Do you have some favorite success stories that you want to share with my listeners today?

Dr. Pilar Vergara: In amblyopia or in anything, Anything in vision therapy? Yeah, well, I have many, many, many, many, many, many, many. Really? If you tell me, choose one. I think I cannot. I can tell you one recently, one from this week, if you want.

Denise:  Ok, yeah.

Dr. Pilar Vergara: That touch my heart. Very strong. I live in a small city in Spain, very small, so you cannot fly directly. You have to go to Madrid. I moved from Madrid to my hometown. And it's one hour, you know, and people from other countries come to visit to me. And I feel a big responsibility with that. Imagine.

Denise: Yeah.

Dr. Pilar Vergara: So some people from Romania came this week, and the mother is a physician. The boy had, when he was one month, a big, big, big stroke. 90% of the brain was dead.

Denise: Wow.

Dr. Pilar Vergara: Wow. Now he's about 10 years old or 9 years old. So the mother wrote to me because I attended other people from Romania, Serbia, and the mother speak with another mother. Okay. So I said, well, you come from another country. I cannot promise to you anything, as you know. Oh, yes. Oh, yes, I understand. I saw the kid. Well, the mother was wonderful. The kid wonderful. Nystagmus, low vision and cerebral palsy, you know, with problems in one side of the body, a terrible, terrible balance. Terrible. He cannot read, he cannot write, he can speak. Just that. And he doesn't want to wear the glasses. So the mother wasn't sure that the glasses was okay. The glasses was with myopia. So nystagmus low vision and -5, more or less of myopia. And he doesn't wear the glasses on all these things. Okay. Yeah.

Denise: And just so that the listeners know what you're talking about, can you just explain what nystagmus is? Just quickly.

Dr. Pilar Vergara: Yeah. Nystagmus is when you see that the eyes are moving from one side to side, you know, boom, boom, boom, boom, boom, boom. They cannot control the movement, and that reduces that. The visual acuity is going to be down because the one part of the retina that we need to be fixed to see, well, they don't have it. So it's very difficult. And also the stroke and the balance, everything was very difficult. And I learned. I have something inside myself that is always. If you don't try, of course you are not going to help this person. You need to try. That is in my brain all the time. So I have many tools in my toolbox. That is something I love a lot. I have syntonics, optometric phototherapy. I have special functional lenses, neurobalance lenses that are not related with the refractive errors.

Denise: Okay.

Dr. Pilar Vergara: We have also the lenses, the regular lenses. We have VT, we have sectorial occlusion. We have filters. We have o,n, on on. Okay, Many things. Sure. So I. I was with a kid. I prescribed some special lenses to him, and suddenly he began to have balance for first time in his life.

Denise: Wow.

Dr. Pilar Vergara: And he didn't throw away the lenses. The Prescription he was wearing was okay. And he put the lenses with the prisms. He began to look. He began. And the mother was crying.

Denise: Wow.

Dr. Pilar Vergara: You know, I was crying. And they told me they were going to be here. Yes, two days. Okay. Monday and Tuesday. That was last week. And then I said to her, could you stay here for one more week? And she told me, why. Oh, I have more stools. I want to see if I can help more. And she organized everything in her country. She was here one more week. We did phototherapy and we did VT. One week, only one week. He improved so many things. Attention, visual acuity, balance. He was happier. Many, many things that the mother said, why everybody don't know that you assist? And I say, well, it's a good question. Not me. What we do like a group, you know. And she said, I'm going to talk about your job to everybody. I'm going to say. And I invite her to. We have a association in Spain, like you have in OVDRA now. That was  COVD in the past. We have the same type in Spain. I'm one of the founders and right now, and the president. I invite her to come to our congress with other doctors to understand what we do. And she said, absolutely, I'm going to come.

Denise: Wow.

Dr. Pilar Vergara: And she asked me, there is no one in Romania who does this. And I say, yes, no one. You told me which is your favorite case. It's every week almost, you know, that was this week. And I'm still with my feet not floating the floor. I feel so proud to belong to this group of optometrists that I, you know, really, we change lives that, you know, we send her some work to do in Romania. I'm going to follow the case online and they're going to come back in October to do an intensive work again for a couple of weeks.

Denise: Okay.

Dr. Pilar Vergara: Wow. Wow. Imagine, you know, to come from another country with this type of boy with so many problems, you know, that and to find someone that can help you, you know. It’s great. But I have these stories with patients with brain injury. We had diploma. I have one in my website. It's in Spanish. I need to do subtitles in English. I have one with a subtitle in English. It was a man with 70 years old. That is one of my favorite also that came after Covid, that after the vaccination he had a problem in the heart and double vision.

Denise: Oh, wow.

Dr. Pilar Vergara: The doctor fixed the problem in the heart, but they couldn't fix the double vision. So, he put a patch on himself. He couldn't do anything. He couldn't drive. He couldn't. And the same day he came. I just prescribed a Fresnel prism. What is not so difficult, you understand? And he see once again, once again he was crying, the wife was crying. I was very emotional too. We were doing VT. That was a special case we solved in three months. That is not the average, of course, but in this case, syntonic was the key.

Denise: Okay.

Dr. Pilar Vergara: You know, so with this syntonic we reduce the double vision. A lot, a lot, a lot. The prism. A lot, a lot, a lot. And then we finished the case with VT. And now is maybe three years that he did everything. He keeps being perfect.

Denise: Wow.

Dr. Pilar Vergara: He sent me dozens of patients and he said, why people don't know that? And I say, good question, sad question, very sad question. Because in a beautiful world, we should be collaborating with a neurologist, ophthalmologist and another optometrist. And when they receive one of these patients and they don't know what to do, they will be very happy to send to us. And they don't send to us because two reasons. One, the most important is because they don't know we exist. That is the main reason they don't know we exist. And secondly, at least in my country, most of the optometrists are people who sell glasses and fit contact lenses and do the compensatory lenses. And they think that all optometrists, we do the same. They never thought that there is different approaches, different studies and you can find an expert in other field in optometry. They don't know that. And the third group, that is the group I like less, of course, is because we are not physicians.

Denise: Yeah.

Dr. Pilar Vergara: You know, and that happens a lot, not only in optometry, also in physiotherapists or speech therapists or many others, psychologists with psychiatrists. And that is sad. Also, I can choose to be a physician or to be a different thing. I chose to be optometrist because I work in a different things. But, you know, many, many physicians think you are not a physician. You, you are out of this. And that is also sad.

Denise: It is.

Dr. Pilar Vergara: And people, people think if you are not a physician, you cannot work with the brain, for instance, you know.

Denise: Well, I think a lot of people put it in the same category as alternative things like chiropractic, you know, and., it's still coming around.

Dr. Pilar Vergara: Yeah, we are. Yeah, I agree. There is here in Spain there is a big campaign against many things that are not science, you understand, between courts and we are there. Yeah, please. There is a lot of research. That's first and secondly, even in medicine, you have to prove something in the clinical part before you do a research. If not, the medicine cannot go ahead. You know, what happened with cancer? How many people are trying you know something that is not proved, but they do anyway because, you know, I'm happy that the research assist. It's not that I don't have it, but I think that some people have lost their head with that completely, you know. So if you cannot do and prove a double blind with blah blah, blah, blah blah blah to publish in the most top journal in the planet, what you do is something is not worth. Jeez, what happened with the, you know, with some drops for glaucoma or maybe I don't know if you know that for instance, the bipolar depression. I don't know if you know that that is treated with lithium. They have no idea how it works. They no idea. In the bipolar disease, the psychiatrist send lithium. They don't know the mechanism. They don't know how aspirin decreases the fever yet and it's something normal. 

So if the medicine uses these type of things, it's okay. Although it's not proved by science. But if a person that is not a physician use any tool. We are what we are. Alternative means that we don't know what to do. And we are witches or what we are. You know, it's sad also again, I think that the word that I'm happy to use today is sad because how many people are not being helped? How many people are with so many problems that nobody can help because they really believe what the other people said. Because we don't have a double blind research on that, you know. But that is the reason that some of the people like you or me or another many, many people are always fighting, fighting, you know.

Denise: Yeah.

Dr. Pilar Vergara: And we don't, we don't shut up. We say what we think.

Denise: Exactly. We definitely say what we think. What can we do more than we're doing to help people understand the different options that they actually have when we're treating an amblyopia.

Dr. Pilar Vergara:  I don't know because I speak, I write books, I give lectures, I give, you know, I go everybody who calls me, I always there, you know, to talk. And I'm a. I don't have a lot of time, you know, But I think that is a priority. Iit's the way I understand. And I'm not afraid. It doesn't mean that I'm happy, you know. Because some people sometimes talk about me very ugly, you know, things or against me or whatever. I don't care. I think that when your goal is bigger than you, then you don't care. And my goal is. I don't know if I will see that or maybe I will be in other dimensions. But my goal and Dr. Sanet’s goal and our goal is that even one child in the world has to have a patch in the future. Even one. That people laugh when they study in the books. Oh my God. People were patched when they have 200 and a binocular problem. Were they doing this? That was an anecdote. You know, like now, for instance, when you read things like the psychiatrists treated some problems taking out part of the brain. You know, now it's like, oh my God.

Denise: Right.

Dr. Pilar Vergara: Was. Was part of the process. And I patched in the past, but in the moment I understood what the science is telling us. For years I understood I have to find another way.

Denise: Right.

Dr. Pilar Vergara: So it's my responsibility to. To find another way or to accept another way or to treat another way that someone else give to me an idea how to do it. So this is my goal and I work for that. And I'm going that we will get it. Absolutely. I have no doubt. But I don't know if I will be alive to see. That I don't know.

Denise: Okay, that's a great goal. A world where no one uses patches to treat amblyopia. I like that.

Dr. Pilar Vergara: Exactly. That is my goal. That is my goal.

Denise: Great. So, I know you do a lot with brain injury patients too. What can you tell us about recognizing when you have a brain injury that needs vision therapy as opposed to whatever else other people would do for a brain injury?

Dr. Pilar Vergara: I think that we have like three big groups of people that we treat that are very long when they have visual problems. And people don't recognize the visual problems like part or big part of the problem. The first group is learning problems. The second group is that amblyopia and strabismus. That is, they know that this is a visual problem, but they don't understand that this more beyond that 20/20 visual acuity. And you know, and also that is not just surgery.

Denise: Right.

Dr. Pilar Vergara: And the third group is patients with brain injury and concussions. So, first people think that brain injury patient have to be someone who have been in the hospital because (they) have had an accident and it's a dramatic, you know, problem. And. Yes, yes. But there is much more that are mild brain injury.

Denise: Right.

Dr. Pilar Vergara: Or they had a concussion in sports or in your life, many children. Because it's very easy to bump with something. And if you think that 55% of the neurons belong to the visual system and all the lobes in the brain and all part in the brain are related in some way with the visual system, also the cerebellum, also the brain stem, also, you know, blah, blah, blah. So many. It's very easy that something is not going well after you have this problem. But if your thought that is the problem in learning problem and in this group, especially if yours and also in amblyopia and strabismus in some way. If your thought is that vision is synonymous or 20/20 sight, you don't understand anything about this. You know, because we have so many skills related with vision that we use in a normal way in our life every day. And we never think about it. That is so easy that we have a problem in a. You know, if we have an accident or a mild brain injury and our life can be destroyed. I cannot read again. I cannot walk well again. I cannot have balance well again. I cannot think well again. I cannot have a visual memory good again. I can’t have so many things. A list of symptoms. 

They can go to the NORA website in United States. And if someone who listens this podcast think, oh, that is interesting. Maybe there's a list of symptoms that you can see if you have it that are not only not to see 20/20. And the good news is that there is a part of optometrist I do also this, that we work with the brain and we can reconnect some part of the brain that have been interrupted. We can to do new connections in the brain that this brain began working better. We can do many things with all the tools that we have to give another opportunity and to give them their life back again many, many times and or to improve their quality of life. Maybe the problem is so severe that we cannot solve absolutely. But tumors that have been removed, people who have had a stroke, not only an accident. And that is in my new book. I have some questions about that. But really, the website NORA, they have a lot of. And every day I have more and more patients with that because I work very hard to give lectures and to give information so people can understand how we can help them.

Denise: Nice. So there's more people learning that they can have a better quality of life if they treat that traumatic brain injury with vision therapy. Right?

Dr. Pilar Vergara: Yeah. I'm going to give you an example with a patient.

Denise: Okay.

Dr. Pilar Vergara: Maybe that was seven or eight months ago. That is a dramatic one. Okay. But I can give you not so dramatic for this week. A boy, 23, 24, had a very severe car accident and was in a wheelchair. Okay. Very traumatic. He almost died. After two years, two years. Listen well, working with him with many, many things, but he was in the wheelchair, he couldn't walk. So he was recovering, recovering, recovering. But he couldn't walk. He stand up and he sit down again. So Sunday, one speech therapist who have listened to me in a lecture said, why you don't go to see Pilar? I think she works with this type of person. He came, you know, he had a functional visual field so small, like  5 degrees. And this peripheral awareness is completely related with balance, right. And is not related with his feet. So he had 20/20 and he doesn't have balance. So I did syntonic and I put a special lenses and with training now he's walking.

Denise: Wow.

Dr. Pilar Vergara: So absolutely. It's not always like that. You can have a different type of problem that you cannot walk. But also we have to consider how important is vision for balance. This. This week I have a different one. No, this week, not last week, various sport, 23 or 24 old man who have a punch. You say a punch in the eye in a soccer match.

Denise: Okay.

Dr. Pilar Vergara: He have an injury. The ophthalmologist care about the injury. And when he finished and everything was well, he said, but I'm not okay. And the ophthalmologist said, yes, you are okay. No, when I turn my head to the left, I feel dizzy, I'm slower. I'm an engineer in computers, I'm slower. I feel not well. But I have two screens. And that didn't happen to me before, right. The ophthalmologist said, it's your brain because your eye is okay. He came to me, I did the evaluation, absolutely. He had visual problems. And it's only two weeks we are treating him. He recovered, I don't know, 70%. He come back to do us. He's so happy. And I said, if you want to recover more now we have to do VT because we use his lenses. I use syntonic again and I use sectorial occlusion with him. And he was so happy. But he came by accident here also. His brother is a physiotherapist and he heard about me. And this man said, what was going to happen with my life if I didn't meet you? And he said, sad, very sad. So you see, this is two streams, you know, one very, very severe, he couldn't walk, right. And the other one, it seems like everything was well, but he was slower, he was dizzy when he turns the head to the left, he cannot do a sport again. But both of them diminished their quality of life because of vision problems.

Denise: Right. And that's not the first thing that people think of when they have those kinds of issues. They don't think, oh, it has to be my vision.

Dr. Pilar Vergara: Oh, not the first. They don't think about it.

Denise: Yeah, exactly. So I think it's important.

Dr. Pilar Vergara: People have the intuition, you know, this, this man, the second one have the intuition. He said, something is wrong with my vision. I don't know what it is, but it's with my vision. He had the intuition. But when you go to one doctor, another doctor, another doctor, and all of them say, no, everything is okay.

Denise: Yeah.

Dr. Pilar Vergara: Then you begin to think, oh, maybe it's true, I need to go to the psychologist.

Denise: Well, they say it's in your head, but they're not actually telling you the truth. That it's in your head, but it's your brain and you need the right doctor.

Dr. Pilar Vergara: Exactly. It's in your head. But you know, I had a testimonial in my website about another woman who had a bus. I don't know how you say in English, you know, he was crossing the street and a bus, how do you say, bump her? You know, okay, yeah, She had a brain injury and she was in the psychologist and psychiatrist treating by depression for some months and the problem was be solved.

Denise: Yeah.

Dr. Pilar Vergara: So, but finally she was thinking, oh, maybe they're right and you know, they cure some part of the body that was hurt. But all the time she said that, she said, I see well, but I don't see well. She uses this quote, I see well, but I don't see well.

Denise: Yeah.

Dr. Pilar Vergara: So imagine, thinking you are not good in your brain. You know, you need a psychologist. But she was right. She. The side was good, but she had problem in the spatial part. So, for her the world was like not stable, not any more stable. And then she felt very insecure. Very insecure.

Denise: Right.

Dr. Pilar Vergara: Again, we use the lenses in a very special way and we solve it. With that I want to say that we don't solve all the problems in the planet.

Denise: Right?

Dr. Pilar Vergara: No, I want to be clear with that because maybe I'm very passionate. And then. And you too. And then talking, maybe. Oh, this woman think that she can solve everything. Absolutely not. I wish, but it's not, you know, but we help many, many, many people. And that is true, completely true.

Denise: Right.

Dr. Pilar Vergara: And there is groups of optometrists like me in many countries, so they have to look for and to, and to. If one doesn't help you, doesn't mean that another one can’t help you.

Denise: Right.

Dr. Pilar Vergara: Maybe the first one doesn't have enough knowledge.

Denise: Yeah.

Dr. Pilar Vergara: I'm very stubborn. So I keep looking for, looking for myself, even for my health problems, you know, always. And I also take responsibility. I always say to my patient a thing that I think is very important. I say, you have a visual problem. I don't know if I have the knowledge to fix it or not to fix it. If I don't have the knowledge, it doesn't mean that it cannot be fixed. Maybe you find someone else who can fix it, or maybe in the future we have other tools to fix it. But I take responsibility because I'm a person who thinks that most of the things can be fixed, but we don't have the knowledge to do it.

Denise: I agree. Yeah, I, I feel like most things can be fixed too. We have to figure out exactly what the issue is and then come to the solution because we've gone through all this.

Dr. Pilar Vergara: Yes. And you know, but you know, also another important point. I think that you need to find a doctor, an optometrist, a doctor, whatever, that cares. Because now in the world, many people don't care.

Denise: Yeah.

Dr. Pilar Vergara: And that is something. You know, I'm a neurological person with problems. I had the tumor in my back in the colon when I was 27 years old. And then I had a lot of side effects, neurological side effects. And so I have a big empathy with a group of brain injury and with all the patients, because I was this type of patient who went from one doctor to another doctor to another doctor to try to be helped.

Denise: Yeah.

Dr. Pilar Vergara: And the only thing makes me feel well is when I find someone who cares.

Denise: Right.

Dr. Pilar Vergara: Because I found so many who really didn't care, you know, so if they didn't care, what can I expect?

Denise: Right.

Dr. Pilar Vergara: So look for someone that really cares.

Denise: That is great advice. I feel very blessed that I did find a doctor that really cared.

Dr. Pilar Vergara: Exactly, when the doctor cares, you know, in the moment. And maybe you are younger, maybe you don't have all the knowledge, but because you care, you try to study, you call your colleagues, you try to put not 100%, you put 300%, you know, with the patient. Because I want to help you. Absolutely. The knowledge is important. You  can care, you can have a very good attitude. But if you don't have knowledge. So these two things, knowledge and care. Knowledge and care. But, if you only have Knowledge. It's not good. Usually it's not enough. Yeah, no, you need someone who cares.

Denise:  That is wonderful advice. Yeah, I. I totally agree with that. Well, I know I've kept you a long time today, and you have things to do that you need to get to, so we'll probably.

Dr. Pilar Vergara: I was so well talking with you that the. The time fly. You know, I don't know how you say in English. We say. In Spanish, we say el tiempo vuela. That means in literally in English is like the time flies.

Denise: That's how we say it.

Dr. Pilar Vergara: Okay. We say the same.

Denise: Yes, it did.

Dr. Pilar Vergara: Thank you very much. To invite me was very. Really an honor. And I wish that some people can you now listen this podcast and think, oh, maybe someone can help me. I have this or have the other thing. These are options. I wish.

Denise: I think they will. I appreciate it. And we'll catch up again at another point in time and hopefully you'll have that book in English and then I can tell everyone that your third book is in English for them to read.

Dr. Pilar Vergara: Oh, yeah, I need. Well, I want to do both.

Denise: First one and the third. Yeah.

Dr. Pilar Vergara: Yeah. Because some people told me, oh, there is hundreds of books, like your first book in English that is related with learning. And I say, no. Related with learning. Yes. But, like, my book is only my book.

Denise: Right, right.

Dr. Pilar Vergara: You know, every book is different. Yeah, every book is different. And you can take some pearls or some keys or some. From this book, from the other book, and maybe some people can benefit from my book. I write in a way, like, very simple.

Denise: Yes. I agree.

Dr. Pilar Vergara: And yeah, it's my gift.

Denise: Yeah.

Dr. Pilar Vergara: You know, I can communicate with simple words and I. I can explain difficult things in a simple way. And it's my gift. And so I deserve. I. I think that it's my obligation to use my gift to help people, giving them information.

Denise: Yes.

Dr. Pilar Vergara: So I want to translate this and I want to translate the third one.

Denise: Yeah, both great. We're going to have to work on that together somehow.

Dr. Pilar Vergara: Oh, yeah, could be great. Maybe. Yes, Maybe it's the only way. You know, I have tons of, you know, priority things. And then I say, okay, that next month. That next month. And because I don't find the time, you know, I say always, I cannot clone myself. It's. The time is limited.

Denise: Right. Yeah. Okay. I'm going to give that some more thought.

Dr. Pilar Vergara: Thank you not only for the interview, thank you for all the podcasts that you do to give the opportunity to the people to have these stories. This, you know, to share, to find a secure place to share and so people can. Can have this. This is gold. It's gold. So thank you.

Denise: Thank you. I appreciate that. It's my pleasure.