Taking The Lead Podcast_081226_Joshua Robinson
Leslie: [00:00:00] Welcome to the Taking The Lead podcast, where we empower people to be unstoppable I'm Leslie Hoskins with my co-hosts, Alyssa Otis and Timothy Cunio You know, guys, it's that time of year already where we're prepping for Blindness Awareness Month and some of my most favorite activities.
Alyssa: Yes. This is the month that...
Leslie always shines. But this is the month that she truly shines. Every... She's got her cane earrings on, and she's got little clips on her bag, and we are all about the white cane for October.
Leslie: Yep.
Timothy: Don't you have a cane in your house with some lights on it?
Leslie: Oh, my gosh. That's a fantastic idea, Timothy.
Alyssa: It's a new, new sconce.
Leslie: Yeah. A
Alyssa: little
Leslie: folding cane. I do have a lot of canes always, like, with me and around. Like, I've got some at my house just I don't know for what, just in case maybe- Yeah ... somebody needs it or... I used to always have one in my car, too.
Alyssa: I was gonna say, I just gave a, a GDMI a ride in my car, and they go, "Why do you have a cane in here?"
I go, "Well, you know, Leader Dog." "We offer more than guide dog mobility," you know? [00:01:00] Um, so that was a great learning opportunity for them.
Leslie: You just never know who you're gonna run into and what you need to... I always have a business card on me because- Oh,
Alyssa: gosh, yes ...
Leslie: anytime I, uh, run into somebody out in the public, I've been known to stop people.
At, uh, Ron Jon in Florida, I saw a woman traveling with a cane, and I introduced myself and...
Alyssa: That's... I always say we're doing outreach- Mm ... regardless if we're actually at work. I was at a garage sale not long ago wearing my Taking the Lead shirt. Yeah. And somebody starts talking to me about community events that they wanna get into, so I handed them a business card.
Leslie: It's great.
Alyssa: Yeah, 'cause you never know when you're gonna meet people out in the world for, uh, volunteer opportunities or- Yeah ... potential clients.
Timothy: Well, I run into some at... Like, at last weekend, I ran into a guy at the, at the, uh, restaurant, and he had a cane. He's probably 40, 50 years old, and I went up, introduced myself, gave him a card about Leader Dog- Yeah
and said, "Hey, you know, if you need a, a f- a refresher or whatever, give m- give us a call." So- Yeah ... you just never know. You-
Alyssa: And that's so true ... you don't. You never know who can benefit from these services, and even sometimes it's not the services that we [00:02:00] offer all year long. So all year long, we of course have our guide dog program and our orientation and mobility, and we do have our teen programs and teen summer camp and teen O&M, but we do other programs too that people can get involved with that are not necessarily run by Leader Dog.
But for example, we have Cane Quest coming up.
Leslie: One of my favorites. I... It, it really is, and it falls in October, which of course is my favorite month, and White Cane Day. And we kinda host Cane Quest around that time because we're celebrating. Uh, so Cane Quest, this is gonna be our fourth year hosting. Yeah.
And we partner luckily, uh, with the, uh, Education Consultant Department, Michigan Department of Education Resource for Blind and Low Vision, just a fantastic team of professionals, and they really reach out to school-aged kids living in Michigan. And we invite them to Leader Dogs for the Blind campus, where we have kind of this cane contest.
Alyssa: That's a good way to put it.
Leslie: Yeah. It's like an obstacle course for your cane, and we're, like, testing all these different skills. And really, they're competing [00:03:00] against themselves, right? Hopefully, their scores increase from the year previously, but there is a first, second, and third place winner.
Alyssa: And the prizes are clutch.
Leslie: So many great prizes. family members come- Mm-hmm ... and we do educational opportunities, and also we do get to talk about guide dogs. Not everybody gets an opportunity to learn about what a guide dog can and cannot do, and if it's a goal of theirs, what skills do they need to have in order to achieve that?
So it's just, it's one of my favorite days because it also brings all of our COMs, our certified orientation mobility specialists, at Leader Dog and around locally together, so it's like this networking, and you get to catch up with all your people and, and see the kids really thrive, and it's just great.
It's one of my favs.
Alyssa: It is one of the better... Well, I shouldn't say one of the better events, 'cause I happen to love all of ours. But I feel like with all the kids, it just, it's like running wild. It's like teen summer camp, but just for a day, um, which is an absolute blast.
Leslie: Yes. Lots of fun. Timothy, if only you were [00:04:00] here to have- And a teenager.
Right, and a teenager.
Timothy: Feeling
Leslie: a
Alyssa: little bit young.
Timothy: Yeah. That's the pr- I think the age problem's the biggest problem.
Leslie: It really... Yeah. There's only a couple... But you know what? It would be fun to do this with adults. I think actually- It's actually a
Alyssa: really good idea ...
Leslie: right? Like, really test your cane skills and, and not just cane skills, but all orientation mobility skills.
Mm-hmm. So we, you know, we talk about low-hanging objects or obstacles and things like that. Yeah. Upper hand protective. Street crossing. Yeah, just like so many things, but we put it in a very controlled situation, and it's very, very fun. So if you are living in Michigan, um, and you're a student and you're interested, ask your O&M specialist about Cane Quest.
We do it here on the east side of the state, but they also have been doing one on the west side of the state- Mm-hmm ... too, so to cover all the ground. And also if you're not in Michigan, check out your state. Yes. A lot of states are doing Cane Quest, um, so it's a great opportunity to get to know other people in the community and, and test out those skills.
Alyssa: And that's it. There's so many things that people can learn by coming and doing [00:05:00] those, those programs that we have. Um, and today we actually want to talk to somebody who works in the blindness and low vision field. So a lot of these teenagers or kids that are coming to us are bringing family members, and this is somebody that they might wanna hear from, too.
Um, he unfortunately will not be at Cane Quest- ... but you get to hear him right here on the podcast. So today we are joined by a highly accomplished leader in the field of low vision care.
Leslie: Yes. Joshua Robinson earned his undergraduate degree from Indiana University and graduated magna cum laude from Illinois College of Optometry.
He completed a residency in low vision rehabilitation and ocular disease through the Illinois Eye Institute, the Chicago Lighthouse, and the Spectros Institute for Low Vision. He is an associate professor of clinical ophthalmology and visual sciences at Vanderbilt University Medical Center and serves as the Janet and Jim Ayers Director for Low Vision Care at the Vanderbilt Eye Institute.
He is a fellow of the American Academy of Optometry and a diplomat in the low [00:06:00] vision section of the academy.
Timothy: Dr. Robertson, it's a pleasure having you here this morning. We could talk about my Georgia Bulldogs taking on Vanderbilt here in a few weeks. But that's a different show.
Leslie: Yeah.
Timothy: Uh, can you tell us about your journey with optometry and low vision?
Joshua: I'd be happy to. Thanks for having me, and I'd probably steer your f- college football conversation toward the Indiana Hoosiers while you tie me in. If, if you're gonna open that door, I'll take it. All right. Uh, still s- still riding that high from, from last season. But thank you. Um, thank you all for having me.
Sure. I, um, I ... I'm someone who knew for a long time that I wanted to, um, do something in the healthcare field. I, as you mentioned, I got my undergraduate bachelor's degree from Indiana University, and at my time there, I was fortunate to be able to s- spend some time, uh, shadowing and spending time clinically and personally with, with folks in a lot of different areas of healthcare and kind of whittled down my interest and decided I didn't wanna be a surgeon [00:07:00] and, and wanted to provide kind of day-to-day, face-to-face, immediately impactful care for people.
And, and optometry was one of the things that I was exposed to that I kind of, um, really connected with and fell in love with the immediacy of it and some of the relationships that were able to be built. And so I, I dove into that and got as much exposure as I could, and that's what set me on the path to eventually attend optometry school in Chicago, like you said.
And as far as sub-specialization into the field of low vision, you know, again, coming back to a common thread in a lot of my life, which relates to sports, I, um, uh, while I was a student in Chicago a- and as someone who had grown up a lifelong fan of the Chicago White Sox, I found out that one of the alumni from our school, the Illinois College of Optometry, was practicing in the Chicago area and happened to be the team optometrist for my beloved Chicago White Sox.
Which again, that's going pretty well. It's ... This is a, a good time. The first [00:08:00] time in maybe a decade I've been able to publicly express my fandom for that team. They're, they're finally relevant again. There you go. So it's been a pretty good year from a sports standpoint for, for yours truly. But, um, I reached out to him, Dr.
Tracy Williams. I try to give him as much, as much credit as I possibly can for setting me on this path. I, I connected with him via email and said, "I understand you work with the White Sox. I'm, I'm here at ICO. I'm doing research for the summer. I'd love to hear more about what that's like and how you got into that.
Like, that interests me. I don't know what I wanna do within optometry." And he replied pretty promptly, and he said, "Um, I'm glad you reached out. Uh, you know, thanks for getting in touch. The work that I do for the White Sox is probably less than 1% of, of what I do day to day and week to week. But if you're interested in learning about the other 99% and what I'm really passionate about, you should come out and, and visit my clinic."
And it turns out his clinic was the Spectrios Institute for Low Vision, which you int- [00:09:00] introduced in, in my introduction as eventually part of my residency training and my clinical practice. And it's a, it's a small, you know, relatively small private nonprofit in the suburbs of Chicago that does low vision, comprehensive low vision rehabilitation.
And at that point in my training, I didn't know what low vision care was, and I said, "Of course, I'm gonna come out and, and spend time with this guy. I don't care what he's gonna show me." And I, I sat down and observed a couple patient interactions and saw, like, a real immediate impact that he was having and his staff were having on, on people dealing with vision loss, and immediately clicked and said, "I could see myself doing this.
Like, this is-- I think this is what I, what I wanna do." And it was all because I reached out um, about his connection with my favorite baseball team. So, uh, kind of by chance, he introduced me, and, and we're good friends to this day, and I learned a lot from him, and it kinda set me down this path of pursuing residency [00:10:00] training in this field.
Again, I practiced with him at Spectrios for a few years before relocating here to Nashville and, and trying to build a similar service here within our Department of Ophthalmology, and that's, that's where we're at today.
Alyssa: I feel like that has been the journey. Um, I know a lot of, you know-- Leslie and I, we're, we're lucky enough to go to Chicago.
We got to visit, uh, Spectrios and, and a few other different places. But you mentioned the term low vision a few times, and I just wanna make sure we touch on that because maybe not everybody fully understands exactly what that means. So how would you define low vision? How is it different from blindness?
Joshua: Sure. Um, I get that question a lot. I think sometimes for a normally sighted individual, it's hard to appreciate the continuum or s- sort of the, the levels of vision impairment beyond normal vision and, and total blindness. I see people who have low vision or impaired vision that is basically [00:11:00] suboptimal, can't be corrected with traditional glasses or contact lenses or surgical intervention.
Um, typically low vision in my patient base results from a medical eye condition or injury or neurologic condition that causes vision to not be correctable through typical means, and that's why they get referred to someone like myself who, um, tries to help them to maximize what they've got and then learn to adapt and adjust and work with the vision that they have so that they can keep doing the things that they wanted to do in their lives.
Timothy: So, as long as you've been doing this, uh, in this field, how, how much has changed since then, since you started?
Joshua: A lot continues to change. I think we, we use a lot of optical tools and devices that play by the same rules that they have for centuries. Lenses and light interact in the same way that they did 200 years ago, and we use [00:12:00] various lenses as sources of magnification in our patient base.
I think, um, where the big changes continue to occur very rapidly and in a way that's hard to even keep up with, uh, which is a good thing, is assistive technology and the, the smart devices that we all carry around with us every day, and that, that contain a lot of power and capabilities that many of my patients and people who maybe might benefit from some of the vision accessibility features don't even know they're carrying that sort of poc- uh, power around in, in their pocket or in their bag.
And so with new apps and accessibility features and more portable and more accessible, and now, uh, artificial intelligence capabilities, um, that technology continues to evolve very rapidly, and it's changed the way that we, uh, care for and educate our patients, and in many ways changes how they're able to, um, you know, maintain independence in certain ways or, or, or continue [00:13:00] working or, you know, some of-- some meaningful things that can be threatened by vision loss.
Leslie: It-- And you're ex-exactly right. There are so many different tools and resources now available to individuals, and if you're not experiencing low vision or blindness, you may not be even aware- Mm-hmm ... what our phones are capable of. Sure. And different, uh, even, right, using a camera and zooming in on different things can be incredibly helpful as a tool.
But can you tell us a little bit about, you know, somebody comes to you, they're referred to you from, uh, from a doctor and for your low vision services, what does that process look like? Like, like what services are you able to provide on your team?
Joshua: So we're hoping that this continues to grow, um, in the near future.
Currently, I'm, I'm the one performing, you know, independently performing the low vision evaluation when these referrals come in, typically from an ophthalmologist or an optometrist or, or a physician of some sort who's monitoring or managing the eye [00:14:00] condition which has caused the vision loss. Mm-hmm. Once, once an evaluation is completed with me, I have, um, I have resources here within our medical center, including both outpatient and home health occupational therapy- Mm-hmm
which I lean on, and Beyond that, much of what I am connecting patients with or referring to for additional training and support services lies outside of VUMC, our medical center. Some of it is local within our county or within our state programs. You know, national programs like Leader Dog and others that we are trying to put the pieces together and connect patients to, um, is a big part of, of sort of my management plans and making sure that someone who might benefit from those services is being made aware of them and being connected in a timely manner after I've done what I can do clinically to try to optimize their vision
Leslie: That is just such an important piece.
I know. We can't stress that enough. Thank you for [00:15:00] doing that. I-- We hear from clients all the time, right? They have their diagnosis at... and they hear there's nothing else that can be done, and, and then sometimes that's the end, right? They're not referred out to that next step of blind rehab, um, or additional resources.
So just passing along that information that resources exist- So helpful ... rehab is available in so many different ways, it really impacts people's lives. And, a- and it's the next step when they're ready, right? Sometimes they're not ready- Yeah. ... and they need to- For sure ... take some time. But to be able to do that, and I'm sure as part of your, um, appointments and evaluations, I'm sure a lot of education is happening there in those conversations, like explaining what their eye condition is and what that means as a prognosis, but also, right, like, it...
They call it practicing medicine because we are practicing. We don't necessarily always know definite answers for each person. So how do you approach some of those conversations?
Joshua: Yeah. Regarding what you just said about the initial referral [00:16:00] being important, you know, I'm not the one... I'm rarely ever making a diagnosis.
Like, these are individuals who are being managed and monitored outside of my direct clinic, and the first hurdle is them even getting referred to someone like me. There's not enough-
Leslie: Yeah. ...
Joshua: of us doing what I do, and the, the population sort of demographic, uh, trends indicate that especially some of these age-related eye conditions will continue to become more prevalent and have a broader impact, um, on more people.
And I think there's just a lot of patients floating around out there, like you say, who are told maybe medically accurately so that there's nothing more that can be done. They're getting their injections for their macular degeneration, or they've, they've, uh, they've controlled intraocular pressure to the point that their glaucoma is not progressing, but then they're left with day-to-day functional deficits that their medical eye care provider cannot help them meet.
And if they're not told that there's a next step and that door's not open, then they're left [00:17:00] thinking, "Well, that's it." Like-
Leslie: Yeah ... "
Joshua: I may never, y- you know, be able to socialize in this way or drive or work in the same way that I've done or get through school" or, or whatever that is. And so a lot of what I'm trying to do in, in building bridges and connections here is to make the first step, that referring provider, aware of my services so that then I can refer to Leader Dog or for other resources outside of what I'm doing.
And a lot of the, a lot of the conversations, as you ask, with my patients and what that education looks like with them is both trying to answer as many questions as I'm equipped to answer regarding their eye condition or why their diagnosis causes their s- the center of their vision to be absent, or why they have trouble navigating in a dark room, um, to the capacity that I can because many times their retina doctor has, you know, 90 seconds of, of time face to face with them.
Mm-hmm. Mm-hmm. They come in and they anesthetize, and they give them their [00:18:00] injection, and they say, "See me in six weeks," and then they're out the door. My patients are left thinking, "But, but what about all the other stuff? Like, what about all the questions and the fears and the, and the anxieties that I may have, and the questions my family has, and what does this mean for everything?"
And so, um, as much as I, you know, I'm, I'm not a counselor, uh, but as much as I can, I try to make space in that visit for people to ask their questions or air out their thoughts and their grievances that they haven't been able to. Just give them sort of a, a, a safe space where they feel like they're being heard, and that I can validate some of the concerns they have so that if we can finally sort through all of that, I can say, "Okay, now, I've, I've heard you ask this question.
I've, um, I get the sense that you're struggling or dealing with this. Let's try to find some ways that we can, not perfect or undo your eye condition, but how can we equip you to better tackle that stuff that's causing you to lose sleep at night? Like, how [00:19:00] can we, how can I try to help you adapt and adjust to this new reality and not have to give up on that meaningful thing that you don't wanna give up on doing?"
And so a lot of steering, uh, steering the discussion toward turning our attention and focus to what's in front of us and Realistic, but, but positive and hopeful expectations rather than, uh, pouring that energy into what's been lost and focusing on what I once had that might not be coming back. And that's a delicate sometimes, uh, as you all probably know, that's a delicate conversation that sometimes requires someone with better, you know, higher level credentials than me, and that's why I connect with support resources and, and counseling and mental health type things too because that's a big part of the puzzle.
Alyssa: And that's so important, is, is treating the whole person. So, you know, we talk about that often at Leader, how we focus, you know, at this point mostly on that [00:20:00] mobility. Uh, but there's so many other things that people might need. So I wanna thank you 'cause I know one of the big things that Leslie and I do is we go out, we travel, and we try to, to educate people in the blindness and low vision field to be able to refer to Leader Dog or any other organization that might fit somebody.
So that is exactly what, what we need out there. You are boots on the ground helping, helping everybody out, so thank you on that.
Joshua: I'm trying.
Timothy: Well, Dr. Robertson, do you feel like over the past 10, 15 years that more people are needing your services? Do you see an uptick in how many patients you see?
Joshua: Yeah, there's definitely an uptick.
I think there's well-studied and documented upticks in, in frequencies of some of these, uh, irreversible eye conditions. And while there's medical advances being made that are able to maybe stabilize or in some cases reverse course in some of these conditions, I think, you know, the vast majority of the patients I see and of the [00:21:00] patients seen by others in my role at other, um, academic institutions or, or 501[c][3]s boils down to a lot of age-related macular degeneration and glaucoma and diabetic eye disease and related complications.
And as the population ages generally, um, those age-related conditions become more prevalent, and there's more and more people who need these services. And it's a type of service that is, is time intensive, as you can probably imagine. And so I'm, I'm at my capacity as far as how many patients I can care for in a day.
And so trying to, uh, trying to spread the word and get more people trained and in positions like mine so that we can care for those growing numbers of patients is, is like a whole other side of this discussion and making sure we can meet those needs.
Leslie: And to that point, I mean, thinking of the next then progressive, the next 10 to 15 years, what would you like to see in this area of, you know, low vision [00:22:00] resources a- and the healthcare field and, and how really we can pre-prepare obviously more people, but what else do we need to do?
Or what do you hope to see?
Joshua: What would I hope to see? I think from an education standpoint, in my field, in optometry, and I'm, I'm part of the efforts trying to make this more of a reality, I think there has to be better early exposure and education to low vision as a sub-specialization option and, and demonstration of the impact it can have.
Like when I visited Dr. Williams that first day, and I didn't know what low vision was, and I sat in on a patient visit, and it blew me away that he was doing things with tools and with taking a lot of time and with very, you know, intentional listening and, and communication that seemed to be changing this patient's life on the spot in a way that that person never thought was going to be possible.
And I don't think that optometry [00:23:00] curricula and, and the education that we get in optometry school focuses enough early enough on the impact that this field can have. And so it leads to less students and graduates going into this field and, and making this sort of impact. Um, so that's sort of the, the grassroots approach to try to meet these needs.
I think in general, if, if I could have my way, it would be nice to ... I think, I don't wanna put words in your mouth, but from what I understand in working with, uh, blindness and low vision programs and collaborating with them across the country, it's a similar issue that there's not enough certified O&M specialists coming out of these programs to- Yeah.
Absolutely ... to serve the needs of these populations. And so how do you, how do you advertise it and present it as a meaningful and rewarding and viable, uh, career path for someone who might really fit into that but just doesn't know what they don't know when they're, uh, at some point in their undergraduate education, or maybe they're out and they're [00:24:00] working in some other field?
And so I think that getting at it from the foundational kind of educational standpoint is, is a big part of it. I'd love to see more, uh, Medicare and insurance coverage for some of the tools and services that we prescribe- Mm-hmm ... and utilize, and less of a separation between sort of the medical reimbursement model of medical eye care and the more, I guess, colleges of education-related, uh, blind and low vision rehab services that are not typically traditionally billable through, um, some of these insurance means.
Because oftentimes folks on limited or fixed incomes or on, on disability incomes can't, uh, afford some of these tools and services, and then we, you know, we utilize services like Leader Dog, or I utilize some of the limited grant and [00:25:00] philanthropic funding that I have to bridge that gap. But it's gonna continue to be a problem as these, you know, populations change and as more and more need arises for these things that, um, insurers are not recognizing.
Leslie: Yeah. There's, there are a lot of gaps and areas that we need to improve, as you mentioned. Uh, people not qualifying for certain services. There's barriers there. And also that education piece. I ... You know, we've heard from lots of eye care professionals that there's really not an opportunity or And maybe not a t- a lot of time spent on just what blind rehab is, right?
Like, you're focused so much on the medical and the fixing and the curing that there's not a lot of talk or conversation when in the, the college time education opportunity to learn just what, what goes beyond that, right? Mm-hmm. Like, if you can't fix it, then what kind of a thing. And, and then on our side too, right, as the certified orientation and, and mobility specialists and other professionals in this field, you're right, we don't have enough of us, and it's gonna be a continuously growing problem as this [00:26:00] blindness and low vision population increases.
So do ... where do we find people, right? Like, how do we educate on the undergraduate level that this is a, a great career path, and it's very- Mm-hmm ... fulfilling, and it's, you know, uh, something to get involved in. But lots of areas, lots of dreams and hopes. And I do hope in the next 5, 10, 15 years we hear some of these things coming to fruition.
Um, but I do wanna talk about, like, you guys, I know you're mentioning you're having all these conversations, and you're referring and different things like that too, but you have a wonderful team member, uh, Janet Lonus, who also hosts ... You guys do these, like, support groups virtually. Can you tell us a little bit how those got started and what those have grown to?
Joshua: Yeah, definitely. That's one of the more exciting, I guess, areas of, of the comprehensive program we're trying to put together. I'll go back again and, and shout out Spectrios. That place has been operating now for, I think they just celebrated their 40th anniversary- Wow ... this year, which is awesome. And when I was training there and, and practicing there, [00:27:00] uh, they had staff, specifically when I was there, Leah Gerlach, who is now retired, and was just a, such a great advocate for our patients, who ran support group meetings.
And I, I sat in on them, and I saw them be really effective in connecting people who often feel very, very isolated by their vision loss or the fact that no one in their family or their social circles has, has vision loss. And, and I saw them meet other people who th- they saw were like themselves or had the same goals or, or concerns and, and sort of form a community through that.
So once I came to Vanderbilt, one of the first things I did was explore could we just start hosting meetings. I think we, we started doing two meetings per month, and they were in person for a while, and then around 2020, we all know that everything kind of went virtual. We weren't allowed to meet in person, and we went to this virtual format that really, like, blew the doors open on our capacity to reach people because they could join from anywhere, and they didn't have to get transportation to [00:28:00] come to our in-person meetings.
And while there's a lot to be said for meeting with other people in person and being able to hug or wave or shake hands or whatever, um, the fact that the virtual format was sort of forced on us, uh, allowed us to recognize that Our numbers grew and there were a lot of people who found it much more accessible to do it that way.
And it's to the point now where we run these monthly meetings through Microsoft Teams, and I would say probably on a weekly basis I get an email from a total stranger in another part of the country who says, "Hey, my brother's friend," or my whoever. A lot of folks say, "Hey, I met someone at Leader Dog who
who attends, who attends your meeting. I live in Seattle, Washington. Like, is that a problem?" And I say, "No, of course not." So I put them on our invite list. Yeah. And we get, um, we have different topics, and we have, I think it might be you, Leslie, someone from Leader Dog is speaking at our meeting next week.
Yeah. I think. Yeah. Is it you?
Leslie: Yep.
Joshua: Okay. Well, we're looking forward to it. It's always a great one. [00:29:00] Um, we have different topics and different speakers and experts, local and national and international, and we just try to give people a forum to hear from other folks who have vision loss. I think we've got maybe almost 900-
Timothy: Oh, my gosh.
Joshua: Wow ... people on our invite list. We usually get 40 to 50 kind of live in the virtual meeting at the time, and we record them. It's a good turnout. It's real- Yeah, it's, it's incredible how it's kind of taken on a life of its own, and some of the originals who were attending our in-person meetings have become sort of outspoken leaders and unofficial, uh, kind of sub-leadership roles in our, on our calls.
And it's really just a nice, a nice way for people to connect and realize, you know, they're not alone, and learn about resources and, um- It's been really fun to see that grow, and I think it'll continue to grow and might even eventually form offshoots that are maybe diagnosis specific or- Yes ... you know, in- interest groups that are [00:30:00] particularly, uh, uh, you know, they wanna learn more about technology specifically, or they wanna learn more about mobility skills or- Yeah
transportation, some of the things we talk about more generally. Um, I don't know where this goes, but it's something that we love doing. Janet LaMonace is, uh, a staff member of ours who I couldn't do much of what I do without- ... without her. And, and I think you guys got to host her for a visit- Yeah ... for a while earlier in the year, which everyone enjoyed from what I hear.
And- Yes ... um, we're just gonna keep, keep doing it and hope that it keeps growing.
Leslie: Oh my gosh, thank you so much for the... I've heard from so many people who join those meetings- Mm-hmm ... how great they are, and they feel heard and seen and just a part of a group, right? They're not alone. And- Yeah ... Janet is absolutely lovely.
Thank you so much for-
Alyssa: Sharing
Leslie: her ... uh, yeah, for sharing her, really. She came, and she just wanted a tour of Leader Dog because she refers, you guys refer to us so often, and she wants to be able to answer questions more accurately. So she [00:31:00] came just for herself to experience and learn a little bit about Leader Dog, and it was absolutely lovely.
She's lovely. You guys are both lovely. So thank you so much for all of the work that you do and, and everything and being such a great partner with us. We're so honored to refer back to you when we have that opportunity and also share all that you guys are doing.
Joshua: Yeah, absolutely. Thank you. Your programs fill a void that many of my patients, you know, that exists for many of my patients in the state of Tennessee and for those who are willing to, um, in some ti- uh, some cases for the first time in their life, jump on an airplane.
Alyssa: Yeah. Yeah,
Joshua: yeah. And, and fly to Michigan, sometimes in, in not ideal seasons- ... for travel to Michigan. Uh, to put it lightly, the, everyone comes back and just has a glowing, uh, review about their experience, and to a person basically says You know, I should have done that a lot sooner. I actually had ... This is timely.
I had a, a patient yesterday who I wasn't even seeing in my [00:32:00] clinic. He was being seen by one of our other providers, and he stopped at the desk and asked for me, and I went down to see him, and he had a brand-new guide dog with him. He said, "I was at Leader Dog last month." Ah. Amazing. And since our last visit together, he's been up there for white cane training.
He's gone back, and he's got his new guide dog, and he's learning his day-to-day life with his dog, and he, he just was, was glowing about the level of independence that it's given back to him. And I hear that over and over again, and as long as I keep hearing it, I'll keep- ... I'll keep sending 'em and trying to, trying to beat that drum for, for you guys and what you do.
Alyssa: Well, I hope you hear that for a long time. Yes. 'Cause I, I think our programs are fantastic. But thank you again so much. I mean, like you've been saying during this podcast, there's not enough of us out there in this field. Refer, refer, refer. You know, find programs. Find organizations that might work for you.
So thank you so much, Dr. Robinson, for coming on and, and talking about all of the work that you do in the low vision community. And, uh, I wanna thank everybody else for joining us today on Taking the Lead [00:33:00] podcast. I'm Alyssa Otis with hosts Timothy Cugno and Leslie Hoskins. We hope you enjoyed learning about the low vision field and the ways that professionals can refer people to low vision organizations.
Please join us next time as we continue to dive into the world of blindness.
Leslie: And if you'd like to learn more about applying to Leader Dog, you can head to leaderdog.org or call us at 888-777-5332. Don't forget, you can reach us at takingthelead@leaderdog.org with any questions or ideas. If you liked today's podcast, make sure to hit subscribe and check us out wherever podcasts stream.
Leslie: [00:00:00] Welcome to the Taking The Lead podcast, where we empower people to be unstoppable I'm Leslie Hoskins with my co-hosts, Alyssa Otis and Timothy Cunio You know, guys, it's that time of year already where we're prepping for Blindness Awareness Month and some of my most favorite activities.
Alyssa: Yes. This is the month that...
Leslie always shines. But this is the month that she truly shines. Every... She's got her cane earrings on, and she's got little clips on her bag, and we are all about the white cane for October.
Leslie: Yep.
Timothy: Don't you have a cane in your house with some lights on it?
Leslie: Oh, my gosh. That's a fantastic idea, Timothy.
Alyssa: It's a new, new sconce.
Leslie: Yeah. A
Alyssa: little
Leslie: folding cane. I do have a lot of canes always, like, with me and around. Like, I've got some at my house just I don't know for what, just in case maybe- Yeah ... somebody needs it or... I used to always have one in my car, too.
Alyssa: I was gonna say, I just gave a, a GDMI a ride in my car, and they go, "Why do you have a cane in here?"
I go, "Well, you know, Leader Dog." "We offer more than guide dog mobility," you know? [00:01:00] Um, so that was a great learning opportunity for them.
Leslie: You just never know who you're gonna run into and what you need to... I always have a business card on me because- Oh,
Alyssa: gosh, yes ...
Leslie: anytime I, uh, run into somebody out in the public, I've been known to stop people.
At, uh, Ron Jon in Florida, I saw a woman traveling with a cane, and I introduced myself and...
Alyssa: That's... I always say we're doing outreach- Mm ... regardless if we're actually at work. I was at a garage sale not long ago wearing my Taking the Lead shirt. Yeah. And somebody starts talking to me about community events that they wanna get into, so I handed them a business card.
Leslie: It's great.
Alyssa: Yeah, 'cause you never know when you're gonna meet people out in the world for, uh, volunteer opportunities or- Yeah ... potential clients.
Timothy: Well, I run into some at... Like, at last weekend, I ran into a guy at the, at the, uh, restaurant, and he had a cane. He's probably 40, 50 years old, and I went up, introduced myself, gave him a card about Leader Dog- Yeah
and said, "Hey, you know, if you need a, a f- a refresher or whatever, give m- give us a call." So- Yeah ... you just never know. You-
Alyssa: And that's so true ... you don't. You never know who can benefit from these services, and even sometimes it's not the services that we [00:02:00] offer all year long. So all year long, we of course have our guide dog program and our orientation and mobility, and we do have our teen programs and teen summer camp and teen O&M, but we do other programs too that people can get involved with that are not necessarily run by Leader Dog.
But for example, we have Cane Quest coming up.
Leslie: One of my favorites. I... It, it really is, and it falls in October, which of course is my favorite month, and White Cane Day. And we kinda host Cane Quest around that time because we're celebrating. Uh, so Cane Quest, this is gonna be our fourth year hosting. Yeah.
And we partner luckily, uh, with the, uh, Education Consultant Department, Michigan Department of Education Resource for Blind and Low Vision, just a fantastic team of professionals, and they really reach out to school-aged kids living in Michigan. And we invite them to Leader Dogs for the Blind campus, where we have kind of this cane contest.
Alyssa: That's a good way to put it.
Leslie: Yeah. It's like an obstacle course for your cane, and we're, like, testing all these different skills. And really, they're competing [00:03:00] against themselves, right? Hopefully, their scores increase from the year previously, but there is a first, second, and third place winner.
Alyssa: And the prizes are clutch.
Leslie: So many great prizes. family members come- Mm-hmm ... and we do educational opportunities, and also we do get to talk about guide dogs. Not everybody gets an opportunity to learn about what a guide dog can and cannot do, and if it's a goal of theirs, what skills do they need to have in order to achieve that?
So it's just, it's one of my favorite days because it also brings all of our COMs, our certified orientation mobility specialists, at Leader Dog and around locally together, so it's like this networking, and you get to catch up with all your people and, and see the kids really thrive, and it's just great.
It's one of my favs.
Alyssa: It is one of the better... Well, I shouldn't say one of the better events, 'cause I happen to love all of ours. But I feel like with all the kids, it just, it's like running wild. It's like teen summer camp, but just for a day, um, which is an absolute blast.
Leslie: Yes. Lots of fun. Timothy, if only you were [00:04:00] here to have- And a teenager.
Right, and a teenager.
Timothy: Feeling
Leslie: a
Alyssa: little bit young.
Timothy: Yeah. That's the pr- I think the age problem's the biggest problem.
Leslie: It really... Yeah. There's only a couple... But you know what? It would be fun to do this with adults. I think actually- It's actually a
Alyssa: really good idea ...
Leslie: right? Like, really test your cane skills and, and not just cane skills, but all orientation mobility skills.
Mm-hmm. So we, you know, we talk about low-hanging objects or obstacles and things like that. Yeah. Upper hand protective. Street crossing. Yeah, just like so many things, but we put it in a very controlled situation, and it's very, very fun. So if you are living in Michigan, um, and you're a student and you're interested, ask your O&M specialist about Cane Quest.
We do it here on the east side of the state, but they also have been doing one on the west side of the state- Mm-hmm ... too, so to cover all the ground. And also if you're not in Michigan, check out your state. Yes. A lot of states are doing Cane Quest, um, so it's a great opportunity to get to know other people in the community and, and test out those skills.
Alyssa: And that's it. There's so many things that people can learn by coming and doing [00:05:00] those, those programs that we have. Um, and today we actually want to talk to somebody who works in the blindness and low vision field. So a lot of these teenagers or kids that are coming to us are bringing family members, and this is somebody that they might wanna hear from, too.
Um, he unfortunately will not be at Cane Quest- ... but you get to hear him right here on the podcast. So today we are joined by a highly accomplished leader in the field of low vision care.
Leslie: Yes. Joshua Robinson earned his undergraduate degree from Indiana University and graduated magna cum laude from Illinois College of Optometry.
He completed a residency in low vision rehabilitation and ocular disease through the Illinois Eye Institute, the Chicago Lighthouse, and the Spectros Institute for Low Vision. He is an associate professor of clinical ophthalmology and visual sciences at Vanderbilt University Medical Center and serves as the Janet and Jim Ayers Director for Low Vision Care at the Vanderbilt Eye Institute.
He is a fellow of the American Academy of Optometry and a diplomat in the low [00:06:00] vision section of the academy.
Timothy: Dr. Robertson, it's a pleasure having you here this morning. We could talk about my Georgia Bulldogs taking on Vanderbilt here in a few weeks. But that's a different show.
Leslie: Yeah.
Timothy: Uh, can you tell us about your journey with optometry and low vision?
Joshua: I'd be happy to. Thanks for having me, and I'd probably steer your f- college football conversation toward the Indiana Hoosiers while you tie me in. If, if you're gonna open that door, I'll take it. All right. Uh, still s- still riding that high from, from last season. But thank you. Um, thank you all for having me.
Sure. I, um, I ... I'm someone who knew for a long time that I wanted to, um, do something in the healthcare field. I, as you mentioned, I got my undergraduate bachelor's degree from Indiana University, and at my time there, I was fortunate to be able to s- spend some time, uh, shadowing and spending time clinically and personally with, with folks in a lot of different areas of healthcare and kind of whittled down my interest and decided I didn't wanna be a surgeon [00:07:00] and, and wanted to provide kind of day-to-day, face-to-face, immediately impactful care for people.
And, and optometry was one of the things that I was exposed to that I kind of, um, really connected with and fell in love with the immediacy of it and some of the relationships that were able to be built. And so I, I dove into that and got as much exposure as I could, and that's what set me on the path to eventually attend optometry school in Chicago, like you said.
And as far as sub-specialization into the field of low vision, you know, again, coming back to a common thread in a lot of my life, which relates to sports, I, um, uh, while I was a student in Chicago a- and as someone who had grown up a lifelong fan of the Chicago White Sox, I found out that one of the alumni from our school, the Illinois College of Optometry, was practicing in the Chicago area and happened to be the team optometrist for my beloved Chicago White Sox.
Which again, that's going pretty well. It's ... This is a, a good time. The first [00:08:00] time in maybe a decade I've been able to publicly express my fandom for that team. They're, they're finally relevant again. There you go. So it's been a pretty good year from a sports standpoint for, for yours truly. But, um, I reached out to him, Dr.
Tracy Williams. I try to give him as much, as much credit as I possibly can for setting me on this path. I, I connected with him via email and said, "I understand you work with the White Sox. I'm, I'm here at ICO. I'm doing research for the summer. I'd love to hear more about what that's like and how you got into that.
Like, that interests me. I don't know what I wanna do within optometry." And he replied pretty promptly, and he said, "Um, I'm glad you reached out. Uh, you know, thanks for getting in touch. The work that I do for the White Sox is probably less than 1% of, of what I do day to day and week to week. But if you're interested in learning about the other 99% and what I'm really passionate about, you should come out and, and visit my clinic."
And it turns out his clinic was the Spectrios Institute for Low Vision, which you int- [00:09:00] introduced in, in my introduction as eventually part of my residency training and my clinical practice. And it's a, it's a small, you know, relatively small private nonprofit in the suburbs of Chicago that does low vision, comprehensive low vision rehabilitation.
And at that point in my training, I didn't know what low vision care was, and I said, "Of course, I'm gonna come out and, and spend time with this guy. I don't care what he's gonna show me." And I, I sat down and observed a couple patient interactions and saw, like, a real immediate impact that he was having and his staff were having on, on people dealing with vision loss, and immediately clicked and said, "I could see myself doing this.
Like, this is-- I think this is what I, what I wanna do." And it was all because I reached out um, about his connection with my favorite baseball team. So, uh, kind of by chance, he introduced me, and, and we're good friends to this day, and I learned a lot from him, and it kinda set me down this path of pursuing residency [00:10:00] training in this field.
Again, I practiced with him at Spectrios for a few years before relocating here to Nashville and, and trying to build a similar service here within our Department of Ophthalmology, and that's, that's where we're at today.
Alyssa: I feel like that has been the journey. Um, I know a lot of, you know-- Leslie and I, we're, we're lucky enough to go to Chicago.
We got to visit, uh, Spectrios and, and a few other different places. But you mentioned the term low vision a few times, and I just wanna make sure we touch on that because maybe not everybody fully understands exactly what that means. So how would you define low vision? How is it different from blindness?
Joshua: Sure. Um, I get that question a lot. I think sometimes for a normally sighted individual, it's hard to appreciate the continuum or s- sort of the, the levels of vision impairment beyond normal vision and, and total blindness. I see people who have low vision or impaired vision that is basically [00:11:00] suboptimal, can't be corrected with traditional glasses or contact lenses or surgical intervention.
Um, typically low vision in my patient base results from a medical eye condition or injury or neurologic condition that causes vision to not be correctable through typical means, and that's why they get referred to someone like myself who, um, tries to help them to maximize what they've got and then learn to adapt and adjust and work with the vision that they have so that they can keep doing the things that they wanted to do in their lives.
Timothy: So, as long as you've been doing this, uh, in this field, how, how much has changed since then, since you started?
Joshua: A lot continues to change. I think we, we use a lot of optical tools and devices that play by the same rules that they have for centuries. Lenses and light interact in the same way that they did 200 years ago, and we use [00:12:00] various lenses as sources of magnification in our patient base.
I think, um, where the big changes continue to occur very rapidly and in a way that's hard to even keep up with, uh, which is a good thing, is assistive technology and the, the smart devices that we all carry around with us every day, and that, that contain a lot of power and capabilities that many of my patients and people who maybe might benefit from some of the vision accessibility features don't even know they're carrying that sort of poc- uh, power around in, in their pocket or in their bag.
And so with new apps and accessibility features and more portable and more accessible, and now, uh, artificial intelligence capabilities, um, that technology continues to evolve very rapidly, and it's changed the way that we, uh, care for and educate our patients, and in many ways changes how they're able to, um, you know, maintain independence in certain ways or, or, or continue [00:13:00] working or, you know, some of-- some meaningful things that can be threatened by vision loss.
Leslie: It-- And you're ex-exactly right. There are so many different tools and resources now available to individuals, and if you're not experiencing low vision or blindness, you may not be even aware- Mm-hmm ... what our phones are capable of. Sure. And different, uh, even, right, using a camera and zooming in on different things can be incredibly helpful as a tool.
But can you tell us a little bit about, you know, somebody comes to you, they're referred to you from, uh, from a doctor and for your low vision services, what does that process look like? Like, like what services are you able to provide on your team?
Joshua: So we're hoping that this continues to grow, um, in the near future.
Currently, I'm, I'm the one performing, you know, independently performing the low vision evaluation when these referrals come in, typically from an ophthalmologist or an optometrist or, or a physician of some sort who's monitoring or managing the eye [00:14:00] condition which has caused the vision loss. Mm-hmm. Once, once an evaluation is completed with me, I have, um, I have resources here within our medical center, including both outpatient and home health occupational therapy- Mm-hmm
which I lean on, and Beyond that, much of what I am connecting patients with or referring to for additional training and support services lies outside of VUMC, our medical center. Some of it is local within our county or within our state programs. You know, national programs like Leader Dog and others that we are trying to put the pieces together and connect patients to, um, is a big part of, of sort of my management plans and making sure that someone who might benefit from those services is being made aware of them and being connected in a timely manner after I've done what I can do clinically to try to optimize their vision
Leslie: That is just such an important piece.
I know. We can't stress that enough. Thank you for [00:15:00] doing that. I-- We hear from clients all the time, right? They have their diagnosis at... and they hear there's nothing else that can be done, and, and then sometimes that's the end, right? They're not referred out to that next step of blind rehab, um, or additional resources.
So just passing along that information that resources exist- So helpful ... rehab is available in so many different ways, it really impacts people's lives. And, a- and it's the next step when they're ready, right? Sometimes they're not ready- Yeah. ... and they need to- For sure ... take some time. But to be able to do that, and I'm sure as part of your, um, appointments and evaluations, I'm sure a lot of education is happening there in those conversations, like explaining what their eye condition is and what that means as a prognosis, but also, right, like, it...
They call it practicing medicine because we are practicing. We don't necessarily always know definite answers for each person. So how do you approach some of those conversations?
Joshua: Yeah. Regarding what you just said about the initial referral [00:16:00] being important, you know, I'm not the one... I'm rarely ever making a diagnosis.
Like, these are individuals who are being managed and monitored outside of my direct clinic, and the first hurdle is them even getting referred to someone like me. There's not enough-
Leslie: Yeah. ...
Joshua: of us doing what I do, and the, the population sort of demographic, uh, trends indicate that especially some of these age-related eye conditions will continue to become more prevalent and have a broader impact, um, on more people.
And I think there's just a lot of patients floating around out there, like you say, who are told maybe medically accurately so that there's nothing more that can be done. They're getting their injections for their macular degeneration, or they've, they've, uh, they've controlled intraocular pressure to the point that their glaucoma is not progressing, but then they're left with day-to-day functional deficits that their medical eye care provider cannot help them meet.
And if they're not told that there's a next step and that door's not open, then they're left [00:17:00] thinking, "Well, that's it." Like-
Leslie: Yeah ... "
Joshua: I may never, y- you know, be able to socialize in this way or drive or work in the same way that I've done or get through school" or, or whatever that is. And so a lot of what I'm trying to do in, in building bridges and connections here is to make the first step, that referring provider, aware of my services so that then I can refer to Leader Dog or for other resources outside of what I'm doing.
And a lot of the, a lot of the conversations, as you ask, with my patients and what that education looks like with them is both trying to answer as many questions as I'm equipped to answer regarding their eye condition or why their diagnosis causes their s- the center of their vision to be absent, or why they have trouble navigating in a dark room, um, to the capacity that I can because many times their retina doctor has, you know, 90 seconds of, of time face to face with them.
Mm-hmm. Mm-hmm. They come in and they anesthetize, and they give them their [00:18:00] injection, and they say, "See me in six weeks," and then they're out the door. My patients are left thinking, "But, but what about all the other stuff? Like, what about all the questions and the fears and the, and the anxieties that I may have, and the questions my family has, and what does this mean for everything?"
And so, um, as much as I, you know, I'm, I'm not a counselor, uh, but as much as I can, I try to make space in that visit for people to ask their questions or air out their thoughts and their grievances that they haven't been able to. Just give them sort of a, a, a safe space where they feel like they're being heard, and that I can validate some of the concerns they have so that if we can finally sort through all of that, I can say, "Okay, now, I've, I've heard you ask this question.
I've, um, I get the sense that you're struggling or dealing with this. Let's try to find some ways that we can, not perfect or undo your eye condition, but how can we equip you to better tackle that stuff that's causing you to lose sleep at night? Like, how [00:19:00] can we, how can I try to help you adapt and adjust to this new reality and not have to give up on that meaningful thing that you don't wanna give up on doing?"
And so a lot of steering, uh, steering the discussion toward turning our attention and focus to what's in front of us and Realistic, but, but positive and hopeful expectations rather than, uh, pouring that energy into what's been lost and focusing on what I once had that might not be coming back. And that's a delicate sometimes, uh, as you all probably know, that's a delicate conversation that sometimes requires someone with better, you know, higher level credentials than me, and that's why I connect with support resources and, and counseling and mental health type things too because that's a big part of the puzzle.
Alyssa: And that's so important, is, is treating the whole person. So, you know, we talk about that often at Leader, how we focus, you know, at this point mostly on that [00:20:00] mobility. Uh, but there's so many other things that people might need. So I wanna thank you 'cause I know one of the big things that Leslie and I do is we go out, we travel, and we try to, to educate people in the blindness and low vision field to be able to refer to Leader Dog or any other organization that might fit somebody.
So that is exactly what, what we need out there. You are boots on the ground helping, helping everybody out, so thank you on that.
Joshua: I'm trying.
Timothy: Well, Dr. Robertson, do you feel like over the past 10, 15 years that more people are needing your services? Do you see an uptick in how many patients you see?
Joshua: Yeah, there's definitely an uptick.
I think there's well-studied and documented upticks in, in frequencies of some of these, uh, irreversible eye conditions. And while there's medical advances being made that are able to maybe stabilize or in some cases reverse course in some of these conditions, I think, you know, the vast majority of the patients I see and of the [00:21:00] patients seen by others in my role at other, um, academic institutions or, or 501[c][3]s boils down to a lot of age-related macular degeneration and glaucoma and diabetic eye disease and related complications.
And as the population ages generally, um, those age-related conditions become more prevalent, and there's more and more people who need these services. And it's a type of service that is, is time intensive, as you can probably imagine. And so I'm, I'm at my capacity as far as how many patients I can care for in a day.
And so trying to, uh, trying to spread the word and get more people trained and in positions like mine so that we can care for those growing numbers of patients is, is like a whole other side of this discussion and making sure we can meet those needs.
Leslie: And to that point, I mean, thinking of the next then progressive, the next 10 to 15 years, what would you like to see in this area of, you know, low vision [00:22:00] resources a- and the healthcare field and, and how really we can pre-prepare obviously more people, but what else do we need to do?
Or what do you hope to see?
Joshua: What would I hope to see? I think from an education standpoint, in my field, in optometry, and I'm, I'm part of the efforts trying to make this more of a reality, I think there has to be better early exposure and education to low vision as a sub-specialization option and, and demonstration of the impact it can have.
Like when I visited Dr. Williams that first day, and I didn't know what low vision was, and I sat in on a patient visit, and it blew me away that he was doing things with tools and with taking a lot of time and with very, you know, intentional listening and, and communication that seemed to be changing this patient's life on the spot in a way that that person never thought was going to be possible.
And I don't think that optometry [00:23:00] curricula and, and the education that we get in optometry school focuses enough early enough on the impact that this field can have. And so it leads to less students and graduates going into this field and, and making this sort of impact. Um, so that's sort of the, the grassroots approach to try to meet these needs.
I think in general, if, if I could have my way, it would be nice to ... I think, I don't wanna put words in your mouth, but from what I understand in working with, uh, blindness and low vision programs and collaborating with them across the country, it's a similar issue that there's not enough certified O&M specialists coming out of these programs to- Yeah.
Absolutely ... to serve the needs of these populations. And so how do you, how do you advertise it and present it as a meaningful and rewarding and viable, uh, career path for someone who might really fit into that but just doesn't know what they don't know when they're, uh, at some point in their undergraduate education, or maybe they're out and they're [00:24:00] working in some other field?
And so I think that getting at it from the foundational kind of educational standpoint is, is a big part of it. I'd love to see more, uh, Medicare and insurance coverage for some of the tools and services that we prescribe- Mm-hmm ... and utilize, and less of a separation between sort of the medical reimbursement model of medical eye care and the more, I guess, colleges of education-related, uh, blind and low vision rehab services that are not typically traditionally billable through, um, some of these insurance means.
Because oftentimes folks on limited or fixed incomes or on, on disability incomes can't, uh, afford some of these tools and services, and then we, you know, we utilize services like Leader Dog, or I utilize some of the limited grant and [00:25:00] philanthropic funding that I have to bridge that gap. But it's gonna continue to be a problem as these, you know, populations change and as more and more need arises for these things that, um, insurers are not recognizing.
Leslie: Yeah. There's, there are a lot of gaps and areas that we need to improve, as you mentioned. Uh, people not qualifying for certain services. There's barriers there. And also that education piece. I ... You know, we've heard from lots of eye care professionals that there's really not an opportunity or And maybe not a t- a lot of time spent on just what blind rehab is, right?
Like, you're focused so much on the medical and the fixing and the curing that there's not a lot of talk or conversation when in the, the college time education opportunity to learn just what, what goes beyond that, right? Mm-hmm. Like, if you can't fix it, then what kind of a thing. And, and then on our side too, right, as the certified orientation and, and mobility specialists and other professionals in this field, you're right, we don't have enough of us, and it's gonna be a continuously growing problem as this [00:26:00] blindness and low vision population increases.
So do ... where do we find people, right? Like, how do we educate on the undergraduate level that this is a, a great career path, and it's very- Mm-hmm ... fulfilling, and it's, you know, uh, something to get involved in. But lots of areas, lots of dreams and hopes. And I do hope in the next 5, 10, 15 years we hear some of these things coming to fruition.
Um, but I do wanna talk about, like, you guys, I know you're mentioning you're having all these conversations, and you're referring and different things like that too, but you have a wonderful team member, uh, Janet Lonus, who also hosts ... You guys do these, like, support groups virtually. Can you tell us a little bit how those got started and what those have grown to?
Joshua: Yeah, definitely. That's one of the more exciting, I guess, areas of, of the comprehensive program we're trying to put together. I'll go back again and, and shout out Spectrios. That place has been operating now for, I think they just celebrated their 40th anniversary- Wow ... this year, which is awesome. And when I was training there and, and practicing there, [00:27:00] uh, they had staff, specifically when I was there, Leah Gerlach, who is now retired, and was just a, such a great advocate for our patients, who ran support group meetings.
And I, I sat in on them, and I saw them be really effective in connecting people who often feel very, very isolated by their vision loss or the fact that no one in their family or their social circles has, has vision loss. And, and I saw them meet other people who th- they saw were like themselves or had the same goals or, or concerns and, and sort of form a community through that.
So once I came to Vanderbilt, one of the first things I did was explore could we just start hosting meetings. I think we, we started doing two meetings per month, and they were in person for a while, and then around 2020, we all know that everything kind of went virtual. We weren't allowed to meet in person, and we went to this virtual format that really, like, blew the doors open on our capacity to reach people because they could join from anywhere, and they didn't have to get transportation to [00:28:00] come to our in-person meetings.
And while there's a lot to be said for meeting with other people in person and being able to hug or wave or shake hands or whatever, um, the fact that the virtual format was sort of forced on us, uh, allowed us to recognize that Our numbers grew and there were a lot of people who found it much more accessible to do it that way.
And it's to the point now where we run these monthly meetings through Microsoft Teams, and I would say probably on a weekly basis I get an email from a total stranger in another part of the country who says, "Hey, my brother's friend," or my whoever. A lot of folks say, "Hey, I met someone at Leader Dog who
who attends, who attends your meeting. I live in Seattle, Washington. Like, is that a problem?" And I say, "No, of course not." So I put them on our invite list. Yeah. And we get, um, we have different topics, and we have, I think it might be you, Leslie, someone from Leader Dog is speaking at our meeting next week.
Yeah. I think. Yeah. Is it you?
Leslie: Yep.
Joshua: Okay. Well, we're looking forward to it. It's always a great one. [00:29:00] Um, we have different topics and different speakers and experts, local and national and international, and we just try to give people a forum to hear from other folks who have vision loss. I think we've got maybe almost 900-
Timothy: Oh, my gosh.
Joshua: Wow ... people on our invite list. We usually get 40 to 50 kind of live in the virtual meeting at the time, and we record them. It's a good turnout. It's real- Yeah, it's, it's incredible how it's kind of taken on a life of its own, and some of the originals who were attending our in-person meetings have become sort of outspoken leaders and unofficial, uh, kind of sub-leadership roles in our, on our calls.
And it's really just a nice, a nice way for people to connect and realize, you know, they're not alone, and learn about resources and, um- It's been really fun to see that grow, and I think it'll continue to grow and might even eventually form offshoots that are maybe diagnosis specific or- Yes ... you know, in- interest groups that are [00:30:00] particularly, uh, uh, you know, they wanna learn more about technology specifically, or they wanna learn more about mobility skills or- Yeah
transportation, some of the things we talk about more generally. Um, I don't know where this goes, but it's something that we love doing. Janet LaMonace is, uh, a staff member of ours who I couldn't do much of what I do without- ... without her. And, and I think you guys got to host her for a visit- Yeah ... for a while earlier in the year, which everyone enjoyed from what I hear.
And- Yes ... um, we're just gonna keep, keep doing it and hope that it keeps growing.
Leslie: Oh my gosh, thank you so much for the... I've heard from so many people who join those meetings- Mm-hmm ... how great they are, and they feel heard and seen and just a part of a group, right? They're not alone. And- Yeah ... Janet is absolutely lovely.
Thank you so much for-
Alyssa: Sharing
Leslie: her ... uh, yeah, for sharing her, really. She came, and she just wanted a tour of Leader Dog because she refers, you guys refer to us so often, and she wants to be able to answer questions more accurately. So she [00:31:00] came just for herself to experience and learn a little bit about Leader Dog, and it was absolutely lovely.
She's lovely. You guys are both lovely. So thank you so much for all of the work that you do and, and everything and being such a great partner with us. We're so honored to refer back to you when we have that opportunity and also share all that you guys are doing.
Joshua: Yeah, absolutely. Thank you. Your programs fill a void that many of my patients, you know, that exists for many of my patients in the state of Tennessee and for those who are willing to, um, in some ti- uh, some cases for the first time in their life, jump on an airplane.
Alyssa: Yeah. Yeah,
Joshua: yeah. And, and fly to Michigan, sometimes in, in not ideal seasons- ... for travel to Michigan. Uh, to put it lightly, the, everyone comes back and just has a glowing, uh, review about their experience, and to a person basically says You know, I should have done that a lot sooner. I actually had ... This is timely.
I had a, a patient yesterday who I wasn't even seeing in my [00:32:00] clinic. He was being seen by one of our other providers, and he stopped at the desk and asked for me, and I went down to see him, and he had a brand-new guide dog with him. He said, "I was at Leader Dog last month." Ah. Amazing. And since our last visit together, he's been up there for white cane training.
He's gone back, and he's got his new guide dog, and he's learning his day-to-day life with his dog, and he, he just was, was glowing about the level of independence that it's given back to him. And I hear that over and over again, and as long as I keep hearing it, I'll keep- ... I'll keep sending 'em and trying to, trying to beat that drum for, for you guys and what you do.
Alyssa: Well, I hope you hear that for a long time. Yes. 'Cause I, I think our programs are fantastic. But thank you again so much. I mean, like you've been saying during this podcast, there's not enough of us out there in this field. Refer, refer, refer. You know, find programs. Find organizations that might work for you.
So thank you so much, Dr. Robinson, for coming on and, and talking about all of the work that you do in the low vision community. And, uh, I wanna thank everybody else for joining us today on Taking the Lead [00:33:00] podcast. I'm Alyssa Otis with hosts Timothy Cugno and Leslie Hoskins. We hope you enjoyed learning about the low vision field and the ways that professionals can refer people to low vision organizations.
Please join us next time as we continue to dive into the world of blindness.
Leslie: And if you'd like to learn more about applying to Leader Dog, you can head to leaderdog.org or call us at 888-777-5332. Don't forget, you can reach us at takingthelead@leaderdog.org with any questions or ideas. If you liked today's podcast, make sure to hit subscribe and check us out wherever podcasts stream.
