Treating vision problems is more than addressing the issues with the eyes themselves, but also retraining the human brain. Dr. Bryce Appelbaum, founder and CEO of VisionFirst, explains how focusing on the eye-brain connection can lead to innovative vision and eyesight treatments and improvements. Joining Harbir Sian, he explains which vision therapies and training programs offer positive results – and which ones are actually doing more harm than good to your eyes. He breaks down why eye patching is bad, why pencil pushups are good, and how to be wary of bad health advice shared all over social media. Dr. Bryce also talks about his ScreenFit program that aims to minimize the damage of digital devices on vision and promote healthy visual habits for extended screen use.
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Patching is BAD, Pencil Pushups Are GOOD (And Other Things You Don’t Want to Believe) – Dr. Bryce Appelbaum
Welcome back to another episode. Thank you so much for taking the time to join me to learn and grow. I want to say a big thank you for all the sharing, liking, commenting, and everything that you do for the show to help improve our reach, get to more of our colleagues, and share the messages and all the important lessons that we’re learning on the show.
I have a big request right off the top, which is if you do get some value from this or if you found this interesting, please share it with somebody. Send a link via text. Put it on LinkedIn. Put a screenshot up on Instagram and tag us. I guarantee you that this episode is going to raise some eyebrows, but I’m hoping it ruffles some feathers and gets you a little worked up about what is going on in the world of vision therapy and vision training.
This is not just for my vision therapy friends. If you’ve heard me talk about this, I don’t do vision therapy, but I found this whole area of our profession and our industry so intriguing. I have one of the most outspoken people in this world of vision therapy and vision training here on the show, Dr. Bryce Appelbaum. I’m going to give you a quick synopsis of his resume, and I’m going to let Bryce talk a little bit about what he’s up to these days.
Bryce graduated from ICO in 2009. He’s been practicing for 15 or 16 years. He has two locations in the Maryland area. His practice is called MyVisionFirst. He also has an online vision training program called ScreenFit, which is a DIY vision training program. He also hosts intensive vision performance training bootcamps. People are flying in from all around the world for this vision training. He is one of the most outspoken people in this area of vision therapy and vision training.
He has been on all sorts of different platforms, not just in the eyecare industry, but in the world of dyslexia, early childhood learning, and all sorts of other things. He has been in the biohacking space with Dave Asprey, who is one of the biggest names in that space. He certainly has put himself out there to share this message. As we get into this, I’m going to talk a little bit about how I heard of Dr. Appelbaum and what my initial thoughts were. We’re going to go into answering some of the questions that may have arisen at that time. First of all, Bryce, thank you so much for being here. I appreciate it.
It is such an honor and such a pleasure. I have been very intentional and resistant to going on optometry shows because a lot of it has been with the intention of poking and prodding rather than educating and empowering. When you reached out, it was a “heck, yes” immediately because I love what you’re doing. I love how you are building so much awareness, challenging what we all know from what we learned in schools, so that we can ultimately deliver the best care possible for our patients. That’s what it’s all about. What we learn in textbooks and school is just the foundation. If we’re not growing and evolving past that, we are selling ourselves and our patients short. It is such an honor to be here. I have a lot of gratitude for you.
Dr. Bryce Appelbaum Of VisionFirst
I appreciate that. Thank you very much. I know I gave a little bit of an intro, but I skipped over a lot of things. Give us a little bit more of an introduction to who Dr. Bryce Appelbaum is.
I’m a product of the work that we offer. As a kid, I was an absolute mess. I had visual developmental delays. I had an alternating exotropia. I had bilateral amblyopia. I was lost in space. I was struggling in the classroom. I had a hard time with interpersonal connections. I attribute all of my success in life, athletically, academically, and even interpersonally, to what was done for me with vision therapy and sensory integration-based occupational therapy at the time.
My father was a developmental optometrist. My mother was a sensory integration-based occupational therapist. They created a practice to support me and my needs. I was four at the time when this all started. It’s so incredible to know what’s possible when you do the right work with the right motivation in the right place. I’ve looked at this as my mission to build from that, evolve that, and help empower the world with what is possible.
I’ve gone from patient to clinician. I’m trying to be on the leading edge of pushing our profession, allowing for innovations and technological applications, and getting this eye-brain connection work and functional optometry a firm seat at the medical table with all other professions, such as functional medicine, integrative medicine, and even reactive and structural healthcare. We take a proactive approach in that, but there is a healthy, happy marriage for both, especially with where the world is now. I look at this as I am a messenger, one who is loving living my purpose in real life.
I love the passion, and I love that you’re so in tune with your vision of what you want to accomplish. It’s hard to find somebody who is so conscious of what they want to achieve that they can put everything else to the side and streamline their life and their work. Most of us, myself included, are like, “Let me try a little bit of that. That seems interesting.” You’re honed in.
I wasn’t for a while. A couple of years ago, a fire was lit underneath me, and then I was like, “There is nothing more important than taking this work and shouting it from the rooftops, so that the people who are struggling unnecessarily in life know what’s possible and have hope for what they can achieve and accomplish.”
Understanding Functional Medicine And Optometry
First of all, I want to tap into the word functional a little bit. You mentioned functional medicine. I’ve heard the term functional optometry from a few of my friends and colleagues. Even a couple of people who have been on the show, Dr. Paul Rollett, Dr. Vi Tu Banh, and Dr. Amrit Bilkhu, talk about functional vision or functional optometry. What is that exactly?
It’s recognizing that there is a brain attached to the eyes. How well the eyes, brain, and body work together allows us to be successful in life or allows us to struggle unnecessarily in life. It’s looking at the necessary visual skills and abilities for reading, learning, sports, driving, navigating through space, and social interaction to be functioning and operating where they’re supposed to be, not allowing our brain to be in a constant state of fight or flight and distress, where it then operates and functions differently than it would if that was not the case. It’s a proactive approach to eye-brain-body integration, while also recognizing there is structure, acuity, and all of the other systems and areas that are important, but this picks up where those areas leave off.
I’ve watched some videos of you talking about the idea of stress. I know some of our colleagues talk about this. We attribute our changes in vision to structural and anatomical changes in the eyes. In the area of functional optometry, which is what you’re doing, you’re saying there are other stressors on the visual system as a whole. For example, the brain can cause axial elongation in myopia. Can you give us at least a high-level understanding of that? It’s a tough concept to grasp. It has been indoctrinated in us that the eyeball is growing, and we are matching that with the minus lens we’re putting in front of the patient. It’s a natural progression, but you’re saying there’s a lot more to that.
We hear so many of our colleagues talk about how screens don’t ruin our eyes and blue light isn’t a bad thing. If we’re being picky with language, that’s accurate. It’s the internal response of our body to the screen and the blue light, and not having the visual foundation in place to support those demands. When our body, our brain, or our visual system is under stress, we have two options. It’s to adapt or to avoid.
Maladaptation is the root cause of so many functional vision problems. The vast majority of patients that we work with who are showing myopia progressing, there is a functional component to that that if we’re not addressing that or looking into that, we’re leaving a massive portion of healing still on the table. The accommodative system is so intimately related to myopia. I know everyone hears that and maybe questions that, but we are in a different visual world now than we’ve ever been in, with screen time becoming this new pandemic, and creating all this new visual stress.
I would love to hear what you’re seeing, but we are seeing every single person who has a different visual profile now than they ever have, where the inside and outside muscles of the eyes are not working together in synergy like they’re supposed to. We’re seeing leads and lags of accommodation, eyes focusing in different planes, and the brain sending the signal of the eyes to try harder, fragile eye coordination manifests, binocular instability, and then even strabismus and other challenges that are because of this foundation in place that’s not where it needs to be in terms of visual skills and abilities.
I’ve certainly seen that. I have explained that to a lot of my patients, we’re talking about young patients, and also their parents. I would say that when I started practicing fifteen years ago, if I had a kid this age with this profile, I would probably not be all that worried about them having too many issues in the near future or down the road. Nowadays, I have to monitor this so closely because I don’t know where you’re going to go. You may become nearsighted. You may end up with this issue. It’s a crapshoot given the visual demands that we all have now.
The trouble for me on this is that some things are accessible to us that can help either reduce the progression of myopia or can help an adult patient who has a lot of visual strain, tasks, and things like that. There’s also a lot of stuff, especially stuff that we’re going to talk about that you do, that is not accessible. It puts the primary care optometrists at a disadvantage and in a weird position where we’re stressed out about, “I want to help this person, but I don’t know how to help this person. There’s a world of stuff out there, but I don’t even know how to enter that world.” There’s too much of this void between the worlds.
It’s such a problem. It leaves so many doctors and people who are even looking into vision unaware and unarmed in terms of knowing what to do with that information. Working with somebody who is board-certified in this space, knows what they’re doing, has the business, the programs, the team, the system, and actual protocols in place is the gold standard, but that’s not accessible for most people.
There is so much that can be done with lenses, prisms, filters, nutrition, environmental modifications, and supplementation. All of these can at least get people across the start line to start addressing that functional component that comes with seeing, processing, and then deriving meaning and directing the appropriate action in terms of how our eyes should work together in life.
For those of us who are interested in this and want to help our patients in a different way, it’s going to require a lot more education and training in this space. This is at least for us to scratch the surface in our primary care setting and then understand when something needs to be referred out to somebody like yourself in that functional space.
Divide Between Medical Education And Training
Since we’re hovering around this education and training aspect of it, I want to get into why there is such a divide between what we’ve learned in school, what you are telling me, and what Paul and Amrit have told me. Where does that happen? Have we learned the wrong things in school? Have we only learned a tiny fraction of what we’re supposed to learn? What do you think is going on there? Why didn’t we learn what you have learned in optometry school?
I didn’t learn what I’ve learned in optometry school. What we learned in optometry school is the ground floor of everything. There’s a lot more cut-and-dry education, knowledge, and protocols for intervention of eye disease, pathology, and even primary care. Primary care optometrists have such an opportunity to screen for, evaluate, diagnose, and then reroute so much of what’s occurring.
At least in this space, the big issue is that there’s no consistency yet on what vision therapy or vision training looks like. This isn’t like physical therapy, where for a grade 1 sprained MCL, you’re getting a dozen sessions, for grade 2, you’re getting two dozen. Depending on which PT around town you go to, you’re pretty much getting similar work and the same outcomes. There is no consistency yet on what vision therapy or vision training looks like.
Even the board certification through COVD, NORA, and a few other areas is a great starting point to figure out what you don’t know and learn more about what you need to know, but just because somebody is board certified doesn’t mean they know exactly what to do and have the opportunity to change somebody’s life with that work. They have the opportunity, but maybe that’s not a clear runway that’s able to be set.
I hate saying this, but I want to talk about it. We see a terrible number of patients who have tried vision therapy, and either it left a lot to be desired or they say it didn’t work. Just like physical therapy, vision therapy works, but you have to be in the right place. You have to be there for the right reasons, and you have to do the right work.
Vision therapy works, but you have to be in the right place and have the right reasons for it to work.
It’s hard from a practice management standpoint to have an office that can deliver the care that’s needed unless you’re all in with it. If you’re just dabbling, you’re probably more comfortable seeing ocular motor dysfunction and the reading and learning challenges. Somebody who has had multiple strokes, multiple head injuries, or crazy sensory overload from the mall or grocery store can’t respond to junk lighting without feeling the need to retreat.
The world is constantly changing. Even what we do here post-COVID is drastically different from what we did pre-COVID. We were talking before all this about these new profiles that have emerged. We are constantly upleveling and reiterating our treatment to match what’s coming in. We’re constantly learning from our patients. We’re constantly raising the bar and challenging our status quo, which means we have to think on the fly.
I’m blessed to have an amazing team of four doctors who are all in this with the same mission to raise awareness, end unnecessary suffering, and unlock potential through vision. I know at some point in my career, we’re going to be offering training and teachings to people who want to learn more. We have such a high volume that we have amazing data and analytics in terms of what works, what doesn’t, and what’s needed. We’re in very advanced stages with three clinical trials with a local university that is going to help.
There’s a stat I read a few years ago that said the average piece of research doesn’t get put into clinical practice until seventeen years after it has been done. That’s nuts. Seventeen years from now, we’re going to know what decades of screen engagement do to somebody, especially to a child who doesn’t have a brain that’s developed at the adult level. At that point, we’re going to have whole new protocols in place.
The world is moving too quickly. Visual demands are drastically increasing too quickly. Unless there was a specific school for functional eye care or vision therapy, it would be hard to even get close to what we need to. Schools are limited as well in a lot of other areas. It’s a problem. I don’t have the answer, but as a faculty member at Southern College of Optometry, we’re always talking about this and talking about how we can get this where it needs to be. It can take a lot of us.
I had Dr. Howard Purcell on. He’s the President of NECO. I was asking him a question about business education. His answer still would apply to this as well. He graduated, whatever the number was. It was a while back. He was saying that at that time, optometry was a four-year program. At that time, they were not able to use diagnostic pharmaceuticals, let alone therapeutic pharmaceuticals. The curriculum was smaller, but it was still a four-year program.
Fast forward 34 years, and it’s still a four-year program, but we got DPAs, TPAs, injectables, advanced procedures, and all this stuff. We run through the summer. They added this course. The course load is a little bigger. Even with that, there’s still not enough time to add in too much of a business program outside of maybe one course or whatever it might be. To play devil’s advocate and to answer my own question a little bit, it probably is tough to fit in what you’ve taken a decade or more to train on into a couple of courses in a four-year program in optometry school. I get that part, but I still find that there’s such a divide. It’s a bit mind-blowing to me.
To your point about the lack of consistency, isn’t that detrimental to us as a profession and the perception that the public and other people within healthcare have of optometry? If one optometrist is saying, “You don’t need vision therapy,” and one is saying, “You need traditional vision therapy,” and the other one is saying, “You need functional training. You need to do this type of stuff,” which sounds almost woo-woo to a lot of people, doesn’t that have a negative effect on the perception of optometry?
100%. Not only, “Do you need this or do you not need this?” How about, “Does this work or does this not work? Is this snake oil?” When you don’t know what’s possible, you can’t possibly allow a patient to have hope for that. I was taught in school that there’s a critical period of neuroplasticity where, after age eight, what you see is what you get. More than half of my practice is with adults. We have a 92-year-old in office-based vision performance training, developing depth perception for the first time. Most schools would say that’s not possible.
We have patients who have had hemianopsia or visual field defects from stroke. There’s no research or literature that says anything can be done about that. The overwhelming majority had seen an improvement in their visual field, for sure, and their functional fields. Yet, that’s something that 99% of docs and people in the space would say is not possible.
It is detrimental. Even separating vision therapy and functional vision is more so than it ever has been, because the people who are doing great work are inundated with too many patients. These problems are everywhere, but then once we’re dabbling, it’s almost overwhelming and a pill that you can’t swallow. It’s like, “Let me go back to my 15 to 20-minute eye exams.”
You’re stacked up all day, you get burnt out, and then you’re out of optometry. You lost an opportunity for somebody to change lives because of all that goes into that, whether it’s practice management, getting a paycheck to pay the bills, or even knowing where to dedicate the little bit of time that you have for continuing education and focusing more on what you’re doing now versus what you want to be doing. There are so many barriers there.
In having all of these amazing opportunities to give talks, podcast interviews, and keynotes, the functional medicine space, the integrative medicine space, and so many other specialties are not only receiving this type of work with open arms. They are all in. I’ve had so many people tell me, “It feels like the eye-brain connection is like the new microbiome.”
We’re realizing that this is going to be related to so many aspects of critical decision-making, thinking, attention, productivity, and efficiency that we didn’t even know we could tap into, much less optimize and enhance. I’m a firm believer that any brain at any age can be enhanced and optimized in terms of vision and visual function.
Any brain at any age can be enhanced and optimized in terms of vision and visual function.
That’s maybe a little mindset shift that we all should have. It’s been ingrained in us, “At age 7 or 8, neuroplasticity stops. That’s it. If you have amblyopia at that age or you don’t have binocular vision at that age, it’s game over. Sorry. Let’s stop trying.” It’s very interesting to hear. Most of your patients are adults. We’ve been trained in that, so it’s easy to discount when somebody like yourself says otherwise.
It’s a similar parallel to amblyopia and the whole patching protocol from a hundred years ago that is now being challenged and being a little bit more accepted, understanding that it’s a two-eye problem manifesting on one side. It’s a brain problem showing up through the eyes. Unless we address it on a brain basis, we’re not scratching the surface.
At least from my perspective, there’s movement there. It’s still nowhere near where it needs to be. We still have people who have been in eye patches for years or decades. Things are different, not better or a little better, but the brain is still on overdrive all day long. Seeing that shift has been a little eye-opening for me in terms of we’re going to get there with this space, but it’s going to take a while.
Alternatives For Eye Patching
I have so many follow-up questions, and also the questions I had written down before. I’m trying to stay on track. I’ve been yelled at for patching a couple of times by colleagues in the functional space. Even my friend, Vi Tu, in Toronto, said, “Wear a patch for 10 to 15 minutes and tell me how you feel.” It sucks. You’re asking a five-year-old to do it for hours a day or whatever it is. I felt like a simple little test, but all of a sudden, you’re way more empathetic to that child. As much as you can in a short 90 seconds or something, what’s the alternative to patching?
First of all, patching isn’t necessarily wrong in every scenario. There is a time and a place for that, especially based on the visual profile, the age, and all of that. Active patching is a part of every one of our patients’ home programs. We have patients equalizing skills between the right eye and left eye that when both eyes are open, there’s less of an opportunity or no opportunity for one eye to take over. Everyone who is an optometrist knows it’s way more complicated than that.
Patching, in general, we’re taking fragile binocularity, covering up one eye, and making it that much harder for an unstable system to even work together. To me, it stems from a lot of fear from the structural eye care world about whether we’re going to get past that critical period, and then we’re going to be screwed, and there’s nothing we can do there.
We’re always ingrained from day one of optometry school that our biggest mission is getting every single patient to see the smallest letters on the back of that dark exam room, all the way at the bottom of the chart. All of a sudden, with patching, strabismus often emerges, suppression starts to be tapped into, and then the emotional toll that takes on people.
There’s work that can be done where learning takes place, but if learning doesn’t take place, there’s no reason to do it. It’s the same thing with reps with working out or even with vision training. If you’re just going through the motions and getting in 100 reps from a quantity standpoint, quality is what matters. I’d rather you spend 30 seconds on home therapy and thinking about what it feels like, what it looks like, and the depth that ensues when you are using both eyes together, compared to going through the motions just to do it.
It depends on the case, but we do a lot of active patching. We do a lot of monocular in the binocular field. We do a lot of bi-ocular work. We’re all taught in school where it’s monocular work, then monoc and a bi-noc field, then bi-ocular, and then binocular. That protocol is not one we adopt. We start day one of treatment with 99% of our patients doing monocular work, but also doing binocular work and creating peripheral glue and fusional work that allows us to then have a baseline to step from.
We take a holistic approach where we’re integrating movement, balance, cognition, and vestibular input into all of the work from day one because vision doesn’t operate in isolation from these systems. It’s a cross-training approach that we need with any functional work, not just one specific treatment modality. We need to be putting a lot of them together to maximize the benefits.
Why Are We Obsessed With 20/20 Eyesight
You mentioned something in there about wanting to see small letters on a chart in a dark room. In your opinion, why do you think we are so obsessed with 20/20 vision? It’s something that the public knows about, but in general, in primary care, we’re always aiming for that 20/20 line. Maybe if we’re like, “This person has amazing vision,” we’ll push them to 20/15, 20/10, or whatever. I don’t know if there’s any real-world translation to that, but we are so obsessed with the 20/20 that if we don’t get it, we’re like, “What’s going on here?” Why do you think that is?
First of all, I always correct anyone who says 20/20 vision and say it’s 20/20 eyesight. We have to look at eyesight and vision as separate things. Vision being the brain, and eyesight being a symptom. Truthfully, it starts with what we’re taught in school, the origins of our profession, ophthalmology, and optician work, selling glasses, and selling the opportunity to improve acuity. If we pull away all the bells and whistles, getting the eyes to see and getting them to hopefully work together is the base of all of this. That’s something where it’s a very clear skillset that we’re all experts in and hopefully still evolving and learning from. From day one, that’s what’s ingrained in us.
I always talk about 20/happy and the ideal prescription being the one that’s most balanced between each eye. In my opinion, that’s the weakest lens possible to give the most improvement. Any prescription should improve performance. If it doesn’t improve performance, why are we giving it or changing the prescription?
Any prescription should improve performance. Otherwise, medical professionals should not give it to patients at all.
One thing that gets misinterpreted is, “I’m not anti-glasses. I’m a minus 10. I need contacts. I need glasses.” That gives the brain images to process. What the brain does with that information, how it organizes it, filters it, derives meaning from it, and then directs the appropriate action is what our profession should be doubling down on.
Why Pencil Push-Ups Do Not Work
You made the joke earlier in a lighthearted way that functional optometry is recognizing that the eyes are connected to the brain. We talk about that all the time. Our eyes are connected to the rest of our body. We can see in the retinal blood vessels the potential for hypertension and diabetes. We can detect brain tumors, possibly. We talk about these things. We’re proud that we’re trained in all of that. Sometimes, we forget that vision is so much more than just seeing 20/20. It’s the processing and the ability to use your vision to move through space and all of that. I know we could do ten episodes on all of that. Unless you had something else to share on that before I ask you a different question.
Let’s tie a bow on that because we could go into deep rabbit holes.
What I wanted to get at was how I found you and some of the stuff that I’ve seen you talk about online. I understand somebody in your position who is trained and extremely knowledgeable has a very important message to share and is laser-focused on getting that message out there. You’re using the platform and leveraging the platform’s innate tendencies to get more views and things like that. What I’m trying to say, to be transparent, is that some of the stuff you’ve put out there is a little clickbait-y. I’m going to guess that that’s somewhat intentional.
How I found you around the time that I originally messaged you was a video of you with Dave Asprey. You were on his podcast. I don’t remember the exact term, but it rubbed me the wrong way a little bit. Dave was asking you what the two exercises are to correct your vision, or maybe improve your vision. Your answer was the monocular pushups. I thought pencil pushups were not a thing. That got me interested.
I started looking at more of your videos, and I saw that you shared that same technique a bunch of times. What I wanted to get into was for you to explain the exercise and why it’s useful. Have you gotten any pushback from some of the content that you put out there in the digital world to help bring awareness to this functional optometry space?
For anyone tuning in, I always want to be called out if you feel like something that is being shared or said doesn’t resonate with you. That opens up an opportunity for discussion and learning. I can confidently say that anything I or my team puts out there, we can stand behind. You know, as an expert in the podcasting space, that you can control what you ask. As an expert interviewee, I can’t control what’s asked of me or how people interpret what I say. Oftentimes, if I then correct them, it gets edited out and not put in.
Before you go on, I’ll add one more layer. I don’t want to come off as interrogating you on it because we’ve talked about this already. To add one last little thing, that specific clip and other clips that I’ve watched where I felt like, “Bryce probably could have elaborated a bit,” most of them, if not all of them, are shared from the other platform or the other person’s page. As a podcaster and as a person who puts out social media content, I know I’m trying to get the juiciest little clip or that hot take that I could put on social media.
Pencil pushups, respectfully, don’t work. Doing pencil pushups for convergence insufficiency a thousand times is not going to eliminate the spatial mismatch that is apparent when somebody can’t get their eyes to point to the same place. Monocular pencil pushups are solely working on accommodation and tromboning accommodation, allowing for stamina and, in some cases, flexibility when you’re going back and forth.
To me, monocular pushups or eye pushups are one of the most powerful vision exercises we have that anybody can do. I have patients who do those every single day for months or years and see reductions in their prescription, or see the need for near reading glasses to be less pronounced or even weaker. I’m sure everyone is like, “What are you talking about?” We have so many data points to show this.
I speak on what I learn from our patients and what we accomplish as a practice. I know we are the unicorns in this space, and I’m comfortable there. A monocular pushup is very different from doing it with two eyes. On that specific clip, there were so many comments about, “Why are we doing this with one eye? When I do it with two eyes, I get a headache or things go double.” This intentionally eliminates vergence and only focuses on accommodation.
Do you know how many legit, great vision therapy practices there are out there that don’t even train accommodation and don’t even use lenses? For me, that is our heavy-hitter with every patient at NEH, even presbyopes. Something like this, office-based treatment that’s customized, is 1,000 times more effective than doing pencil pushups at home in your underwear, but for some people, that’s all they have access to.
With Dave Asprey’s podcast, it was so wonderful for our profession because he did a week-long bootcamp with us, and then we filmed the podcast on Friday of the week, outlining his wins. He went from 20/40 to 20/20. He dropped the plus he needed for near. He eliminated double vision and improved his depth perception dramatically in five days.
He was trying to share, “If everyone did what I did, everyone is going to get the same results.” This is what worked for him based on the tailored, customized approach for him and where he was, his path, and his development visually. I always say to share what happened to you. Share your experience, just like I share my experience, but in terms of this, for everybody, nothing works that way other than simple things of what to eat, what not to eat, what to do, and what not to do. Language is key. Language, with all of this, is important.
A monocular pushup is gross stimulation and gross relaxation. It’s building flexibility. Most people won’t keep up with that. They’ll do it once and say, “It didn’t fix my headaches,” or “It didn’t improve my this or that.” I always say vision exercises like normal exercise works, but you have to do it. Somebody says, I went to the gym. I’m in great shape now,” but then if you stop working out and start eating donuts all day, you’re not going to stay in great shape.
With this work, it compounds over time, especially for stuff that’s done at home. Stuff at home is going to scratch the surface if you’re intentional to do the right work, but it’s likely not going to be the be-all, end-all. That’s why most people need to be office-based with somebody who’s board-certified and knows what they’re doing.
I agree. The trouble I have with Dave Asprey is that I used to listen to his podcast quite regularly years back. I’ve heard him talk about how he has fixed his vision. I appreciate that you already cleared that up. Dave is probably overgeneralizing, saying, “Here’s how I fixed my vision. You could do it too.” The problem is either that he’s naive to it or that he’s ignoring it deliberately. There are a million different reasons why somebody could have blurry vision, whether it’s an anatomical thing, an axial length thing, or an actual pathological problem in the retina. There are all sorts of reasons why somebody could have blurry vision.
In the case of that clip and others that didn’t include you that I’ve heard on Asprey’s podcast before, he’s a little too comfortable generalizing, like, “Everybody can fix their vision by doing some exercises. I used to have astigmatism. I don’t have astigmatism anymore.” I was like, “I don’t know if that’s how astigmatism works. Maybe you can compensate for it now and can see well, but you can’t get rid of your astigmatism.”
I do feel like I need to say he is one of the most fascinating, sharpest people I’ve ever been around. I have so much respect for him because everything he puts out there and everything he talks about, he has tried on himself. He has vetted that protocol, that tech, that person, that procedure, or whatever it is. In his mind, he has fixed his vision twice, and I would honestly agree with that. With the changes he showed in five days, if he had been working with us once a week for months, we wouldn’t have had the same outcome.
That’s your more intense and tailored approach to that one person. I’m not denying the fact that he had significant visual improvement, but that’s through that tailored approach with you, versus saying, “If I do this one thing, it’s going to fix your vision.” Going back to the comments in that post, there were various comments. One of them was like, “I have Stargardt’s disease. Can I fix my vision with this?” That’s the concern I have, where it’s potentially giving false hope to some patients out there who have uncorrectable vision issues.
More than anything, this is an impossible mission. I’m not denying Dave Asprey is amazing at what he does. I’m not saying he’s not genuinely brilliant, but I wish that there was a bit more acknowledgement of like, “To make sure you understand, this doesn’t work for every single vision issue that has ever existed, but it could work for these things.” Maybe improving your accommodation so you don’t need reading glasses, I’m all on board with that.
I’ve evolved a ton with myself spiritually and personally, and getting to a place where I am fully comfortable with myself and what I put out there professionally and personally. I look at this as if a particular video or reel is going to allow one person to potentially have their lives changed or recognize they don’t need to be struggling unnecessarily with these hidden functional vision problems that are no longer hidden, then I’ve done my job.
Our social media presence is growing very quickly. The amount of comments we’ll get from posts that are fear-based, scarcity-based, or not accurate, anytime I can, I’m responding to comments. I’m blessed to have a team that is also responding to comments because things can go down the wrong path pretty quickly. Believe it or not, everything on social media, you can’t necessarily trust. It’s like the Wild Wild West.
There are so many vision improvement coaches out there that are completely miseducating, missing the boat on everything, and even talking about the Bates method. They’re like, “If you start palming and sunning, then you’ll never need glasses again.” It’s a little more complicated than that. Something like the Bates method is from a hundred years ago. We are in a different world now than we were a hundred years ago. The treatment and the protocols need to be different because screens didn’t even exist when Dr. Bates was out there putting his work into the world.
How Does The Bates Method Works
I know I’ve heard Dave talk about palming before as well in the past. I want to ask you about the Bates method, and then I want to talk to you about the other lady that I saw on social media. The Bates method, what is it? Does it work? I’ve heard a lot of people talk about it. I’ve had comments under my own videos and posts on social media about, “This is all a fraud. You’re a fraud. The Bates method cured my vision.” What is the Bates method?
The Bates method, to simplify it, is to take off your glasses, stop wearing them, and decrease the stress that you’re holding in your eyes. Do eye yoga. Do all of these calming techniques to allow for a better balance in the autonomic nervous system. All of a sudden, everything is going to be cleared up, and you’re going to be perfect.
There are little nuggets that we can take from the Bates method that have value and merit, but we’re in a different world now than we were a hundred years ago. I do have many patients who say they’ve done the Bates method, show up, and are not wearing correction or have minimal refractive error. From there, they recount their experience. They were a minus this X amount of years ago, or they had this much astigmatism X amount of years ago.
I’ve always been incredibly intrigued that there has to be something there, but let’s lift up all the layers to try and find what’s there. In 2025, we have many patients who go through a vision performance training program with us, with the sole goal of wanting to decrease their prescription or eliminate their prescription. We very clearly shared from the beginning that this is not the reason to do this. We do this type of work to improve functional visual skills and abilities and optimize my brain connection. That may be almost a side effect that you need less help moving forward.
I know hundreds of patients whose prescriptions decreased dramatically. I want to say this because optometry needs to know this. We have almost every adult that we work with in our intensive care see an improvement in their acuity and be able to do that much more with less plus or even eliminate plus to the point where their presbyopia has been decreased or improved dramatically. A couple of years ago, I’d say, “That is impossible. What are you talking about?”
My wife is not wearing plus-veneer. On her 42nd birthday, she blew out the candles and was like, “Bryce, I can’t see the small print in the back of the medicine bottle. You’ve got to do something about this.” We put her through a specific protocol of vision performance training exercises. She reversed the age-related changes. She has the focusing system of somebody half her age. A year later, her near acuity is solid, and she’s reading medicine bottles. I always say to docs who challenge this, “Have you ever tried it? If you haven’t tried to figure out what’s possible, you can’t say it doesn’t work.”
I’m still blowing my mind daily with the results we get from patients, where it’s like, “We’ve had enough of these over a long enough period of time that there is something here.” I can confidently say that five years from now, we’re going to be doing very different work that’s going to allow for different outcomes because that’s what the world deserves and needs. That’s what our patients come to us for, and to be on the leading edge of what is possible.
That sounds amazing. I’m sure that’s going to intrigue a lot of our colleagues to be able to help our patients to that degree. I imagine some people in the industry will hear that and say, “That’s going to reduce our sales.”
I want to comment on that. If we’re focusing on sales and focusing on just what it does for us, we’re doing something wrong. We need to be in this space to help people. If you help enough people, you do great work, live with integrity, always do the right thing, and are intentional with what you do, then the abundance in terms of finances comes. If you’re doing what you’re doing to just make money, you should question what you’re doing.
Medical practitioners must focus on helping people and not on sales. If you do great, live with integrity, and do the right thing, the abundance in finances will come.
There are a lot of other ways to make a lot more money, probably more quickly, than churning out eye exams and selling a lot of frames. Ultimately, glasses, lenses, and the optical secrets that we all have in this profession, there’s enough people out there. Everybody has eyes. Everybody has a digital world that they’re engaging with. There’s enough for everybody in terms of what you do to be compensated for your work.
There’s that aspect of it. I wonder in the industry, though, not just optometry, like the manufacturers of the devices and the things that we’re selling in our practices, whatever advancement in lens technology for anti-fatigue or others, if those people are maybe concerned that too many optometrist will get into functional vision, improve their patient’s vision, and reduce their need for their technology that’s being produced, and they’re spending money on R&D and all this kind of stuff.
To ease everybody’s concern here, the vast majority of the world does not want to put in the work and does not want to keep it up 10 to 15 minutes a day every single day. If you don’t do work to counter the age-related changes, you’re going to need reading glasses, 100% of people. We all know that. I’m blessed with people who are motivated, compliant, and will run through brick walls because this matters to them that much for these results. For most people, it’s like, “I can’t see this. I’m going to put on glasses. All of a sudden, I can see this, and now I’m focused on what I’m trying to accomplish.” There should not be concern there. For the small subset of the population who want to be proactive, and this is important to them, there are options and solutions available.
Avoiding False Medical Advice On Social Media
I want to go back quickly to some of the social media stuff. This is what I was thinking. Partly, some of this is, and maybe it’s the wrong term, collateral damage. Sometimes, it’s perceived a little incorrectly. Some patients might feel like, “This didn’t work for me, this pencil pushup,” or some other thing that you’ve mentioned. If there’s one person that you helped, then it was worth it.
I understand that concept. I understand the desire to help somebody out there. This is not just you. This is also about others in the functional space that I’ve talked to. The concern that I have is that because it goes over so many of our heads, it feels a bit intangible, and we didn’t learn it in school, it feels a bit too woo-woo.
There’s a lot of stuff on social media that’s not real. I feel like sometimes, the content that maybe you’re putting out or somebody else is putting out might get lumped up with some of those quacks, for lack of a better term, out there who are sharing stuff that is not real. Yours is, but it doesn’t sound real. Unfortunately, it gets lumped with those others. There was this lady who put out this video, like, “Your optometrist is lying to you. You don’t need glasses. Join my webinar and I’ll show you how.” She was trying to sell essential oils or something like that.
Did she have an accent?
She didn’t. She was American.
I’m thinking of someone else. First of all, if something is controversial, it means it’s arousing a disagreement or discussion. There’s very little out there that is like, “Do this. It’s going to help everybody.” Doing a near-far focus monocular activity to build flexibility with your cognitive system can help everybody. Not everybody needs that. Most people don’t need that, but it can help everybody.
Even from our ScreenFit program, the online vision training program, a couple of years ago, it was a hard no. I was like, “I’m never creating something like that. If I can’t help somebody 100%, I don’t want to work with them.” COVID hit. I saw what it was doing to my own kids, to the world, and everybody, realizing, “This is going to be a bigger problem unless we get ahead of this.”
We created a very intentional program with the right sequencing of exercises with people with strabismus, amblyopia, and massive concussions to allow for the right quality control, where we can constantly say, “It’s not going to make anybody worse. For a lot of people, it will help a lot.” We’ve had 100% of people who have gone through it and see a reduction in symptoms if they’ve completed the program. We’ve had thousands of patients go through it. We’ve had as young as 5 and as old as 89.
This is not a program that is going to rehab the visual brain post-concussion if you can’t leave your room because you’re so symptomatic. I’ve had enough people say, “This changed my life. I can now read text messages. I can now go to the grocery store. I can now drive without feeling like this sensory overload is making me want to hide.” Helping somebody 10% or 20% is still helping.
This is a do-it-yourself program, like doing body weight work instead of going to the gym. If you do enough sit-ups, air squats, and pushups, you’re creative with it, and you’re throwing in planks and other things, you can get in better shape, but you have to do the work. If you’re trying to become an elite athlete, that’s not going to get you there. There’s a lot to that. A lot gets clumped together in terms of what’s shared in different arenas, how it’s interpreted, and what’s meant from that, but it’s educational.
All About The ScreenFit Program
I understand that the goal is that you’re leveraging the platform to reach people. If it helps at least a few people, it’s beneficial. I get it. It’s part of how the platform works, unfortunately. There are going to be some people out there who are leveraging it with no actual substance, and there are going to be people like yourself who have the substance there. Sometimes, the messaging gets a little mixed up with some of the others. Talk a little bit more about your ScreenFit program. I know you gave us a little bit of an idea of who it has helped. How do you think colleagues of ours out there will perceive an at-home vision therapy program that’s a bit of a DIY type of setup?
There are a lot of programs out there. There’s HTS from the ‘80s. One of the biggest pediatric ophthalmologists nearby in the DC area prescribes that for every one of his kids that he sees. We have research to show that it doesn’t work and is a placebo effect. Yet, he’s still prescribing that. I don’t want to attack anybody else, but there are a lot of other programs out there that are specific to amblyopia, and one specific to reading readiness.
Knowing that my partner in ScreenFit, who is a sports vision optometrist, Dr. Joe LaPlaca, and I created this together, and it is clinically excellent, allows me to feel comfortable with it. I know this is probably not going to sound great, but I can’t control how others perceive things. I can’t control how they feel about it. I’m an open book. Reach out. Let’s talk about it.
We have a lot of ODs recommending this for patients. That’s a pretty nice compliment. We have a lot of ODs go through the program because they want to see it, and then they’re like, “This is very different from what I thought it would be.” There are lots of tips in there, like taking breaks from screens. Make sure you’re getting out and walking. Here’s how to engage your periphery when you’re on a walk. It has two different courses. Each course has 30 lessons. Each lesson is 10 to 15 minutes to complete. It’s one lesson a day and a review of the previous one. You don’t need any equipment for it.
Knowing that, this is not going to be the solution for a constant strabismus. This is not going to be the solution for somebody who’s got an autonomous correspondence, but for a lot of people, it is helpful there. There’s a lot that my primary care optometry colleagues are doing that I don’t agree with, but I hope that they’re prescribing and doing what they’re doing because they think it’s in the best interest of their patients. From my standpoint, that’s how I’m approaching it.
Understood. Can you share some of the things that you don’t agree with?
I would love to. Prescribing a compensatory prism for the wrong reasons and having somebody go from a two-diopter base-out prism for a constant ET to being in a 45-diopter prism because they keep eating it up. Yet, they’re saying, “Let me give you more and more and more,” rather than recognizing what’s the root cause. You don’t go from 2 to 45 overnight. That’s built over time. That’s something where we should be drawing a line in the sand and say, “We have to do something differently here.”
Another is prescribing patching for somebody who has amblyopia, and now they have strabismus. You created a new problem. Another is prescribing glasses for somebody for compensatory reasons to see HD-clear all the time, yet their accommodative system is a mess, but you didn’t do any testing to look at their accommodative system to know that. All of a sudden, they’re a moderate myope. If you can lift up the hood and look at the functional systems, you can predict the future in terms of what’s going to happen. You don’t know the level at which it’s going to manifest.
I have LASIK surgeons sending us patients to say, “Is this a good candidate for LASIK?” When you think about that, it’s like, “You should be deciding that. You’re the expert here.” They want to know whether this is somebody likely to adapt to that new setup and then need something stronger to maintain that same clarity. It’s like, “Are we going to need two, three, or five surgeries?” versus, “Are they stable?”
We can predict stability, assuming the visual stress from their life is stable. A child who goes from a reluctant reader to being an avid reader often becomes myopic. That’s a big shift. Unless you can predict that, you don’t know what’s going to happen. A 35-year-old doing desk work who is a mild myope and, all of a sudden, with certain intervention, they become a moderate to severe myope, and now their glasses are glued to their face all the time, and they are having to deal with progressives. They had a head injury when they were much younger. They can’t handle the blend and the progressive setup, so now they’re lost and don’t know what to do.
Oftentimes, we create problems without intention, but problems are created. That’s where I feel like part of my mission is letting people know, even eye doctors know, that we need to be looking at accommodation. We need to be looking at eye coordination. We need to be looking at depth perception. We need to be looking at the areas of life that are clear windows into brain function and how that person is performing in life. Let’s at least unpack what we can or educate where we can. If we are still going down the same treatment path, at least it’s a treatment path that you’re making together with the patient, and you know what to expect.
There are primary care ODs who may have done some of the things I shared, and then their patients no longer see them because they’re like, “There’s more to be desired.” Our average patient has seen four and a half eye doctors before coming to us, looking for a solution. That is a problem within our field. That makes optometry look bad because this person thinks these four and a half eye doctors didn’t know what they were doing.
That’s very true. The one word that resonated with me through all of that was to be intentional. Unfortunately, sometimes, we fall into a bit of complacency, “This is the routine.” We’re doing the same thing for everybody and not maybe listening for that extra little piece of information that might tell us something a bit different about that patient, or being more specific and intentional about what they need.
If they need glasses, what are they specifically for? What is its function? It is that versus, “You’re myopic. Here’s a pair of minus two.” You’re a myope who spends all day on the computer. You’re a myopic who does this all day long. Your myopia has progressed this much in the last couple of months. Taking those extra pieces of information above and beyond just the myopia will help. That’s one extra step for primary care to do a little bit more.
Certainly, to your point, about some of the prisms and stuff like that, if you’re finding things or advancing too quickly, we need to be a little bit quicker to refer to our colleagues. It could be somebody like yourself or someone else who might be able to give us a bit more information, rather than letting the patient continue to slide too far down. It makes not just one optometrist but multiple optometrists look bad because they weren’t able to help a patient. That’s good. I appreciate you being open to sharing that. I’m sure I and others have done some of those things that you’re suggesting that we shouldn’t be doing.
Including myself. If you’re not learning from that experience, then you’re doing a disservice to your patients. If you’re not learning about, “How can I pivot from that?” or questioning what you did, knowing that that could help others, there’s so much more there.
Control Your Eyes And Control Your Mind
There are so many more questions I could ask you, but in the interest of time, this is running about an hour. I’m not a Joe Rogan type of show. I don’t do the three-hour thing here. In the future, maybe we’ll come back and do another one. Before I wrap up, there’s a question I ask every guest. I’m starting to get into a rhythm of asking this at every episode. I didn’t prime you for it, but I’ll give you a second after I introduce it to you if you want to take some time to think about it. You have kids, right?
Three.
How old are they?
Eleven, eleven, and a seven. I’ve got boy-girl twins and then a little seven-year-old girl.
That’s beautiful. Are they into Disney movies?
Yes.
Have they seen Moana? Have you seen Moana?
I could probably recite the entire movie forwards and backwards.
In Moana, there’s a character, Maui, played by Dwayne Johnson. In the movie, he’s got the song You’re Welcome. The point of the song is, “You’re welcome for all the things I’ve given you. I’m so amazing.” It’s egotistical. I’m playing a little tongue-in-cheek with that. I want you to take the opportunity to share one profound piece of advice, a quote, or something that you think will help change our and the audience’s lives. I’m going to say, “Thank you,” and you’ll say, “You’re welcome.” What is the one profound piece of advice you could share with us?
Hopefully, people can take this and start sharing with their patients as well. If you cannot control your eyes and their ability to focus, then you cannot control your mind and its ability to focus. We need to all be looking at eye movements. We need to all be looking at vergence and accommodation. In doing so, we’re going to be able to unlock so much potential for people and allow people to live lives with vision unlocked.
My advice is, let’s all start doing one quick test of the functional visual system. Take a pen and do an NPC. Do an eye movement. Do a near-far focus. Everybody who questioned the eye pushups, try it for a week and see what you notice. You’re going to notice something different if you do it. You’re going to notice that one finger is going to be able to get closer and one finger is in a different plane than the other. Test, don’t guess.
I love that vision unlocked. That’s a cool term. I like that. That’s a cool phrase. Thank you very much.
You’re welcome.
Get In Touch With Dr. Bryce
Before we wrap up, where can people find you and learn more about you?
My practice is MyVisionFirst. Go to MyVisionFirst.com. We’re all over the socials, but Instagram is the one that seems to be gaining the most steam. It’s @DrBryceAppelbaum. Please, if you see stuff that’s on there that you love or don’t love, challenge it and question it. Let’s start a conversation. Our conversation is going to open up the eyes of others and be impactful, but let’s make sure we treat each other with love and respect. From there, there’s a nice foundation to build off of.
I appreciate that final message. That’s great. If somebody has read this and they understand where you’re coming from, your training, and the mission, if I were to go back and rewatch some of the clips that I’d watched before I ever spoke to you, I certainly wouldn’t misconstrue them. I understand where you’re coming from. The message is clear. What you’re trying to achieve is clear.
I’ve come to respect my colleagues and you in this space of functional optometry. It’s opening doors that I feel like we didn’t even know existed, and opportunities to help our patients in ways that we didn’t even know existed. I hope that rather than overwhelming our colleagues, shutting them down, or offending them, I hope it helps them to think a little differently and realize that there’s so much more we can do for ourselves and our patients. Thanks. I appreciate what you’re doing, and thanks for being such a great guest.
My pleasure. I appreciate your openness. You are a mirror that so many of us can look at to recognize that we don’t all know everything. We need to be able to be open to evolving, growing, and learning from our life experiences. That’s going to help so many others through our powerful work that we all do here.
Thanks again.
I appreciate you.
I’m sure I’m going to have you back on at some other point to yell at you about some other Instagram posts of yours. Thanks for the time. Thank you to everybody who is tuning in to the show. We’ll see you guys in the next episode.
Important Links
- MyVisionFirst
- ScreenFit
- Dr. Bryce Appelbaum on YouTube
- Dr. Bryce Appelbaum on Facebook
- Dr. Bryce Appelbaum on LinkedIn
- Dr. Bryce Appelbaum on TikTok
- @DrBryceAppelbaum on Instagram
- Take the Free Online Vision Assessment
- Try ScreenFit for Free
- 5 Steps to Better Vision – Free Guide
- Shop for Your Vision
- Does Vision Therapy Work? Were We Taught Optics Incorrectly? – Dr. Paul Rollett, Vision Therapy Expert
- Can You Heal Your Visual Issues Through Your Emotions? “The Truth Shall Set You Free… But First, It’ll Piss You Off” – Dr. Vi Tu Banh
- Behavioral Binocular Vision Expert: “People Think It’s All Magic”, “BV Docs Are Being Protective”, “Traditional Optometry is Only Treating the Symptoms” – Dr. Amrit Bilkhu
- How to Navigate Student Debt, Do We Need More Optometry Schools, and How Much Should Industry Be Involved in Education – Dr. Howard Purcell: President and CEO of NECO
About Dr. Bryce Appelbaum
Dr. Bryce Appelbaum is a pioneer in neuro-optometry, passionate about unlocking human potential through vision. His expertise includes reorganizing the visual brain after concussion to support “return to learn” and “return to life,” correcting developmental visual delays that interfere with reading and learning, and enhancing visual skills to elevate athletic performance.
He is the founder and CEO of MyVisionFirst, a leading private practice home to Vision Performance Training—a groundbreaking methodology developed by Dr. Appelbaum himself. Unlike traditional approaches, Vision Performance Training uniquely blends Vision Therapy with principles from Occupational Therapy, Physical Therapy, and holistic wellness, while utilizing best-in-class technology. At the core of his work is a deep understanding of the eye-brain connection—recognizing that how we see is directly linked to how we process, perform, and interact with the world around us.
Based in Bethesda, Maryland, MyVisionFirst serves patients both locally and across the globe through virtual consultations and immersive, one-week Vision Intensives that accelerate results and spark transformation. Dr. Appelbaum has worked with hundreds of elite athletes across all professional sports—including the NFL, NBA, NHL, MLB, MLS, and NWSL—as well as Olympic competitors and collegiate teams, using vision to transform raw talent into peak performance.
He is also the founder and CEO of ScreenFit™—a revolutionary online vision training program designed to improve your vision in just 10 minutes a day. Whether you’re experiencing screen fatigue, blurry vision, or digital eye strain, ScreenFit™ provides a powerful, accessible solution to help you thrive in a screen-heavy world.
Dr. Appelbaum is a board-certified Fellow of the College of Optometrists in Vision Development and serves as an Adjunct Clinical Professor at the Southern College of Optometry. He earned his undergraduate degree in psychology and pre-medical studies from Washington University in St. Louis and graduated with clinical honors from the Illinois College of Optometry. He is also certified in Corneal Refractive Therapy (CRT)/Orthokeratology, a non-surgical specialty contact lens technique used to slow myopia progression and improve vision without daytime glasses or contacts.
DrB is on a mission to change the way that the whole world views vision. Real vision isn’t measured in letters on a chart—it’s measured in how you think, learn, move, and show up in the world. And when your visual system is fully developed and the eye-brain connection is optimized, it doesn’t just improve how you see—it unlocks your true potential.
Dr. Appelbaum is a sought-after podcast guest and media contributor, known for sparking conversation and shifting perspectives on overlooked aspects of vision.
He frequently speaks on topics such as:
- Why so many vision problems are misdiagnosed—or missed entirely—in traditional healthcare
- The hidden connection between screen use and the surge in visual symptoms
- How undiagnosed visual issues can mimic ADHD, learning disabilities, and even dyslexia
- Why outdated treatments like eye patching or muscle surgery may do more harm than good
- The critical difference between eyesight and vision—and why it matters
- Vision Performance Training as a breakthrough approach to post-concussion recovery
