Dr. McBryar is referred

to by many family physicians in the greater Chattanooga area

to provide an important part of the continuum of care.

Overview

As the primary healthcare provider and first point of contact, by referring to Dr. McBryar, you can ensure that your patients meet all of the needs required to optimize their vision. People of all ages and backgrounds can benefit from Dr. McBryar’s services as she provides neurological eye care, extending far beyond visual acuity, in order to improve the patient’s quality of life.

Dr. McBryar is referred to by many MD’s for functional vision exams, including:

Strabismus
Amblyopia
Convergence insufficiency
Diplopia
Learning disabilities
TBI
Vision loss
Impaired visual field
Dr. Zurcher cartoon
For example, a person struggling with convergence insufficiency may suffer from headaches or difficulty in classroom performance and may not know that this is due to an aspect of their neurological visual system which is malfunctioning. There is a wealth of clinical research indicating the success of correcting convergence insufficiency with vision therapy.

Our Address

1043 Executive Dr #102 Hixson, TN 37343
(423) 321-8233
hello@123.co

Working Hours

monday-Thursday
9:00 AM - 6:00 PM
Friday-Sunday
closed
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Dr. Heather McBryar

Dr. McBryar runs a professional optometry practice, Southeast Vision Rehabilitation, located in Chattanooga, Tennessee. She graduated with honors from Nova Southeastern University College of Optometry and is a Diplomate of the American Board of Optometry (ABO). Dr. McBryar specializes in the fields of developmental optometry, vision therapy and low vision.
She has many achievements in her field, including that she:
Is a Fellow of the College of Optometrists in Vision Development (COVD)
Is a Candidate for Fellowship in the Neuro-Optometric Rehabilitation Association (NORA)
Has hospital privileges at Siskin Hospital for Physical Rehabilitation
Is a co-founder of the Chattanooga Area Low Vision Network
Lectures extensively on the topics of neuro-optometric rehabilitation and low vision
Runs her optometry practice, Southeast Vision Rehabilitation, which is a performance center of NIH/NEI funded Johns Hopkins research study: Comparative Studies of Low Vision Rehabilitative Outcome Measures.

Publication

Compensatory Prism for Strabismus Secondary to Stroke
Heather M. McBryar, OD
Hixon, Tennessee
Pseudomyopia
Heather M. McBryar, OD
Hixon, Tennessee
Appendix A Bull’s-Eye
Heather M. McBryar, OD
Hixon, Tennessee
Appendix B Brock String
Heather M. McBryar, OD
Hixon, Tennessee
Asset 1@4x
Tritheia is comprehensive vision therapy software written by Levi Zurcher OD FCOVD. It runs on Windows, Mac, and Linux. It’s currently being used at his practice in Olympia, WA.

This is vision therapy helps us provide therapy that is more customizable to meet individual needs. It’s also free to use for our patients.
Learn more

What does it do?

  • Use the software at the office and provide access for patients to use it at home.
  • User Management:  Edit patient information, assign doctors and therapists.
  • Activity Management:  Create your own activities (both traditional and computerized.)  Edit instructions, activity parameters, documentation templates, and report templates.  Freely share these activities with others.
  • Testing:  Hess test, fixation disparity curve, scoring perceptual tests, etc.
  • Program Sequencing:  Create and customize therapy programs for each patient.  Create preset programs to start with.
  • Create your own word lists, stories, and images (for anaglyphs and presentation.)  Share them with others.
  • Keep track of equipment you check-out.
  • Generate reports to monitor patient progress and compliance.

Is it an alternative to traditional vision therapy?

  • No.  This software was designed to help enhance and modernize traditional VT practice rather than replace it.
  • Our visual systems were designed to guide the movement of our whole body in open space.   While there are some activities that are well-suited to the computer,  sitting and staring at a flat screen 70 cm in front of you is not a substitute for many VT activities.

Lorem Ipsum

Eye examinations include simple tests to assess general vision, as well as more comprehensive examinations for overall eye health. Depending on how extensive the testing an exam can take up to 90 minutes. Exams for the young and healthy are generally shorter in duration and should average under 30 minutes. Many experts recommend that children have a comprehensive examination before beginning grade school, followed by subsequent annual testing. Common tests include:
This checks overall vision. You will be asked to read from a Snellen chart where the letters decrease in size as you progress down the chart.
This checks overall vision. You will be asked to read from a Snellen chart where the letters decrease in size as you progress down the chart.
This checks overall vision. You will be asked to read from a Snellen chart where the letters decrease in size as you progress down the chart.
This checks overall vision. You will be asked to read from a Snellen chart where the letters decrease in size as you progress down the chart.
This checks overall vision. You will be asked to read from a Snellen chart where the letters decrease in size as you progress down the chart.
This checks overall vision. You will be asked to read from a Snellen chart where the letters decrease in size as you progress down the chart.

Blog

Binocular Vision Dysfunction (BVD)
[embed]https://youtu.be/SvDj2jgTdwk[/embed] Binocular vision refers to the ability of the eyes to work together. The term binocular vision dysfunction describes a misalignment between the lines of sight of each eye.Those with good binocular vision have the ability to point both eyes at the same point in space and to combine the images that their right eye sees with what their left eye sees into a single image. However, with someone who has binocular vision dysfunction, the eyes are misaligned, and the brain is unable to put together an accurate picture of the combined image from both eyes. There are many different causes and symptoms of BVD.

What are the symptoms of binocular vision dysfunction?

Binocular vision dysfunction has a lot of different symptoms that include: 
  • Fatigue
  • Headaches 
  • Vertigo 
  • Dizziness
  • Balance problems 
  • Nasuea 
  • Brain fog
  • Double vision
  • Problems with 3d vision or depth perception.
  • Problems with eye alignment 
When the eyes don't work together well, the brain will also often adapt by suppressing or filtering out some of the vision in one eye. While this keeps you from seeing double, it can also reduce your ability to perceive depth or 3D vision. Many people with binocular vision problems have trouble aligning their eyes. The misalignment may be from the eyes crossing inward or drifting apart. It can also be because one eye is aiming higher or lower than the other.

What are the causes of binocular vision dysfunction?

Binocular vision dysfunction can be caused by a wide range of factors. Many people believe it's due to weak eye muscles, but this is almost never the case. The causes of binocular vision dysfunction include:
  • Neurodevelopmental delays 
  • Poor muscle tone
  • Brain injuries from car accidents or concussions
  • Resulting from neurodegenerative conditions, such as Parkinson's disease. 
  • In rare cases, it can be caused by brain tumors

What is Vertical Heterophoria? 

Vertical heteropopia is a condition in which the line of sight is higher from one eye than it is from the other. The misalignment (either vertical or horizontal) makes it difficult for the brain to combine the two images taken in by our eyes. This creates difficulties with 3D vision, tracking and much more.

How is binocular vision dysfunction treated?

The treatment options differ depending on the severity of the case. Treatment options may include one or more of the following:
  • Vision therapy, which is one of the primary ways to learn how to manage binocular vision dysfunction more effectively. 
  • Prisms are used in glasses to get the double images to align more easily. Often times prisms are used in combination with vision therapy. 
  • Eye surgery is generally a last resort for extremely severe cases. Even for those that do require surgery, since the problem is in the brain and not in the eye itself, fixing the eye will still require either therapy or prisms. 
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Contact Lens Discomfort Caused by Dry Eyes
https://youtu.be/Febwlp54hjs Dry eye symptoms are the main reason that most people stop wearing contact lenses. There are many causes and reasons why someone may start to experience dry eye symptoms and begin to have difficulties wearing contact lenses, although it is more common as you get older. Your eyes can tolerate almost anything when you are young.  After the age of 40, you may start experiencing more dry eye symptoms. This is why many people tend to wear their glasses a lot more. While there is nothing wrong with wearing glasses, if you want to wear your contact lenses more frequently and are experiencing dry eye or discomfort, then you must address the issue.  

Why do contact lenses cause dry eye?

 

Oxygen & dry eye

The cornea, the front part of your eye, receives oxygen directly from the air. When contact lenses partially block oxygen from reaching your eyes, your eyes can feel dry and itchy. Despite the fact that modern contact lenses are designed to let as much oxygen through as possible, this can still be an issue, especially after prolonged use.

Contact lens friction and dry eye

Our eye is covered by a layer of lipids and water called tear film, when someone has dry eye they may have a deficiency in their tear film. When a person with a deficiency in their tear film wears contact lenses it causes friction, this friction causes feelings of discomfort, dryness, and pain.   

What are the symptoms of contact-lens induced dry eye?

Symptoms of contact lens-induced dry eye can vary in severity, but they tend to start out mild. They include:
  • Dry, itchy, or sore eyes
  • Eye fatigue
  • Red eyes
  • Eye soreness
  • Stinging eyes
  • Blurry vision
  • Light sensitivity
  • Watery eyes
 

How is contact lens-induced dry eye treated?

There are several ways to treat contact lens-induced dry eye.   

Eye drops 

For moderate dry eye you can start with using over-the-counter eye drops, eyelid treatments, and good hygiene.    

Switching to daily lenses

Another way to treat dry eyes is to switch from monthly contact lenses to daily replacement lenses. They only need to last a day and they are typically a lot thinner. This allows for more frequent replacements, which helps with dry eyes. Dr. Levi Zurcher recommends Alcon's daily total 1s and precision 1s. Their outer layer contains high levels of water content and they're extremely slippery. They are designed in such a way that you barely notice you're wearing them. If you are thinking about stopping wearing contact lenses altogether, it is certainly worth trying these.  

Medication

There are two main prescription drops used to treat dry eye called restasis and xiidra.  

Check for Ocular Allergies  

Contact lens discomfort is often caused by allergies. Anti allergy antihistamine eye drops can alleviate this discomfort.  

Change your contact lens solution

Sometimes changing the solution of your contact lenses is all you need to treat dry eyes. Using a high quality brand instead of a generic store brand, especially clear care’s peroxide based solution, can help with dry eye issues.   

Switching to Scleral Lenses

Scleral lenses are customized contact lenses that have a unique vaulted shape. This shape creates a pocket between the lens and the cornea. This pocket is filled with saline solution, which can make scleral lenses a solution for someone who wants to wear contact lenses but experiences dry eye.   

More advanced dry eye treatments

There are a variety of more advanced dry eye treatments that should be discussed with your eye doctor after a full dry eye examination. During the dry eye examination the eye doctor is looking at the underlying causes for your symptoms in order to offer the best treatment.  These may include: 

Punctal Plugs

A few studies have examined punctal occlusion and how it affects contact lens comfort. According to one study, the amount of comfortable time spent wearing contact lenses in the eye where the plug had been placed greatly increased three weeks after it was placed.  

Meibomian Gland treatments

There are a variety of specialized treatments that heat and express the glands in our eyes that are often the cause of poor tear film.   

Amniotic Membranes

For more severe corneal problems patients have experienced significant improvements with dry eye symptoms after having amniotic membranes used to heal their eye.
Read More
Contact Lenses for Astigmatism
[embed]https://youtu.be/KB4DkKWttHc[/embed] There is a relatively common eye condition known as astigmatism, which historically has been corrected primarily by eyeglasses. Contact lenses now exist that can correct nearly all types of astigmatism, so they may be a better option for you, depending on your needs and preferences.

What is astigmatism?

Astigmatism is a treatable imperfection in the curvature of the eye, more specifically either the cornea or the lens has mismatched curves.  Astigmatism leads to blurry vision in both the distance and near range. Astigmatism is typically inherited, so most people suffering from it were born with it. It can also happen as a result of an eye disease, pressure put on the eye, injury, or surgery.

What contact lenses are used to correct astigmatism?

One of the contact lenses used to correct astigmatism are toric lenses. These lenses must rotate to work correctly. Everyone's astigmatism has an angle, so the contact lenses must rotate accordingly. If they are out of alignment, the vision is distorted. These kinds of contact lenses, though, are generally very effective for most people these days. When considering these contact lenses, you should keep your expectations in check. While you may not get crystal clear vision like with glasses, it should still be good vision. That mainly is due to the fact that there are about a million different combinations of powers, such as astigmatism power, nearsightedness power, or farsightedness power, and the angle, so these companies can't make every combination, but if one has a low or medium amount of astigmatism, one can get these contact lenses to work well.

Are Toric Contact Lenses Good for High Astigmatism?

The treatment of high amounts of astigmatism can be challenging with Toric contact lenses and in general Toric lenses are more suitable for lower levels of Astigmatism. In some cases, extended parameters lenses can be used to treat high amounts of astigmatism. Although the vision tends to be less consistent with those just because if it even spins just a little bit, it can throw things off when you blink for instance. 

What contact lenses are a good option for high astigmatism? 

Patients with higher levels of astigmatism will usually perform better in hard contact lenses such as rigid gas permeable lenses and scleral lenses. These lenses do better due to the hardness and the fact that they cover up the surface of the eye.  Scleral lenses in particular provide better vision and more comfort as they are more customized to the eye, sit on the white part of the eye that is less sensitive, and have a reservoir for saline to ensure comfort. 

Further Questions, Schedule a Contact Lens Exam Today!

You can get additional information or more detailed information about astigmatism contact lenses from our optometrist, who has extensive experience in fitting contact lenses for astigmatism. During a full contact lens examination, our eye doctor will be able to determine what contact lenses for astigmatism are the best option for you.
Read More
What are colored contact lenses?
[embed]https://youtu.be/J_g8YW8MbJM[/embed] Colored contact lenses mimic the natural appearance of the iris, which is the colored part of the eye. Since the iris is composed of shapes and lines, some colored contact lenses mimic this for an even more realistic appearance. As the center of the lens, which covers the pupil, is clear, the wearer is able to see through it. Quite a few people actually wear them every day. 

Why do Air Optix colored contact lenses stand out?

The most popular colored contact lens today is the Air Optix colored contact lens. These colored contact lenses are made from a more breathable silicone hydrogel material, making them healthier for your cornea than some older colored contact lenses you might still be able to find. One of the best things about these lenses is that they come in a semi-opaque color pattern. Another benefit of these is that the natural eye color blends in with the color of contact lenses, making them appear more realistic and less fake. In addition, they can be interchanged with regular Air Optix contact lenses. During the course of the day, you can wear your clear contact lenses and on special occasions you can wear your colored contacts. This can be done within the same prescription.

Are colored contact lenses safe for you?

It is important to determine whether or not you have astigmatism or an irregular cornea shape before trying out colored contact lenses. If you do, you may have difficulty finding colored contact lenses. We urge everyone to always schedule a contact lens exam before purchasing or using colored contact lenses. Contact lenses are regulated as Class II or Class III medical devices by the FDA. Even if you do not have a prescription and are buying contact lenses to change the color of the eye, always schedule a contact lens exam. Improper fitting contact lenses can cause eye infections and potentially serious eye conditions. Avoid purchasing these types of lenses from sites offering them without a prescription. This may suggest that the health and safety of the wearer isn't a priority for the retailer, and the quality of their lenses is lower. Additionally, this is illegal. Saving a bit on cheaper lenses for a costume isn’t worth potentially damaging your eyes.

Why should you consult a professional before using colored contact lenses?

As with anything related to your eyes, it is always best to consult your eye care provider beforehand, this is equally as true before using colored contact lenses. It can help you determine what brands are best for you, find contact lenses that fit the unique shape of your eye, and alert you to any risks to your eyes.
Read More
What is Behavioral Optometry?
Behavioral optometry employs an integrated approach to treatment that views the individual as more than a refractive error, a patient, or visual issue. Extending traditional eyecare beyond 20/20 vision.

What is Behavioral Optometry?

We are more than just our eyes. However, some of us may experience vision based problems. When most people think of eye-related errors they think of issues with acuity. Acuity is our ability to see clearly at near and at distance. For some, this is where their visual journey ends and for others, where it begins. For those with an acuity issue, an eye exam with a refraction and they are on their way to better vision. But what about those who don’t have a problem with acuity, yet they still are unable to see? There happens to be an entirely different side of the same visual coin that people tend to overlook or be wholly unaware of.   

The Two Sides of Vision

The visual equation is two fold. First, as we discussed, is our ability to see clearly. Second, and very importantly, is the manner in which our eyes operate together as a team. A deficiency in this area can lead to a myriad of visual, physical, and behavioral problems. Before we dismiss the implications of that last statement let's talk briefly about perception. Let us consider this: about 80-90% of the sensory input that reaches our brain is visual data. With that type of staggering statistic it’s easy to consider this next statement. How we see largely makes up who we are. This isn’t to invalidate other sensory input or pathways but to emphasize how important this one is.  

The Broader Impact of Binocular Dysfunction

If how we see is who we are then what does that mean for someone deficient in the visual system? The answer brings us full circle to the scope of the first question on Behavioral Optometry. The inability to use our binocular system effectively not only presents as an issue in its own right but will tend to cascade into other areas of our development and our lives.  The inability to perceive the world as it really is, whether it is through double vision or a lack of depth perception, will affect psychological and behavioral development. If the mind and body cannot course correct in an effective and healthy manner then, as wonderfully evolved as it is, the mind will develop another means in which to address the crisis. This is everything from shutting down the relay of visual information from the eye to the brain to hyperactivity and the inability to stay attentive when attention is required. This is just the tip of the proverbial iceberg when it comes to the implications of undiagnosed or unaddressed binocular dysfunction.   

Behavioral Optometry

Behavioral Optometry is the field in which the very nature of these issues, from the neurological to the psychological, are addressed. Optometrists who specialize in this field are focused on preventing, diagnosing, and treating these disorders and the compounded issues while improving the overall quality of life for those afflicted. Behavioral Optometrists typically employ an integrated approach to treatment meaning it’s well-rounded with their interdisciplinary point of view. One of the hallmarks of Behavioral Optometry is viewing the individual as more than a refractive error, a patient, or visual issue. The patient is considered, first and foremost, a human being and from that foundational perspective, the effectiveness of treatment has already changed for the better. Along with the humanistic view, the Doctor will also consider biopsychosocial factors when diagnosing and treating patients. Considering all possible causes, affected areas, medical histories, and behavioral adaptations when treating an individual. These traits of Behavioral Optometry are typically what sets it apart from standard practice. 
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Common vision problems caused by traumatic brain injuries
[embed]https://youtu.be/50WVCXSlAKI[/embed] Many people understand what traumatic brain injuries are, even if they don't know it by that term. These injuries are caused by some type of trauma to the brain, whether it be from an accident or a stroke. Common causes of a traumatic brain injury include sports injuries, motor vehicle accidents, strokes, whiplash, being struck by a hard object and falls. Most people are not aware that these types of injuries are closely related to vision problems. It is sometimes difficult for people with traumatic brain injuries to describe the symptoms they are experiencing, or they worry the doctor will think they are exaggerating.

Vision problems following a traumatic brain injury

  • Sensitivity to light - Optometrists encounter patients with traumatic brain injuries who tend to be very sensitive to light. These patients wear dark glasses and hats whenever they are outdoors, as well as inside.
  • Decreased peripheral vision - Traumatic brain injury patients are sensitive to movement, especially in their peripheral vision. These people can’t go to the grocery store and walk down the aisle because it makes them uncomfortable. This can cause them to become disoriented and limit their ability to get out and do what they have to do.
  • Binocular vision problems - Traumatic brain injuries can also cause binocular vision problems. It is difficult for them to use both eyes as a team. Various manifestations of this problem exist. A person who hits their head hard can damage a particular nerve, the fourth nerve. Damage to the fourth nerve will cause one eye to aim higher than the other and they may experience double vision.
  • Double vision - They may have difficulty aligning their eyes horizontally, which can lead to double vision, especially when they are concentrating on close-up tasks. Severe double vision does not always occur, and some people just get exhausted really fast or feel a pulling sensation around their eyes when they try to do near work such as reading.
  • Difficulty reading - Patients have trouble making accurate eye movements when reading. After traumatic brain injuries, saccadic eye movements may become less accurate, causing them to skip lines or lose their place when reading.
  • Visual midline shifts - Traumatic brain injuries can also cause visual midline shifts. In this case, their perception of  the center is actually offset to the right or to the left. As they walk, these patients will lean sideways or veer to the right or left or they may need to hold on to the side of the wall in order to stay upright. One indication of a visual midline shift is a change in posture after a traumatic brain injury.

How are vision problems caused by traumatic brain injuries treated?

In the case of horizontal or vertical double vision, prisms are used in the glasses. In order to treat visual midline shifts, yoked prisms may be used. These prisms shift the whole world off the other way which changes the sense of center and helps them walk more upright. The usage of tinted glasses has become very common among light sensitive people. Vision therapy is done to try to rehabilitate the visual skills that are lost as a result of brain injury. Usually, a combination of these treatments is done to achieve the best results.
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Why is it important to take care of your contact lenses?
[embed]https://youtu.be/l3bOph5HbGY[/embed] If your contact lenses are not properly maintained, they can become harder to see through, thus defeating their purpose, and they will not last as long. Also, if they are not properly cleaned and disinfected, they can scratch your eyes and you could contract a potentially serious eye infection.

How should you take care of your daily disposable contact Lenses?

Nowadays, it is very easy to take care of your contact lenses. The easiest ones to take care of are daily lenses. All a person has to do is wash their hands before putting them in and then throw them away when they are done using them. 

How do you take care of your bi-weekly and monthly replacement contact lenses?

Taking care of lenses that need less frequent replacement is also quite easy. They need to be soaked in the solution overnight, and then used. Clear Care’s peroxide based solution is recommended by many optometrists. The solution is ideal for anyone who doesn't want too many chemicals in their products. Clear Care's box includes a solution and a special container with a metal disc at the bottom. The metal disc neutralizes the peroxide over time. This solution is only to be used for soaking the contact lenses in. Using it directly in the eyes can cause severe discomfort or worse. The container is filled with solution up to the line, and the contact lenses are placed into the baskets beneath the metal disc. Next, the contact lenses are left in the solution for five to six hours, depending on the brand. After that, one can simply wear them; there is no need to rinse them off since the solution was saline. Optometrists prefer Clear Care's peroxide-based solution because it has fewer chemicals than competing brands.

What is a multipurpose solution?

Multipurpose solution is an all-in-one care solution that allows you to clean, rinse, disinfect, and store soft contact lenses. Soft contact lens wearers commonly use this solution as a care system. For example Opti Free's Puremoist solution is recommended due to its gentleness, however most of the brands have good solutions. However, optometrists do recommend avoiding store-brand products. Store-brand solutions have older formulas and can cause compatibility issues with newer contact lenses made today.

Keep your contact lens clean and free of bacteria

Here are a few tips to ensure proper hygiene when cleaning your contact lenses. 
  • Having clean hands is the most basic and most important part of contact lens care. When possible stay away from oil or lotion based soaps as they can make your contact lenses cloudy. 
  • Use fresh contact lens solution every time you clean your contacts. 
  • Do not use any other liquid to clean contact lenses, water, saline solution, eye drops do not clean or disinfect your contact lenses. 
  • Don’t scratch your lenses with your nails, your nails may scratch the lens or transfer bacteria to your lens. 
  • Do not swim, shower, or do anything that will expose your contact lenses to water.
  • Do not sleep in daily wear lenses, and don’t wear lenses longer than the time that they are intended for. 
  • Replace your contact lens case at least every three months. 
  • It is recommended that you stop wearing your contact lenses and call your eye care provider if your eyes are itchy, red, pussy, or you are noticing blurred vision. This could be a sign of an infection.

Schedule a contact lens exam at American Family Vision Clinic in Olympia Washington

We welcome new patients to schedule for a contact lens exam at our office in Olympia Washington. Dr. Zurcher and our team of eyecare professionals will assist you in finding the right contact lenses for your needs. We take time with each patient to ensure that they are given the information and lenses that will ensure comfortable and healthy eyes and great vision. 
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