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t m c » p u l s e | j u n e 2 0 1 6 35 Kassaundra Johnston, O.D., direc- tor of SNAPS and clinical assistant professor at the University of Houston College of Optometry, started the clinic after seeing a need for care in the spe- cial needs adult population. "After completing my residency, I felt like we were not providing the full service to adults with disabilities. We were doing an excellent job with the pediatric population, we were doing a pretty good job when they got out of pediatrics, but I felt like we could be doing something better and different," Johnston said. "When I became faculty, I was given the opportunity to mold my own clinic, and I wanted to provide a full-service clinic for all adults with developmental delays or disabilities." The clinic provides comprehensive eye exams for patients, fits patients for glasses specifically made for children and adults with developmental disabil- ities and provides families and caregiv- ers with information and strategies to better communicate with their loved ones. "We try to provide the patients and their families with not only the basic eye exam and glasses, but also information that they can take back and use in their daily lives," Johnston said. "For example, if a patient is nonverbal, we can tell the parent that their son or daughter has 20/30 vision and we relate that back to font size, so when- ever they are reading or looking at near materials we know they are able to see it properly." The clinic is run by Johnston through the University of Houston College of Optometry and is staffed by fourth-year students throughout the year. The course is an optional clinical rotation and not required by the school to graduate from the College of Optometry. The course aims to teach students the best techniques to use when examining patients with special needs. "I think one of the biggest chal- lenges for this population is finding an office that can spend the amount of time it takes to do these exams," Johnston said. "There will be times I have to do my exam on the floor because I am working with a patient who feels the most comfortable there, or they might need 30 minutes by them- selves in the room to be comfortable with it. My hope for my students in SNAPS is that when they have their own practices, they will take the extra time to work with these patients and be prepared to do so." The majority of patients seen by Johnston and her team have autism and Down syndrome. Patients with Down syndrome, especially, have a hard time wearing traditional glasses because they do not fit well on their faces. "The facial features of patients with Down syndrome are different than oth- ers because their bridges are flatter and their ears are lower-set. Because of this, most glasses will fall off of their faces or will be uncomfortable for patients to wear," Johnston said. "I don't think twice to recommend a new type of glasses for my patients because I want to give them every option for frame selection we have to provide them with the best vision possible." Specs4us is one of the eyewear companies the University of Houston College of Optometry uses for their patients. The company was started by Maria Dellapina, a single mother of four whose youngest daughter was diag- nosed with Down syndrome. Dellapina had 30 years of experience working in the optical field and was very frustrated that she was not able to get her daugh- ter glasses that fit properly. "When we began looking for glasses for my daughter, there were only two options—Miraflex or Specs4us," said Kalaya Riccio, the mother of an optom- etry patient. "We started [my daughter] out with Miraflex, but they pushed against her eyelashes and made her very uncomfortable. When we switched to Specs4us, there was much less dis- traction and she enjoys wearing them." Whether it be primary care or optometry, Texas Medical Center pro- viders are working to provide quality care to all patients regardless of their cognitive aptitude. Kassaundra Johnston, O.D., explains the different eyewear options for her patients. The Specs4us glasses are specially made for patients with Down syndrome. PATIENTS WITH DOWN SYNDROME, ESPECIALLY, HAVE A HARD TIME WEARING TRADITIONAL GLASSES BECAUSE THEY DO NOT FIT WELL ON THEIR FACES.

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