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Eye issue ADHD


aanj
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I will be discussing this with the optometrist but my question is below.

 

 

My son is 15. He has adhd. He is left handed. He wears glasses.

When he writes, instead of sitting upright and looking down on his page, he brings his whole head to a few inches from the page. He bends his body over the page. He is less than 12 inches from the page.

 

Also, when he plays on the handheld devices, instead of sitting upright and looking at the game, he bends his head over the game and close to the game. I am constantly telling him to stop moving his head to the game. Instead of looking down with his eyes while keeping his head in the same place, he moves his whole head down to his book, game...

 

What could the issue be?

Who should we see?

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I am no expert but you might want to see if there is a Developmental Optometrist in your area, if you haven't already.  A standard optometrist or even an ophthalmologist may not have the knowledge and background to determine if there is a developmental eye issue.  And since developmental eye issues have not been well understood or even acknowledged until fairly recently, many standard eye doctors are not aware of the latest research and tend to dismiss developmental eye issues, even though they DO exist.

 

Look here:  http://www.covd.org/

 

But other than that, I really don't know.  Obviously there is something at work, though.  Hopefully others will respond with more knowledgeable feedback...best wishes.

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I agree with OneStep. We went to a pediatric opthomologist who told us everything was fine. He has 20/20 vision so no problem and "save your $ because developmental optometry is hogwash". Well, I'm glad we did not listen because ds had convergence insufficiency. He had double vision at a standard reading length from the page. His left eye would veer to the left and he could not cross his eyes. He would tilt his head from side to side while watching TV, etc. We did 6 month of vision therapy through a development optometrist we found on the above website and the problem was resolved. 

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I agree with OneStep. We went to a pediatric opthomologist who told us everything was fine. He has 20/20 vision so no problem and "save your $ because developmental optometry is hogwash". Well, I'm glad we did not listen because ds had convergence insufficiency. He had double vision at a standard reading length from the page. His left eye would veer to the left and he could not cross his eyes. He would tilt his head from side to side while watching TV, etc. We did 6 month of vision therapy through a development optometrist we found on the above website and the problem was resolved. 

 

Almost exactly what was happening with my son (no double-vision, but some troubles with things looking weird and major eye strain). 

 

I would see a COVD.

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FWIW, my son passed every eye exam for years.  He has 20/15 vision.  But he also has heterophoria and only a developmental optometrist even knew what to look for.  I KNEW something was wrong, but his visual acuity was better than fine.  Not one optometrist or ophthalmologist even mentioned the possibility that there could be other issues besides visual acuity.  Until I came on the LC board I didn't even know to ask.  I finally asked.  The developmental optometrist ran the tests and found the heterophoria.  It had been affecting my son's coordination and stamina with reading for his entire life as well as his sensitivity to light changes.  Not even his pediatrician knew to have this checked.  

 

There are several different possible developmental vision issues that can be at play.  Some respond to VT.  Some don't.  For the ones that do, it can make a significant difference.  Developmental vision issues are a whole other thing than visual acuity but it is not widely understood by the medical community at large, yet.  Just like dyslexia/dysgraphia/dyspraxia/dyscalulia, etc. it takes a lot of time for information to be disseminated, understood and accepted.  You can have problems with visual acuity and no developmental vision issues or problems with developmental vision issues and visual acuity is fine or you can have problems with both but a Developmental Optometrist is probably your best, possibly even your only option for tracking down both sides of this coin.

 

Best wishes.

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I am no expert but you might want to see if there is a Developmental Optometrist in your area, if you haven't already. A standard optometrist or even an ophthalmologist may not have the knowledge and background to determine if there is a developmental eye issue. And since developmental eye issues have not been well understood or even acknowledged until fairly recently, many standard eye doctors are not aware of the latest research and tend to dismiss developmental eye issues, even though they DO exist.

 

Look here: http://www.covd.org/

 

But other than that, I really don't know. Obviously there is something at work, though. Hopefully others will respond with more knowledgeable feedback...best wishes.

Is it important that optometrist is found the on COVD Website?

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Is it important that optometrist is found the on COVD Website?

Honestly, there may be a very good one in your area that is not on that site.  You should ask around.  Read up on Developmental Vision issues such as convergence insufficiency and heterophoria.  Check out what the Eides say about Developmental Vision issues and Vision Therapy then interview local Developmental Optometrists to see how knowledgeable they are and up to date.  Ask others who may have used them.  Look for on-line reviews.  You might get lucky.

 

But odds are if they aren't on that site they have not had the training and experience and probably have not kept up to date on the latest findings and information you would probably want.

 

 I have no one in my area or even within a few hours drive that appears on that list.  I had to go with a local Dev. Opt. that was not on the list.   He was o.k.  Certainly way better than others we had gone to that were normal ophthalmologists and optometrists.  He at least was able to find the issue when others could not and knew exactly what I was talking about when I described the issues we had been seeing.

 

 My son did VT through him and things did improve.  BUT, I do not feel that we got the rigor and attention DS needed, nor do I think the eye doc had the experience we needed.  I suspect there may be additional issues as well that were not addressed.   We will be getting another eval through a COVD listed doctor at some point in the future, but we will be going several hours away to get it.

 

The main thing is to make certain you see a Developmental Optometrist, not a standard optometrist, and one that has a very good reputation.  Good luck and best wishes. 

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Thanks for the reply. I realize our regular optimetrist is not an expert in this area.

So, I looed on that website. There are two listed there that are in my town.

However, I know nothing about them. There are a few others that are not listed on that site but are rated well on ratemds and do seem to specialize in this area. Still, I don't know anyone who used them.

However, you are making me think it's pretty important that they are on that site.

I guess it's better that they are.

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I wish I knew for sure.  Even if they are listed on that site I can't guarantee that they will be nice people or extremely rigorous in seeking answers or listen to you as a parent.  If you know there are some that are local that are highly rated you could at least maybe talk to the front office and ask if they do preliminary screenings for developmental vision issues when doing a normal eye screening.  And if they do VT where warranted.  If you do it that way, just a preliminary screening first, insurance might cover it so the cost wouldn't be as high.  If they do that, and seem knowledgeable, and thorough and pleasant you might ask why they are not listed with the COVD.  One of those others might work out.  Just call around.  Try to get a set of questions together that you can ask all of them so you are comparing apples to apples.

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Not to say that you son couldn't have an unusual vision problem that needs further investigation, but that would not be my first assumption.

 

What are his current glasses for - distance or near?

 

People who are nearsighted and wear glasses for distance vision don't necessarily need them for near vision. In fact trying to look at close things through the distance correction actually make their eyes work harder, so it is easier not to look through the glasses and just hold stuff a bit closer that "normal". I am currently typing on my iPad about 10 inches from my face because it is easier on my eyes even though I could read it through my glasses if I hold it further away. It is really just personal preference. Bifocal glasses would be one way to compensate.

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Not to say that you son couldn't have an unusual vision problem that needs further investigation, but that would not be my first assumption.

 

What are his current glasses for - distance or near?

 

People who are nearsighted and wear glasses for distance vision don't necessarily need them for near vision. In fact trying to look at close things through the distance correction actually make their eyes work harder, so it is easier not to look through the glasses and just hold stuff a bit closer that "normal". I am currently typing on my iPad about 10 inches from my face because it is easier on my eyes even though I could read it through my glasses if I hold it further away. It is really just personal preference. Bifocal glasses would be one way to compensate.

 

I agree that people who are nearsighted and wear glasses for distance vision don't necessarily need them for near vision since I was one of those in the early years of wearing glasses.  I took my glasses off to read.  I just wore them for distance.  But I didn't keep my face just a few inches from the paper and I didn't shift my head back and forth to see.  That seems to be something more.

 

I would agree with City Mouse, where the first thing is to check whether he needs new glasses?

City Mouse, geodob, you both seem to be suggesting that new glasses might help.  Either to get bifocals or just a new prescription in general.  What confuses me is you seem to be saying not to go ahead and get a vision screening that includes developmental vision issues, too.  Why not get both at the same time?  It shouldn't cost much more, if any more at all, to get a standard vision screening that includes a developmental screening if the OP actually goes to a Developmental Optometrist since they are trained to do both.  Killing two birds with one stone seems a good idea to me.  If there is no developmental vision issue, GREAT!  That has now been ruled out and they don't have to worry about that possible cause any longer.

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I dont care whether she goes straight to a specialist or not. I was just suggestion another option. I live in a rural area where it is not unusual to travel 3-6 hours to finds specialists and many, many people do not have medical insurance. I personally believe in eliminating the easiest/obvious stuff first.

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I dont care whether she goes straight to a specialist or not. I was just suggestion another option. I live in a rural area where it is not unusual to travel 3-6 hours to finds specialists and many, many people do not have medical insurance. I personally believe in eliminating the easiest/obvious stuff first.

I agree.  Since she does have specialists in the area, it just seemed to make more sense to me to just get both types of exams at the same location at the same time.  I hate eye exams so I would have wanted to just get both out of the way with one exam.  I was just wondering if you and geodob had specific reasons why it would make more sense to go to a regular eye doctor first.  Thanks for clarifying.

 

Best wishes.

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As he already wears glasses and has a regular optometrist, it would be a simple process to have his optometrist test whether he needs new glasses?

Where I particularly wonder about his vision in his right eye?

 

Though it's the combination of bringing the page very close to his eyes, as well as turning his head, rather than his eyes?

Where getting the visual acuity of each eye checked, would be a good starting point.

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My son is 15. He has adhd. He is left handed. He wears glasses.

When he writes, instead of sitting upright and looking down on his page, he brings his whole head to a few inches from the page. He bends his body over the page. He is less than 12 inches from the page.

 

What could the issue be?

Who should we see?

 

I suspect the issue is that he's trying to get his face close enough to the book or computer so that he's effectively reading with only one eye. If his eyes aren't working well together, moving close to the page can have the effect of parking one eye off target far enough that he's just using one eye to read. If he tries tracking with his eyes, instead of his head, that can increase his confusion because the "parked" eye might end up fixating close to the eye he's using, giving him double vision again.

 

I fully agree that your next stop should be a developmental optometrist. You've already gotten some good advice on locating one, but here's a page on my site that you might also find useful: Find a Vision Therapy Provider.

 

By the way, the symptoms of some vision issues overlap significantly with the symptoms of ADHD, so it's possible that addressing any vision issues he has could also positively affect some of his ADHD behaviors.

 

If he is moving his face close to print to get down to using one eye, it would be interesting to see how he reacts if you tell him to sit up straight, track with his eyes, but cover one eye as he reads. If you ask him to cover one eye with his hand, the eye he covers is probably the one he's trying to cut out of the action. And if he can actually track with the uncovered eye, and read at normal distance, you'd have a pretty good indication that his problem involves both eyes not working well together. (This last bit shouldn't be considered any sort of diagnostic test, by the way. I'd just be curious how he reacts.)

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What Rod says explains my son's behavior. Thank you!! It is good to be aware of the reason behind his insistence on being 2 inches from the page.

 

Be aware that the danger is, with all that one eye reading, the acuity of each eye can diverge significantly. Ds had 20/20 vision in both eyes even just 2 years ago. About a year ago, he started reading heavily (nearly all the time, compared to sporadically prior to that). One eye is now short sighted while the other is long sighted. He's started VT and, 9 weeks into the program, tells me he's amazed that he has one focus area now instead of the usual two ("one of my eyes just seems to hang around picking up unwanted pictures").

 

At the moment, I'm glancing at him and the book he's reading is about 12 inches away. Not a definitive test, but it's good to know that perhaps, he's reading with *both* eyes. He still does closeups when he's been working at his desk for awhile - this is helpful indication to me that he's tired.

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I found our wonder VT doctor through the COVD website. I also found one I didn't like too much through there. When you talk to some please ask them how much is the eval and does that price cover testing him for perceptual issues if they think he needs to be tested for that? Also ask if there are built in progress evaluations scheduled with VT if they feel like he needs it.

 

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