WWYD? 2 docs, 2 different diagnosis

[sleepymommy]

Ds6 was told by his developmental optometrist that he had to where glasses due to an astigmatism in one eye. She said his left eye was 3 times worse than his right. She also she also said he had very slight nearsightedness.

 

Ds6 saw her again after 6 months for a check-up and she said the same. And that he needed to wear his glasses for 4-8 hours a day in order to avoid getting a lazy eye. This was about 1 month ago.

 

Today, ds6 (and ds4) went to an pediatric opthamologist and he said that ds6 does NOT need glasses and that the other doc was wrong. He said that they both have astigmatisms in both eyes and they are both slightly FAR sighted but that it was not beyond the bounds of normal and to get rid of ds6's glasses altogether.

 

I'm at a loss as to who to believe.:confused: The developmental optometrist saw him twice with the same conclusion. But the opthamologist has nothing to gain by his diagnosis (he said to come back in 4 yrs!) and I'd be thrilled to not have to harp on ds6 about wearing his glasses.

 

But what if he's wrong and ds6 stops wearing his glasses and then later on down the road develop lazy eye.

 

Getting a third opinion will have to be paid for out of pocket. I've already spent $190 on co-pays for these three appts. This doc today and his son are the only pediatric opthos in my area anyway. And the first doc is the only developmental optometrist here.

 

What would you do??

[Jean in Newcastle]

I would tend to go with the ophthalmologist because he has more education and is an actual MD.

[FairProspects]

Come back in 4 years? Are you serious? That does not sound like any trustworthy opthamologist opinion I have ever heard! They usually require at least an annual exam for kids this young.

 

I would go with having him wear his glasses. Developmental optometrists are looking for different things than regular eye docs and he may have picked up on something the 2nd doctor missed.

 

On second thought, I really think you need a 3rd opinion. I realize this would be expensive, but the 2 examples you have are so far apart you need more info to balance them.

[golfcartmama]

I would tend to go with the ophthalmologist because he has more education and is an actual MD.

:iagree:

[v-girl]

I would tend to go with the ophthalmologist because he has more education and is an actual MD.

:iagree:

[wapiti]

Come back in 4 years? Are you serious? That does not sound like any trustworthy opthamologist opinion I have ever heard! They usually require at least an annual exam for kids this young.

 

I would go with having him wear his glasses. Developmental optometrists are looking for different things than regular eye docs and he may have picked up on something the 2nd doctor missed.

 

On second thought, I really think you need a 3rd opinion. I realize this would be expensive, but the 2 examples you have are so far apart you need more info to balance them.

 

:iagree: with all this.

[jplain]

Why was DS6's vision originally checked?

 

I've been skeptical of the developmental optometrists in my area. Everyone seems to end up with multiple pairs of glasses per year, often with prisms, making for an extremely expensive treatment plan that is often mostly out-of-pocket.

 

Can DS6 pass a regular vision screen at the pediatrician's office? What does he think of his vision with and without the glasses? Does he think it is an improvement with them on? Does he seem to be having difficulty learning to read without glasses (if he's started) or does he have other vision related issues when he's not wearing glasses? If he's already reading, does he tilt his head while reading without glasses?

 

Since there are no other pediatric ophthalmology practices in the area, in your shoes, I'd probably try to find the money to take them both to a regular optometrist (Sears or Lenscrafter or the like) for a third opinion. Call around to find the lowest price for the exam; they should give a discount if you're paying out of pocket. If the optometrist agrees with the ophthalmologist, great! Hedging my bets, I might still take them back to the ophthalmologist or optometrist yearly for a few years; if a lazy eye develops, you'll catch it fairly quickly.

 

On the other hand, I don't think a 4 year re-check is ridiculous. Our ophthalmologist doesn't want to see our younger daughter (whose vision is 20:20) for 2 years. However, the doctor also made it clear that if she isn't having problems and passes vision screens at the ped's office, we shouldn't feel obligated to bring her back.

 

Our older daughter is seen by the same ophthalmologist at least yearly, and every 6 months if her prescription is changing. She has serious astigmatism in both eyes, and this assessment was confirmed by an optometrist as well. From day 1, at age 3, she was instructed to keep her glasses on 100% of waking hours. Fortunately, we haven't had to nag; they improved her vision so much that she's never tempted to remove them.

Edited January 13, 2011 by jplain

[Hen]

I would go with a 3rd opinion, from a pediatric eye DR.** if the 2nd diagnosis didn't confirm suspicions or observations you had.

 

We had an optometrist diagnose my young son w/needing glasses. My son, usually compliant to our instructions- kept taking them off and saying he could not see with them on. We took him back for another exam, the same Dr. concluded yes, he needs glasses.

 

after a few months of trying to make him wear them, lots of mom guilt/not making him wear them...doing little tests ourselves to see if they helped or hindered his seeing...I talked to our pediatrician who sent us to a pediatric opthamologist - with actual equipment to use with little people...and were told he did not need glasses. I was really mad that we could have messed up his eyesight with those stupid glasses. bottom line, I'd trust the medical Dr. with a specialty in children over an optometrist.

 

if you are really not sure, get a third opinion, but get one from a Dr. with a specialty in children.

[bettyandbob]

what prompted you to go to the developmental optometrist in the first place? Have you noticed your ds having trouble tracking while teaching reading. Have you noticed hand-eye coordination lagging behind most 6 year olds. Is he having head aches.

 

My ds's vision problems did not become obvious until he was older (10) and then they were undeniable (eye rolling back, eye vibrating, headaches). He had told an opthamologist at 7 or 8 that he could see out of one lense only when using 3D glasses--the opthamologist didn't think this was important, but it was in fact a sign of serious problems.

 

When I got my ds to a developmental optometrist I was told most kids with my ds's problems have a lot of trouble learning reading as well as do most sports (ds was never successful with sports. ) Anyway, we worked with the optometrist with home exercises with and without special glasses for the exercises for most of a year. The result is no more tracking, eye rolling/vibrating, headaches. The opthamologist we saw was very respected in my region, but he just wouldn't have done the right thing for my ds's problem.

 

The developmental optometrist and opthamologist are good for different things. The opthamologist may not be looking at the same issues at the optometrist at all. My thought would be if your ds did not have problems before you went to the optometrist, then you may be ok with dropping the glasses. A young child can grow out of needing to wear glasses (my brother did) if he just doesn't wear them. This would be for minor vision correction issues only.

[sleepymommy]

Why was DS6's vision originally checked?

 

I

 

what prompted you to go to the developmental optometrist in the first place? Have you noticed your ds having trouble tracking while teaching reading. Have you noticed hand-eye coordination lagging behind most 6 year olds. Is he having head aches.

 

 

 

His ped. doc said he should go for an eye exam and suggested this developmental optometrist who happened to be his wife! But in fairness, I have heard great things about her from other people as well.

 

He does flip words when reading and writes letters and numbers backwards pretty frequently. He does lose his place when he reads, using a cursor has helped this a lot. He has excellent hand-eye coordination though and doesn't complain of headaches unless he is sick.

 

We are moving in a few months, maybe I will wait and make an appt for a third opinion when I have more options. I like the idea of just going into walmart optical or something similar for a quick check to see what they say.

 

The biggest difference that I could notice from the exams was that the opthamologist put the dilation drops in ds's eyes whereas the optometrist did not. There were other tests put that is what stood out to me since I don't have a lot of knowledge on the various tests and such.

 

The optho insisted that without the drops a correct diagnosis could not be made and since he could see the whole eye with the drops and she (the optometrist) could only see part of it without, he was right. And since we bought glasses for ds6 it was an expensive mistake.

 

He's been THE ped. optho around here for years and years and has a very good reputation, but man his bedside manner could use a little buffing.

 

They both came highly recommended (granted in this small town where they're the only ones in their field), so I'm just shocked at how completely opposite the results of their evaluations turned out.

 

Thank you everyone for your input!!

[Lolly]

I'd go with the optho.

 

My dd was told by an optometrist that she needed glasses several years ago. We got them and disposable contacts. Left for a month long trip. 24hrs of driving away from home, dd lost a contact in her eye. We went into a Walmart opt. to have help finding it. It turns out the contact was not even in her eye. It must have fallen on the floor when she thought she put it in. That opt. informed us that her vision was a tiny bit off, but she did NOT need to be wearing contacts or glasses. Especially contacts because it introduced the possibility of infection. Glasses only if she needed them in a classroom or something. When we got home, I took her into an optho. He agreed that her vision was slightly off, she was borderline on needing glasses. But, if she wasn't sitting in the back of a classroom trying to read the board, there was NO reason for her to have them. In fact, together her eyes functioned at 20/20. No real reason to need them at all. He suggested coming back in 4 years when she was getting her driver's license for a recheck.

 

When an opt. suggested a different dd might be starting to need glasses, I took her into a optho. just to check. He said no problems, very slightly off, bring her back in 4 years. I questioned the 4 years. It seems that is the norm for evaluating a kid's eyes who don't have any reason for worry. When mine were little, I had to take them more regularly because they were at risk because of prematurity. Optho. say that eyes don't usually change that quickly. Yearly checks are a waste of money. (Direct quote. He told me that he would take my money if I insisted, but he had plenty of patients who had a real need for the visits.)

[Mama Anna]

FWIW, my bil is a optometrist and he mentioned when he checked us all out over the holidays that it's possible to check the same eyes on each day of a week and come out with slightly different prescriptions each time. So if neither the farsightedness or the nearsightedness is pronounced in the prescription, it could just be opposite ends of a range that your ds operates in all the time.

 

I guess I'd probably go with your gut - are you sure that the letter-swapping stuff is vision-related and not something else? Do you have the nagging feeling that it just won't work to take away the glasses?

 

You could always take away the glasses for awhile and then try to get in to see the Optho again in 6 months or so. See if his diagnosis changes at all.

 

Just in case you needed another opinion! :)

 

Mama Anna

[katemary63]

No way would I take the opinion of an optometrist (nothing against them) over an opthomologist. There just isn't a comparison. If you feel you need a third opinion (I would just to be sure) go to another opthomologist. We go to an optometrist every year or so, but an opthomologist every third or fourth for a thorough medical eye exam as well as prescription check.

[littlebug42]

I would go with the ophthalmologist especially since he dilated the eyes and the optometrist did not. I have had eye problems for many years and the dilation is essential to diagnosing such. I would not take the word of an optometrist that skipped this step. My kids and I see an optometrist now but he dilates and does everything the ophthalmologist does.

[sleepymommy]

FWIW, my bil is a optometrist and he mentioned when he checked us all out over the holidays that it's possible to check the same eyes on each day of a week and come out with slightly different prescriptions each time. So if neither the farsightedness or the nearsightedness is pronounced in the prescription, it could just be opposite ends of a range that your ds operates in all the time.

 

I guess I'd probably go with your gut - are you sure that the letter-swapping stuff is vision-related and not something else? Do you have the nagging feeling that it just won't work to take away the glasses?

 

You could always take away the glasses for awhile and then try to get in to see the Optho again in 6 months or so. See if his diagnosis changes at all.

 

Just in case you needed another opinion! :)

 

Mama Anna

 

I'm not completely sure if his letter reversals are due to vision issues. It could just be his age or if it continues I would have evaluated for dyslexia. I don't get any sort of nagging feeling about the glasses, I just don't want to take them away and then him end up with lazy eye.

 

Dh had a bad astigmatism as a child and wore glasses for around 8 years and then the astigmatism corrected itself and he's had perfect vision since. He was also dyslexic.

 

From what I understand astigmatisms and dyslexia can run in families so I'm just trying to be super alert to both possibilities.

 

 

 

And I'm always open to more opinions, thanks! It really does help to get everyone's different thoughts as it helps me through my thought process. So thank you to everyone!

[StephanieZ]

I'd believe the DOCTOR, definitely.

[fenni]

Based on my experience with my kids and all 3 types of eye dr.'s, I would go with the ped. ophthalmologist! and I do not find the 4 yr. recommendation strange, either.

[TechWife]

His ped. doc said he should go for an eye exam and suggested this developmental optometrist who happened to be his wife!

 

That strikes me as unethical! I would seriously consider finding another pediatrician.

 

I'd also take the opinion of the ophthalmologist over the optometrist, even without this knowledge. Ophthalmologists are the docs that treat lazy eye and so I really think that the MD would know what to look for in diagnosing those issues.

[Margo out of lurking]

On second thought, I really think you need a 3rd opinion. I realize this would be expensive, but the 2 examples you have are so far apart you need more info to balance them.

:iagree: I'd hate to spend the money, but it's your child's eyesight. I'd go for the third opinion too. Do you have a university hospital even a few hours away, and you can make a day trip out of it?

[EKS]

If one eye is significantly worse than the other, you should be able to pick it up using a standard eye chart. My son has a mild astigmatism in one eye and this is how we first noticed something was wrong.