Vision Therapy Question

[OrdinaryTime]

Background: My son, who is almost 8, has been complaining of headaches after doing silent reading and that he has to focus "so hard" while reading since we started school this fall. He has had glasses since he was 5 for nearsightedness, and I took him to the our pediatric ophthalmologist to check his prescription as soon as he started complaining. It is fine. He is reading at grade level or maybe a bit below, but is much further along in other areas.

 

My daughter, who is 6, has hydrocephalus (spinal fluid that doesn't drain properly from the brain) that has caused vision problems for her. Her eyes cross, she has significant nystgmus, she looks out of the corner of her eyes instead of straight ahead, etc. She has been in glasses since 8 months of age, and we see her ophthalmologist regularly. Currently, the ophthalmologist has told me there is nothing further we can do beyond glasses for her eyes at this point in time. She reads at grade level and does not complain of headaches or about looking at books or papers from strange angles.

 

I decided to take both of the kids to have them evaluated for vision therapy. I think my son may actually have some kind of vision problem because of his headaches and the fact that his reading skills are out of line from his other academic progress. I figured it didn't hurt to take my daughter in since her eyes behave so crazily, and the ophthalmologist didn't have any suggestions to offer at this time. (When I mentioned vision therapy to my ophthalmologist, she told me it was all quackery.)

 

Problem: So today I took the kids to an optometrist in my area I found on the COVD website. There are several in my area, but he is the only one who takes our insurance. The evaluation was....weird. He evaluated both of their eyes for their regular vision to check if their prescriptions were correct and did some general tracking tests (follow a light or target around with their eyes), but nothing further. (I had told the scheduler on the phone when I made the appointment that my children had just been to the ophthalmologist for their vision check, and I was looking specifically for a vision therapy evaluation.) It didn't seem any different from our ophthalmologist appointments. He then gave me some exercises to do at home (practicing following a target while patching an eye, looking at a target from four different head positions, different types of crawling and rolling towards targets) and told me to come back in 3 weeks. I wasn't given a diagnosis of any type for the kids or a time frame for needed services. I wasn't given any explanation of the need for vision therapy or not.

 

Is this normal? I had very different expectations, but maybe those were off.

 

I can go to a different optometrist, but I would have to pay out of pocket for everything. This doctor only costs me a $20 co-pay per visit. Ultimately, I would like peace of mind that I can either rule out vision problems for my son or address them.

[Joker]

When I took my dd in, it was a 45 minute appointment. They did the normal vision tests and then she did a lot of tests that had to do with tracking and teaming. She did a lot of the following targets and lights. She also did a lot of testing to see how she switched when going near to far and vice versa. It was eye opening for me because dd really struggled with bluriness when switching. She said there were definitely issues and had us come back the very next week for a 1.5 hour test that I think was mostly on paper. I wasn't in the room for the longer one. Dd started vision therapy a few weeks ago and that was when they started giving us exercises to do at home.

[bluedarling]

That does sound odd. Both vt docs we used did extensive exams, including watching their eyes while reading text (one used a computerized eye tracking and one observed...but they both did it.) Our first doc did have us come back a couple weeks later after the first appointment, and that is when I got the report and went through the results of the (thorough) exam....so maybe your doc will be giving you more information when you come back? I'd call this doc, and ask lots of questions. Ask exactly what was evaluated and if you will be getting any kind of report/diagnosis/plan. Do any of the other docs offer free screenings? Because if they do, you could get a free screening and ask questions of another doc for a 2nd opinion?

[PeterPan]

Well, sigh, now you know why we tell people to check around, compare, and be careful. There's a whole lot more that occurs in a proper developmental vision exam, and this guy didn't do it. I wouldn't go back. Find someone who is doing this a lot, preferably someone who is a Fellow, and pay the money. If you're leery, start with your boy (since he's having headaches that clearly need to be checked out and explained) and just mention the girl. Then, when you know you have a good doc and know they're good enough to help with the girl, then take her for an eval.

 

Look for a practice with a Fellow. Lean toward a place that has COVD-certified therapists. See if they can connect you with patients who have used them. Use the email option on their website and email and start corresponding with them. If you have 3 places that are options, write all of them. See how quick they are on their response, how informative they are, etc. I corresponded with one of the docs and the lead therapist at our place before we started. It's a good way to get info and check them out.

 

Sorry you got a screwball. They should have made you the proper appointments and gotten you the information that day.

[Sharpie]

Our VT appointment was by a Fellow through COVD. It involved far more than just "vision". There was the typical eye stuff, following a laser, checking for color blindness, following an object without moving your head, etc. Then we went into a separate room and there many more OT type challenges were given. Walking like a duck while watching the arm movement. Trying to lay on your belly and lifting both arms & legs and holding them in place. Reading numbers and then alphabet letters off a chart while being timed, copying various shapes from pictures, walking in a straight line and then doing it backwards,etc. All of it meant something. It was very in depth!! Yes, it was expensive but honestly, I felt like it was well worth the cost!

[OrdinaryTime]

Thanks, everyone, for the feedback. I appreciate it! I think I'm going to go to another optometrist who has treated some families I know personally for a second evaluation.

 

I do not think the doctor I went to yesterday was purposely trying to do a poor job or was trying to rip anyone off; he is actually a Fellow through the COVD and was given some rewards for service through PAVE (Parents Active for Vision Education). He is just so old that I do not think he staying current in the field or provides the same comprehesive evaluations that others now do. Seriously, he graduated from optometry school in 1949! God bless him, he must be at least 85 years old, and he was crawling and rolling around on the ground to demonstrate different exercises to do at home. I may still go to him for some therapy sessions while we wait to get into the other doctor and get the results from those evaluations because I do like the fact that he is very focused on giving lots of detailed instructions for extensive home exercises and jumped right into starting to some therapy at home immediately. It isn't costing me almost anything, and I do think his suggestions could help. But for my own peace of mind, I think I will pursue a more "normal" evaluation.

[PeterPan]

That sounds like a balanced approach! Let us know how it goes! :)