My Son and Vision Therapy -- Need Opinion

[Jonathan Banks]

At the current moment, I'm dealing a rather severe problem. My son, Michael, has been a terrific reader his entire life. Literally, a book a week, sometimes two or three. Reading, as well as writing, has been life and dream for quite some time. About three years ago, we suffered the severe loss of his mother. Although he took it hard psycologically, he also experienced some odd visual abnormalities: floaters in both eyes, double vision and, after a Vision Therapy asssessment today, convergence insufficiency. He just turned 17, so I'm worried that this could have a dramatic impact as he heads toward college.

 

It was around one year ago that he started experiencing severe reading issues. Whereas before he was able to read quickly and accurately, that seemingly dissapeared. It seems now that he skips lines, has terrible headaches after reading only a few pages, and complains now he sees double from his peripheral on the page when reading. As a parent it's an utter tradgedy for me to see him struggle like this. Which of course brings the next question...

 

Will Vision Therapy help him? Thankfully, I have a well-paying job that will cover the expenses, but is it worth putting him through the therapy? Will he see a massive improvement and return to reading comfortably? Any help or experience with similiar symptoms from others would be deeply appreciated.

 

Thanks,

Jonathan

[3monkeys]

My ds is only 9 and is in VT for convergence insuffiency. He has had only 5 sessions and I already see a huge improvement. I think it would definitely be worth it. Actually, CI is the only vision problem proven to be corrected by VT. Prayers sent your way!

[Jonathan Banks]

My son is currently on his seventh week and hasn't seen any improvement so far. He's been doing the at-home exercises and is consistent with his in-office routine as well. Will it simply take longer for him?

[3monkeys]

I'm no expert but I'm sure more experienced moms on this board will chime in soon. I have read that many things can cause changes with the eyes, like puberty, growth spurts, etc. It could just be that he's older and the therapy will take longer. I do know the older you are the harder it is to correct. I assume that's for older adults who have lived with the issue and didn't get treatment. Stay tuned.....I know someone here will give you good advice!

[3monkeys]

Also is he taking any medication that could be giving him side effects? I personally do not trust medication anymore. My ds has crazy side effects to allergy medication that no literature has been written about. However, as soon as I stop giving it to him, they go away. Just trying to think outside the box!

[3monkeys]

Sorry..double post.

[Jonathan Banks]

No medication. He actually just lost a ton of weight through exercise and diet. When he first started experiencing the symptoms, I made sure to rule out anything medically. Thankfully, his eyes are perfectly fine health-wise. It just seems to be a weakness he certainly wasn't born with. He has tremendous focus and is an unbelievable son to have, but seeing him struggle is truly hard.

[itsheresomewhere]

Has he had a complete medical workup? I mean the whole thing with blood work. I would take him to his doctor asap if he hasn't had a complete workup recently.

[Jonathan Banks]

Absolutely. He's also had a CT, which turned out to be perfectly normal as well. This all began happening when he turned sixteen. It was literally an overnight change, which I find particularly strange. Vision Therapy was reccomended and we love our Vision Therapy center, but we'd like to see results seven weeks in. Is that normal not to see results? He's definitely improving with the exercises, but not necessarily with reading.

[itsheresomewhere]

Absolutely. He's also had a CT, which turned out to be perfectly normal as well. This all began happening when he turned sixteen. It was literally an overnight change, which I find particularly strange. Vision Therapy was reccomended and we love our Vision Therapy center, but we'd like to see results seven weeks in. Is that normal not to see results? He's definitely improving with the exercises, but not necessarily with reading.

 

 

Has he been to a neurologist or was this his regular doctor? Has any MRI or CT been repeated recently? From your last post these tests haven't been repeated recently.

[sbgrace]

Goodness. The sudden change at his age sounds concerning medically, but it sounds like all medical causes have been ruled out. Is he healthy otherwise?

 

My son corrected his issues (convergence and tracking) with vision therapy. He was quite a bit younger. But my understanding is that it can help in teen years as well.

 

Is there a COVD Fellow within driving distance? When we just couldn't seem to make any progress, we saw another COVD Fellow. It was a bit of a drive, but she had some new ideas that really seemed to help my son get over the starting hump. I think a fresh set of eyes can help sometimes.

 

That said, it took quite a while of every day (torture like) work to begin to see improvement here. When he finally got past that point, for him anyway, improvement was much more rapid. Still, I would have expected to see something in 7 weeks if he's following up at home as well. Have you discussed the apparent lack of progress with the doctor? It might be that he is making tiny improvements. Our initial improvements were really by miniscule bits. I could only see them because I was doing the home exercises with him. I knew he tracked for a second more than he could the week before. Those were the types of initial things I saw--just almost nothing--but it was some progress.

[Jonathan Banks]

 

Has he been to a neurologist or was this his regular doctor? Has any MRI or CT been repeated recently? From your last post these tests haven't been repeated recently.

 

 

The last CT was about six months ago.

 

As for his overall health, he's literally perfect. As I said before, this wasn't an issue until he was about sixteen. His eyes tracked and teamed perfectly until a sudden shift in about a few days time. He saw it immediately.

 

Right now, I'm definitely see his eyes move quicker on Bead and String, and I feel that they are working together quite well. However, he doesn't seem to be noticing it quite yet. Since he's young he is impatient and wanting results quickly. I'm just at a loss as a parent -- I'm trying like crazy to make sure we're doing everything correctly.

[MyLittleBears]

I had a friend who's son struggled with odd vision despite multiple trips to different eye doctors. He would put on his father's glasses and say that he could see clearly with them on than not. They thought he was faking. One doctor actually did accuse him of lying. It turns out that migranes were causing changes in vision. This happened more as an adolescent. I know there can be many causes for migranes, sometimes dietary. I'm not sure how they resolved this but I thought it might be worth mentioning, just in case.

[PeterPan]

My son is currently on his seventh week and hasn't seen any improvement so far. He's been doing the at-home exercises and is consistent with his in-office routine as well. Will it simply take longer for him?

 

This is a very blanket statement, and you need to talk with his doctor. On the one hand, you're saying he is getting improvement with the *exercises*, and on the other hand you say he's getting *no* improvement. So what you mean is you're not seeing it CARRY OVER yet to YOUR concern which is reading. Is that correct? Well not every kid is going to have the outward issues resolve that quickly. My dd was 2-3 months in before her reading comfort improved.

 

Yes, they can have vision go crazy with a growth spurt. Yes, I like the idea of following down that headache and allergy route. The eye doc should have talked that through too. And yes, it's ok to back up and ask how you found the doc, whether they came well-recommended, etc.

 

If you're seeing progress with the exercises, it's probably that he hasn't gotten enough changes yet to change the big stuff you're wanting. Some things do take time. The doc likely gave you an estimate. You need to talk it through with him/her. I'm not saying go blindly and see no results, but changes in the exercises, at this stage, would be pretty normal progress. I wouldn't have expected his reading to get magically better by now, just sayin'. In another month or two, maybe, but not in 7 weeks, not with what you described.

 

As far as the why suddenly at 17, that's something to talk through with the doc. Did they do a FULL vision exam, including dilation?

[Jonathan Banks]

As an adult, it's definitely more my pain in seeing his discomfort time-wise. I want to make sure we're doing the right thing. When reads, he tends to skip words, endure headaches and see double vision from peripheral (or know that it's doubling, which make tracking hard). And yes, we did a full work up, including dilation.

[itsheresomewhere]

What does your gut say? You can give vision therapy a little longer but if it were my child, I would be at a neurologist office today. Those symptoms are very concerning. I know you say the CT was clear and so was blood work but there are still others things it could be in the long run that do not show up on a CT or blood work. There are even auto immune disorders that can present differently with eye symptoms. It is not uncommon for things to start showing symptoms around 16. Stress can bring the symptoms on earlier.

 

I know this is not an easy question or thought but how involved are you in his diet? Boys are not immune to eating disorders and they are harder to see the symptoms. They can also cause vision changes, too.

[Jonathan Banks]

Very involved. Obviously he's a young man, but over the past year he's changed everything about his diet. He is now eating healthier than ever. Absolutely no junk food (which he used to gorge on) and has safely lost over one-hundred pounds. As for the neurologist, I've also taken him to a opthamalogist who specializes in diagnosing diseases. He took a look behind my son's eyes and didn't see anything.

 

To be honest, it was basically like: learn to live to live with it, which I hated obviously.

[RamonaQ]

Because these changes were so dramatic and overnight, I would want a full neuropsychiatric evaluation.

[Jonathan Banks]

I think that's probably the next step. We're definitely staying in Vision Therapy, but I'll definitely consult a neurologist for a second opinion.

[Heathermomster]

I don't know a thing about this....so take what I say with a grain of salt...Has his blood serum been taken to determine any mineral or vitamin deficiencies? You've mentioned the emotional upheaval coupled with the weight loss. Between all the changes, stressors, and puberty, your son may need a really good vitamin/nutritional supplement. Is he taking supplements of any kind?

[PeterPan]

Jonathan, every time you post, more details come out. Even a quick google turns up hits for vision disturbances after large amounts of weight loss. You've talked about psychological stuff, stress, now weight loss. That weight loss could involve unintentional nutrient deficiencies or metabolism problems. We aren't doctors. You need to spend time googling and put together the pieces. Unfortunately you're right, it's like you have to know what the problem is before you can go to the right doctor and get it diagnosed. But yeah, that would be a red flag to me if someone drops 100 pounds and has major vision changes at the same time. I don't know who you need to see, but keep asking till you find it.

[itsheresomewhere]

Jonathan, every time you post, more details come out. Even a quick google turns up hits for vision disturbances after large amounts of weight loss. You've talked about psychological stuff, stress, now weight loss. That weight loss could involve unintentional nutrient deficiencies or metabolism problems. We aren't doctors. You need to spend time googling and put together the pieces. Unfortunately you're right, it's like you have to know what the problem is before you can go to the right doctor and get it diagnosed. But yeah, that would be a red flag to me if someone drops 100 pounds and has major vision changes at the same time. I don't know who you need to see, but keep asking till you find it.

 

 

This. That is why I suggest a neurologist. The eye symptoms may actually not be the eyes but symptom to an entirely different issue. For example- in some people MS can appear years before it can be diagnosised. DS's neurologist was recently talking about a patient whose ocular migraines was actually seizures that were miss diagnosed.

 

Please seek a second opinion or a third. See a neurologist. The fact you are asking tells me you know something is not quite right. Follow that feeling.

[Jonathan Banks]

Jonathan, every time you post, more details come out. Even a quick google turns up hits for vision disturbances after large amounts of weight loss. You've talked about psychological stuff, stress, now weight loss. That weight loss could involve unintentional nutrient deficiencies or metabolism problems. We aren't doctors. You need to spend time googling and put together the pieces. Unfortunately you're right, it's like you have to know what the problem is before you can go to the right doctor and get it diagnosed. But yeah, that would be a red flag to me if someone drops 100 pounds and has major vision changes at the same time. I don't know who you need to see, but keep asking till you find it.

 

 

This post is highly inaccurate. First, he experienced visual problems before his weight loss. His weight loss was controlled and handled by a terrific trainer. He lost one-hundred pounds over the course of a year, and it was done with supervision. He's managed to rebound physically, emotionally and mentally, but the eyes problems still persist. My gut feeling tells me Vision Therapy will work, but I was hoping that there may be other advice on this forum. And yes, I've done my research.

 

For the record, he has been seen by an optometrist, an opthamalagist (who also specializes in diseases regarding the eye), our own family doctor, our Visual Therapy doctor, and a neurologist who basically told my son to take a baby aspirin. He has also had extensive blood work, a CT, and hasn't experienced any other symptoms.

[Heathermomster]

I've been looking on-line for visual disturbances. Interestingly enough, overtraining causes visual disturbances. Puberty has absolutely affected my son's eyeglass prescription. As you continue with VT, perhaps consider having your son take a training time out for now. Maybe restrict exercise to cardio or Pilates and have him rest. Push moderation until this business is straightened out. Try to be patient. I realize that is difficult. I'm sorry we can't more helpful.. Blessings, h

[Jonathan Banks]

Again, it has nothing to do with training. It seems that he's suffering from Diplopia, but it's carried over onto the page. Will Vision Therapy help him with this? We've been told that it will, but does anyone have any experience?

[Heathermomster]

Rod Everson is our resident WTM VT expert. Maybe contact him directly with your questions. He's been extremely helpful in the past. Blessings, h

[Rod Everson]

Hi Jonathon,

 

First, I'm not exactly the "resident expert." I've just worked with a lot of kids following vision therapy, teaching them the phonics they missed, or were unable to absorb, while they had the vision issues.

 

Everyone's asked the same sort of questions I would have asked about his physical health, etc., and you seem to have covered those bases, so back to your main question about VT helping convergence insufficiency. Yes, it should help, since that's what the purpose of VT is, i.e., to train the visual skills.

 

That said, your son's case isn't typical, in that it apparently was a result of a shift from a normal visual system, rather than a failure of certain skills to ever develop properly. For that reason, I wouldn't give up on VT until I'd gotten one or two additional opinions from other developmental optometrists. I'd be looking for one who was perfectly comfortable with the sort of case your son presents, i.e., a sudden onset of symptoms as a teenager. Remember, though, that a lot of teens with vision problems do exist. They just haven't been diagnosed properly until that time, so experience with teenagers isn't enough since most VT departments have that. You're looking for someone familiar with the sudden onset of symptoms.

 

Maybe your optometrist has that experience, and maybe not, so that's the course I'd take if it were my son. VT approaches do vary, as does the experience of the individual optometrists, but they also talk to each other to figure out the unusual cases, so your optometrist might do some of the legwork for you in finding another OD who has particular experience with cases like your son's. Again, this is assuming the present VT fails to resolve his issues.

 

I'd give the present course of VT some time to work first and then dig deeper if his problems persist. The cases you're reading where there was a rapid resolution are cases where the child just had to have demonstrated for him the way it feels to be using both eyes together. That plus a little practice quickly solved the main convergence problem and then the remaining VT sessions lock in the behavior as well as work on other visual perceptual skills that were probably lagging due to the convergence issue.

 

In your son's case, something else has happened and it might take considerably longer to retrain his visual skills. Think of it more along the lines of his having suffered a trauma that requires significant retraining, rather than his just needing to be shown what to do, and then going ahead and doing it. (In this last part, I'm definitely speculating, by the way, but that's how I'd view it once you've ruled out other physical issues.) After all, even if he did experience some physical problem that's never accurately diagnosed but that affected his visual skills, vision therapy would be the obvious way to address his problem. Knowing why it happened isn't the main issue, unless there are other health implications.

 

As for the floaters following his Mom's passing, this is just a hunch, but I'm guessing he always had some floaters but finally noticed them at that time. He probably spent quite a bit of time simply staring into space, at the ceiling, at the sky, thinking...wondering... During that time, floaters could very easily become apparent. I used to do some duck hunting, and that's when I'd really notice floaters, just staring at blue sky for extended periods. Pretty soon I'd be following the floaters around, instead of looking for ducks. Of course, his might have appeared suddenly, but since the reading problem only appeared later, I suspect the floaters and the reading problem aren't related.

 

Hope this is of some help.

 

Rod Everson

OnTrack Reading

[Rod Everson]

My ds is only 9 and is in VT for convergence insuffiency. He has had only 5 sessions and I already see a huge improvement. I think it would definitely be worth it. Actually, CI is the only vision problem proven to be corrected by VT. Prayers sent your way!

 

 

I just want to clarify something so people reading your comment don't misinterpret it.

 

You're right that about convergence insufficiency being "proven" to be corrected by VT in the sense that a very good study was done that showed that in-office VT outperformed other treatments or placebo, and that symptoms and visual performance improved with the in-office treatment.

 

However, that doesn't mean that other issues aren't corrected by VT, because they almost certainly are. I say "almost" only because the same sort of studies haven't been done on those other issues. I'm "almost" certain that if the money and effort were devoted to those studies, they'd also get similar results. In fact, the developmental optometry community has done hundreds such studies, but few of them met the double-blinded, placebo-controlled, standards of a rigorous experimental trial. The one on convergence insufficiency did, however, and the medical community participated in it.

 

In fact, it was so conclusive that the various optometric organizations that have an existing joint statement questioning the efficacy of VT should probably consider revising that statement before someone gets a good lawyer and takes them to court for misleading parents, causing irreparable harm to many kids in the process. To my knowledge they have yet to retract that statement, though I could have missed it.

[Jonathan Banks]

Hey Rod --

 

That seems fairly reasonable. If I'm understanding correctly, will staying in Vision Therapy help retrain his visual system to be accurate? I definitely agree with the trauma part -- the stress, combined with the emotional trauma, definitely contributed to whatever happened. It's definitely not a physical issue as he's as healthy as a horse. As I'm financially secure, Vision Therapy is not somthing he'll have to leave anytime soon, which seems to be a good thing.

[Rod Everson]

Yes, that's the intent of vision therapy, i.e., to train, or in his case retrain, the visual skills, particularly his convergence ability. Something knocked his visual system out of whack, and while it would be nice to learn what that something actually was, it's important to try to get his visual system functioning properly again.

 

People often refer to vision therapy as "physical therapy for the eyes" and in your son's case the analogy is even closer, since physical therapy is often used to address a skills deficit resulting from a previous trauma.

 

Another area you might consider investigating, because it couldn't hurt and there's a small possibility that it would help, is diet, especially since your son apparently changed his diet significantly. I'm thinking of two particular aspects of diet, the Omega-3 essential fatty acids found in fish oil, and vitamin D3 (really a sunshine issue more than a dietary issue, but dietary supplements are available.) If you think there's a chance that his change in diet and lifestyle could have dropped his Omega-3's significantly, or especially his vitamin D3 level, you might want to explore that further. Frankly, I doubt that will yield much progress toward solving his vision problem, but there's a chance it could and maintenance of appropriate levels of both D3 and Omega-3 EFA's is good for overall health anyway. Obviously there are other dietary possibilities as well, such as lactose or gluten intolerance, but I haven't looked at them very closely at all, and have no reason to relate them to vision issues, although both tend to suddenly appear in many individuals.

 

Following up on Dr. John Cannell's theory that the recent autism epidemic might be due to a vitamin D3 deficiency, I've speculated on my website about the possibility that a general deficiency of vitamin D3 (due to widespread medical advice to avoid direct sunshine) might be responsible for the increase in other developmental issues in kids over the past couple of decades, but I doubt that a drop in D3 levels would cause an onset of vision issues such as your son experienced. On the other hand, if his lifestyle changes resulted in his getting a lot less sunshine, I wouldn't rule it out either.

 

As for the fish oil, there are some good studies out there that indicate that increasing dietary Omega-3's has an impact on reading ability, but again these seem to apply more to kids who were struggling all along, and not to any sort of sudden onset of symptoms.

 

I personally take both a daily fish oil supplement and a daily vitamin D3 supplement. Those are the only supplements I take beyond my normal diet, and I take both just for general health considerations, and not to address any particular existing health issue.

 

I guess I'm rambling now. Stick with the vision therapy and see if he starts to get some results in time, and do have the discussion with the OD about his/her experience with a sudden onset of convergence insufficiency, as I suggested earlier.

 

Rod

[Heathermomster]

Rod, how long does it take to see results? Is there a ballpark figure?

[Jonathan Banks]

I'd love to know the answer to this as well.

[Jonathan Banks]

Hey Rod --

 

Would you have any time frame for him? He's currently entering his sixth week. Our Vision Therapy believes it might take anywhere from twelve to to sixteen, but I digress.

[Guest toddchaney]

I took my son for his vision therapy at Killeen Vision Source and it really helped him. I'm sure your son would benefit too.