10yo with blurry vision, doc says 20/20

[Surprise Symphony]

For several weeks my dd10 has consistently complained of blurry distance vision and intermittent near vision. She complains of not being able to read billboards, or see the whiteboard at co-op. We waited to take her in to the eye doctor so that we could do all the checking and verifying that she was indeed out of focus and not just wanting glasses, or having allergy eyes, etc.

 

The doctor's assistant checked over and over again, jumping around from the larger letter lines to the smaller and back and dd was consistent with seeing no better than the 20/70 line. I was convinced we were on the route to glasses, until the doctor informed me of the computer tests which showed she is 20/20. My dd said she never say the "Hot Air Balloon clearly" in the doctor's machine (they told her she would see one). The doctor suggested that dd was making up her vision problems and then, when quiet tears rolled down her face, he took me aside and said that he could prescribe placebo glasses if I'd like. I turned them down.

 

My dh and I choose to believe my dd, when she says she is out of focus, because she believes so strongly herself. But I would like to know if anyone has any experience with this at all. Can eyes be perfect, but vision be blurry. So that we are doing something, and she feels safe and believed, I have promised we'd find some eye strengthening exercises, take a daily optical vitamin and do some stress-relieving exercise, but is there anything else I should check on before ignoring this symptom?

 

Thanks,

Lisa

[itsheresomewhere]

Does she have any allergies or sinus issues?  They can cause vision issues.  If it were my child, I would take her to another eye doctor.  Make sure they are certified in children.

[TXMomof4]

Did they dilate her eyes? I would definitely get a second opinion. It could be a surface issue - dry eyes can cause tremendously blurry vision. Taking allergy meds would exacerbate that.

[Zebra]

I'm confused.  If she couldn't see better than the 20/70 line and didn't see the hot air balloon, then she doesn't have 20/20 vision.  

 

I would take her to another eye doctor, and see what they have to say.  Other options are an ophthalmologist, or her primary care doctor.  

 

Without going into details, I have been through too many things in life with doctors saying everything was fine and it turning out to not be the case.  Trust your gut, and trust your daughter until you have exhausted every other possibility.

 

Does she have dry eyes?   Because that can also make things blurry, maybe you could try a preservative-free eye drop for awhile and see if that helps.

[Surprise Symphony]

They took a picture of the back of her eye (retinal imaging?) and said that was in place of dilation.   I hadn't been giving her allergy medication regularly, but thought I'd try a regular dose of Claritan for a week or two, as we have been all suffering with some allergies since we got all the rain.

[prairiewindmomma]

Find a COVD dr who checks her functional vision. We've had two kids with 20/20 vision who have had problems seeing.

[Surprise Symphony]

I'm confused.  If she couldn't see better than the 20/70 line and didn't see the hot air balloon, then she doesn't have 20/20 vision.  

We're confused too.  He seemed much more interested in finding she was faking/lying/being dramatic than figuring out what she could and couldn't see.  He trusts his equipment, I guess.  We won't be going back.

[Surprise Symphony]

Find a COVD dr who checks her functional vision. We've had two kids with 20/20 vision who have had problems seeing.

 

What is a COVD? 

[AmyontheFarm]

Run from that dr.  Life is too short to not trust your gut.  If I hadn't trusted mine, my son would be in a wheelchair right now, and not now chasing his sister around the house driving me batty this morning.

[Matryoshka]

I would also go to see a developmental optometrist (I think that's the same as a COVD). 

 

Run away from that Dr.   I hate, hate, hate dr's who listen to their machines and ignore their patients (and worse, imply that they are making it all up).  When I was in the hospital having my twins, the nurse told me "the machine said" I wasn't in active labor.  Almost gave birth to twins, one breech, unassisted on the antenatal floor (thankfully finally got through to my doc, who listened to me and didn't give a hoot about what a machine said).

[gardenmom5]

the dr is relying upon the COMPUTER'S report rather than doing an actual exam??????

did he actually examine her with the whatchamajig? the black thing they stick in your face where they flip back and forth with various lenses and ask which has more clarity?

 

 

even if he did do an actual exam (but especially "if not"), I'd be demanding my money back and going somewhere else. 

 

eta: some drs are not good with children - and don't want to deal with them and will give crap care.  I see a ped developmental OD who gets lots of special needs kids - and she get's interns.  there was one who absolutely should not be going anywhere near children.

[wapiti]

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Edited September 15, 2016 by wapiti

[Acorn Island]

The EXACT same thing happened to my daughter, and at about the same age.   She had trouble with distance vision being blurry, we took her to the eye doctor, who told us our dd 'wanted' to have glasses more than she needed them.   My daughter was incredibly insulted.  She is not high drama, and would not 'pretend' she needed glasses.

 

Nine months later we were back again, and this time the SAME eye doctor found that she needed a fairly strong prescription, like a 2.0 or so.    I would try another doctor.   By the way, there are a lot of kids that do 'pretend' to need glasses, and I feel like the doctor assumed that was what was going on in our case.   But it wasn't.

[Twigs]

Glasses correct for problems relating to the lens. There are other problems besides the lens that can lead to blurry vision.

 

Did you take her to an optometrist (a Dr. but not an MD) or an ophthalmologist (an MD)? Be sure to see an ophthalmologist.

 

One cause of blurry vision is diabetes, so get a general checkup and be sure to mention the blurry vision. (I had a friend who became a diabetic and one of his first symptoms was blurry vision.)

 

Best wishes.

[Surprise Symphony]

did he actually examine her with the whatchamajig? the black thing they stick in your face where they flip back and forth with various lenses and ask which has more clarity?

 

 

even if he didn't do an actual exam (but especially "if"), I'd be demanding my money back and going somewhere else. 

 

He did use the black whatchamajig, but he set it at no correction (I didn't know it at the time, but he told me later), and then spun the dials (for show only) and did the "is this better, or this?"  She said "no" for a while, and then (I think, in order to please him) she said yes.  So he made her then read the letter lines while looking through it.  When she couldn't read the 20/20 lines through it, he made the lines larger and larger to the 20/70 mark, then she could see and read the chart. 

 

But here's the thing... he then stepped the lines back down to 20/20 each time asking her to read them. She said she couldn't read them initially, but each time, he would say "Try harder".  I couldn't always see her eyes, but I did notice once that she was squinting.  I know she was tearing up (perhaps out of frustration) at this point, I could tell from her voice.  So, while he was a jerk,  maybe her problems could stem from dry eye....

 

[wapiti]

 She said she couldn't read them initially, but each time, he would say "Try harder".  I couldn't always see her eyes, but I did notice once that she was squinting.

 

 

I would take her for another exam and tell her NOT to squint!!!  Preferrably elsewhere.

 

In the meantime, the wetting drops are over the counter, if you wanted to give them a shot.  I forgot what they're called...  I'll check when I'm upstairs.  However, if she was squinting, I don't think you can count on the accuracy of that exam.  Note that, of course, it's possible to have more than one thing going on (dry eyes and needing glasses).

[Zebra]

My dd needed glasses this summer and the eye dr SPECIFICALLY told her NOT to squint when reading the chart.   He actually had me sit right there and went over the chart with me while she was reading it, and then he made the chart blurry where she couldn't see it, so I could see how my daughter was seeing things.  I knew she needed glasses, but there was no doubt in my mind after seeing the blurry chart.  

 

Your mommy instincts are right on this one, run, run away!     

 

[magnificent_baby]

I would go to another doctor, preferably a children's specialist. Our eye doctor *thought* dd might have needed glasses, and explained that kids compensate so much for abnormal vision, that it is difficult to get an accurate exam unless the eyes are strongly dilated. He wanted her to come back and have her eyes dilated with a much stronger dilation drops than adults get (it can last up to 24 hours, IIRC) I declined at the time, but she did end up having that done at a pediatric eye/brain specialist when she was referred there for her chronic headaches. (her exam ended up being normal, but my point was to let you know about what the first doctor said)

 

[Harriet Vane]

Fire your doctor and get a second opinion. Make sure your second opinion is with an opthalmologist who works with children.

[Caraway]

I didn't read all of the responses, but wanted to add...  My vision is 20/20, but my eyes focus at different focal lengths.  So when I am well rested all is good.  But when I am tired, or there is other eye strain, my vision becomes blurry.  

[Mommyof4ks]

I would take her to a good pediatric ophthalmologist. It could be something simple like too much oil from her eyelashes getting into that eye (my youngest had that happen for a few months once), or it could be something more, but I would want a doctor to look at them, not just an optometrist.

[MyThreeSons]

Did you take her to an optometrist (a Dr. but not an MD) or an ophthalmologist (an MD)? Be sure to see an ophthalmologist.

While you are correct that an ophthalmologist is a full MD, that isn't always the best thing. When it comes to diagnosing diseases, performing surgery, etc., an ophthalmologist is the way to go. However, when it comes to prescribing corrective lenses, an optometrist has much more specialized training. The MD spends about six weeks training in lens fitting; the OD spends the bulk of his two years of study fitting lenses.

 

My youngest is EXTREMELY nearsighted. When first diagnosed by an OD 13 years ago, the OD correctly sent us to a pediatric ophthalmologist. She worked with us on the underlying issues, had him tested for some scary possibilities, prescribed glasses that she says is the best we can do until he stops growing, and maybe can have surgery that will help. At that time, he MAY be able to pass the vision test at the DMV.

 

When he turned 18 this summer, he didn't want to go to the kiddie doctor anymore. He saw an OD, who fit him with contacts that immediately corrected his vision to the point where he can pass the DMV test. Oh, and she knew the state law that says that he doesn't have to pass the test at the DMV. When he passed the test in her office, she gave us a waiver that overrides the "look in the box" test at the DMV office.

 

I've had several experiences with optometrists referring a patient to an ophthalmologist when warranted. I have not heard of an ophthalmologist referring a patient to an optometrist for better lens fitting. I can't help but wonder how different my son's life could have been throughout his teen years if the MD had admitted that she didn't have all of the answers when it came to prescribing lenses.

[Pawz4me]

After doing the test with the yellow drops, ultimately what he found was that her eyes are dry, and intermittent dry patches on the eye will indeed cause the blurriness.  He gave her wetting drops.  She already has allergy drops

 

I thought "maybe dry eye" when reading the OP.  I know mine causes blurriness.  I have allergies that affect my eyes, too.  I have to use allergy eye drops, wait about ten minutes and then use lubricating (dry eye) drops.

 

While you are correct that an ophthalmologist is a full MD, that isn't always the best thing. When it comes to diagnosing diseases, performing surgery, etc., an ophthalmologist is the way to go. However, when it comes to prescribing corrective lenses, an optometrist has much more specialized training. The MD spends about six weeks training in lens fitting; the OD spends the bulk of his two years of study fitting lenses.

 

I agree.  I *think* what optometrists are allowed to do varies by state.  Here they are almost always the first stop for all things related to vision and eyes.  They're allowed to treat a wide range of eye issues and injuries (scratched corneas, etc.).  I don't know of any ophthalmologists around here who would prescribe lenses, with the possible exception of a pediatric ophthalmologist.  The others would refer to an optometrist.  The ophthalmologist my mom saw for a retinal issue flat out told her he didn't know a thing about glasses!

[wapiti]

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Edited September 15, 2016 by wapiti

[source of joy]

I read last night about the fact that blurry vision could be an indicator of celiac. Has she been tested for that?

[Tammi K]

I didn't read all of the replies, so excuse me if I mention something already suggested. I did see someone mention allergies. My allergies drive my vision buggy. On bad allergy days, my visual acuity drops significantly. The other thing I wanted to mention is something that will not show up on a basic eye exam. Both my daughter and I had significant focusing issues. In my case, my vision was better than 20/20 as long as I had my head still. As soon as I tried to 'use' my vision in a dynamic way, I found I couldn't see. So I can see why you daughter would have trouble going from near work to board work even though her 'vision' is fine. My daughter had a similar type of problem.

There are things that can correct, or at least help correct, the problem after it is diagnosed if it is a focusing problem.

 

Hugs to your daughter. How terrible that her doctor didn't believe her. I hope you can get to the root of her problem.

[gardenmom5]

Did you take her to an optometrist (a Dr. but not an MD) or an ophthalmologist (an MD)? Be sure to see an ophthalmologist.

 

 

I have congenital eye problems  - I've been to MANY different eye specialists over the years. 

 

I started with an ophthal when I was 4.  even though he had great recs - he gave lousy care.  well, he did save the vision in my left eye - but standard tx included things he wouldn't do.  my mother didn't know. 

 

I *finally* got with a developmental Ophthalmologist when I was 18.  I went to him for ten+ years before his health failed and he had to retire.  He had added a developmental OD to his practice before retiring and I go to her - even though she is a pediatric OD.  (except when there were insurance issues forcing me elsewhere.  I went to ophthals and ods.  I finally told dh I didn't care if it was out of pocket, I was only going to her.)

 

speaking as someone with eye problems, developmental is much more important than OD or MD.

 

 

He did use the black whatchamajig, but he set it at no correction (I didn't know it at the time, but he told me later), and then spun the dials (for show only) and did the "is this better, or this?"  She said "no" for a while, and then (I think, in order to please him) she said yes.  So he made her then read the letter lines while looking through it.  When she couldn't read the 20/20 lines through it, he made the lines larger and larger to the 20/70 mark, then she could see and read the chart. 

 

But here's the thing... he then stepped the lines back down to 20/20 each time asking her to read them. She said she couldn't read them initially, but each time, he would say "Try harder".  I couldn't always see her eyes, but I did notice once that she was squinting.  I know she was tearing up (perhaps out of frustration) at this point, I could tell from her voice.  So, while he was a jerk,  maybe her problems could stem from dry eye....

 

just getting someone who is comfortable with children would probably be a world of difference. 

 

the guy was irresponsible - and he deserves to have a letter sent off to the state medical board.  his (non) treatment was inexcusable.

[prairiewindmomma]

Ok, I have time for a longer response now.

 

I assume that your initial visit ruled out true acuity issues, retina detachment (that was the photo that was taken), allergy eyes (zatidor drops are good if you think this may be an issue--generic is $8 at Wal-Mart), dry eye (I use the systane generic drops), potential medical causes (puberty, diabetes, brain tumor, etc.).

 

I have had a variety of eye doctor experiences:

*the optometrist who missed the brain tumor

*the pediatric opthamologist who missed the severity of the functional vision issues in one child but caught the brain tumor one child, the cranial nerve issues in two of my other kids, and who managed preemie baby's eye issues

*the covd dr. who finally got one child enough vision to read but didn't know how to manage the non-therapy-fixable issues

 

All five of my kids have had eye issues from a variety of causes. We actually have one kid see both a ped opth and a covd optometrist because they offer differing opinions and solutions (and we like to hear every viewpoint on the complex issue).

 

 

If her eyes have good acuity, but aren't working well together (like the potential accommodative focus issue mentioned above), she could still have blurriness.

The ability to read an eye chart is just that, the ability to read an eye chart....it's not the same as the vision issued from moving your eyes between blackboard and desktop or the vision issued when objects are in motion.

 

Trust your daughter's description.  It was only a minor comments from my children that led us to discovering big huge issues. I got blown off a few times until we finally got to the heart of (our admittedly rare) issues.

[Hwin]

Have they ruled out double vision? My vision itself is OK but when my eyes are tired, I see like a reflection or shadow when looking at things. I know it's time to fish out my glasses when I have to close one eye to see better. It's also usually time to shut off the TV.

 

My eye doctor never would have discovered this if I didn't know her well and we weren't chatting casually. Some of the things I said were a flag to her and she immediately screened me to rule out any serious neurological issues.

 

My vision was corrected with prism lenses.

 

Editing to also add that stories about doctors like this are why I pay out of pocket for one I trust, though she doesn't take our insurance, rather than going to some random in network person.

[MedicMom]

I spent five years in my 20s telling doctors I couldn't see well out of my left eye and that something was wrong.

Finally someone believed me and I had a corneal transplant in January. Guess what, I was right--something was wrong.

[TechWife]

Has she been tested for diabetes? 

[kbutton]

He did use the black whatchamajig, but he set it at no correction (I didn't know it at the time, but he told me later), and then spun the dials (for show only) and did the "is this better, or this?"  She said "no" for a while, and then (I think, in order to please him) she said yes.  So he made her then read the letter lines while looking through it.  When she couldn't read the 20/20 lines through it, he made the lines larger and larger to the 20/70 mark, then she could see and read the chart. 

 

But here's the thing... he then stepped the lines back down to 20/20 each time asking her to read them. She said she couldn't read them initially, but each time, he would say "Try harder".  I couldn't always see her eyes, but I did notice once that she was squinting.  I know she was tearing up (perhaps out of frustration) at this point, I could tell from her voice.  So, while he was a jerk,  maybe her problems could stem from dry eye....

 

 

I recommend a COVD doc also or a pediatric ophthalmologist. COVD is the professional organization for developmental optometrists, and they have a website that you can use to find a COVD doc. We recently had bad experiences with our regular optometrist, so we switched to a COVD listed doctor. She found major errors with one of my son's Rxs, including a lens that had been made wrong! No one had checked it when it came in. His Rx was also off by a LOT in one eye because the doctor hadn't dilated my son's eyes. The other son has covergence insufficiency, which was brushed off by our regular doc. Also, I once needed to be corrected to  20/15 was because I was getting constant headaches at 20/20. It happened just once, so I think maybe my eyes had changed but the muscles were still desperately trying to accommodate. My distance vision was constantly blurry at 20/20 that time as well. However, that is a bit unusual, and such an approach can lead to being overcorrected, so you'd definitely want to ask questions if the doc recommends this. I would also push for a dilated exam every time with children. Their young muscles accommodate really well, and the dilating drops impair those muscles so that the doc can see what's really going on. COVD docs are sometimes more likely to recommend or try vision therapy than an ophthalmologist, so depending on what's wrong with your DD's eyes, you might get different advice from each type of doc.

 

You are lucky your daughter can articulate her problems! Some kids (and even adults) don't know that what they are seeing is not what others see. Best wishes.

[Tess in the Burbs]

My dd started complaining in spring about double vision. Her regular dr said she was fine but I got a referral to vision specialist. After 3 long visits its a convergence issue, focusing long time basically.

 

Just started vision therapy. After 2 weeks dd has noticed a difference in how long she can focus.

 

Go see a specialist that offers vision therapy

[Surprise Symphony]

OK, my dd has an appointment about an hour & some from the house with an O.D. who is both FCOVD and FAAO. Her emphasis is on vision therapy and has extensive experience with children.  I don't know anyone who uses her (so far away), but the staff was really good with dh on the phone.

 

I will make a well-child visit with our regular doctor and rule out diabetes (although blurry vision is the only symptom she has).  He could hopefully rule out any other medical issues then, too.

 

Thanks for all the advice, the only thing left to do is wait -the appointment isn't until mid-October.

[Katy]

Since you mentioned it comes & goes, you might also ask about ruling out migraine auras - sometimes kids get them for years before they ever actually feel a headache, because blood vessels dilating in the brain are pressing on the optic nerve rather than the trigeminal nerve (affecting vision rather than causing pain).

 

You could also tell her to tell you right away the next time it's blurry and then immediately have her take a couple excedrine with either a mountain dew, an energy drink, or a Mexican Coke (the kind in the glass bottle).  If it improves in 20 minutes or so I would take that as a sign it's possibly a migraine, but you should still take her to a get a CT & MRI with & without contrast to make sure it's an innocent migraine and not something more dangerous going on with the vessels in her brain.

[Guest SeeJaneSurf]

Hive Mind Larvae, how did this issue resolve for your daughter? In case my story might help you in some way, I thought that I would share it here. I am a 45 year old female and having a similar experience as your daughter's. I cannot read street name signs and speed limit signs are blurry, yet my visual accuity tests as 20/20. My opthamologist wrote a prescription to correct my vision to 20/15, and what a difference! To me, it is like night and day. I also have allergies and dry eyes and, like your daughter, sometimes the blurriness is worse than other times. I am no expert, but from what I understand, 20/20 refers to "normal" vision, not "perfect" vision. It refers to a person being able to distinguish from 20 feet away things (eye chart content) that a "normally sighted" person can distinguish from that distance. I had LASIK about 13 years ago to correct moderate myopia and the surgery brought me to 20/15. That has degraded over time, and no matter what the eye chart test says about my vision now, things are blurry; I have trouble seeing the Powerpoint content projected onto a screen across a 20-foot wide conference room when others in the room have no trouble at all. I am wondering whether in the case of your daughter, she was perceiving blurriness because her visual accuity had degraded over time. Regardless, I would love to hear an update - it was disconcerting for me to be told that my vision is "normal" when my perception is that it's "fuzzy", and I'm a full-on adult! I can only imagine how that felt to your 10 year old. Has her problem been successfully addressed now? Thanks! Jane

[HSmomof2]

My ds was complaining of intermittent blurry vision last year. It would mostly be when he was doing work close-up, like reading, writing, on the computer, etc. We took him to the dr. He did a very thorough exam, asked lots of questions, etc. Ds's vision was fine. The dr. thought he was not blinking frequently enough-- causing his eyes to be dry and causing the blurry vision. He told him to give his eyes a break frequently and make sure to blink when reading, etc. This seemed to have solved his problem, and he hasn't been complaining of blurry vision any longer.

 

However, as with anything, if you don't feel comfortable with the dr. and the diagnosis definitely get another opinion.

[Surprise Symphony]

I should have posted an update!   We saw  the new doc in October and she saw what can best be described as eye spasms in my dd.  The computer also registered wild swings from extremely near- to extremely farsighted vision.  She could see these spasms through her equipment.  The doctor then dilated dd's eyes and tried again with both a manual and a computer eye exam and found dd to be only very, very mildly farsighted not something one would normally correct.

 

This doctor suspected that this was a stress-induced muscle spasm. My dd immediately started to cry and said that it was "not in (her) head", but the doctor explained that she both saw and believed the lack of visual acuity. She said that stress can cause heart palpitations and serious diseases, why not eye spasms? I was not inclined to believe this stress theory right at first,  (my dd is not an anxious kid), but since, I then I do. 

 

We bought prescription glasses to correct the mild farsightedness with the instructions to wear them whenever blurry, we did not emphasize the stress connection, just the blurry vision.  She wore them all the time for weeks and now will wear them on and off depending on the day.  On very stressful days, she tends to wear them, and while this makes the glasses sound a bit like a placebo, she is so consistent with her complaints - these glasses don't fix the random blurriness that can best be described as nearsightedness - but she is better.  Is this the placebo effect?  I don't know, but I think that having the glasses does make her feel less stressed.   I don't know if this would help an adult who understood everything and was having a similar problem.

 

I will talk to her about dry-eye, next time she is blurry.

 

 

[tygrus]

Not placebo. On a good day the muscles & tissues can relax/tighten enough to accommodate enough to get close enough. Stare close then stare far & you may notice your eyes can improve slightly. If eyes are overused & other intermittent conditions can make it harder to obtain/keep focus. Dry eyes, irritation, poor teaming/coordination, darker & lower contrast & other conditions exacerbates the need.

I too had a Optometrist say my eyes were good but he was completely wrong. It's just a pity it took so long to get a 2nd opinion. Many more possibilities than simple near/far sightedness. Even me with glasses, <1 degree is in focus, I read using a window of 3or4 characters (per saccade) scanning the full line.

(I wrote this reply for any person searching the question above)