Developmental Optometrist - Updated question

[OneStepAtATime]

O.k. I have an appointment with an Optometrist tomorrow for my 9 year old DS, as I mentioned on another thread.   I strongly suspect he has some unusual vision issues, which isn't uncommon in our family. So far, this person looks like he might be the best of a lot of poor to fair options in our area, and I have used him to get glasses that better addressed my unusual eye issues (only one I ever went to down here that realized I HAD unusual eye issues) but he doesn't take our insurance so this could be pretty costly.  

 

I want answers and going out of town in the next month is not an option, so if I don't take DS to this appt. tomorrow, we wait at least a month, maybe longer to try and get answers.  The nearest optometrist on the COVD list is over 4 hours away.  If I take him and this person is able to determine that there are some unusual issues with his eye site, then we could still go way out of town for a second opinion and possibly a more detailed eye exam.  But at least we would have a better picture of what may need to be done, right?  Or am I just wasting our money...? (they told me the initial exam could be anywhere from $125 to $325 depending on if he has to take pictures of the eyes)

 

I am really in a quandary as to what to do.... 

 

UPDATED:

 I will post this at the bottom, too, but I am trying to consider all the questions I should ask when i call the Optometrist today.  Answers to this will kind of determine if we go ahead and at least TRY the local guy before attempting a 4 hour trek....

 

1.  Why are you not registered with the COVD?

2.  You say that you can assess for developmental vision issues.  What, specifically, do you test for?

3.  If there ARE vision issues, you implied you could do VT.  Can you confirm that and what types of VT you are able to provide?

 

 

I am sure I am missing questions that I should be asking.  Any suggestions?  Doctors in my area are notoriously ignorant of many of the latest scientific findings so I can't assume anything.

[wapiti]

I'd probably go tomorrow anyway (I'm impatient like that).  But, the cost doesn't make sense to me about the pictures of the eye - I wonder what they mean by that.  $125 would be a normal cost for a regular eye exam where we are.  However, the Optos picture thing that looks at the back of the eye (takes pictures of the retina) is only like $40 extra here; the alternative is free dilation.  AFAIK, both of those are related to eye health rather than developmental vision issues.  For me, I prefer the Optos, LOL, so that I don't have to deal with the inconvenience of dilation, though I had most of the kids do dilation at their last checkup, not something we'll do every year.  There are medical situations in which both might be warranted, or dilation might be preferred.  E.g., when my dd was having blurry spots (from dry eyes), IIRC the doc insisted on dilation to rule out some particular problem.

 

If he finds nothing and you still suspect something, you can call the other place and ask about a full developmental eval; if he finds something, it'll be interesting to hear what he recommends to do about it and you might call the other place and ask them what they think of the recommended action for the identified problem (if he identifies a problem, be sure to get the official name of the problem).

 

Good luck!

[OneStepAtATime]

I'd probably go tomorrow anyway (I'm impatient like that).  But, the cost doesn't make sense to me about the pictures of the eye - I wonder what they mean by that.  $125 would be a normal cost for a regular eye exam where we are.  However, the Optos picture thing that looks at the back of the eye (takes pictures of the retina) is only like $40 extra here; the alternative is free dilation.  AFAIK, both of those are related to eye health rather than developmental vision issues.  For me, I prefer the Optos, LOL, so that I don't have to deal with the inconvenience of dilation, though I had most of the kids do dilation at their last checkup, not something we'll do every year.  There are medical situations in which both might be warranted, or dilation might be preferred.  E.g., when my dd was having blurry spots (from dry eyes), IIRC the doc insisted on dilation to rule out some particular problem.

 

If he finds nothing and you still suspect something, you can call the other place and ask about a full developmental eval; if he finds something, it'll be interesting to hear what he recommends to do about it and you might call the other place and ask them what they think of the recommended action for the identified problem (if he identifies a problem, be sure to get the official name of the problem).

 

Good luck!

Thanks for the feedback.  And the good luck wishes!  :)

[SKL]

Personally I'd skip it and go to the COVD.  Even if they told me tomorrow that he didn't have eye problems, I'd still want to hear it from a COVD, because the whole point of going to a COVD is to cover areas that most other eye docs miss or minimize.

[OneStepAtATime]

Personally I'd skip it and go to the COVD.  Even if they told me tomorrow that he didn't have eye problems, I'd still want to hear it from a COVD, because the whole point of going to a COVD is to cover areas that most other eye docs miss or minimize.

That is what DH says, but this gentleman does do developmental optometrist stuff.  He is not just a standard Optometrist.  And he is apparently the only one in our area that seems to actually do the more developmental evaulations.  He just isn't listed with the COVD.  And when no other eye doctor I had ever been to caught my fragmenting vision, he did, and pulled out a whole other set of tests and equipment to try and give me a fighting chance at a set of glasses that might genuinely help.  I do intend to ask why he isn't listed with the COVD, though.  Maybe because no one else here is he didn't think it was necessary?

 

DS is struggling with reading anything past the sentence level and it really seems vision related.  He is doing great with Barton.  Phonics issues are really smoothing out considerably, spelling is beautiful, verbally he knows what he is learning and can read well at the word stage and mostly at the sentence stage, etc..  But trying to read off a paragraph or larger of text is exceedingly difficult.  And I hate to keep moving him forward in Barton until we have some answers on the eye issue  but he doesn't want to stop Barton, even temporarily.  He worked so hard to catch up to his sister and really is grasping everything and applying it very quickly...he wants to stay on the same lessons as DD very badly.

 

Here is my thinking, but maybe I am off.  If we wait, there is no guarantee that the COVD 4 hours away will be that much more qualified since some here on this board have had issues even with those that are listed on the COVD site.  Driving 4 hours plus every time we have to get a follow up exam or if we were to end up doing VT there when my poor van is old and in need of replacing is not a happy thought for me, especially since DH travels constantly and DD gets violently car sick (and would probably have to go with us each time).  It feels wrong on a gut level to wait any longer than we already have, too.

 

On the flip side, you are right, if he says it isn't vision related, then I will still seek a second opinion and will have wasted money.  Because insurance won't cover this through him, even if he DOES find something that needs correcting, cost could be really high and insurance wouldn't help, and there is no guarantee that he has enough experience and knowledge to truly help the situaiton.  Ugh!

 

I hate waffling.  I really, really do....

[SKL]

If he does find something wrong, will he be able to handle the therapy part?

[Julie of KY]

I'd probably do both. I'm not sure I'd trust the first to figure out everything so I'd still want to go to the COVD. However, given the distance, he may reassure you that the first doc is doing the right thing (or not).

 

Ask the first doc lots of questions about his training and why he isn't listed as COVD.

[OneStepAtATime]

If he does find something wrong, will he be able to handle the therapy part?

They implied that they could, but I want to talk to them in more detail.  Planning to call tomorrow and ask more questions.  

 

I'd probably do both. I'm not sure I'd trust the first to figure out everything so I'd still want to go to the COVD. However, given the distance, he may reassure you that the first doc is doing the right thing (or not).

 

Ask the first doc lots of questions about his training and why he isn't listed as COVD.

Agreed.  I have postponed our appointment until next week so I can ask additional questions (the receptionist was new and unable to answer any detailed questions).  I think we will go ahead and keep the appointment here, though, and hope the price doesn't get too high.    Wish we had better options...

[Julie of KY]

My daughter is at the beginning of VT and it has made a dramatic difference already. She has pretty severe convergence insufficiency as well as other problems. She is on level 7 of Barton and she is ABLE to decode words but has no speed and this fall she worsened to the point that she could only read a paragraph or two before her eyes were watering and she had a severe headache. We noted a big difference in her speed of short passages (in board games) as soon as she got stress glasses. A month into therapy she is picking up books and reading for fun for the first time in her life.

 

I have two boys that started VT this week. They have different problems from my daughter, but I've become convinced that it will help them as well.

 

Hope you find the help you need and hopefully it doesn't take too much driving and isn't too hard on your pocketbook.

[OneStepAtATime]

UPDATED:

This is posted at the top, too, but I am trying to consider all the questions I should ask when i call the Optometrist back today.  Answers to this will kind of determine if we go ahead and at least TRY the local guy before attempting a 4 hour trek....

 

1.  Why are you not registered with the COVD?

2.  You say that you can assess for developmental vision issues.  What, specifically, do you test for?

3.  If there ARE vision issues, you implied you could do VT.  Can you confirm that and what types of VT you are able to provide?

 

 

I am sure I am missing questions that I should be asking.  Any suggestions?  Doctors in my area are notoriously ignorant of many of the latest scientific findings (or anything in the past 30 years) so I can't assume anything.

[SKL]

Do people ever ask for references in this context?  It might be good to talk to a couple of people who have done VT with this doc and see if they felt it helped much.  If he has good results, it would be nice to avoid the 4-hour drives to go to the other doc.

[Soror]

In a somewhat similar situation here and I cannot decide. There is 1 COVD here and I took him a few years back and she cleared him, now reading more I don't know that she really gave him the full eval, she does do therapy though, she did seem a bit dismissive though. Anyway, so I'm worried if I do the eval w/ her again I'll just doubt her report if she says no but then again driving 2 hrs (1 way) for therapy is not a great option either.

[OneStepAtATime]

Do people ever ask for references in this context?  It might be good to talk to a couple of people who have done VT with this doc and see if they felt it helped much.  If he has good results, it would be nice to avoid the 4-hour drives to go to the other doc.

I hadn't thought to ask for references but I guess I should.  Surely SOMEONE has used him for more developmental stuff and they would be willing to share that info...

 

I know I haven't found anyone around here personally that has gotten VT or even a thorough eye exam for anything but normal glasses, so my asking around has netted me very little in the way of information.  My niece actually has a brain tumor that caused severe vision issues for years and the vision doctors she went to around here would tell her mother things like, "You let her walk too young and now she can't focus."  "Your daughter had too many sodas at birthday parties and now she can't keep her eyes tracking."  "She's just tired because you let her stay up too late."  They had to go 4 hours out of town to find out she was nearly blind in one eye and that she had a brain tumor pressing on her optic nerve (which meant that she could see out of a few spots in the "blind" eye, but not have a full picture).  Thankfully, at least so far, the doctor I am looking at seems a bit above the normal caliber for around here...

 

In a somewhat similar situation here and I cannot decide. There is 1 COVD here and I took him a few years back and she cleared him, now reading more I don't know that she really gave him the full eval, she does do therapy though, she did seem a bit dismissive though. Anyway, so I'm worried if I do the eval w/ her again I'll just doubt her report if she says no but then again driving 2 hrs (1 way) for therapy is not a great option either.

So sorry you don't have a better option, either....  UGH!  Sometimes it feels like pulling teeth to get any kind of answer.

 

 And I can't STAND dismissive doctors.  I am sorry you had to deal with that.   I had a kidney infection when I was 8 that lasted months because the first and second time my urine was tested, Mom brought the sample in from home (I could NOT pee in a hospital to save my life as a youngster).  The sample showed massive infection but they assumed that she was just clueless on how to get a clean sample, and they didn't follow up.  They dismissed it out of hand, but didn't even call for a follow up.  She finally called THEM and was told to bring in another sample and to come pick up a new catch cup.  She tried again, the new specimen still showed massive infection, they dismissed it again as "mother goofed up", never followed up with anything, wouldn't give Mom a straight answer over the phone and then we moved and she had to start over with a new doctor.  I ended up with all kinds of health problems that year because the infection went untreated for so long due to "Dismissive Doctor" syndrome.