Eye tracking issues—how do I get him tested??

[Garga]

I’ve been on these boards for over a decade and in that time I’ve randomly scanned posts about kids with eye tracking issues.  And every time I read an eye tracking post, people point out that eye tracking issues aren’t detected during a normal eye exam and that you have to ask for extra eye-tracking testing to be done.

I’ve read those threads with interest, but didn’t really think they’d apply to me, so I didn’t study or take notes on them. 🙂

Well....now I want to have my DS15 checked to see if he has eye tracking problems.  I feel like there’s a 50/50 chance he has issues.

He has always complained of headaches and drowsiness when he reads.  Back when he used to read out loud to me he often skipped lines.  But...I kinda discounted those things as him just not wanting to read or still learning to read and I didn’t think about it much.

But then he told me just a month or so ago that sometimes words just disappear from in front of him when he’s reading on a screen and he has to blink for them to come back and that he gets “stuck” in the middle of a sentence on easy words like “and”, and he has to make himself move on with the sentence. These aren’t new things that happen to him, it’s just he never thought to mention it to me before. I’ve never had words disappear and I don’t get stuck on words when I’m reading, so that sounded odd to me.

He’s 15 now, so this isn’t like a 4 year old learning to read and getting stuck.  He’s old enough to articulate what is happening and it doesn’t sound normal to me.  And when I add it to the headaches, drowsiness, and skipped lines in the past, I’m starting to wonder if he has eye tracking issues. 

But at the same time, when I read about other symptoms of eye tracking issues, he doesn’t have those...so that’s why I’m thinking there is a 50/50 chance he has tracking issues.  He has about half of the symptoms.  He might have issues...he might not...I don’t know...but I want to know before he goes to college in 3 years and has to read huge textbooks.

 

So, I contacted the local eye place and asked told them, “I think my son might have eye tracking issues and I’d like him to be screened for that. Do you do that?” The lady on the phone said, “Oh, I had that as a kid and my son did, too!  Yes, we screen for that!” I thought, “Great! She knows what she’s talking about!” 

We had the appointment today and I spoke with the person who was about to do some initial stuff with him before seeing the doctor, and I started giving her a bit of the story and I told her, “He had a routine visit in December, but we’re here today for the extra screening for eye tracking issues,” and we went round and round for a bit misunderstanding each other until she clarified that today’s appointment would just be a regular appointment just like what he had in December and if wanted extra screening we’d have to go to an Ophthamologist.  She said, “Our exam does check for tracking issues, so what exactly did the doctor tell you about his eye tracking issues during his December appointment?”  Well...nothing. The eye doctor told me nothing. There was nothing found about eye tracking issues in that appointment, BUT I remember the WTM saying that eye tracking issues are NOT found in a routine exam...so I’m confused.  Are they found in routine exams or not?  She seemed to they are, but I thought I’d read here that they’re not.  She was very polite, but now I’m wondering if I’m wrong about how vision tracking issues get found.

 

So, I have a pediatric ophthalmologist to call, because the lady gave me a business card for them.  I do not live in a heavily populated area, so this guy is the closet one to my house, but is still 50-60 minutes from my home.  

I DO NOT want to drive all that distance and realize I’m barking up the wrong tree.  

 

I feel completely out of my depth.  What do you guys think:  

Is it true that his routine exam in December would have caught eye tracking issues?  Will I call the ophthalmologist and they’ll say, “Why in the world are you bothering us?! If the initial eye exam didn’t find anything, then your son is fine, you crazy hypochondriac!”?

What do I say when I call them so they understand what I want?  Am I being a crazy hypochondriac?  Should the regular exam have reassured me he’s fine? Remember, I’m waffling about whether he really has an issue or not. My son has been getting full eye exams every year since he was about 7 or 8 (so about 7 visits), and none of those have ever showed any tracking issues.   

I turn up nothing when I try to google this stuff. I don’t even know how to start googling it—how to ask the questions. I can’t figure out if it’s really true that I need to bypass the optometrist and head to the ophthalmologist or if the optometrist would have caught an issue and forwarded me to an ophthalmologist. 

When I called the insurance company they said they don’t pay for anything to do with eye tracking problems/vision therapy, so I’m looking at a few hundred dollars to have testing done and I don’t want to do this lightly and waste my money (and 2 hours of driving) if the routine eye exam really is accurate and my son is perfectly fine. What do I say when I call the pediatric ophthalmologist?

 

What does the hive say?

Edited August 14, 2020 by Garga

[PrincessMommy]

I don't know how to get it dx. but my own son had an issue with this due to his concussion just before the close down.  PT has helped tremendously with some of his symptoms, but he's still getting headaches everyday that require a long break in a dark room (sun sensitivity was another issue).  We went in for the concussion and were referred to PT for his lingering issues....and the PT is the one who actually caught it.  

[Storygirl]

The kind of eye doctor that you are looking for is a COVD -- not an opthamologist. You can search this website to see if there is one in your area. https://www.covd.org/

I've had two of my kids tested by a COVD in the past, but she didn't recommend vision therapy for them, so the initial screening is as far as we went with it. There are some moms on the LC board that have experience with vision therapy, though, so you might want to cross post your message there.

Edited August 14, 2020 by Storygirl

[domestic_engineer]

You want a doctor from this list:  https://www.covd.org/

An annual appointment will check for near/far sightedness for sure.  Few doctors may screen for developmental vision problems (convergence, tracking, depth perception are the big items), but like hearing and vision screenings at the pediatrician's office, they can miss some less obvious cases.  The COVD doctor can run a more in-depth test/evaluation that takes, in my experience, around an hour and should provide you with a written report soon afterwards.  

Insurance *is* hesitant to cover vision therapy, but a doctor in VT may be able to provide guidance in getting the most from an insurance company.  

Our COVD doctor will screen for tracking by moving a ball/point left-and-right, figure-8 and watching how well the eyeballs follow the ball.  Then she asks questions of the patient while the patient continues to track the motion of the ball.  For convergence, she screens by having the patient focus on a point, then bringing the point closer and closer towards the patient's nose.  She again observes how well the eyeballs follow the point.  And for depth perception, she screens using a special pair of glasses and a special page and asks the patient to tell her which item pops up out of the page.

From your description, I'd guess he has convergence issues more than tracking issues.  (Not that I'm diagnosing, but rather just giving you fodder for your google researching.)

Best of luck to you.  I hope you find a doctor close by.

[melbotoast]

Yes, a COVD doctor is what you need. Ours had a free initial consultation/screening.  They had lots of experience on how to work with the different insurance companies and were willing to go to bat for us as much as they could. Good luck!

[mmasc]

35 minutes ago, Storygirl said:

The kind of eye doctor that you are looking for is a COVD -- not an opthamologist. You can search this website to see if there is one in your area. https://www.covd.org/

I've had two of my kids tested by a COVD in the past, but she didn't recommend vision therapy for them, so the initial screening is as far as we went with it. There are some moms on the LC board that have experience with vision therapy, though, so you might want to cross post your message there.

This ^^^

[mmasc]

24 minutes ago, domestic_engineer said:

You want a doctor from this list:  https://www.covd.org/

An annual appointment will check for near/far sightedness for sure.  Few doctors may screen for developmental vision problems (convergence, tracking, depth perception are the big items), but like hearing and vision screenings at the pediatrician's office, they can miss some less obvious cases.  The COVD doctor can run a more in-depth test/evaluation that takes, in my experience, around an hour and should provide you with a written report soon afterwards.  

Insurance *is* hesitant to cover vision therapy, but a doctor in VT may be able to provide guidance in getting the most from an insurance company.  

Our COVD doctor will screen for tracking by moving a ball/point left-and-right, figure-8 and watching how well the eyeballs follow the ball.  Then she asks questions of the patient while the patient continues to track the motion of the ball.  For convergence, she screens by having the patient focus on a point, then bringing the point closer and closer towards the patient's nose.  She again observes how well the eyeballs follow the point.  And for depth perception, she screens using a special pair of glasses and a special page and asks the patient to tell her which item pops up out of the page.

From your description, I'd guess he has convergence issues more than tracking issues.  (Not that I'm diagnosing, but rather just giving you fodder for your google researching.)

Best of luck to you.  I hope you find a doctor close by.

And this ^^^

our Covd doctor did these tests and when she pointed out her findings to me in the exam room I could actually SEE what she was talking about. I don’t remember which of the tests above showed this, but I could see that one of his eyes was moving at a different rate of speed than the other. One would move to the object and then a moment later the other would catch up. It was not noticeable in normal day to day life but clearly obvious in the exam. He did end up having vision therapy (and it helped him) Our insurance covered the exams before and after the therapy, but none of the actual therapy, unfortunately. We paid out of pocket.

oddly enough, we actually had routine optometrist exams this morning and even with the knowledge that ds had had vision therapy, convergence issues, and tracking issues just over a year or so ago, the doctor still didn’t do any of those tests listed above. 

Edited August 14, 2020 by mmasc

[CTVKath]

Our vision therapist is listed on the COVD website. My 8yo son had his initial exam about 2 months ago. It was almost 2 hours of testing.

[ElizabethB]

Yes, COVD. Screen for everything while you're there, there are a lot of different things besides tracking and convergence, but those are most common.

[PeterPan]

There's sort of turf war between opthamologists and developmental optometrists. An optham is a surgeon and *often* (not always) they poo poo developmental vision issues and vision therapy. 

So in general, you're looking for a developmental optometrist, and *usually* those people with that training are listed with COVD. However there are *iccasional* opthamologists who do vision therapy. There's one in our area I know of. I've heard stories both ways (great and hairbrained) so I went with the COVD practice that does this a lot and had a good experince.

Practices vary even when you find someone who does vision therapy. Yes, it sounds like he has convergence issues. It will respond well, to therapy. I would call several places and ask how they roll (cost, who does the therapy whether the doctor or a therapist, whether they have  a *certified* therapist which does exist, etc). Also ask for names of people to talk to or google them!! Some places will have info meetings and let you meet a doc, tour their therapy rooms. Ask questions upfront and yu'll be more happy in the end.

Rule of thumb is no big bucks upfront. Pay as you go, one month at a time. Should have homework (10-20 minutesa day)