Eye alignment and school eye tests

[akafred]

We consented to a school eye screening (done by the Lions, I believe) primarily because DD didn't want to be the only one not doing it. We did this last year, and because they didn't dilate her pupils, it said she was very myopic. We followed up at her regular optometrist, who explained that this can happen when they don't dilate especially if the child squints etc. Let me just say that DD has had about 2-3 eye exams per year over the past few years because of things like this and because she wants glasses, because of possible dyslexia, etc etc. We usually pay OOP for at least one a year, as insurance only covers one. Her last appt was about 2-3 months ago and they again said they don't see a need for a Rx, but DD does show remarkable improvement with reading when wearing magnifying lenses (OTC type readers) and recommended I get her some OTC readers sized for kids, which I have done and which she uses for school work.

This year's Lions test again showed myopia, which I now know for sure is garbage, but it also showed an eye misalignment that has never been a problem before. Is this likely to be another false positive? I did have a developmental optometrist who does vision therapy look at her a few years ago because she does have some symptoms of vision issues in this area. They did say she had teaming issues as well as tracking, saccades, and a couple other things, but didn't say her eye turned in. I'm getting kind of tired of this... Anyone have experience or insight? I had amblyopia and strabismus as a kid, and VT fixed it, so I am onboard with getting help if she needs it, but I don't want to fall down another rabbit hole if she just squinted too much during the test or something.

[waverly]

We aren’t to the end of our eye journey yet either. But she has been to multiple eye doctors and optometrists with no issues, so I definitely would not go down the rabbit hole. It is my understanding that the Lions test is just to point you in the direction of a doctor if needed to verify the findings discuss treatment etc and that has been covered already.

Since you had a vision therapist look at her and they saw some issues there, did they recommend therapy at that time? You might end up at vision therapy in the future if those issues you mentioned are still present. Since you have already done opthamologist and optometrist, I think, then I don’t think you need to go back to them right away.

ETA- maybe you haven't seen the opthamologist?  So in that case you might want to for knowledge sake, but I think in the end the treatment, if there is one, would be more vision therapy.  

[akafred]

No ophthalmologist. Yes the developmental specialist wanted to do VT, but there was an insurance situation and we ended up elsewhere and that guy was a complete quack.

[waverly]

akafred, yeah that is my fear as well ending up with a quack.

[waverly]

Since she is in OT already have they ever looked at her eyes? OT has been very helpful with eye stuff. It doesn’t take the place of eye doctors or vision therapy which is much more comprehensive testing. But DS did respond well to their exercises and I was able to get a clearer picture of what was going on without adding appointments or cost because he was already doing OT.

[akafred]

No, her OTs have never mentioned vision at all, actually. I don't have the warm fuzzies about most of them though.

[waverly]

I really liked our PT and OT. The eye test was kind of a standard OT test although I did make sure to mention it and bring it up often as we were progressing. Towards the end that became one of our primary goals.

I can understand not having warm fuzzy feelings about them though, if they don't test them or mention it at all because again I think it is supposed to be standard that they at least check and report back to you.

[bugandbibs]

Do you know what kind of test they used? Was she scanned using an automatic vision screener machine? I would recommend that she see a pediatric ophthalmologist at her next yearly appointment and tell them about her previous results. In the mean time, I would mention it to the OT and ask for guidance. Frankly, I don't love vision screening tests that involve responses of kids or manual adult input.

I screen thousands of kids a year with a machine for school vision tests. I only see myopic come up as a result maybe 1 out of 500 (totally made up ratio, but it's not common for me) times. Our machines won't read if a child is squinting usually, and we do screen in low light.

[akafred]

May 10, 2018 18:06:14 GMT -5 bugandbibs said:

Do you know what kind of test they used? Was she scanned using an automatic vision screener machine? I would recommend that she see a pediatric ophthalmologist at her next yearly appointment and tell them about her previous results. In the mean time, I would mention it to the OT and ask for guidance. Frankly, I don't love vision screening tests that involve responses of kids or manual adult input.

I screen thousands of kids a year with a machine for school vision tests. I only see myopic come up as a result maybe 1 out of 500 (totally made up ratio, but it's not common for me) times. Our machines won't read if a child is squinting usually, and we do screen in low light.

Yes it was a machine. Unfortunately, our OT quit so we are waiting until fall when hopefully they will have hired someone new. This place is discouraging because the turnover is really high. The first few OTs were awesome, but the last couple were pretty much just there.

DD came up as myopic last year too. We rushed her to our optometrist and, since she had had an appointment 6 months previously, we paid OOP. Results came back as they always have, which is just slightly far-sighted but within the range of normal for her age, no glasses needed. Dr said it was likely because she was squinting or straining and they did not dilate. Then last fall one day when she was reading, she took my new reading glasses off me and put them on her and the difference was staggering. I took her to a new optometrist (we've moved since last spring) and again had to pay OOP because the year wasn't quite up, but I didn't want to wait if she needed glasses. Same result. Age-appropriate farsightedness. But the optometrist listened to me about the readers and did an experiment and had DD read without and with lenses. Now DD is a smart cookie and could easily fake it, but I was there and it wasn't totally put on unless she had faked struggling with reading for literally years waiting for this moment lol. The optometrist said, "That is remarkable! I've never seen anything like it!" She recommended OTC readers in a child's size, and her reading has seen marked improvement since. I did talk to a reading expert afterward who said she has seen this happen, and it may be because the eye muscles can be a bit more relaxed and also it cuts down the field of vision so the amount of text is less overwhelming to the child. But everyone agrees it won't hurt her to wear them. Of course by now the novelty has worn off and she no longer wants to wear them.

If you're keeping track, that is two eye exams in the past 12 months and 3 in the past 18 months, all without any signs of myopia. The eye turn thing is new though. That said, I would absolutely not put it past DD to intentionally cross her eyes. Not sure her motivation at this point because she doesn't want glasses anymore though lol.

[bugandbibs]

It sucks that you are having so much trouble with OT. Progress depends so much on the consistency and relationship- is it possible to find a new clinic? I'd stay where my insurance is covered, but for us I drive about 20 minutes farther for my son's OT because I prefer the therapists there. Obviously, that's not always possible but I wanted to put it out there.

I definitely wouldn't pay out of pocket for another eye exam, but I would see an ophthalmologist next time instead of a optometrist. I'm dyslexic and I wear reading glasses even though I technically don't need them. They help me focus better and prevent eye strain, so I totally get it. I prefer wearing bi-focal with clear glass on top while I am doing work because I don't have to take them on and off. I get mine from zenni.com because they are so much cheaper than through my insurance.

It's so frustrating when you can't trust the results because your kiddo might be willingling screwing things. We have this issue with DD1 and she is forever setting off red flags and then I have to put the fires out. I hope things settle down for you soon.