Gifted Issues Discussion homepage Forums Twice Exceptional Vision vs Eyesight issues

I am looking for BTDTs.

edited

I know nothing about vision therapy, except that it has been proven to benefit a very specific, limited type of problem, despite being used for much broader issues. That said, bifocals are unusual in kids- they are mainly for adults with presbyopia or age-related vision changes, so I would certainly ask a lot of questions about the rationale for those.

Regarding the newer, stronger glasses, most ophthomologists will try to prescribe the weakest glasses that are effective for the patient, because (I believe, not sure of the evidence) overcorrection can exacerbate the progression of myopia. The doctor should be able to tell you to what degree his vision is corrected (20/20, or 20/30, etc- not all people are able to be corrected to 20/20.

When you say the script arrived, was he fitted for the glasses in person? A good optometrist can be as important as the ophthalmologist (sorry, but personally I would avoid the mass market places as the people fitting glasses there have minimal training, in my experience, and are mainly salespeople.) Regarding the peripheral vision, some curvature or distortion at the periphery can be normal, depending on the prescription and the style of glasses (more square shapes will have thicker lenses in the corners, this is minimized by a more round and/or smaller lens.) These are all issues that a good optometrist should be able to help with, although it's also possible the glasses are just centered or adjusted poorly.

Caveat- I have a medical degree, but am not an ophthalmologist, I just have a lot of high myopia in my immediate family and have spent a lot of time dealing with issues like this.

Actually, I agree with you about having the optometry shop within the ophthalmology office (seems like that should be illegal) but I am also wary of the huge discount places. If possible, I think one gets the best results in an office where the optometrist or optician sees you as a patient with an ongoing relationship, keeps a record of everything, etc, Ours regularly contacts the ophthalmologist to confer when needed, and we visit for adjustments and checks when needed, He is a wizard as far as suggesting frames, and will discuss the pros and cons of shape, lens composition type, anti-glare coating, etc- as with all things, there are good and bad aspects to most of these decisions, and we have benefitted from someone knowledgeable to help tease out the best choices for us and our specific vision problems and preferences. Also, as you have probably experienced, it is easy for kids (anyone, really) to bend or twist even the titanium frames, and a small asymmetry can really affect the vision, so having someone open to drop-in adjustments, etc, is also helpful.

I do think I would have him checked with the glasses on- for us, the optician would be comfortable (and competent) and would consider it part of the initial fitting, but you could also see the ophthalmologist, Reading a card on the table is a quickie short-cut, in my opinion- our optician uses eye charts just like the ophthalmologist. I think they should also do measurements with the glasses on, where they measure the pupil distances, temple distances, and probably some other measurements, too- it takes a bit of time but they do it every time one of us gets new glasses (sadly, several times a year between all of us!) (I don't mean to say they didn't do a thorough job, as I am not an eye doc- its just that in my expeience it is usually more involved that what you described.)

All glasses are not created equally. The reason many practitioners also sell glasses is that they can control the quality of the frames and more importantly the lenses that their patients are receiving. It is like comparing a pair of faux leather shoes from your local big box store and a pair of hand maid Italian loafers, they are both shoes, right?? Also, they should have been fitted when you picked them up. Did your son try them on and they measure anything? If not, that may be your problem. I am assuming his eyes were dilated during the exam, it would be very difficult to get an accurate prescription for a child otherwise.

Actually, it's my understanding that dilation is important for other parts of a thorough exam, but not necessary to test acuity. Especially if acuity is being tested more than once a year, it ican be done without dilation.

Actually, cricket3 the technology is so good now you can get a better view with the tech than dilation. You still may dilate if someone is diabetic etc.. and you are watching something specific. You dilate children because they have significantly more accommodative ability than adults and it helps you determine an accurate prescription. They are not just small adults (at least not when it comes to their eyes😜

Well, thanks for your expertise, My frequent flyers are teens now and avoiding dilation is a huge deal when that exam otherwise wastes an entire day for them, so they are thrilled to have exams without it occasionally (and yes, they did see a ped ophthalmologist when younger.) Either way, it sounds like Portia's DS is seeing someone who is addressing the issue.