My random thought is that he may have pulled out his best for the ophthalmologist and masked how bad his problem is.
Our DD has a significant problem with her hands, our children's sensory OT told us to be happy if she grew up able to sign her name and tick boxes, but sent us to an adult hand specialist just in case they could make a brace small enough that might help. At the hand specialist DD was all hapoy and excited and pulled off the best pencil grip and handwriting ever (developmentally appropriate for age), and I got the funny look. The OT wandered off to do something and mercifully DDs grip and writing devolved in her absence, OT then physically manipulated DDs joints and was all "oh... Oh...OH! I'll just get my supplies, this needs bracing".
