Vision Therapy – Page 6 – Strabismus Solutions

When I first discovered Vision Therapy I was extremely skeptical. I had been to so many different eye doctors throughout the years and didn't really believe that this one was going to be any different. My first appointment was nothing like I had ever experienced at an eye appointment before. So what should you expect at your first Vision Therapy appointment? Your Vision Therapy inital appointment will begin much like any other eye appointment, reading letters off of the wall at near and far and looking through that big machine saying "better" or "worse." Then you will progress towards more involved testing, eye pressure, peripheral vision, eye tracking, 3D vision, suppression, reading, primitive reflexes and more. My son also went in for testing, he has Convergence Insufficiency, and the testing was slightly different for him. In addition to the testing I received for Strabismus, he was also tested on left and right, his writing, spelling, and ability to copy a sentence. The Optometrist also went into more depth testing his 3D vision and abilitiy to fuse images. Each Developmental/Behavioral Optometrist will change and adjust initial vision therapy evaluations according to their style, specific training, and the patient's diagnosis. In general, you'll have an initial consult to see if vision therapy is a good fit for you, if it is, you will be scheduled for further testing. There are some clinics that will start with the full examination, so be sure to ask. I've seen the full testing referred to as binocular vision assessment, developmental vision evaluation, binocular and visual information processing evaluation, comprehensive vision testing, functional vision exam, or perceptual testing assessment. Whew, maybe they should all call it the same things so it's not so confusing! This testing is usually broken up into two one-hour appointments. After all of the testing is complete, you will head back for a "parent conference" or "patient education visit," but I think it feels more like a sales pitch. Let's go into a little more detail about what to expect at each of the different initial visits that occur before you start official vision therapy. First- The Initial Consult My optometrist offered a free consult so I went in to see what they did that was different, I didn't have anything to loose. First, my optometrist had me read letters off a chart...20/20 in both eyes, the same result I always get, despite the fact that the images from one eye are blurry. Then reading up close. Same old same old. Then I looked through the big machine with all the lenses, nothing new. Then he watched me follow a light while covering my eyes one at a time. I wasn't impressed, everything seemed the same as every other eye appointment I'd ever been to. Then he broke out something called the Worth Four Dot Test that I had never seen before. It kind of looks like a flashlight with four dots on the front, 2 green, 1 red, and 1 white. I put on a pair of glasses that had a red lens on one side and a green lens on the other side. Then he had me look at the light (worth four dot tool) and tell him what I saw. I was amazed. I didn't see four dots. I could feel my eyes switching from the left to the right very quickly and the lights were changing from 2 red dots to 3 green dots. This meant that I had alternating suppression. At that point, he had my attention. He then went on to explain why I still couldn't see well, even though I had 20/20 vision. He also explained that he could help me overcome the vision struggles I was having. He asked me what goals I had for my vision, I didn't even know what I wanted, I just wanted it to be better. With that, he asked me to schedule another appointment for more in-depth testing. I want to note that depending on the diagnosis, vision therapy testing is going to look different. My son went to the same eye doctor because he was seeing double while reading. Our exams started out exactly the same, but more time was spent analyzing how well my son could keep images single at different distances than on suppression. Second- Comprehensive Binocular Vision Testing Did you know there are 17 different visual skills? Visual acuity (that 20/20 number) is just one of them. A developmental optometrist examines all of these different abilities through a variety of tests as a part of your vision testing. They include things like focus, alignment, central and peripheral vision, depth perception, fine and gross motor skills, and overall eye control. Comprehensive is a great word to describe this testing because they test it all! He tracked my eyes while I look at different targets, near and far, sometimes with glasses and other times without. I looked into different machines that tested for blind spots in my visual filed and my reaction time. He tested the extent of my peripheral vision and analyzed how my eyes were (or were not) working together at near and far. I can't remember every single test and I definitely don't know the names, but I left the office feeling confident that he had tested every nook and cranny of my vision and left no stone unturned. If there were problems, we were going to know every one of them! Third- Functional/Perceptual Testing The second day of testing is more focused on how you use your vision on a daily basis. You will wear these great big goggles and read passages and answer questions. It is called a visagraph and can actually track your eye movement as you read, so fascinating! My son, Teagan, doing the reading/tracking/comprehension test with the Visagraph Glasses There will also be testing to analyze the presence or absence of primitive reflexes. Primitive reflexes are something I've still not totally bought into, but I'm obediently doing exercises. Babies are born with reflexes that they should eventually grow out of. Overcoming these primitive reflexes provides a strong foundation for the visual system to function well (supposedly). Writing, copying, lefts and rights, and visual processing were also tested during this second set of tests. For my son, the focus was on those skills that could be limiting him at school. For me, there was a bigger focus on reading, tracking, and getting measurements for my eye turn. After all of this extensive testing, we went home and gave the Optometrist about a week to study and compile the results. This is typical for most Vision Therapy Clinics. I called a wide array of clinics collecting information for my article on The Cost of Vision Therapy and every clinic varied on the number of days for testing and time for testing, but they all shared one thing in common, the parent consultation. Fourth- The Parent Consultation The parent consultation is offered for free, but don't be fooled, vision therapy comes with a hefty price tag. The purpose of this final appointment is to help the parent and/or patient understand the limitations that were found in the testing and present a plan for improving and fixing the patient's vision problems. My optometrist really wanted my husband there because he wanted my husband to understand and experience the way that I was seeing the world. He would have me do a test and then have my husband do the same one. It was interesting for my husband to see the way that I viewed the world and really understand that there is a huge difference. My husband and I were both shocked during my son's consultation to see the way that he views words on a page in double! After you do all of these tests, you will be convinced that you or your child needs vision therapy. At this point, the Optometrist will hand you a contract that will explain your exact diagnosis, the number of visits you will need, and your total cost. You will then be asked to sign a contract and pay for it all at once or set up a payment plan. I think vision therapy is an amazing service and I believe in it 100%. That being said, I think that requiring patients to pay for 30 appointments in advance is strange, to say the least. Honestly, can you imagine if your regular eye doctor asked you to pay for your next 30 appointments in advance? Or maybe you go to Physical Therapy and they decide you need 10 weeks of therapy and they want all the money up front and a signed contract?!? Sorry, soapbox over. Even if I don't agree with the business model, I believe in the business and we are choosing to do therapy for me and my son despite my annoyance at how they run the financial aspect. After your consultation, you get to go home and decide if you're going to sell your right kidney or your first born child to pay for the therapy. When the money is taken care of, you'll be set up with weekly or bi-weekly in-office appointments and make amazing strides in your vision journey! Good luck! Related Questions How do I Pick the Right Clinic for Vision Therapy? When choosing a clinic, check the credentials of the Optometrist in charge. They should be a COVD and a list can be found on the COVD website here. You may also want to ask about who will be actually doing the vision therapy, will it be an Optometrist or Vision Therapist? Some clinics use Occupational Therapists as well. You can join the facebook group, "Vision Therapy Parents Unite" and seek opinions there as well. What to Bring to my First Vision Therapy Appointment Bring any glasses, contacts or prisms that you are currently using to your initial vision therapy exam. If you've had a recent eye exam, bring in those results as well. If you've had eye surgeries, you can have your medical records sent to the Optometrist to help them more fully understand your history.