Reader Posts: the importance of thorough vision exams and pediatric specialists.

Tami sent me this story about her experiences in getting her daughter diagnosed.  I have more to write about the importance of vision exams over vision screenings, but there is so much good advice in this story, that I wanted to publish it on its own.  -Ann Z

My daughter, Lilly, turned 5 in June. During her annual check up we were sent to the optometrist’s office to read the eye chart. That is the only thing that is required by our school system for kindergarten entrance. There was no specific line for her to stand on, the lady just told us to stand in an approximate spot about 4 feet from the chart and read as many lines as possible with both eyes. Next she was told to cover her left eye with her hand and read as many lines as possible. Then the same with the right eye covered. We were handed a slip of paper saying she had 20/20 vision.

I knew our health insurance covered one eye exam a year as long as we saw an ophthalmologist. We don’t have vision insurance and I have been wearing corrective lenses since I was 10 so I always take advantage of that. I had also taken Lilly in before she started preschool when she was 3. He didn’t find any problems at that time. Her preschool also had the Lion’s club in doing eye checks and there were not problems found.

I had an exam already scheduled for her the next week after her annual pediatrician’s exam (June 30th). I figured it was a good idea to get her in before she started kindergarten, just to be sure there were no problems.

After going back to the office she sat in the exam chair and was told by the nurse to read the chart with both eyes, no problem. Then the dr came in. He had her read the chart with both eyes, no problem at all. Then asked her to cover her left eye with the plastic thing, no problem. Next he told her to cover her right eye, she sat there for a moment, then started moving the plastic thing and cheating. I could tell the dr was getting annoyed by it so I went over and covered her eye. To my complete shock, she could not read it! Not even the top line. My heart sank. How could I not know that my baby couldn’t see out of one eye?

Next the dr put dilating drops in and asked us to wait in the hall for a few minutes. When we went back in he did all the usual things optometrists and ophthalmologists do with adults. Looking into her eyes, changing lenses to find the right prescription the reading the charts again.

Sadly this dr was not very good about explaining her situation. He told me she had good vision in the right and bad vision in the left along with an astigmatism. She would need glasses and I would need to put atropine drops in the good eye every day. That was about it. As soon as I left the office I was on the phone leaving a message with a friend who’s daughter also wears glasses, just to get  some general information from her such as a good place to buy glasses.

After a night of stewing, not sleeping and worrying about how we were going to pay for all of this with no vision insurance I talked to the nurse and she informed me that it was called Amblyopia and that our health insurance would probably pay for it. So, I called the insurance company, they told me that yes it was a medical diagnosis so insurance would pay for exams, but not glasses. I find that crazy. If you break a bone your insurance pays for getting a cast put on!

I was talking to the mother of one of Lilly’s t-ball teammates. Her daughter had amblyopia also and they had a wonderful pediatric specialist that they really liked in another city about 45 minutes away. I decided we’d go back for her re-check the next month and see what the dr said.

A month later (August 6) we had to go back for a re-check. After reading the eye chart and looking at her eyes he tells us that she’s had tremendous improvement and we could stop the drops, continue wearing the glasses and come back in a year.

After all that I had read on the internet, I didn’t like what I heard. So I called the specialist I had been told about, and actually had heard his name from a few other people too. It was hard to get an appointment (September 6) and I had to take Lilly out of school for half the day, but I had no choice unless I wanted to wait until January.

I am totally sold on the pediatric ophthalmologist! When we were called back into the exam room the assistant asked us what brought us there and I explained everything up until that point. That place is fantastic. What a difference going to a place that is geared toward children! The staff is so much more patient and they have so many tricks to making the kids cooperate. In the first room Lilly read the eye chart with her glasses on and the lady took her glasses for a bit to check them. Then she dilated both her eyes and sent her into the waiting room filled with toys and a Disney movie playing.

After a few minutes we were sent into a different room to wait for the dr. When he came in he asked us to again tell him the story of what brought us to his office. He seemed very irritated by us being told that everything was fine after a month. He told us that treating amblyopia can take many months and even years to treat. He did all the same things as the other dr, but he was much more patient with her and had the tools to get her to cooperate for him, such as animals and movies to draw her attention.

At the end of the exam he told us that she definitely needed to return to treatment and gave us the option of doing the drops again or try patching. She also needed new lenses in her glasses, a stronger prescription for the bad eye. He told us that if the drops didn’t make enough improvement we would have to start patching and also warned us that it was possible that she would need surgery if the the patching didn’t work. He asked if we had ever noticed the lazy eye , which we hadn’t, so he made her eye drift off so we could see what was going on. He was also very thorough about telling us all about the condition, such as most of the time children have it from birth and how often it goes undiagnosed. He waited to see if we had any more questions for him before he left too. Nothing is worse than a dr that darts out of the room before you have a moment to think about things.

I walked out of that office feeling much better about the situation than I ever had. I will NEVER deal with someone who is not a pediatric specialist for anything again. The original dr is a good dr for me, but not for her!

We go back next month (November 5th) to see if she’s improving with the drops.

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3 responses to “Reader Posts: the importance of thorough vision exams and pediatric specialists.

  1. Wow, I would almost swear that the most recent doctor you saw is my son’s PO. It’s rare that you find a doctor in whom you really, really trust. I found that with my son’s PO, and I’m glad that you have found it with your daughter’s. What a wonderful article. I wish you and your daughter much success.

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  2. Pingback: vision screenings vs comprehensive eye exams « little four eyes·

  3. As the original story writer I had to post an update.

    We went for her re-check and the po was so impressed with her progress we’re off the drops at least until her next appointment! He did say that their eyes can regress when stopping the treatment so we are going back again in another 2 months to see where we are. It will be nice to have a break though. We didn’t have to get new lenses either! She does still have some drifting in the weak eye, but he’ll just keep an eye on that for now.

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