One of the things that came from Ranees school learning assessment was that seemed to be an issue with her vision. This was something that I had explored when she first started having learning issues. I had been working as an optician for 16 years, I knew about vision and eyes that was my profession. I would know if my daughter couldn’t see. Ranee had her first vision exam when she was old enough to know her letters, I took her to the office I worked in as I’d done with her siblings previously. She went through the vision exam and she passed with flying colors her visual acuity was fine. She did not need glasses the only thing that I remember being different was that she read the vision chart backward from right to left instead of left to right like it’s done traditionally. Her eye doctor didn’t really think anything of it and neither did I.
But I still wasn’t fully convinced, she still couldn’t keep her place when she read, she would skip lines she would flip letters like b,d p,q numbers 2,5 6,9 and her reading level wasn’t improving. Next, I turned to a pediatric optometrist thinking maybe my doctor just missed something since he doesn’t specialize in children. But again she passed the eye exam with flying colors. They insisted her vision was fine. So I let it go guessing her reading issues had to be attributed to something else. We just had to figure it out.
It was the school that recommended a behavioral optometrist. A behavioral optometrist can decipher vision issues that most vision exams typically wouldn’t show. The school assessment or even a traditional eye exam does not explore vision problems, the school exam or typical eye exam mostly addresses visual acuity, which wasn’t Ranee’s issue. A behavioral optometrist can customize a treatment plan focusing on the individual’s specific vision deficiencies. The idea is to strengthen the eyes skills if they are weak. Through vision therapy the brain is retrained to better communicate with the eye muscles, it’s like physical therapy for the eyes. Because the brain and the eyes are closely related visual deficiencies can affect the ability to learn. The goal of this type of doctor is through vision therapy resolving the issues that interfere with reading and learning. Vision therapy isn’t a cure for learning disabilities but it is another component that can help improve learning issues.
The school gave me a list of behavioral optometrists but finding one that took our insurance was challenging. We finally found one that participated in our insurance however it was an hour drive from our home. A two-hour round trip for a half an hour appointment. But again it was just something we had to do, the only problem was Ranee had terrible motion sickness, I would have to give her Dramamine to make the drive but by the time we got there she was so drowsy it would be difficult to concentrate on the vision therapy.
Dr. Yui* has been in the field of visual therapy for ages. She is a well-educated, brilliant woman although a small woman her demeanor was somewhat intimidating. A great woman just not great with children. Her office was filled from top to bottom with stuff, stuff everywhere. The office was old and dark all her equipment antiquated but functional. I remember that first time stepping into her office just being overwhelmed with the sheer amount of stuff. When we came into the exam room I was shocked to find her still using equipment I had never seen, just only heard of in my Optician textbooks there was nothing modern about the place. They even still kept track of appointments by handwriting them on a calendar. It was like taking a step back in time. But it was apparent from the get-go this woman knew her stuff and was passionate about it like a lot of the specialist I’ve encountered. I figured the drive was worth it and I would just close my eyes to the clutter. Maybe Ranee would warm up to her.
She accessed Ranee and diagnosed her with convergence insufficiency and binocular dysfunction. The convergence insufficiency meant Ranees’ eyes don’t converge or focus together. This would mean that she has difficulty changing focus and sees double when looking at things up close. The binocular dysfunction has a similar definition again it means her eyes don’t align properly, because of this she alternates suppressing her eyes. The eyes are actively connected to different sides of the brain that process memory and cognitive thinking so this would explain why Ranee had such a hard time with memorization. If she was suppressing the vision in the eye that was connected to the brain lobe that controls memory, that would mean she would not remember anything. This is why we would practice for a test all week and she would forget everything we went over. Or why she would read instructions and forget what she was supposed to do. Also, stress is a major factor in vision suppression which she experienced a lot of at school when she was overwhelmed she just couldn’t focus.
She was prescribed glasses with prism, and vision therapy in office, and exercises at home to help along the process. But Dr. Yui stayed cold and Ranee dreaded the sessions, one because the car ride was intolerable because of her motion sickness and also Dr. Yui’s poor bedside manner. A lot of the exercises involved wearing an eye patch or glasses with different colored lenses, Ranee has crazy curly thick hair that falls in tight ringlets around her head. Now anyone with curly hair knows the struggle. You can’t just put things over your head without a careful gentle plan of action, everything has to be placed just so or you’re going to lose a headful of hair when that thing comes off. I would cringe when Dr. Yui would roughly try to wrangle the patch over Ranee’s hair or yank the glasses off of her, unaware that curls on her head had fused around the eyeglass temples. And I’m sorry but I don’t know what that woman ate but she had a terrible gas problem, and never said excuse me when she broke wind. Ranee would glare at me with a smirk on her face every time and wrinkle her little nose. I could hardly contain myself as well as sometimes the odor was putrid. Now brilliance is a great thing I love a brilliant mind as much as the next guy but that’s no excuse for not having manners.
After about 6 months the drive just became too far especially in the winter months which can be quite brutal in Connecticut. We were seeing very little progress and Ranee had very little motivation to attend the sessions. I was feeling little motivation to make the drive myself as it was such an ordeal to get her there. So when someone recommended to me a vision therapist that was a half an hour closer I was ecstatic. Dr. A is young and upbeat and bubbly her technique very similar to Dr. Yui’s but she had a gentle soothing nature about her that Ranee responds well to. She’s got a great hip sense of style and has a really cool eyeglass wardrobe and she wears cat eye glasses, Ranee clicked with her right away. By this time Ranee’s mental health issues had started she was compassionate about it and recommended neuropsychological testing additionally to help us work out some of the deeper issues with Ranee’s learning. A neuropsychologist can accurately diagnose dyslexia which would explain a lot of the flipping of letters and numbers that Ranee has difficulty with.
Dr. A started where Dr. Yui had left off using a lot of the same types of therapies. Ranee progressed to the point of no longer needing prism in her glasses and then to part-time wear. Although she does look super cute in her hot pink Kate Spade cat eye glasses, she only needs to wear them on a limited basis now which she is happy about. Part of vision therapy is what is done in the office and a large part is also home-based we were always sent home with homework to keep working on her vision insufficiencies daily. She doesn’t resist the homework as she used to, we just make it a part of our daily routine.
Within months we started seeing real improvement. We even took a trip recently to South Carolina and Ranee didn’t need Dramamine, her motion sickness has gone away. So why such a difference now? Why was there such a vast improvement with a new doctor? I have a quote in the entrance of my house that says
“You are responsible for the energy that you bring into this space”
I believe that completely, the energy you bring to your space has a clear impact on the people who enter your space. An upbeat personality and disposition is contagious and can make a world of difference. Dr. A’s energy and loving personality was the motivational factor. Ranee made a connection which is so important for her in every area of treatment. The great thing is the type of visual deficiencies Ranee has are treatable and the treatment is working. She still struggles to read and write but she’s not skipping lines like she used to and her memory has improved significantly. It’s a step in the right direction.
And you can only move in the right direction if you can see clearly in front of you.
If you have a child that experiences any of the following things, you may want to seek out the help of a behavioral Optometrist
- Loses place easily when reading, skips lines or leaves words out
- Covers one eye when reading or writing
- Had difficulty remembering what they read
- Complaints of tired eyes, eyes often appear strained and red
- Difficulty concentrating
- Eyestrain especially after reading
- Problems with motion sickness
And remember just because a child passes a school vision exam or even a vision exam at a traditional optometrists office they can still have a vision problem. Go with your gut if you feel like something’s wrong seek out a second opinion or a third for that matter. It’s okay to seek out another option if your child doesn’t mesh with their doctor. Whether it’s a vision therapist or a psychiatrist or case worker. It’s important for the child to feel comfortable especially with someone they are going to be working with regularly and closely, they need to build an ongoing relationship with this person. If it’s just not working move on. The fight is ours, you know your kid, it’s okay to keep searching when the answers still are unclear.
*names have been changed to protect subjects privacy.