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Frequently
Asked Questions
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When should my kids be examined?
Children
should be examined during the first year of life and once a year
throughout their lives. As a birthday present to all children and
families, we will perform a comprehensive infant eye assessment
during the first year of life at no charge for the visit. This is
provided on a space available basis in affiliation with the American
Optometric Association.
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Why aren’t basic vision screenings enough?
Basic
screenings like the ones often done at school or in the doctor’s
office generally target the child’s ability to see letters
at a distance only. While this is important, these screenings tell
us very little about your child’s ability to read and understand
in the classroom.
Another
flaw in the screenings is that they are only able to detect problems
after they occur. A quality vision care program helps assure that
your child will be able to perform at their best in school, sports,
and the other activities of daily life.
One
of the saddest things that happens is when the screening misses
a serious problem or when the results of the screening are not well
communicated to the parents. In a recent study of in-depth vision
screenings conducted in the US and Canada, 10% of those with serious
problems were missed by the screeners and it sometimes took years
for the problems to be treated, even when found.
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Why can complete exams take almost an hour to perform?
Vision
is the most important way a person learns about the world. It is
much more than clear eyesight. To understand how a person uses their
vision we need to get to know who they are and what they do at school,
at home, at work and for fun.
After
we know about who you are and how you use your vision, we need to
make sure you have healthy eyes and healthy visual pathways. Once
we know this we conduct an in-depth evaluation of how you use your
visual system. We want to know how you focus and how you point your
eyes. We want to know how you follow the print as you read and how
well you are able to use your two eyes as a team.
It
takes time to answer these questions and to design the best vision
care program for you based on what your goals are. Good vision care
is a lot more than contact lenses or a pair of glasses.
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What are some possible symptoms of poor visual performance?
Some
of the most common vision problems are blur, headaches, and inconsistent
performance. Most people would know enough to have their vision
checked if they see blur. In many cases, headaches or reading problems
are also the signs of severe or disabling vision problems. Some
headaches are ignored. Many times a simple vision exam can put things
right and greatly reduce headaches, even migraines, both in numbers
and severity.
Many
children who struggle in school have never had a vision evaluation.
They may be suffering needlessly. [See Dr. Lewis’s biography
here on the site]. Smart children who don’t perform up to
their expectations are prime candidates for hidden vision problems.
We
have put several checklists here on the website where you can do
a self-assessment or ask your child’s teacher to fill in an
assessment for you.
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What is Vision Therapy?
Vision
Therapy is a curriculum of activities provided by optometrists designed
so that each patient has the opportunity to develop the visual skills
they need for comfort and success. Each patient learns to use their
visual abilities in new and more efficient ways through the use
of lenses, prisms, instruments and equipment. The principle goal
is to maximize overall performance and comfort through meeting each
patient's formerly unmet visual needs and thus improving each patient's
quality of life.
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How long does therapy take?
Our
curriculum of therapy usually takes about nine months to complete.
Just as with any curriculum some students or patients may take a
bit more time than others. Our therapy contract includes up to one
year to complete the therapy curriculum.
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How often and how long does my child have to practice?
Should
you or your child elect to take part in a vision therapy program,
we see the best results when therapy is done at least 4 days per
week at home and once weekly in the office. Research has shown that
this pattern of meaningful participation in visual activity provides
for the maximum change for the resources expended.
Therapy
homework is critically important. We ask that each patient complete
from three to five activities lasting from five to eight minutes
each, so the maximum time spent actually doing the therapy at home
is forty minutes. More time doesn’t usually help much and
less time can keep a person from meeting their therapy goals.
In
the event that the home therapy is not being done, we may ask that
therapy be discontinued or that the program be modified to multiple
in office therapy visits at a higher cost.
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Why should I consider therapy instead of surgery or in conjunction
with surgery?
In
most cases when people ask us about therapy as an alternative to
surgery, they are asking about a turned eye. Research has shown
the five-year vision outcomes for therapy are better than for surgery.
Many children who undergo surgery alone never achieve the kind of
vision improvement we routinely expect as a part of vision therapy.
A previous
surgery is not a roadblock to success. Although each surgery leaves
scaring and reduces the person’s neurological awareness of
the eyes, we have been able to be successful with several patients
whose eyes remained turned, even after multiple surgeries.
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What does it cost? Will my insurance cover it?
Although
there are some differences in individual visual therapy programs,
the cost of vision therapy about the same as braces. It is interesting
that an old name for a limited form of VT is orthoptics, similar
to the real name of the dental health program that includes braces;
orthodontia.
Just
as with orthodontia, some insurance plans cover vision therapy.
If you have insurance that includes coverage for vision therapy,
we will be glad to help you do the appropriate billing in order
to take full advantage of your coverage.
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Have I waited too long for Vision Therapy?
Vision
can be developed at any age when a person can learn. [See Dr. Lewis’s
biography here on the site] Vision therapy is a program based on
a person’s ability to learn. It was once thought that some
visual function, especially in cases of amblyopia, could not be
developed after age six. This is not true, but became embedded in
the thinking of many medical authorities in spite of numerous successful
cases reported in both the optometric and ophthalmic literature.
Fortunately
the antiquated idea that vision can only be developed until age
six has been less and less of an issue as we learn more about the
development of vision. The American Academy for Pediatric Ophthalmology
and Strabismus website says:
In the past, most eye doctors thought that adults with misaligned
eyes could not be treated successfully, or that treatment was "only
cosmetic". Advances in the management of misaligned eyes now
provide benefits to most adults as well as children. Treating adults
with strabismus can improve depth perception, the way the two eyes
work together, and the field of vision. Many patients report improved
self-esteem, communication skills, job opportunities, reading and
driving.
Unfortunately AAPOS still only recognizes more primitive treatments
such as surgery and patching, but progress is being made.
It is never too late to learn and to improve vision. |