developmental optometrist?

[Anonymous]

Any experiences or recommendations for a developmental optometrist? My DD's OT eval suggested tracking problems and they recommend vision therapy. I have heard mixed things about it and am wondering if anyone could recommend a developmental optometrist in NOVA, or perhaps share some experiences, good or bad,

Thanks!

[Anonymous]

I can recommend someone in MD who our daughter recently saw - Dr. Sanford Cohen - [phone].

[Anonymous]

OTs love to recommend vision therapy. The science doesn't back it up and it can be harmful if seeing a developmental op keeps your child from seeing a medical doctor if she has a real problem. Developmental issues, attention issues, are brain issues, not eye issues.

[Anonymous]

Thanks 13:32, but MD is a hike for us. I'd love to find someone closer.

PP, yes I have been skeptical about vision therapy, but I also trust the opinion of Dr. Fernette and Brock Eide (authors of The Mislabeled Child, one of the most helpful books on learning issues) and they say that eye issues are often implicated -- not that they can cure LDs themselves, but they are a helpful adjunct to other therapy. I am not entirely convinced it would help my DD, but she does has some visual motor integration issues, visual tracking, and severe dysgraphia that the OT thought would benefit from vision therapy.

Any other opinions or recommendations?

[Anonymous]

Anonymous wrote:I can recommend someone in MD who our daughter recently saw - Dr. Sanford Cohen - [phone].

I also recommend Dr. Cohen. It's more than just vision therapy. He recommended a prescription that helps my daughter's overall functioning -- hard to explain -- by helping muscle tone.

[Anonymous]

A double blind NIH study recommended vision therapy as the best treatment for convergence insufficiency http://www.nei.nih.gov/news/pressreleases/101308.asp. Despite many other studies (though not randomized or double blind) which show the benefit of vision therapy, pediatricians tend to dismiss it.

Dr Malhotra in Vienna treated my two children; their headaches went away and their reading improved so I believe vision therapy to be helpful.

[Anonymous]

Tracking problems are not the same thing as convergence insufficiency. Tracking problems are what OTs love to diagnosis and send people to developmental optometrists for. Next time you're in the waiting room for your OT ask how many other kids there have been sent to developmental optometrists. I suspect a high number. Its the current fad. Save your money.

[Anonymous]

Interesting, our old OT recommended it for DD. I asked specific questions as to why and she couldn't explain. Took my DD to a pediatric ophthamologist who found no problems (and said she did the tests a developmental optometrist would do). SHe found no problem with DD's eyes. Lo and behold, we switch OTs. The new OT (who is much more experienced) was perplexed as to why the old OT would have suggested a developmental optometrist. Apparently, DD's visual perceptive scores were actually very good.

I'm not saying vision therapy isn't right for anyone but I am very suspicious. I would suggest you do your homework and ask a lot of questions. I would also get a couple opinions. It's very expensive (and a huge money maker for the optometrist) and not generally covered by insurance (except, I believe for one condition for which it is proven to be effective).

[Anonymous]

My daughter goes to a developmetal op. and my OT never said a word about it. I researched it and found the doctor on my own. She does not see the D.O. for "tracking therapy" or any other therapy. She sees the D.O. because she has a serious developmental disorder that affects her eye muscles and a D.O. is the doctor to handle it. As I stated in my previous post, he gave her a prescription that helped her.

To the mom who keeps harping on the notion that everyone in the D.O.'s waiting room is there because of a referral from an OT for tracking therapy, YOU sound obsessed with tracking therapy. I had never heard of it -- ever -- before your multiple posts and no one had recommended it to me in the years of therapy my daughter has received from OTs.

[Anonymous]

OP here -- PP, it sounds like your daughter really needed the therapy. But I think the other poster's reference to tracking issues pertain to my situation, I took my daughter to the OT to assess her for writing problems. And in addition to recommending 60 minutes weekly OT, they also recommended a vision screening with a developmental OT because she noticed some issues with her pupils not tracking properly,

DD is a very advanced reader and reads hours each day. And I thought most kids with this at least had trouble reading. When I asked DD more about it she did say that some times the letters jump, but she just ignores it and it doesn't bother her too much. So it seems that maybe there is something there, but I just don't know if this might be something ok to ignore, and/or if it gets better over time on its own.

[Anonymous]

I'm the PP you claim is obsessed but I only mentioned tracking in one post and that was in a direct response to someone else bringing it up. if you went to a DO without the recommendation from an OT you are in the minority. When my DS was in OT pretty much everyone in the practice got that recommendation.

[Anonymous]

OP again. PP, I am curious about your experience. Did you feel that the developmental optometrist is likely to find a problem, even if none exists -- or that maybe they treat problems that go away on their own? I am suspecting that they are likely to find something wrong with most anyone who goes in for a vision screening and that they have a financial interest in doing so. I have read so many conflicting things about it -- some say it works, some say it's a waste. If there is a problem that can be fixed, I don;t want to ignore it; but if it's something that will just be a waste of time and money, I want to figure that out before we go through with our appt.

[Anonymous]

8:27 again. OP, unfortunately you aren't going to get a definitive answer here. You will hear from parents who swear by it. And you will hear from others, like me, who thinks its a racket. I see you keep asking your question over and over and I think you've actually heard everything you're going to hear. We're all going to repeat ourselves and that doesn't help.

I'm happy to tell you again that I think its a waste of money, but someone else will come along and tell you their child made progress because of it.

[Anonymous]

Np here with my two cents: If I had to do it over again, I would go to a pediatric opthamologist after I did the initial eval with the developmental optometrist. Find someone who is familiar with what dev. ops do and what the dev. ops tell patients. For us it worked out fine b/c the opthamologist did see a small convergence insufficiency which is what dc had been treated for with vision therapy (which we had already stopped by the time I got to the opthamologist). DC's vision (reading) had improved and I wasn't planning on going back for more VT and opthamologist gave suggestions of other ways to help the convergence insufficiency (e.g., reading, gameboy,etc.). To be honest, DC couldn't do those well or comfortably before vision therapy. I am happy with result but I wish I had taken dc to opthamologist before we started the vision therapy so I could have seen if opthamologist agreed with dev. optometrist that dc really had such a severe convergence problem. Bottom line is that no one here is going to be able to tell you if it is going to be a waste of money for you. We aren't doctors (at least I believe most of us aren't) and we don't know your dc. The only way you are going to know if it will work is to try it or to get the opinion of another medical professional familiar with VT to take a look at your dc's eyes.

[Anonymous]

It has been found in multiple research studies that approximately 20% of school children have vision problems which interfere with vision and learning. The vast majority of these difficulties respond well to vision therapy. For some of the copious research, see http://covd.org/Home/ResearchWhitePapers/ResearchonVisionTherapy/tabid/189/Default.aspx.

This is not new, nor is it a fad. Vision therapy has been around in some form since the 1700s. Just because your child does not complain, or is a good reader, does not mean he or she does not have a vision problem. Children typically will not complain unless there is pain (and often not even then), because they don't know that what they're experiencing is not normal. I frequently encounter a child who, much to the parents' dismay, reports double vision. "Why didn't you tell me?" asks Mom. "Because you didn't ask," says the child. I was (and still am) a rabid reader despite the vision problems I had. Fortunately, I could improve my comfort by removing my distance glasses. I discovered vision therapy in optometry school when it was recommended by a professor as a cure for the blinding headaches I developed while working on the computer. I never complained to my parents--- it never crossed my mind to. I didn't even complain to my professor looking for a cure, just happened to mention it in conversation!

Those of us who provide developmental optometry care do so because we enjoy helping people, and enjoy improving the lives of children and adults in profound ways. If I had primarily wanted to make a good living in optometry, I would sell eyeglasses. Or I would have become a surgeon. The reason most of us don't take insurance is because it doesn't cover our overhead costs. Most insurance reimbursements of vision therapy services is less than the vision therapist's salary. The reason most insurances don't pay better is because there is insufficient demand from their consumers for this care. Until enough people complained, the insurance companies never covered occupational therapy, speech therapy, physical therapy either. That doesn't mean children don't require these services.

We are truly very fortunate that in the DC metro area there are many competent and caring developmental optometrists. Those previously mentioned are good and caring doctors. I don't care if there are people who don't "believe" in the work that I do, but as a doctor I do believe in making informed decisions. The science, as well as the clinical experience of myself and my colleagues, back up our work. The hospital at Bethesda Naval recently opened a new state-of-the-art facility for brain-injured soldiers, and a key part of their rehabilitation is vision therapy. Because the science backs it up.

http://visionhelp.wordpress.com/2011/03/04/do-physicians-have-a-blind-spot-when-it-comes-to-understanding-optometric-vision-therapy/

Amanda Zeller Manley, O.D.
http://www.vcdcwashington.com/