Low Plus Lenses

[Anonymous]

Does anyone have a child who has low plus lenses (low power reading glasses)? Our DD has 20/20 vision, but has been prescribed low plus lenses by a developmental optometrist for near work. We brought DD to the optometrist because she has some trouble with confusing letter order in words, and letter orientation (she's 8 y.o.). She also has complained that the print is blurry when she's reading a book with small font, and she sometimes reads with her head leaning all the way down blocking one eye. On the other hand, she does like to read, and she draws and does crafts it seems with no problem. I watched the OD do some of the near vision testing with DD, and DD was rubbing her left eye during much of the screening. DD, who is sensory sensitive and I would have thought would be against the notion of wearing glasses, agrees that the low plus lenses help her to read more comfortably and is interested in the glasses. DH however is strongly opposed because he's concerned her vision might deteriorate as a result of relying on the low plus lenses to read. He had a similar vision issue (but not the reading/spelling difficulty) and has had to get progressively stronger prescriptions over the years. I'd appreciate any other insights others may have as to whether it's a good idea to try low plus lenses for DD in this situation or not.

[Anonymous]

My ds had the glasses for awhile while he did vision therapy. We could never tell if it made a difference with his reading. A couple of months after we stopped vision therapy (stopped on our own -- were not discharged), I took him to an opthamologist who said that he didn't need the glasses (he hadn't been wearing them a lot anyway). He has been fine for the last few years without them. He did vision therapy for a convergence issue -- opthamologist said it was slight and we did not need therapy any more. Since he did not see the opthamologist before he started therapy, it is impossible to know if the therapy helped make the convergence issue smaller or if it was that small all along. Lot of threads on vision therapy on this forum. Lots of heated opinions. I don't think the glasses help or hurt. FWIW, dh and I both have terrible vision. Plus, ds was a preemie so he has an increased risk of near-sightedness. He just had his annual appointment with opthamologist and eyes are still 20/20 -- and he is 3 years past the age when I got glasses. Good luck.

[Anonymous]

Thanks PP. Did your DS ever have any issues with reading or spelling, or any physical symptoms when it comes to reading (along the lines of what I listed for our DD)? I'm also trying to figure out, if glasses don't help with the blurriness/eye strain issue, then what will? We do try to increase font size where we can. Currently she reads regular books, but if we don't go with the glasses I plan to look into whether we can/should get her school-assigned books on an iPad or a Kindle (we'd purchase for her), and we can increase the font.

[Anonymous]

I believe your DD is where my DD would be in a few years if we hadn't corrected the vision in her left eye. At her 5 yo visit to the pediatrician, she did that simple vision test. Her binocular vision was fine, her right eye was fine but the vision in her left eye was significantly poorer. We had her checked out be a pediatric ophthalmologist who said there was nothing structurally wrong with the eye but that the good eye was doing all the work and if we didn't improve the vision to the left eye one of two things would likely happen:

1. In a couple years, her brain would 'turn off' that eye, she would have little vision in it and it would become susceptible to become a 'lazy eye'.
2. Her brain would continue to try and use the input of that eye but wouldn't be able to do it well, her vision would become blurry, she would likely develop headaches and her reading would be impacted.

We started with glasses but the fashion these days is small lenses and she frequently would be looking over her frames rather than through the lenses. Her vision, uncorrected, didn't improve so we started patching her stronger eye several hours each day. The research seems to be mixed on that but the alternative was putting a contact in that eye. I had a very difficult time accepting that a 5 year old could wear a contact.

We patched for 6 months with very little improvement. DD was about 6.5 at this point and the doctor said we were nearing a crossroads. The vision had to be corrected or one of the two things above would be likely to happen. This wasn't acceptable to us so we went with the contact. She only needs the one and a vision tech spent about an hour with us teaching DD to put it in and take it out. The tech was very patient and DD did really well. Initially, DH and I had to put it in and take it out but we had DD practice it each time. She's now to the point she can take it out by herself and she can get it in by herself when it doesn't get stuck on her finger. I have to say, the contact is far better than the glasses. We observe DD cleaning it each day and we've had no problems. Her vision is improving and while she likely won't ever have 20/20 vision in that eye uncorrected, it's better than what it was and we don't have to worry about the above 2 things.

Of course, I don’t know but from your description, it sounds like your DD is suffering from thing 2. Whatever is going on, you need to correct the vision in that eye. Have you talked to your doctor about your DH’s concerns? I’ve never heard that getting glasses young has anything to do with the need to get increasing stronger prescriptions. I don’t know how it would. Of course, you should talk to your doctor about it as bodies grow, so do the eyes. I have two other kids who have tone issues and they both have been evaluated by the ophthalmologist. The doctor told us that at some point, the boys would likely need glasses for nearsightedness. At this point, their vision is within normal ranges for their age but at on one end of the spectrum. It might be one year, it might be 5 years but they are likely to be nearsighted.

[Anonymous]

My child was prescribed glasses similar to OP's child - some low power glasses for some vague reason by a developmental optometrist. My child refused to wear them (a thousand dollars later - the optometrist's fee was something like $700 for the initial appt.). We then went to an opthalmologist who said my child's vision was fine and was not sure why the optometrist prescribed the glasses except that's what they like to do! Needless to say, I am really wary of developmental optometrists b/c my child is doing fine without glasses! We went there in the first place for some possible visual learning problems which are no longer a problem. Just needed some time.

[Anonymous]

Amen, PP!!
OP: Please take your child to a pediatric ophthalmologist and stop with the developmental optometrist. I highly recommend Dr. Vicente: http://www.pediatric-ophthalmology.com/html/doctors.html

[Anonymous]

This is OP - thanks everyone for the comments.

We did take our DD to a pediatric ophthamologist, who said that DD's visual acuity, binocularity and tracking were all fine. However, he could not explain to me why DD rubs her eyes and/or leans all the way down covering her left eye when she reads, has complained that print is blurry (she's also said that small font looks like it's moving), and she has trouble reading small print on things like a ruler. She also has much more trouble processing information that's presented visually vs. orally (e.g., she'll completely "not see' instructions or entire questions on tests, but she has no problem attending to verbally presented instructions). All he had to offer is that DD might benefit from academic tutoring. That didn't make sense to me, so I wanted another opinion.

The optometrist did a number of tests with DD to test how her eyes function as a team - the testing was much more detailed than what the ophthamologist did. DD can see things at a distance just fine, but her issues are with saccades and convergence. So, if you bring a pencil from a distance to DD's nose, she'll start to recoil in discomfort at about 6 in. away; she can read a vertical column of numbers with no problem, but she has difficulty reading horizontally across with accuracy (e.g., she'll skip words, lose her place, cover one eye, etc.). The optometrist did recommend vision therapy in addition to the glasses to target the weak areas. I didn't find the VT recommendation unreasonable (est. 6 months, once a week, plus at-home exercises). I realize others such as the PP (and DH frankly) are skeptical.

As I see it one of three things is happening: (1) DD doesn't have a vision issue, and any issues she has are neurological in nature. (This is the ophthamologist's view.) (2) DD has a vision issue, but there's nothing that can be done about it. (That's where we are now.) or (3) DD has a vision issue, and there is something that can be done about it. (Optometrist's view.)

The vision therapy exercises (for example, training the eyes to better track text across a page) make sense to me. It seems to me we've pinpointed the source of DD's issues, and I'm not aware of any way to address them other than what the optometrist recommends. Again, the ophthamologist provided no meaningful help. If anyone has any other ideas, I'm all ears!

[Anonymous]

Anonymous wrote:Amen, PP!!
OP: Please take your child to a pediatric ophthalmologist and stop with the developmental optometrist. I highly recommend Dr. Vicente: http://www.pediatric-ophthalmology.com/html/doctors.html

8:14 here. LOVE Dr. Vicente. Op, my ds did not have the issues your dd is having with reading. If the therapy helps, continue. If you want a second opinion from an opthamologist, I highly recommend Dr Vicente. He understands vision therapy and it's benefits and limitations.

[Anonymous]

If money is no object or if by some crazy chance your insurance covers the VT, try it for a few months as you have really nothing to lose and should start to see some benefits during that time. However, perhaps just time and maturity may also be the reason for the improvement. I am one of the PP who are very skeptical about developmental optometrist as we wasted a not insignificant amount of time and money being evaluated by one who prescribed unnecessary glasses and VT (which we did not do at the recommendation of the pediatric opthalmologist who said it would be a complete waste of time and money). My DD got better (reading and handwriting, etc. were issues for her) on her own. Good luck and let us know what you decide!