Developmental eye exam

[Anonymous]

Has anyone had one of these? How are they different than a regular exam? Are they typically covered by insurance? Is it a single meeting like a regular exam?

[Anonymous]

DS's was covered at 80%, but he does have a cerebral palsy diagnosis. I don't know if that makes a difference. We went to Children's and saw Dr. Jafaar. He's got the personality of a rock, but he's good. The exam takes several hours, so bring snacks and something to do for both of you. Eyes will be dilated, and that what takes the longest. You can leave and come back while you wait for the eyes to dilate. They check distance, color blindedness, how well the eyes work together, depth perception, how well the eyes transition, movement, and tracking. They can adjust the testing for infants, as well as older kids. The only "scary" part is having the eyes dilated because it burns a bit. This is all done in one visit, but depending on what is found there may need to be follow-up visits. These are typically several months out. One thing to keep in mind is that scheduling an appt. can be a pain because these specialists fill up fast and tend to stay filled up.

[Anonymous]

OP here, would you do a regular eye exam first? Our OT suggested have a developmental eye exam to look for tracking issues.

[Anonymous]

PP gave a pretty good analysis. We had it done (though I didn't know that's what it was called), because DS had a wonky, drifting eye. They tested anything and everything, and diagnosed him as needing a patch. Now we go back every 3 months to check for progress.

There is no need for a regular eye exam first. They will test what the regular exams test for.

[Anonymous]

We went to the Wilmer Eye Institute in Bethesda for this testing.

[Anonymous]

Did your OT recommend seeing a vision therapy practice? Those are usually optometrists and opthomologists are usually skeptical, or downright critical of them. We have e regular opthomologist who does all those things mention above with my DD's regular exams. As soon as I mentioned the OT, he was did not mince words about what he thought. (I disagree, but it is controversial. Research vision therapy for more on this.)

And FWIW, many insurance plans do not cover exams by an opthomologist unless there is a specific problem or diagnosis. And medical plans often don't cover optometry. So make sure you ask first for whichever you schedule.)

[Anonymous]

Vision therapy is a service being sold as opposed to a medical treatment. Before paying a lot of money for it consult a pediatric ophthalmologist.

[Anonymous]

Vision therapy is a service being sold as opposed to a medical treatment. Before paying a lot of money for it consult a pediatric ophthalmologist.

I vehemently disagree with this statement! One of my biggest parenting "regrets" is I didn't understand earlier how limited an ophthalmologist exam is. We had been dutifully taking our DD to a Washingtonian best type pediatric ophthalmologist from when she was an infant and we had strabismus concerns. OT's had mentioned developmental optometry even when she was a toddler but it never rose to the top of the priority list. In 2nd grade yet another OT eval noted possibility of concern with eye movement - nothing definitive just a "might want to look at". I took her to the ophthalmologist who put it in writing that there was not a problem. For whatever reason I still didn't feel right about it and made an appointment for developmental exam. All the optometrists recommended by the OTs had waiting lists and were in traffic prone locations so I made an appointment with Dr Borsuk totally based on his location near I-270. It was amazing - even from the other side of the room I could tell that my daughter's eyes were not moving in sync with each other when he asked her to move her eyes while spelling her name backwards (simple cognitive task). I've since learned that the ophthalmologist only checks what they eyes themselves are able to do in "perfect" office conditions - even when parents specifically point out school problems. In hindsight, it makes sense that her eyes might be impacted by the fine motor integration problems the OTs noted but we would not have found that out if I'd stuck with the pediatric ophthalmologist.

Vision therapy was a pain in the neck for me as it was 9 months of twice a week therapy but it was incredibly effective. Unfortunately not all the therapy was covered by insurance but that is largely because we switched insurance half way through to one that offered better OT coverage. Given that we knew there was an end in sight for the vision therapy it made sense to switch for better OT coverage. (n.b. OT has no end in sight because there are so many areas to work on - not because it isn't effective)