vision therapy

[buggaboo2]

My daughter, 6 yrs old, has had vision prob. since birth.  at 12 mo. was dx as blind without known cause, by 12 months seh could see, still unknown cause. She has left and right strabismus surgery helped right eye but didn't help left.  She has nystagmus, ambliopia, no or minimal depth perception, convergence insuff. exotropia, and is far sighted vision corrected is 20/40 left and 20/60 right.  we have taken her to ped. opth. since birth and have always followed the patching sched. and other orders given us.  she suffers significant developmental delay all gross motor skills were delayed as well as fine motor difficulties, speech was extremely delayed.  she is on grade level with great difficulty in reading, has a one on one teacher aid and has been in special education since age 3. her ped. opth recently mentioned Occualar motor apraxia but doesn't support special education services so won't discuss it any further with us.  I have looked up as much info online as possible but unfort. there isn't much avail.  I am looking for a new ped. opth. but hate to switch drs as there is so much history to explain.  anyway, recently I heard about vision therapy and from everything i read it sounds promising.  I understand most opth. don't believe in this therapy, is it was hoax or is it worth giving it a try. I want my daughter to have every opportunity to advance in school and eventually get out of special ed.  she is very smart and besides the vision problems causing her to have diff keeping up with reading and diff. tracking she is an A student.  Please give me your oppinion.

[Forum-OD-MP]

vision therapy certainly has its place in optometry.  it is not a hoax, but it is not a cure-all, either.  radio ads and some fringe practitioners imply that VT can fix more things than i think it can fix.  YES it is likely that she could improve (but unlikely to get rid of) her exotropia and convergence inssufficiency with VT, and possibly also improve her depth perception.  it is fairly unlikely IMO that she will improve her acuity, nystagmus or amblyopia.  but possible, i guess.

you'll have a hard time finding someone to do it.  even in metro areas docs who specialize in VT are fairly rare.  and none of them are ophthalmologists.  you'll end up either switching to an optometrist or adding an optometrist to the list of doctors she sees.

if she and you are considering further surgery, then you need to stick wih a pediatric ophthalmologist.  if not, switching to a VT optometrist is probably a good idea IMO.

[buggaboo2]

thank you for your input, I have found an OD that does vision therapy in the Atlanta Metro area, EVEN our medical coverage is cooperating!! Another concern I have is that I strongly feel my daughter MUST be followed by an Opthamologist and am afraid of the conflict which will more than likely come up.  OD has already mentioned changing her glasses to include Prisms, this is confusing to me and I can't go ahead with the diff. Rx without confirmation from Opth.  I hope the 2 can work together!! What is your take on prisms, does it make a diff.  Thank you

[Ag-i-doc]

whats my take on prisms?  some people need them, some dont.  if your daughter has an obvious constant exotropia and you are not considering further surgery then it is probably a good idea to at least consider them.

you'll end up seeing both the pediatric ophthalmologist and the optometrist likely.  good luck.  they might conflict in their treatment options, in which case you'll ultimately have to make the final descision.  

the local pediatric ophthalmologist in my town and i have frequently butted heads on what treatment to give.