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Frequently Asked Questions

"My child passed the vision screening test at school and at the pediatrician's office, doesn't that mean their vision is fine?"

Many children successfully pass school eye screenings that may still have vision problems because most screening tests only check a child's distance vision. Only children who are nearsighted (myopic) or who have a severe 'lazy eye' (amblyopia, strabismus) will fail this screening. Children who are farsighted (hyperopic), have astigmatism, or who have much more subtle, and often more debilitating problems with eye movements, perceptual skills and control of their ocular focusing system may pass these test with flying colors.

For more information visit What is Vision?

"At what age should my child have an eye exam and who/where should I schedule the appointment?"

According to the American Optometry Association (AOA), your child's vision should first be evaluated at 6 months of age. This is when the structures of the eye are fully developed. If all is well, your child should be examined again at age 3, then again before beginning school. Once you child has started attending school, they should get examined every 2 years unless your doctor advises otherwise (Adults should be examined every 2 years, too!).

Remember, it is good to get a clean bill of health from your eye doctor. Eye exams should be though of as wellness exams. Just like seeing the dentist, you should visit your eye doctor before something is wrong.

For very young children, up to age seven, a pediatric optometrist would be recommended. They often have more specialized equipment to test young children who don't yet know their letters or numbers and who cannot yet follow some of the standard tests used on most adults. Optometrists who specialize in pediatrics often note this speciality in their business listing. Doctors who list an association with the American Optometry Association (AOA), College of Optometrists in Vision Development (COVD), or specialize in the areas of vision training, vision therapy, or sports vision are also good resources.

For further information on these organizations see Recommended Links.

"What is the difference between an optometrist and an ophthalmologist?"

Both ophthalmologists and optometrist are highly trained eye doctors with different areas of specialty.

An optometrist has spent four years beyond an undergraduate program in a professional school earning a doctor of optometry degree studying the body and how it works, but really specializing in how the eyes works and the fundamentals of visual function.

Their training primarily consists of the following: learning how to test for refractive error, prescribe glasses and contacts, how to test visual skills and treat problems when detected, treating eye diseases and conditions, managing disease with pharmaceuticals, and co-managing eye surgeries.

Ophthalmologists also spends four years in a graduate program in medicine or osteopathy. Then they spend four years of residency specializing mostly in eye surgery, but also in how to manage and treat eye diseases and conditions. Some ophthalmologists also prescribe glasses and contacts, but very few gain training in the function of the entire visual process.

"If the optometrist recommends vision therapy for my child will insurance pay for it?"

Many plans now cover some vision therapy (VT) sessions, but every insurance plan is different. Some plans will cover it without a referral. Others require a referral from an ophthalmologist or primary care provider. Some plans require certain diagnoses in order for them to approve coverage. Then there are the insurance companies that consider VT preventative or homeopathic care and will not cover it.

Most optometry offices handle a large number of insurance plans and often know if your particular plan is accepted and many are often willing to call for you to verify your benefits as they know the proper steps to find this information.

When in doubt, ask your eye doctor that provides vision therapy. If they can't answer your questions, they can tell you what you need to ask your insurance company in order to get a good answer.

"Is vision therapy only useful for children?"

Vision therapy (VT) can be useful for people of all ages but undoubtedly the plasticity so apparent in children is not seen to nearly the same degree in adults. Adults can be set in their ways and be less resistant to change, but it all depends on patient motivation. Who says you can't teach old dogs new tricks?

VT can work for adults, but the rates of progress and therapy strategies may be different. Another aspect to consider is the type of dysfunction being treated; different problems respond more readily to VT (but this also applies to kids,too).

An ever growing and more specialized area of VT is treating people who have suffered traumatic brain injuries (head injuries, strokes, etc.). 85% of our brain is involved in vision and brain injuries can really affect visual skills. The people who are affected come in all ages and sizes.

For more information on traumatic brain injury, you may want to visit the Neuro-Optometric Rehabilitation Association International (NORA) site to learn more.

"I am over 40 and need bifocals. Will VT help me?"

VT cannot remove the need for reading glasses or bifocals as our vision ages (presbyopia), however it has been shown that doing VT exercises prior to the onset of presbyopia may delay the need for reading glasses or bifocals and the power needed may be reduced as compared to cohorts.

Unfortunately, presbyopia happens to everyone. As you age, from your late teens on, you slowly lose your focusing ability (accommodation) due to the lens that focuses the light getting bigger, less flexible and the way it pushes against the muscles that flex it. All these things eventually make it too difficult for you to change how the light comes into the eye to make things clear.

"Can taking vitamins improve my vision?"

Vitamins, particularly the antioxidants with lutein, are showing great promise in delaying changes associated with certain eye diseases, such as those associated with age-related changes. However, there is much controversy surrounding the use of vitamins because of the difficulty to study the affects of JUST vitamins without other factors such as age, sex, race, environment, current health, heredity and so forth. Some professionals need definitive proof, while others are satisfied enough with the studies out there to recommend vitamins.

Vitamins do not seem to affect refractive error, however, so vitamins will not lessen your need for wearing glasses or prevent you from ever needing them.

"Why is this refractive vision problem (nearsighted/farsighted/astigmatism) showing up now?"

Vision difficulties can "show up" at any time, however some definite trends have been noted. Studies have shown distinct trends toward myopia (nearsighted vision) in certain age groups, primarily ages 8-11 years old.

During this same time frame, usually around third grade, we find that the size of text gets smaller and the classroom demands get more intense. Not only are students asked to read smaller words on a page, but they are reading more words than ever before AND now have to add reading comprehension! This change in reading demand can will impact kids with fragile visual systems.

Some kids are just not caught earlier on because they have vision problems that are not as easy to spot by parents and educators. For example, a child that is farsighted can often "hide" or cover up their farsightedness (involuntarily) by putting their focusing system into overdrive. Eventually due to constant stress the system breaks down and the child cannot compensate any longer. Third grade is a good time for this.

Care by the doctor should be taken when prescribing lenses by taking into considering their patient's age, visual skills performance, overall development and environmental demands.

"Will wearing glasses or contacts make my vision worse?"

If glasses or contacts are worn appropriately this should not create any problems. Glasses for hyperopia are generally worn at all times and a prescription with extra power is sometimes needed for near work. Prescriptions correcting large amounts of astigmatism should also be worn full time and at all distances. Myopic corrections for most people should be worn to see clearly in the distance and taken off to do near work (homework, computer work, reading, desk top work). There are cases where this is not possible, such as myopes with high prescriptions and people with certain types of visual dysfunction. Many times, one pair of glasses is not the ideal wearing regiment. A second pair of lower powered lenses or a bifocal may be needed up close (even over contact lenses) for optimal visual function.

Contact your doctor to see what wearing schedule you should be on so your prescription is worn appropriately.

"Will I become dependent on my glasses or contacts?"

People sometimes feel they have become dependent on their glasses when the more likely case is that they have grown used to enjoying seeing things clearly and when the glasses are removed the world is not as sharp and crisp in appearance. Now that you have a basis of comparision, it feels like your eyes are getting worse, but in fact, your level of tolerance has changed.

Some people can make their vision worse by wearing their glasses or contacts inappropriately. See your doctor if you are unsure of your wearing schedule, or if you want more information about different pairs of glasses for different types of activities that may be more appropriate than the one pair you may have.

"Will wearing glasses or contacts, improve my vision?"

Most of the time glasses and contacts will not improve your vision, but only compensate for the refractive error you have. They are an aid, not a cure for your refractive error.

There are doctors, however, that may use glasses or contacts as part of their vision therapy regiment that CAN make long term improvements to their patient's vision.

For more information on vision therapy, click here.

"Can refractive surgery correct my vision problems?"

Laser refractive procedures are becoming more common everyday. Just as the procedure says, refractive surgery is intended to correct REFRACTIVE problems that include myopia, hyperopia and astigmatism. This will help you see clearly, but problems related to visual dysfunction WILL NOT be corrected by these procedures. People with fluctuating prescriptions are not candidates for these procedures. Most surgeons will not touch children or adolescents, either.

Patients who are nearing 40 years of age or older should be aware that correcting their distance vision will not eliminate the need for near reading glasses. An exception to this statement is the patient who has successfully functioned in a state of monovision, (one eye corrected to see in the distance and the other eye corrected to see up close). These people may have the option to have the refractive procedure done correcting the eyes in a state of monovision. Monovision works very well for many patients, but it does affect binocularity and glasses worn during driving, to re-establish binocular vision, should be worn.

Refractive procedures will not prevent the development of cataracts that come with age; cataracts can cause refractive error to change and involve an additional surgery to be removed. The good news is, cataracts are generally not a problem for most people until they near 70 years of age or more; a thirty year old patient having a laser refractive procedure could reap the benefits for decades before these issues arise.

If you are seriously considering a refractive procedure, you should discuss whether you are a good candidate and surrounding issues with your eye doctor; educate yourself. Most institutes performing these procedures have free seminars to discuss risks and benefits. If you attend a seminar, go prepared with questions. Ask questions like...How many procedures has this doctor done? How many surgeries of the particular procedure you need has this doctor done? What is their success rate? What does the procedure entail?

"If I wear glasses/contacts and/or had learning difficulties as a child, will my child have the same problem?"

There is a chance that your child's chances of having similar problems that you experience are increased if a parent has refractive problems. The same is true with learning difficulties and visual dysfunctions. This can happen for a number of reasons, including heredity, similar environment, and similarly learned behaviors and adaptations.

If the parent has/had any of these issues, regular and thorough vision exams are strongly recommended for their children. Remember detecting problems early increases your child's rate of success and can possibly prevent or better manage vision changes that may occur.

For more information on risk factors, click here.


   

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