Vision problems but eye exams are fine...any remedies besides glasses?

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1

My oldest son, 15, has been complaining since he was in K that he couldn't see the board in school. Naturally, we had his vision checked and his exam was fine, his eyes were perfect. In first and second grades we were going through the process of figuring out what his problems were in school and he was diagnosed with some learning disabilities, including visual tracking problems, and AD/HD - inattentive, and again had his eyes checked and again they were fine. His LD accommodations call for him to be seated in front of the room so that took care of the seeing the board problem. In 3rd grade he was found to have Irlen syndrome, which is when the eyes see text abnormally on the page (e.g. tracking the white spaces between words instead of focusing on the words, being distracted by the glare of light bouncing off of a page) so for a while he read with a colored transparency. Fast-forward to 9th grade and he's been complaining of blurry vision when looking at things from a distance (e.g. the menu board in a coffee shop or fast-food restaurant) and eye strain and fatigue when reading. His pediatrician did a check in her office and noted that one eye was 20/25 and the other was 20/30, which is normal vision for a teen and wouldn't account for the level of complaining he has. So we went to Children's Hospital Boston's eye clinic to once and for all have him get a thorough eye exam from the most reputable clinic around here. He got the full workup and...his eyes are fine!

The doctor did prescribe +0.75 glasses, which are basically reading glasses. She said that they will magnify text close-up but won't do anything for distance vision. She said that they might not even help and suggested that we go to a drug store, have him bring a book and try on a pair of reading glasses there and have him read for a while to see if they help. If they do, then we can go ahead and get him something a little more stylish with the prescription.

They also have a behavioral optomotrist who might be covered by insurance. We looked into behavioral optomotry years ago for him but it wasn't covered by insurance and was thousands of dollars with no science to back up whether or not this field actually works. The doctor did suggest that although structurally his eyes are perfect, and some parts of his vision are exceptional, such as depth perception that it could be a case where some of the neural connections that form in early childhood didn't form strongly enough or at all and that's why his vision seems weak. More of a neurological problem than a vision problem. She said that there's nothing that can correct that.

Has anyone experienced anything like this and was there anything you were able to do to improve vision? I'm pretty open to supplements, exercises, etc. but I can't really find the right term to search for to find more information. The general vision weakness would be technically be amblyopia, but that's normally caused by an structural abnormality of the eye. Has anyone done behavioral optometry? We'll of course check out the reading glasses and I hope they help with the strain of reading but it would be nice to be able to help him with distance vision as well. Thanks!

2

Is behavior optometry the same as vision therapy? Vision therapy has helped many children, and they also do it for adults. My own eye doctor recommended that I get an evaluation because my eyes jump while I read. (Part of getting older…) She said that vision therapy could help me.

Here’s the thing. It may not be covered by insurance. But vision therapy has helped a lot of people. Not everyone has insurance to cover braces but they pay for them anyway so that their kids can have straight teeth. Eyesight is even more important than straight teeth. Do this for your son.

3

I haven’t heard of “behavioral optometry” but my son does see a developmental optometrist. He had fairly severe tracking and convergence issues but has made a great deal of progress. We did vision therapy with our developmental optometrist for about 6 months, but what I think has made the biggest difference is YEARS of work with our reading tutor (she has a master’s degree in reading disabilities).

Your post rang a bell with me because my son recently got reading glasses too. Otherwise he has almost perfect vision (technically).

I agree that there is a heavy neurological component to all this (that’s my hunch anyway) but working those muscles does help too.

My son went from being able to sit for about 5 minutes of reading with his tutor, to a full hour. And he reads past the high school level.

We’ve been homeschooling since 3rd grade (9th grade now) so we have been able to spend a great deal of time on this issue. My son has been back in the classroom setting for various classes and seems to function better.

Good luck - just wanted you to know that you are not alone, and give you our experience.

4

No, but I hope he uses a reading guide. It can be a ruler or just a piece of paper under each line of text.

I tutored a child that was really having trouble reading. I had him read aloud to me and that is when I noticed..he seemed to jump words and sentences. After he finished, I asked him to tell me what he had just read.. He could not recall what it said.

I folded a plain sheet of colored paper and had him use it to guide his reading..all of a sudden he was reading without any mistakes and a lot faster. I then asked him to just tell me what he read.. He answered correctly.

For some of the reading, if it was very detailed , we made a card that blocked the word to the right and the next line. This way he would naturally slow down and concentrate on each word..

Not sure about the distance reading.. It may take some sort of special therapy..

5

Does he play a lot of video games? If he is on the computer or game system alot, he may have eye strain, which will cause problems when you are looking at things not on a screen. For example, after a while, I start to see black floaters.

If you want to try the glasses, CVS, Walmart, Walgreens, etc all sell reading glasses. Costco has good prices on glasses and a 3-5 day turn-around on prescriptions.

There are also several online sites that are good. Coastal.com is a good sight, and your first pair of glasses are free!

You type in your prescription, and they send you your glasses. The downside is that you can’t try them on. So maybe you could go and try some one to see what styles work best. Example, my kids look best in glasses with rectangular lenses. My FIL prefers round lenses.

We went to an optomotrist that gave us some vision exercises.
You can print out some charts, have your son cover one eye and read every other letter or word.
You can put some words up on the wall, using a stick or a laser pointer, have your son touch each word.

My kids also have slight balance issues because of their vision. So we had to do exercises like

  • standing on one leg, while trying to pick up cheerios with tweezers
  • hold up 2 fingers in front of him. Keeping one finger still, and not moving his head, have his eyes follow the 2nd, moving finger. Switch.

We saw an opthamologist last year that said they agreed with the prescription, but didn’t think it was extreme enough for glasses so my kids have stopped wearing them. I don’t know if the exercises made a difference since the two exams were 9 months apart, but I think they helped.

Another thing that happened in that 9 months is that my son got a concussion playing sports. During his evaluation, we determined that he had had a concussion back when he was 7y, bad bike accident, that we didn’t realize and that some of his school issues for the past 3 years and his vision problems were related to that. It took 3 months to get him cleared by the Concussion Specialist. Many of the problems that we’ve had with school for the last 3-4 years have vastly improved.

6

I don’t know if this is applicable to your situation, but we found an optometrist who did an eye exam which focused on eye function/eye teaming as well as acuity.

Kiddo has 20/20 in both eyes, yet also has convergence dysfunction issues and ocular motor dysfunction. Both have been improved by eye therapy and using eye exercises. The convergence dysfunction was strengthened and is supposedly corrected (for now-- we go for a re-exam in August.) The ocular motor dysfunction is the trickier one: he’ll have it all his life and the therapy works to provide correct biofeedback for the eye/brain. The latter is the more challenging of the two to address, which is why we re-exam in August and will likely restart therapy exercises for a while.

If you haven’t heard about PAVE, here’s their website (they are a resource for parents of children who have vision issues):

Sorry I don’t have more to offer.

7

So though all of this it has never occurred to you that this is his back up excuse? I am really not trying to diminish what you are going through it is just I know the mind of a person with ADHD, I have it, my kids have it.

I was never a bad student, just a bored student. It was just when I did get in trouble, or miss something, or not write something down, I threw every excuse in the book at my teachers and parents and if one stuck it was golden! That would be my go to excuse for everything.

Yes, I have seen this in my kids as well but I raise the BS flag quickly because if there was a rule to be broken, an excuse to be made, I had already covered that in my youth, yes pity my children. :slight_smile:

If you stare at anything even for a short period time, well it takes me four seconds to make my eyes go out of focus, everything blurs.

With my kids, other than the BS flag, I found out why they were making excuses and figured out how to help them not make the mistakes that were causing the excuses. Much more effective.

Not saying this is what is going on with your son it is just a lot of what you said mirrors some of my life experiences so I thought I would share.

Oh and yes, every single one of my four kids claimed vision problems by fourth grade. By sixth, two had glasses. My son who just finished eighth got glasses this year. It is a fairly common excuse.

8

We’ve got a friend with a daughter with convergence insufficiency .
Perfect vision. Often misdiagnosed as ADHD. Quick, east check by an opthomologist. Lots miss it!

9

My oldest was diagnosed with vision problems too but not eyeglass stuff. She’s just starting vision therapy. And no, it’s not covered by insurance. But if Children’s Hospital did a full workup, seems odd they don’t find anything. A regular optomitrist spotted her problem fairly easily and then sent us to a specialist. Her pediatrician did not id the problem. She also has 20/20 but can’t focus between near and far quickly like most people, one eye turns off sometimes and her tracking is poor too. But they’ve checked for all this?..

10

Let me ask a simple but overlooked quesiton - does he spend time playing games on a smartphone or ipod? I know that eye fatigue is much more obvious and quick to present after playing on these for as little as 30 minutes.

In my freshman year of college after my first round of final exams and all the cramming and studying that go into a 4-5 day period I was scared / astonished when I couldn’t focus on signs that were only a few aisles away in the store from where I was standing, I had worn glasses & contact lenses for a number of years by that time so I knew what blurry vision was. The next morning after a good night’s sleep my vision was back to normal (correctable with lenses). Fast forward 30 years and now if I get caught up in a stupid iphone game for a half hour, or if I’ve been reading on my kindle for a few hours I find my visions to be very blurry. With the smart phone games it takes only about 30 minutes to affect my eyes.

11

Have you taken your son to a Neuro-Opthalmologist yet? You only mention Optometry, and those are not MDs.

Visual distortion can be caused by many things, including migraine, dehydration, lack of sleep, etc. Have those factors been addressed?

12

Have you been to a Neurologist? One who specializes in Ophthalmology?

Good luck!

13

The muscles of the eye are controlled by adrenal hormones cortisol and aldosterone. Those hormones also control blood sugar and fatigue, concentration and attention (and so much more). Many kids with a ADHD diagnosis are actually suffering from adrenal imbalance or adrenal fatigue. Most doctors are not trained in endocrinology and will not recognize it as such. That is why the boom in ADHD. Those same hormones affect the nervous system and the hormones SEROTONIN, testosterone, estrogens, growth hormones, etc..Serotonin is low to non existent in adrenal fatigue. Many ADD drugs are serotonin ‘uptake’ inhibitors - which leave more serotoninin avail the body.

My daughter has low adrenals and has many eye issues… She gets blurry vision (it comes and goes depending on blood sugar levels) light sensitivity which causes headaches and nausea (especially florescents) , seeing objects differently (again blood sugar can come into play)… she has low aldosterone. Please lookup ‘adrenal fatigue’ and ‘hypoglycemia symptoms’ and do an extensive research.

14

Does it get worse at certain times of the year? Both of my six year olds have incredibly dry eyes and were presenting as if they had vision problems. Like you, I did multiple full workups to figure out what was wrong. One doctor finally suggested eye drops as a way to help until we figured out a real diagnosis, and voila - problem solved. The main problem had been blurry distance vision and the extra moisture in the eyes solved it.

So before you see another doctor, maybe try something like Visine?

15

My kiddo is younger but the symptoms you describe seem very familiar. My son always had normal eye exams but we knew something was going on that didn’t seem like straight ADHD. We saw a lot of specialists and one finally recommended a developmental optometrist. When we finally got in to see her, she discovered a convergence insufficiency and prescribed glasses to try to get his right eye to stay in focus. The appointment wasn’t covered by insurance but it was only a couple of hundred dollars plus the cost of the glasses and it.has.changed.our.lives. Immediate improvement across the board. After six months of just glasses we started vision therapy which has also been helpful. More expensive as we go every week but it’s been worth it.

Looks like you are also in Boston, so if you need a recommendation, let me know. Good luck!

16

J.B. I have a few quick questions for you. Have you ever had your son tested for diabetes? I have a patient that exhibited the same symptoms as your son, and what was found out after much testing and repeated fine exams, was that he was having sugar lows. My patient was borderline diabetic, so his vision sometimes was better than others (does your son notice a difference during the day, ie better vision after eating or worse? This is just a suggestion of what it might be. He could just have really sensitive eyes that do need the correction. I have patients that even though the doctor says it’s not a huge correction, the patient themselves see a major improvement. Another question I have is the type of prescription that the doctor gave him. Does it have a cylinder in it? If it does, the readers off the shelf will not give him clear vision. I have found several doctors telling patients that a reader off the shelf are fine. Unfortunately, that would be like looking through a pair of binoculars, but not adjusting the middle dial for the clearest vision. If he has just a sphere, then definitely try the readers. The other option could be a type of ocular migraine. There is no headache with an ocular migraine, just blurred vision and sometimes disorientation. The blurred vision can last extended periods of time. Hopefully, this helps some. If it was my son, I would have him wear slightly tinted glasses or glasses that have the platinum finish on them (anti glare) all the time to deal with the glare issue and tracking problems. It really makes a difference. One of the things that came to my mind in what you are saying is that if he has been having that much trouble with the glare/focusing on the white spaces, it might be that his eyes are just getting tired from straining which is causing the blurry vision. He has been trying to filter out all that extra stuff. I am wondering if a simple pair of glasses with the platinum coating on it would be just what he needs. You can get a decent pair of glasses fairly inexpensive now a days. An easy way to find out this is the case, is to have him wear sunglasses for a day and see if his vision is clearer. I would have him wear blue/green ones, brown ones or amber, as these all give better clarity than the dark gray. Just a few thoughts, good luck with all this. From one mom to another, these are just suggestions and not an actual professional opinion, even though I do work in the field.