Convergence Insufficiency and Vision Therapy - Experiences

[mama2alex]

For those who've done vision therapy with your child, can you tell me what benefits/improvements you saw? Was it worth the time and money? Has it improved your child's handwriting, focus, grades, mood, overall happiness?

 

This just happened to come up when our LLMD was doing an exam on my son for a summer camp form. He said it looks like he might have convergence insufficiency and urged me to have him evaluated. I've been doing a little reading and was surprised to learn that CI can cause ADHD symptoms, something we're also taking a close look at right now, as well as ODD symtoms, which we've seen all his life. My son seems to read well and likes it, but he avoids writing like the plague, is bright but doesn't always do well on tests, and has a lot of trouble focusing on homework.

 

The evaluation and therapy are expensive, so if anyone has seen great results please let me know. I need to know we are not flushing money and need to be able to convince my husband, if I decide this is something we should pursue.

[Hopeny]

My dd has it bad. Not sure where you are located but two llmds recommended Padulla institute in Connecticut. One llmd told me not to do vision therapy but to go to Padulla for prism glasses. Also a fortune. However llmd said school must be torture for her. I was going to do vision therapy but now thinking about trying to see Padulla, not sure where to get the funds though. Curious to hear what others think.

[LNN]

We've done 22 weeks of vision therapy so far. Will finish up in two weeks. The Dr would like her to continue b/c her progress has been slower than expected but the piggy bank is empty. The Dr checked her lens prescription last week and her vision is somewhat better than it was before we started. The prism lens that corrects for the CI has also been hugely helpful. With her glasses on, she is a much stronger reader and can read for longer periods without fatigue.

 

My DS also has CI but we couldn't afford to do therapy for both kids at the same time and we'd already spent so much money on DS for medical. Plus DD is younger and would likely gain more from the therapy. So DS only has the prism glasses without the benefit of therapy (tho they both did home exercises for a period of time). Even without professional/in office therapy, he too greatly improved in his reading abilities. He was less diligent in wearing his glasses (he has 20/20 vision and found the bifocals distracting when he wasn't at his desk). But since he's been wearing them for reading, there's a huge improvement. Went from reading Diary of a Wimpy Kid as a 5th grader to Lord of the Rings in a matter of a few months.

 

We paid $100 per session (got a discount for paying for 12 sessions at a time), which was broken into 2 charges on the insurance claim form ($60 and $40 but don't have one in front of me to tell you what each charge was for). We had Cigna when we started in '12 and Cigna denied the $40 service and paid 60% on the $60 service, so we got a whopping $36 reimbursement. In '13 we had to switch to UHC and they pay 60% of the $100, so we get $60 back. So is the therapy worth $100/week? No. Was it worth $64/week - maybe. Is it worth $40/week, yes.

 

The glasses are a different story - a resounding yes they are worth it, no matter the cost. We paid $200 for the initial 1 hour exam which assessed whether they had CI and also what their lens prescriptions needed to be. The prescription had to be filled by a local optometrist the doctor recommended. We couldn't use lenscrafters or a Walmart/Costco operation. They aren't equipped to handle prism lenses. The lenses were about $150ish and the frames were on top of that. This fall, when it's time to get new lenses, we'll get DD's new frames at a cheaper place (she's outgrown the old frames), keep DSs frames and then bring the frames to the "special" optometrist to have him order the prism lenses for the frames we provide.

 

I don't rule out doing vision therapy for DS tho braces are around the corner and the car has 180,000 miles on it, so I don't see us having spare change anytime soon. But I do plan to continue the exercises at home and to keep both kids with the prism glasses for probably another year.

[LNN]

Hope - a friend of mine sees Padula and has not been happy. Her biggest gripe is that she never knows what she's going to spend when she sees him. It "depends" on how much time he spends with the patient. He doesn't do vision therapy but instead wants her to take her son someplace that does biofeedback - to the tune of $5K! Since October of last year when we both went down this path, we've probably parted with the same amt of money but in different ways. Both of our kids have made great progress with schoolwork. But both of us have reservations about our respective doctors. (my biggest gripe is that my dr doesn't give me progress reports and I felt in the dark a lot of the time). My friend is considering switching to my doctor but I suggested she try the exercises at home for the summer and then decide. I'm meeting her on Saturday to give her a copy of our exercise worksheets and teach her how to do them. It won't be perfect and her son would probably benefit from professional therapy - but at what cost?

 

Like I said in my last post, for $40/week, yes it's worth it. For $100/wk, well....maybe if we weren't all bleeding cash already.

 

I will say one thing in favor of my doctor - after our initial 1 hour ($200) exam, she gave each kid a neuro/vision assessment to measure how their eyes/brains interpreted information. A 2 hour assessment ($475) where they had to say which shape might come next in a pattern, which letters were reversed in a paragraph of text, whether they could do certain eye-hand coordination movements...I was shocked at how many things the kids got wrong. She then wrote a 15 page assessment along with specific recommendations for 504 Plans that the school could implement. The school was quite impressed and never questioned the need for 504 accommodations based on her report. The fees for these exams were covered by medical insurance 60%.

 

This site http://www.childrensvision.com/reading.htm has a great visual aid for helping you understand the issues CI gives our kids and there's a "find a doctor" under the additional resources tab. You can probably find someone much closer to you than Padula and if as long as the economics/insurance work for you, I'd consider vision therapy - least for a few months. I found a few research studies that do support the efficacy of VT plus prism over a 3 month period of sessions. (I think prism glasses alone ranked 2nd in terms of efficacy, pencil pushups didn't help at all).

Edited June 5, 2013 by LLM

[Hrosenkrantz]

My son had a vision therapy eval a few weeks ago. I was told he has convergence issues and will get a report soon. One thing that struck me was how much more expensive, for no apparent reason, the eval was than others we have done -- ie speech and OT evals way less expensive. The price seemed to come out of thin air.

 

We had to do the eval over two sessions and wasn't entirely effective bc our son is in the middle of a pandas flare.

[dcmom]

I am interested in this subject, and wonder if those who have done an eval or more, can elaborate on what symptoms, if any their child has displayed.....

 

My younger dd has a little trouble keeping her place when she reads. She compensates for this by using a bookmark to slide down the lines as she reads. She is an avid reader, reading by choice for sometimes hours per day. She understands and retains what she reads. But I wonder why she cannot keep her place, and if this affects her at school when she is w/o the bookmark.

 

She also has complained of seeing "floaters" (?) in the past. (shapes, of various colors, that are not there, floating around the room). I don't know if this is and eye symptom or a pandas symptom, or unrelated.

 

We are seeing a pediatric eye doctor in a few weeks, as our ped recommended checking it out. Don't know if they will have much to say, but we are also being screened for uvitis (sp?).

 

Are eye tracking problems the same, or part of convergence insufficiency?

 

thanks!

[Hrosenkrantz]

The reason we were referred was because our son was having a hard time seeing/two dimensional shapes, but was very sophisticated 3-d images. So he could build and understand and process elaborate block structures and puzzles, but has a very hard time focusing and seeing a letter on a page. That's because its tougher for his eyes to "converge" on that single point, if that makes sense.

[LNN]

I wanted to make time to update my posts from last month. Last week, my DD had a re-evaluation from the behavioral optometrist - an abbreviated (1 hr) assessment similar to her initial assessment last fall. After 22 sessions, DD made very significant improvements. In one probem area, she went from testing at 4 deviations below normal to 2 deviations above normal. In another measurement, she went from the 0 percentile (unable to complete one cycle of an exercise in 60 seconds) to 38th percentile (able to complete 10 cycles of an exercise in 60 seconds).

 

In about 2/3 of the areas where she had tested below average, she is now at or above average. The doctor would like to her to do 12 more sessions to work on the remaining areas of weakness. After taking a month off in July, I'm now feeling that it will be a wise investment and we'll re-start in August. I'll also probably scrounge up the money for DS as well. If we can find $5-7K for braces to improve cosmetics, then it seems well worth it to spend a few thousand to improve their eyesight. I have to say, seeing the test results - measurable, definitive - made me feel much better about the whole thing.

 

I have no idea how Pans plays into CI - those with certain neurological disorders like Parkinson's seem to have a higher than average rate of CI. But I also believe that sometimes I may have blamed Pandas for reading or school problems that instead may have been CI-related. I'm now glad I can look back and say we treated both conditions.

[mama2alex]

Thanks for the update LLM! I think we are going to move forward with an evaluation. I just need to look at the doctors in our area and try to figure out who's best.