I've heard that you can do vision therapy to help correct strabismus. Can anyone tell me any excercises I can do. Ive been to the doctor about it but I cannot get the surgery if its for cosmetic reasons(insurance). So I wanted to know if theres something I could do even if it only helps a little. I dont have severe strabismus but it is noticeable to some. Any help would be appreciated.
Please any ideas, I really need them.
See a pedicatric ophthalmologist who employs an opthoptist. He/She is the one with knowledge and training on this. Us opticians sho ain't the ones to ask.
Huh? You mean an orthoptist (there's an 'r' in there). We won't even start on the word "pedicatric"??Originally Posted by chip anderson
Joe, as much as Mr. Anderson has a huge chip on his shoulder and a gigantic bias against all things OD, what you need to do is to seek out an Optometrist who is a fellow in vision development/therapy. They deal with your type of condition routinely and would be most likely to help.
http://www.covd.org/membersearch.asp
Last edited by NC-OD; 09-08-2005 at 09:20 PM.
You would need treatment in orthoptics and pleoptics which usually has to be done at a very earlyy age to be effective. Here are some some links to give you an idea:
at: www.aoj.org/
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Terminology or glossary of Strabismology
Orthoptics, In the widest sense, it aims to re-establish comfortable (binocular)
and equal vision. ... The term was coined by Bangerter. ...
www.geocities.com/sapatney/terminology.htm - 62k - 7 Sep 2005 - Cached - Similar pages
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Willkommen bei RYSEROPTIK - [ Translate this page ]
Die Occlusivfolien nach Bangerter sind CE-zertifiziert. Die Bangerter Okklusive
sind CE-zertifiziert. Ryser Ophthalmologie führt das ganze Programm an ...
www.ryseroptik.ch/ - 102k - 7 Sep 2005 - Cached - Similar pages
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Diplopia
The management of double vision may include prisms, orthoptics, therapy, ...
With an eye to the world for related products, the Ryser Bangerter Occlusion ...
www.lowvision.org/new_page_1diplopia.htm - 5k - Cached - Similar pages
Joe a really good ophthalmologist would not have recommended surgery if exercises would correct the problem. Have you ever considered paying for your surgery (out of your pocket)? I do remember when people used to do this without relying on third parties (the government, insurance companies).
Chip
In Orthoptics and Pleoptics nobody claims that you can cure the problem with exercises.
When there is a strabismus.........there is amblyopia. On eye shuts off because the brain receives a double vision picture. This means that people with a strabismus usually have one good eye and one that that does not perform so well.
The eye that shuts off will get weaker vision with time. The exercises done in Orthoptics and Pleoptics, before and after corrective surgery are to improve the performance of the amblyopic eye.
This is not really true. You can, and many people do, have strabismus without amblyopia. There is accommodative esotropia, primary comitant esotropia, primary comitant exotropia, microtropia, cyclovertical deviations, A-V patterns, sensory strabismus, etc.....It can be constant or alternating. Obviously the constant variety is where the amblyopia comes in.
This poster says it's not too bad but is noticible by some people. As I mentioned, he would surely be better off finding a dedicated vision therapy Optometrist than a tech in an OMDs office. Many mild versions of strabismus have showed through research to be correctable throughout adulthood. Unless, of course, it is a great deviation in which case surgery is the only option for cosmesis.
P.S. I do not do vision therapy in any way, shape or form. But I did learn more about it than I wanted to know in school. :o
Last edited by NC-OD; 09-09-2005 at 08:37 AM.
Another and I hope my last thought. If the eye is capable of seeing to any extent the insurance company should consider this "corrective surgery" and pay for the surgery. If the eye sees very poorly this could be why it is "cosmetic only" and surgery is probably the only alternative. But still another consideration is eyes that see poorly have a nasty habit of turning in or out over time after surgery even if "straight" after surgery. Many surgeons I know are reluctant to do muscle surgery on eyes with very little visual potential for this reason.
Tech in an MD office................................
Here we go again.......one of the age old arguments...............just for information, orthoptists are in a full fledged profession as is an optometrist.
Her is an example:
ALLIED HEALTH PROFESSIONALS
TRAINING AS AN ORTHOPTIST
Pre Registration Orthoptic Programmes
EDUCATION
Orthoptic courses last for 3 years (full time) and lead to the award of a degree recognised by the Health Professions Council (HPC) for the purposes of registration.
The course leads to the honours degree of Orthoptics and provides the necessary training for professional practice as an Orthoptist.
The first year of the course provides the necessary scientific background for an understanding of the normal visual system, plus an introduction of optics and orthoptics. In years 2 and 3 you will develop a knowledge of investigation and the management of disorders of binocular vision. Opthalmology and Pathology are also studied in detail to enable students to recognise ocular disorders and to understand the disease process.
A total of 32 weeks of clinical placement are completed during the 3 year course - the placements are arranged in various orthoptic departments throughout the country. Students will undertake the clinical work under the supervision of clinical tutors
I'm with NC-OD.
I believe it is normally a 2 year training program after a 4 years bachelors degree. Extensive, either way. ("Qualifications, Education, and Credentialing Orthoptic students attend a 24-month post-baccalaureate internship in an accredited orthoptic program")
I did not mean to downplay a vital role these professionals play. But from what I gather, certified orthoptists are few and far between in the U.S. There is no need to reinvent the wheel. Strabismus, especially, small angle deviations, are the bread and butter of old school optometric training. I was put through years of it despite my lack of interest. Let a good VT OD either 'fix' the guy or refer him to a reputable surgeon for help. I'm just not sure an Orthoptist will be able to go from start to finish without further help from their "boss" the OMD who will have very little interest unless there is insurance or a bank account to pay for potentially unnecessary surgery. Keep it simple, I say. Start from the most logical source.
Last edited by NC-OD; 09-09-2005 at 02:20 PM.
A friend of mine is going throug this program at NY eye and ear hospital!
Its verrrrrryyyyy tough!
And this is after being an optician for a few years!
Am Orthopt J 41: 1 (1991).
Symposium: Perspectives in Strabismus: Celebration of 50 Years of Orthoptics
Introduction Maynard B. Wheeler, M.D.
We do not often take the time to step back and review our heritage. Tonight we have such an opportunity. The history of modern motility and orthoptics begins in Europe and Great Britain. We are more familiar with events and persons of English origin.
Mary Maddox, the daughter of the famous ophthalmologist, Ernest Maddox, was considered to be the first English orthoptist in 1919. By 1932 Legrand Hardy and Elizabeth Stark had started the first American Orthoptic Clinic in New York City.1 Twenty years later, in 1953, Alfred Bangerter and Conrad Cuppers in Europe introduced pleoptics which was to dominate the therapy of orthoptics for several decades.2 Fifty years ago, Conrad Berens was busy enhancing our examination equipment demonstrated by the first thermoplastic prism bar and a red/green fusion test for children.3,4 I will leave it to you to decide how far we have come since he introduced these.
Fifty years ago some ophthalmologists of vision set in motion the standardization of orthoptic training and skills. We all owe them a deep debt of gratitude as we are the beneficiaries of their foresight and energy. At the same time, the orthoptists formed an association with Julia Lancaster as its first president, now called the American Association of Certified Orthoptists. Today we wish to honor their historic step with this Symposium.
There are many other milestones and names which could be mentioned. However, we are here to listen to the reflections of our colleagues who have had more than the usual involvement in the field of motility and orthoptics, although perhaps none of them personally for the full half century.
REFERENCES
1. Edelman PM: Orthoptics. A Syllabus of Ocular Motility. Amer Acad Ophth, 1987, p.viii.© 1991 The Board of Regents of the University of Wisconsin System
2. Duke-Elder S, Wybar K: Ocular Motility and Strabismus in System of Ophthalmology, Vol. 6, 1973, p.433.
3. Berens C: A prism bar of thermoplastic material for measuring high degrees of squint. Trans Am Ophthalmol Soc 1939; 37: 404.
4. Berens C: A test for binocular vision particularly applicable to the examination of amblyopic children (modified Worth test). Trans Am Ophthalmol Soc 1939; 37: 406-407.
Presented as a Symposium at the Joint Meeting of the American Orthoptic Council, the American Association of Certified Orthoptists and the American Academy of Ophthalmology in celebration of the 50th Anniversary of the founding of the AACO, Atlanta, Georgia, October 28, 1990.
First of all, that is not true. There are plenty of article about adult strabismus affecting the quality of life for adults. The articles prove that people with strabismus don't get hired, get married, etc as often as people with straight eyes. I'm sure strabismus ophthalmologists can provide these for you.
Second of all, "cosmetic reason" is to improve, enhance something that is originally normal. Strabismus surgery is re-alignment of abnormal condition (eyes are not straight). You’re making “disfiguring” into normal. If you had a huge scar on your face, insurance would cover the procedure to get rid of it. Same is with strabismus.
Any strabismologist will tell you the same otherwise they would never get paid for adult strabismus surgeries.
Joe X, are you still visiting this thread ? If you do, tell me if you also have amblyopia. You should know I have strabismus and amblypoia (in my right eye) since birth ( I am 20 now) so I could give you some facts.
they will not cover for an adult. It is considered a cosmetic procedure. this is relatively well known.
you may have refractive strabismus, meaning your eyes could straighten with glasses or contact lenses.
Chamilun, if there's a will-there's a way. Trust me, they DO pay for it as long as you prove to them it's not cosmetic-read my reply above.
Yes I have both
Here is another link you can read up on the subject:
http://www.aoj.org/abstracts/41/41_1.html
All right Joe X.
About strabismus:
I am 20 now, and I made an eye surgery when I was 11 or so. NOTA BENE: I did have severe strabismus. The surgeon I went to is among the best in my country. Most people with my "used to have" strabismus condition would make this surgery more than once in order to dramaticaly reduce the eye flaw. I only had it done once, and my strabismus only shows when I wear off my glasses. However, it is not that bad, I would recon it is about the same situation you have. It is not severe, but noticeable to some. It really can't get any better than that, so my suggestion is not to make the eye surgery, even if wearing eyeglasses does not temporarily "fix" it. After all, eyes are very important, and if you are young , well, you have only got one pair.
About ambliopya:
Personally, I did not hear about terrapy for correcting strabismus, but have heard and practiced terapy for correcting the amblyopia. All the doctors you will ask will probably tell you that we must be at most 5 years old to correct this particular flaw. From my own experience, this is true. About at the same time(or shortly) after I had my surgery made, I started those eye exercises, which basically forced you to overlap 2 images on a machine (consisting of 2 moveable parts) - each image could be seen through only one eye, so this is how binocular view was forced. There was really no result. Actually, I even experienced double vision for some years after giving up exercises. You should be advised, eyecare is not a trifle. Cases where this sort of terapy actually gave pozitive results at maturity are very rare.
And one more thing. Your weak eye tends to become weaker, and, of course, lose acuity. My weak eye can now see only about 85% of a normal eye, even with glasses. That's how far it will go. So it is a good idea that, from time to time, 3-4 times a week, at home, cover your strong eye allowing your brain to use the other. This is how you prevent severe vision loss at the weak eye. I don't believe one could go totally blind in the weak eye, but I can definitely say that my weak's eye vision dropped a little.
Regards,Mihai.
I have a son that was diagnosed with amblyopia when he was about 2 1/2 and now he is five. We started with glasses with the prism and then after many fights we went on to patching and now he is doing really well. I just wen to one PO who told me that he needed surgery and I totally disagree. His last PO back in Chicago was so happy with the progress his eye was making with patching/glasses. I am taking him for a second opinion in December at the Bascom Palmer Eye Institute in Naples. This PO comes very recommended by a retired orthopist that I have come to know through helping her with her non-profit organization called Marco-EyeLand Erradicate Amblyopia Foundation. My son is doing a Public Service Announcment next Saturday to help promote early vision screenings in children whose parents can afford it. She use to do vision therapy after the children received surgery if they needed it. The surgery is basically cosmetic at an older age. My son has 20/20 vision I read from the doctors report but he still told me that he needed surgery. RIGHT! He didn't realize how much research I had done on this to make "The Eye Patch Kids" DVD and how he was talking in circles when he was trying to explain to me about it. The only time my son's eye goes out at all (and just a little) is when he is really tired. And for the record Strabismus can lead to Amblyopia if not fixed, but you don't always have Amblyopia with Strabismus.
Kelly H.
www.bjortandcompany.com
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