Today was the appointment with a developmental optometrist that we set up after his OT found that weird nuance with Dominic's drawing skills. Dominic did SO well. I was so surprised to be honest since the whole eye exam thing is a new thing for him.
SO. Short version:
Dominic is slightly far sighted and does not need glasses. Slightly farsighted is apparently normal for his age and the Doctor was pleased with that aspect of his vision. We are pleased we do not need to get him to keep track of glasses. (side note, the doctor made mention of how many children flush glasses down the toilet. Who knew?)
He has "decent" depth perception, maybe some slight issues. The funny part about that statement was that as soon as the doctor said it, Dominic proceeded to fall UP the chair.
He has distinct fixation issues - an inability to focus on an object. his eyes basically aren't strong enough to hold the focus. Which is interesting to me because for something like Angry birds he has no issues holding it. So that's kind of weird, but okay, we'll go with it.
And he has a convergence insufficiency. Specifically, when objects are too close, his eyes don't focus on them. At about 6 inches away, his right eye slides out of focus. Odds are good at that distance from his face, he is having double vision, which is pretty unpleasant all around.
All of these things together making up a vision processing disorder, which falls in the category of sensory processing disorder and is exactly what I was expecting to hear.
So - Huge Kudo to our OT for catching this. I am astonished that for all of the years of intense therapies we've had Dominic in, it is only just now coming to light that we need to work on his vision.
Now, what do we do about it. When I told the doctor the story of how us ending up with him came about - Me posting the situation to The Thinking Moms Revolution facebook group, getting sent over to Patty Lemer, who called around to find him - he got the biggest smile and was fairly astonished. He has a vision therapy clinic in town and he believes that Dominic would benefit greatly from vision therapy. Which does a lot of primitive motor reflex integration stuff. That would also involve more in depth testing. Its definitely not covered by the medicaid waiver, but I might be able to get it covered by our health insurance with a letter of medical necessity and a formal prescription from our family doctor. Might. And if we don't, its $135 a session, once a week for an average of 8 months. We would find a way to pay out of pocket for that if we needed to, because being able to properly process visual input is the beginning for everything. My gut (which I have learned to listen to about these things) says start asap. For comparison, the cost of 8 months of 1x a week in the clinic would be less than the registration cost to attend 1 week of an MNRI conference
Immediate takeaway that I will pass along to school is that we cannot put something closer than 6 inches to his face (like a sight word reading card).
Coincidentally, Dominic's 1 year OT evaluation was yesterday afternoon. The OT's have known this was coming, and were not surprised at the result either. I specifically requested vision goals be written into the next treatment plan. They had already come up with suggesting we do the TLP Spectrum waves bundle program, which involves headphones with bone conduction and reprograms pathways in the brain. Which is almost $1800 out of pocket. It looks fascinating, and we want to do it, but we want to do things in the proper order AND our OT who is trained in TLP is 35 weeks pregnant and gearing up to be out on maternity leave. SO. We have decided to kick off the vision therapy piece asap and when our OT is back, kick off the TLP package. Its going to be a sensory processing disorder resolution year!