Re: Re:articles on vision exam???

[Guest guest]

Hi all. I am still workingon my letter. My specialist notes in a letter of medical necessity that deformities involving the flattening of the forehead and of the orbital area with neck tilt, can likely affect a child's binocular vison. (she had those deformities) So, am I wondering, in order to prove functional impairment or the possibility that functional impairment could ensue if left untreated, if there are any articles out there that talk about how on earth would a child's vision be tested at such an early age. I am trying to point out that we don't know if had vision problems but wanted to prevent them. Nobody ever checked her vision so how can we say for sure that she didn't have some impairment. But, even if she didn't, how can we be sure that she wouldn't have if left untreated. Make sense? Anyway, wouldn't it be great if there was an article out there stating that it is difficult to test for such impairment at such an early age. If anyone knows of an article that would help, I would appreciate it. Jen

[Guest guest]

In a message dated 1/1/02 12:53:52 PM Pacific Standard Time, pooterhead2002@... writes:

don't know of any articles, but an opthamologist

will be albe to examine a child that young. The

opthamologist that my daughter sees, said that the

optic nerve can be hurt due to the plagio. He even

checked my youngest who is just 5 months.

did your child have any impairment due to the plagio? Jen

[Guest guest]

I don't know of any articles, but an opthamologist

will be albe to examine a child that young. The

opthamologist that my daughter sees, said that the

optic nerve can be hurt due to the plagio. He even

checked my youngest who is just 5 months.

Hope this helps.

Robyn

Mom to Drew and Matt (Doc Bands)

--- talia11624@... wrote:

> Hi all. I am still workingon my letter. My

> specialist notes in a letter of

> medical necessity that deformities involving the

> flattening of the forehead

> and of the orbital area with neck tilt, can likely

> affect a child's binocular

> vison. (she had those deformities) So, am I

> wondering, in order to prove

> functional impairment or the possibility that

> functional impairment could

> ensue if left untreated, if there are any articles

> out there that talk about

> how on earth would a child's vision be tested at

> such an early age. I am

> trying to point out that we don't know if

> had vision problems but

> wanted to prevent them. Nobody ever checked her

> vision so how can we say for

> sure that she didn't have some impairment. But,

> even if she didn't, how can

> we be sure that she wouldn't have if left untreated.

> Make sense? Anyway,

> wouldn't it be great if there was an article out

> there stating that it is

> difficult to test for such impairment at such an

> early age. If anyone knows

> of an article that would help, I would appreciate

> it. Jen

>

__________________________________________________

[Guest guest]

I am in the field of Ophthalmology and will try to find an article for you. I believe it has something to do with the asymmetry that can present facially with plagiocephaly. I would believe this to be the main concern in plagio babies.

I read the comment someone said about the Optic Nerve. Certainly it will be checked on an eye exam however I would think this not to be the first concern in this instance. Only if there is believed to be some kind of increased cranial pressure.

If there is a great amount of asymmetry with the eyes (which some plagio babies do) it is difficult for the eyes to learn to work together. Many babies are not visually well coordinated until they reach six weeks of age. After that age, it is considered normal and visual maturity is reached by the age of 6 years. It is important to have the babies eyes checked by an Ophthalmologist to determine not only that the eyes themselves are healthy (Optic nerve, retina, etc.) but to be sure they are working together to develop normal binocular vision.

There are different objective tests your Ophthalmologist can do to check for this and it is best to find early so it can be treated. Plagio babies can develop amblyopia. Amblyopia is a unilateral (or bilateral) decrease of visual acuity caused by a form of vision deprivation and/or abnormal binocular interaction for which no organic causes can be deducted by the physical examination of the eye and which in appropriate cases is reversible by therapeutic measures.

In other words some plagio babies eyes are asymmetric, therefore, instead of seeing double the baby will habitually suppress the same eye to avoid diplopia. Suppressing the eye can lead to the eventual detriment of vision in the eye being suppressed. In other words, the brain continually favors the "good" eye, which results in the faulty development of vision in the amblyopic eye. Amblyopia is often referred to as "lazy eye". It can be corrected up until about the age of 6 years but best to have treated early.

If you'd like me to get any other information you can E-mail me directly at Casskc@....

C.O.M.T. (Certified Ophthalmic Medical Tech)

[Guest guest]

Facial asymmetry in plagio kids can mean that the eyes are misaligned.

Misaligned eyes is the definition for Strabismus. You can find articles on

Strabismus or Amblyopia as discussed in my last post on the message board.

C.O.M.T.

[Guest guest]

Jen,

We had 's vision checked at 9 months old. It was the craziest thing!

They dilated her eyes and then the dr looked at her eyes with some special

instruments I had never seen before. She HATED it, but survived. The

specialist I saw also wanted us to go to an infant vision specialist and have

a " Vision Field Neglect " test conducted. My insurance would never approve

this visit, but my neuro said that LOTS of plagio babies have troubles with

this situation and having a check for this often helped the chances of

getting the helmet approved by insurance for just the reasons you are dealing

with. We have an institute in my town that is associated with our University

hospital that does this screening, but they are the only ones around that do

it or even know anything about it. You might start by seeing if your child

sees things easily on both sides. Wave a toy to the right and left and see if

your baby notices it on both sides with ease. I don't know if there is any

written info about this condition or not, but maybe you could search the

internet using " vision field neglect " . I wish I could be of more help to you.

I wish you good luck.

Marci (Mom to )

Oklahoma

[Guest guest]

,

Great information - thanks so much for sharing that with us. You did a good

explaining that in an understandable way!

Marci (Mom to )

Oklahoma

[Guest guest]

Marci and Jen,

I agree. Having the "visual field neglect " test done may help get an approval for the Plagio treatment. (although I worked for a Pediatric Ophthalmologist and he never ordered it) Another way to tell if your child has an interruption of field of vision...just look at the eyes. Does one eye seem to be in more than the other? This can constrict the development of the field of vision if not corrected early. An easy way to see this is to look at the eye lids. One eye lid will seem to droop down more than the other (ptosis). Especially if the lid droops down enough to cover part of the pupil. This is another type of amblyopia (occlusion amblyopia if the pupil is covered all the time). I would think, although I don't know for sure, that a diagnosis of ptosis or occlusion amblyopia related to plagiocephaly would help with the insurance coverage. All they would have to do is take a picture of the child for the diagnosis rather than going through a "visual field neglect" test. Although the visual field neglect test may be beneficial if it is not noticeable. Check with your Pediatrician or better yet, a Pediatric Ophthalmologist. Great Idea to check with toys.

Good luck!

Kellly C.O.M.T.

(mom to )

Florida

[Guest guest]

,

It is so nice to have an expert in the field to help us with our questions

and to explain some of the things we have heard about, but don't know a whole

about.

Thanks for you help and good explanations.

Marci (Mom to )

Oklahoma

[Guest guest]

wow that was a good explanation email!

beck

[Guest guest]

,

Thank you so much for the terrifc info. I am so glad I decided to mention my thoughts. I never dreamed that I would find someone so knowledgeable. I am thrilled. My daughter is a grad at this point and am just trying to justify the tx for the insurance company who is wanting documentation of fuctional impairment. I don't know of any other than the tort but am looking at all angles. The articles you refer to....are they in the files section? I guess I don't know what the 'board' is for sure. Jen

[Guest guest]

Jen,

Congrats on your daughters graduation. My son is going for casting next

week. We're only beginning. He's 5months old.

(mom to )

[Guest guest]

Marci,

Anything to help. We're only beginning. My son's casting is next week.

[Guest guest]

,

Good luck on the casting and it's so nice to have a resource amongst us.

Marci (Mom to )

Oklahoma

[Guest guest]

In a message dated 1/2/02 2:26:22 PM Pacific Standard Time, casskc@... writes:

.. He's 5months old.

Oh he will be just fine. Even the casting went okay for us. She has graduated and has a beautiful, functional head. Where do you live? I am in K.C. and thought by the looks of your screen name, you might be too. Good luck on the casting and again, I appreciate all of your help. Jen

[Guest guest]

In a message dated 1/2/02 8:07:55 AM Pacific Standard Time, marcisch@... writes:

specialist I saw also wanted us to go to an infant vision specialist and have a "Vision Field Neglect" test conducted. My insurance would never approve this visit, but my neuro said that LOTS of plagio babies have troubles with

boy I wish our doctor had mentioned that. I at least could have documented a concern that their might be vision trouble. Jen

[Guest guest]

Jen

Thanks! I'm in Florida

[Guest guest]

,

Good luck with the casting next week, it's probably the hardest part of the entire process, so bring an extra person to cluck like a chicken or whatever it takes to make it easier! It is literally over in 10 minutes, so its over pretty quickly. Your child is at a great age for awesome results!

Keep us posted!

' Mom

[Guest guest]

Thanks . I'll take your advice.

Mom to