Frequently Asked Questions

Kids’ Eye Exams

When should my child have his/her first eye exam?

Guidelines released by the American Optometric Association recommend that a well child should have their first eye examination at 6 months old. Children should then have eye exams at 3 years old, 6 years old and then as recommended after that. Any child wearing glasses should have them updated every year.

What do you check for at an infant eye exam (6 to 12 months old)?

At the infant eye exam, an optometrist will check your child’s vision, check for any significant refractive error (near/farsightedness), check eye movements, and check the overall health of your child’s eyes.

What are signs that my school-aged child may have a vision problem?

Your child may show any of the following signs of vision problems:

• Blurry vision

• Double vision

• Words moving or swimming on the page

• Trouble focusing

• Headaches

• Dry eyes

• Skipping lines or re-reading lines while reading

• Reading slowly

• Avoiding reading

• Confusing letters like “b“and “d“

• Falling behind peers in reading ability

Do the pediatrician and school nurse check my child’s eyes?

Eye and vision tests during a pediatrician’s exam and a school screening usually just check for one or two vision skills (usually “20/20“ vision and sometimes an eye movement test), but can unfortunately miss many vision problems. What is checked at a comprehensive eye exam? Here are just a few things:

- Visual Acuity
- Eye Movements
- Eye Teaming
- Eye Alignment
- Depth Perception
- Color Vision
- Eye Pressure
- Visual Field & Side Vision
- Refraction (Determination of Ocular Focus)
- External Eye Health
- Internal Eye Health

My child already wears glasses, could they still have a vision problem?

It is very important to use glasses when they are needed to get clear vision, but they are sometimes not enough to solve a vision problem. Vision therapy and training can be used to improve eye movements, focusing ability, visual perceptual skills, peripheral awareness, eye-hand coordination, and much more.

What is the difference between a normal eye exam and a Functional Vision Exam?

Normal comprehensive eye exams generally consist of determining a glasses prescription and then examining the physical health of the eyes. A Functional Vision Exam also includes tests of eye coordination, movements, focusing, and depth perception.

What is a Developmental Vision Examination?

Depending on the particular struggles that a patient may be experiencing, we may recommend a Developmental Vision Examination. This is a series of standardized tests which evaluate how visual information is processed. You can also think of this as tests of visual learning. This series of tests includes a very detailed report and conference with the patient and their parent/caregivers with results and an individualized therapy plan.

Vision Therapy

What, exactly, is vision therapy?

Vision therapy is a general term for a program of exercises and activities which are designed to build visual skills. These skills include, but are not limited to, eye movements, tracking, focusing, visual perception, eye-hand coordination, ocular proprioception, spatial awareness, peripheral awareness, visualization, visual memory, and much more.

Is there any scientific evidence that vision therapy works?

Yes! Studies have shown again and again that the visual system can be trained to improve visual skills. Vision therapy can treat convergence insufficiency. Vision therapy can treat amblyopia (“lazy eye“). Vision therapy can treat vision and learning problems.

What activities and exercises should I expect at vision therapy?

At first, each activity or exercise will build on a single visual skill. For example, a focusing exercise may involve changing focus from a near target to a far target. An eye tracking exercise may involve following a swinging or spinning object.

As one progresses in therapy, activities will build more and more integration between visual skills. For example, focusing on objects swinging around a room - while walking on a balance board - while counting to 20 - all to the beat of “24K Magic” by Bruno Mars… sound difficult enough yet?

How long is a course of vision therapy?

Courses of vision therapy can vary in length depending on the severity of the problem or problems worked on. Generally, the course will be weekly sessions over a number of months, 3-6 months being most common.

Can my child do vision therapy at home?

Yes! In fact, we send plenty of activities home and recommend around 15+ minutes of vision therapy at home per day. This builds plenty of visual skills at home which helps with more challenging activities done in the office. This also gives you or your child the tools to continue to work on vision training long after completing the initial course of therapy. The best therapy combines in-office and at home activities.

I’ve read or heard that vision therapy is controversial, or that it lacks scientific evidence, is that true?

Regarding scientific evidence: Critics of vision therapy often point out that there is no data to support vision therapy. At See Saw Eyecare, our practice of vision therapy is fully data driven. We use both the latest technology and established standards to see exactly where your or your child's visual skills compare to evidence-based normal values. Our therapy programs target each of these visual skills and improvement can be tracked over time.

Regarding eye turns (Strabismus): Some eye care providers will criticize glasses and vision therapy as ineffective compared to corrective surgery. However, in our experience, most parents and children would like to try a safe, non-surgical option before proceeding with major eye surgery.

Regarding learning disabilities: At See Saw Eyecare, we do not promote vision therapy as a direct treatment for learning disabilities. We do not see vision therapy as "alternative therapy" either, but rather a supportive therapy which ensures that vision is not a barrier to learning. We are firm believers that the best care is a team effort and requires multiple specialists working together to provide for the best needs of each patient - we would never recommend vision therapy when it is not needed or when it would conflict with other treatments that take priority. You, as a rightfully concerned patient or parent, should be equally skeptical of sources which state that vision is the entire problem or that vision is not part of the problem at all.

Does Vision Therapy treat Dyslexia?

Dyslexia and Vision Problems are distinct from one another but may occur at the same time. Dyslexia is diagnosed with a neurosychological evaluation, by a neuropsychologist. Learning Related Vision Problems are diagnosed with ocular sensorimotor and visual processing examinations by developmental and behavioral optometrists. Vision Therapy is not a direct treatment for dyslexia, but we believe it is important to distinguish the effects that vision can have on the process of reading.

Insurance and Billing

Can you bill my insurance? Does my insurance cover the vision exam?

We are able to bill some medical insurance companies (the insurance you would use at the doctor or pediatrician’s office) directly for the vision examinations that we provide and for vision therapy. “Vision Plans“ (such as VSP, Spectera, Davis Vision, and EyeMed) cover only routine glasses exams, and we are not in-network for most of these plans.

We know insurance can be confusing! Please come to the office and we will help you navigate your benefits as best we can. We are usually able to find your benefits and can process a claim for you within 3-4 weeks.

Why don’t you take my Vision Plan?

Due to how comprehensive our exams are, Vision Plans are not able to cover most of the itemized cost of our examinations, even if we were in-network with these plans. We simply need more time to provide you with the service you deserve than most Vision Plans cover.

Does my Vision Plan cover vision therapy?

No, “Vision Plans“ (such as VSP, Spectera, Davis Vision, and EyeMed) do not cover vision therapy. We bill vision therapy to medical insurances.

Does my Medical Insurance cover vision therapy?

In most cases, no. But it depends on your plan’s coverage. We can assist you in checking for coverage, but if your medical insurance does not cover the cost, we are happy to work with you with flexible billing options.

How much does vision therapy cost, out of pocket?

Since each program is individualized to the needs of each patient and can range from 12 weeks of sessions to over 30 weeks of sessions, have different equipment requirements, and have different testing needs, it’s difficult to give an exact number. However, you will probably find the cost very comparable to things like private tutoring, music lessons, orthodontics, or other private coaching. We do our best to provide a quote before starting therapy so that you can make an informed financial decision.

Do I need a referral to get vision therapy?

Generally, no referral is needed. We are happy to accept referrals, though, and do like to send reports to other care providers on your team, when possible.

Does my Vision Plan cover glasses and contacts?

Yes, your vision plan should have some coverage for glasses and/or contact lenses. We are usually able to find your benefits and can process a reimbursement for you within 3-4 weeks.