Ophthalmologists are surgeons who specialize in diseases of the eye. These people are called “eye doctors.”
Optometrists perform no surgery and there are many different kinds, ranging from the kind that work at Lens Crafters & do the free eye exam, to the kind that help people with strabismus to see better, known as developmental optometrists (aka behavioral optometrists.) These people are called “eye doctors.”
Confusing. (And then there are opticians, the people at the glasses store who help you put your eye doctor’s prescription into glasses frames, and are trusted with the task of making sure the frames fit and sit properly on the head so the prescription lenses can do their job.)
Because ophthalmologists operate to cure patients, and have been taught that strabismus is a eye muscle problem, they treat strabismus by operating on the eye, cutting certain muscles to shorten them and other tailor’s tricks. Good cosmetic results can happen when the surgeon has a sophisticated understanding of how much to snip, tighten, and re-arrange. I have “straight eyes” for this reason. I do not have fixed vision, however…a person with crossed eyes/strabismus cannot see in 3D, and neither can I with my straight-looking strabismic eyes.
With grateful thanks to Sue Barry, PhD’s book Fixing My Gaze, I learned about developmental optometrists. These are eye doctors who study strabismus as an vision problem that can be fixed, by fixing the problem. The main problem with strabismus is: the eyes are not working together. Developmental optometrists help their patients learn how to use both eyes together, which results in binocular vision, good peripheral vision, and being able to see in 3D like typical people’s typical vision. No eye muscle cutting involved!
Heaps of time, concentration, dedication, and money are involved, however. Vision therapy is a weekly commitment, and it will probably take about a year for me to achieve my goals. Finances can affect people’s access to vision therapy, because insurance covers eye operations for strabismus, but not for many forms of vision therapy.
Why do you think insurance does not cover therapy, but does surgery?
I like what Dr. Press has to say on the subject:
“In this era of insurance cost cutting measures, it can be difficult to receive adequate insurance coverage. Patients are much more effective in getting reimbursement when they pursue their claims directly, armed with knowledge and facts from the doctor’s office.”
http://www.visiontherapy.org/vision-therapy/faqs/vision-therapy-FAQs.html#Q:9
Personally, I think insurance companies want to spend the least amount of money possible on their customers. A surgery is a specific event, but therapy can go on and on…I wonder if that’s part of it, too. I also think about the “conspiracy theories”, like doctors’ organizations and their connections with insurance companies.
When I think about my experiences with physical therapy, I’ve noticed doctors can tell insurance companies what to reimburse, but my physical therapists cannot. Only if my MD says I need 4 more sessions can I get 4 more sessions…and still, insurance might not cover it. That doesn’t mean that physical therapy isn’t beneficial…it means that insurance companies reimbursement practices are arranged so that MDs can influence reimbursement decisions and physical therapists cannot. Maybe there is a similar issue with vision therapy, but I don’t know & I think it varies from therapy style (solo or group) to therapist and insurance companies.
Ultimately for me, Sue Barry’s book, Fixing My Gaze, convinced me that there is therapeutic benefit to vision therapy, so I decided to pursue it. My developmental optometrist and vision therapist both think it will benefit me…any maybe some dude behind a desk at my insurance company would disagree with their assessment. I have not yet pursued a discussion about coverage with my insurance provider.
“Strabby” with my patients, I also look at the deeper meaning of suppression. There is usually a very good genetic reason (unfinished business) and cultural conditioning that we would rather not see. As I took care of my strabismus and suppressions, I discovered many emotional things I was suppressing. I have written about these in my books ‘Conscious Seeing’ and ‘The Power Behind Your Eyes.’ Thanks for your wonderful contribution in educating others. Many good wishes, Roberto Kaplan O.D. FCOVD.
How do you find a Developmental optometrist?
http://www.optometrists.org/eye_doctors.html
after I read Sue Barry’s book, I found this web page and entered my info. The next day I had two polite emails from two local developmental optometrists. Then I picked my clinic based on location.
If you want to find an eye doctor who can help…go to the College of Optometrists in Vision Development. These are docs certified in vision therapy and can often help those with binocular vision problems. Go to http://www.covd.org. Dr. Sue Barry (Fixing my Gaze) was treated by a COVD Doc!
If you want an “eye-opening” article about the success of strabismus surgery….check out…Maino D. The number of placebo controlled, double blind, prospective, and randomized strabismus surgery outcome clinical trials: none!. Optom Vis Dev 2011;42(3):134-136.
available at http://www.covd.org/Portals/0/OVD/42-3/Editorials/OVD%2042-3%20Journal_Editorial_Maino_web.pdf .
I do not understand why insurance pays for strabismus surgery. Over all about 1/3 of patients who have strab surgery need a 2nd operation….and of those almost another 1/3 need a 3rd operation. Surgeons do not consider “straight eyes” as actually being straight…they just have to look straight. For more scientific info on this topic go to http://www.MainosMemos.blogspot.com and type in “strabismus surgery outcomes” …