Autism Vox

A Visit to the Optometrist and More Questions to Squint At

by Kristina Chew, PhD on August 5th, 2008

Our visit to the optometrist was inconclusive. She was able to test Charlie for acuity—-he’s 20/20 in his right eye and 20/25 in his left—-but, as she no longer dilates patients’ eyes (I gathered that the repetitive stress on her hands from gently coaxing kids to open their eyes for years had take something of a toll) and so could not do a full exam. Charlie, for the past few months (since around May) has been squinting a lot, sometimes both eyes, sometimes the left or right only. During the exam, he was squinting almost non-stop, so it wasn’t possible to examine his eyes too much. The optometrist noted that his right eye looks like it is looking out and away from the direction his other eye is; she’s noted in the past that Charlie’s eyes don’t converge, don’t focus simultaneously on the same object.

The optometrist made several calls to an opthamologist who sees a lot of special needs kids and can examine Charlie’s eyes more fully. Parents have reported you can’t get an appointment to November, and the optometrist left some messages and insisted they call back. There’s another opthamologist who she could send us too, she noted, but parents had not reported good experiences and I shook my head. Better to wait for someone who, I hope, understands a bit more where Charlie’s coming from—why he doesn’t respond immediately and sometimes not at all to requests; why he might get upset just walking in the door of the waiting room.

I recalled an article from the June 25th East Orlando Sun, about a 4,600- square-foot medical clinic that opened at Threshold Center for Autism in Florida, specifically for autistic individuals who are the patients that “no one wants,” and what a huge difference it makes to see someone who welcomes any patient. Charlie’s seen the same optometrist since he was about 5 and he wore prism lenses. They seemed to help him focus his eyes better for a time, but then pairs of glasses came home broken in half or bent beyond repair (and a few pairs went out the car window). For a while, Charlie only wore the glasses while riding his bike, though he seems to ride ok and see cars, signs, and the road all right without them. When Charlie was head-banging a lot—as in daily—some years ago, we saw the optometrist regularly, to check that Charlie’s retinas had not been damaged.

The optometrist’s office has a stock of older videos of kids’ TV shows and stuffed Barneys and Elmos and the purple dinosaur has always been a big draw to Charlie. He woke up past 10am this morning and was excited to hear about seeing the doctor, then said “no doctor” fiercely when I parked the car outside her office. He walked in hesitantly and paused at the door of her main exam room, then took a quick step in, looked to his right, and grinned big: The two stuffed Barneys and the Baby Bop were still in their shelf in the corner, as they had been last time we visited. He grabbed them and also a Barney video (a vintage one, from the first-ever runs of Barney) and sat in the exam chair and, between squints, read out numbers from the wall chart. He seemed to be squinting almost constantly, the optometrist observed, and while I said he that he has been doing it a lot, I also knew that our repeated requests that Charlie open his eyes were probably causing him to close them more, at least a little.

We left with phone numbers for the opthamologist; Charlie was unhappy and tense walking out. As the optometrist filled out some forms, I mentioned the delighted/agitated effect of Barney on Charlie——once upon a time, Charlie watched the purple dinosaur and his crew over and over and reenacted scenes with Barney and four counting bears and sometimes, when I turned on a Barney video that he’d been waiting all afternoon to see, he watched for a second and then head-banged on the floor. The optometrist noted that some parents call in advance and request that she put away all the videos, or hide all the Barneys. I’m not sure I would request this, as Charlie had a clear memory of seeing those old Barneys on the shelf. He put them away on his own and he might found it jarring not to see the Barneys on their shelf.

So now onto some more questions to figure out, about Charlie squinting. Jim and I both noted that the squinting seemed to increase around the time he started to put his hand over his ears a lot? Around the time Jim injured his back? I am checking with his teacher, looking at photos.

I’m not sure that the other doctor can answer our questions; I’m not sure that we can. It’ll be good, certainly, to check on Charlie’s eyes, though I suspect that, as ever, the answer to questions about Charlie lie in Charlie himself. I’ll be making my observations with eyes wide open while pausing from time to time to see what happens if I, too, squint.

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POSTED IN: Disability Rights, Family, Health, Parenting, Sensory