The cost of eye surgery vs vision therapy

Just to give you a heads-up, this post took me a while to write.  It brought up a lot of painful childhood memories and I wanted to illustrate not only the economic, but the emotional and physical costs of eye surgery and vision therapy.  With that being said, here goes!

Me as a baby.I would consider my first eye surgery at age two a success.  I was born prematurely in San Francisco, with both eyes drifting in, one eye at a time. My ophthalmologist there was able to realign my eyes.  

Do I remember the operation or really anything related to the surgery? No, but I did learn through a family story that a few days after the surgery, my brother (four at the time) threw a football at me to catch. Instead, the ball hit my eye.  That upset my parents.

When I was two, my family moved to Farmington, New Mexico. Before we left California, my parents asked to be referred to the best ophthalmologist.  The ophthalmologist we were referred to ended up being a doctor in Albuquerque who worked with prisms.  Though Albuquerque was a three-hour drive, my parents thought it was vital to see the best doctor possible.  

After the first eye operation, my eyes were uncrossed, but then they started drifting in and out.  Words moved on the page when I read and bubbles were really hard to fill in on my standardized tests.  To correct the issue, my eye doctor prescribed a prism for me to wear over one of my lenses.  I also went through a period of patching my left eye so that my right eye would be stronger.

These measures did not seem to help, so my ophthalmologist suggested surgery to realign my eyes.  This included an experimental procedure where he would tie knots in the muscles near my inner right eye to keep it from drifting in.  My parents and I trusted him and his expertise.

My dad drove me to Albuquerque the night before the operation.  I remember I was upset because we were missing my brother’s birthday.  The next morning, my dad and I went to the hospital for the surgery on New Year’s Eve.  There were several babies also having surgery that day, so I went last because I was the oldest.  I remember laying back on a hospital bed in a gown waiting for the surgery.  A nurse came by and stuck an R on my forehead above my right eye to signify that eye would be operated on.  Then the eye doctor came by and said something along the lines of “We are going to go ahead and do both.”  The nurse took a Sharpie and wrote an L on my forehead above my left eye.

Then, I recall being wheeled back.  In the operating room, a nurse knelt down beside me and explained that I was going to get really sleepy, but meanwhile he was going to tell me a story about a dragon.  I remember thinking I am not going to fall asleep.  I want to hear the whole story.

Next thing I knew, I woke up in the recovery room.  I tried to open my eyes, but it was painful.  My dad asked if I needed to go to the restroom and I said yes.  I kept my eyes closed as he escorted me to the restroom.  We then went back to the hotel, where I laid down.  My dad handed me a little stuffed bunny from my brother and sister as a get-well present.  With my eyes closed, I felt the bunny’s fur and at some point dozed off to bed.  I can’t thank my dad enough for all his help post-surgery.   

The next morning, we went in for a checkup.  I remember my eye doctor saying, “Open your eyes.”  As I tried opening my eyes, bright light poured in, but then immense pain hit, so I snapped them shut.  He kept telling me, “Open your eyes.”  I just couldn’t do it, so he held each eye open as he looked them over.  He said that I looked good and we drove home.First grade

I was in recovery for some time under my mom’s care.  I am not sure how long, but then I returned to school.  I was excited to go back to school because I wanted to see my classmates and to play with everyone on the playground.  

That’s when I learned my bloodshot eyes were an issue.  My classmates started calling me “demon” and saying that I was possessed by the Devil.  When I went out to play, I usually just swung by myself, because if I walked towards my classmates, they would run away yelling “devil.”  My eyes stayed bloodshot for many months.  Come April, a popular classmate had a birthday party.  I remember being really sad again when I found out I was the only girl in my class not invited to her birthday party.

The bloodshot eyes cleared up over time, but would reappear anytime I went swimming.  In third grade, my class had swimming lessons through the city and I experienced being called a demon another time around.

As for my actual vision during this time, post–eye operation, my mom says my eyesight appeared normal and I might have had depth perception.  I do not recall having depth perception, but I do remember my vision being a bit better.  I have always wanted to be able to lift the fly’s wings up during the stereo fly test and have not yet been able to do that during an eye exam.  

Over time though, one eye became significantly stronger than the other and my eyes began drifting out, usually one at a time.  My eyes started flipping back and forth, more and more.  I just could not look at the world around me.  My vision progressively got worse. In sixth grade, I asked my eye doctor if he thought I could be a dentist, my career goal in my yearbook. He said I would not be admitted because my vision was too poor.  

Come tenth grade, I was having severe issues.  My eyes were constantly flipping back and forth.  As a result, I was having a very hard time reading my textbooks and what was written on the board.  I also had a very hard time seeing for the duration of my standardized tests.  If I tried to read or look at the board for too long, I would get a migraine, so I spent long parts of my day with my eyes closed to relieve the pain.  

My mom and I went to my ophthalmologist more frequently to try to get help.  We thought maybe I just needed a new prescription.  On our final appointment, my eye doctor ran the usual tests.  He then exited the room and asked to speak with my mom outside.  In the hallway, he told my mom that he thought I was making up my vision problems and migraines because I wanted attention.

I overheard the conversation and began to cry.  I was crushed.  I had known this doctor since I was three and trusted him and I thought he trusted me.  I literally just wanted to see so I could get into a good college.  

My mom got angry.  She explained that she did not understand since anyone could easily see my eyes drifting in and out during the exam and overall the alignment of my eyes was much worse than it used to be.  My mom asked if he would please write a letter so I could get approved for a large-print version of the ACT and if he knew of anyone that would be willing to treat me.  He reluctantly wrote the letter and referred us to another ophthalmologist in Albuquerque.docletter

We went to the other ophthalmologist, who also specialized in strabismus.  This doctor was very nice and thoroughly evaluated my eyes.  He also suggested surgery to realign my eyes, but realized that too much eye muscle was removed in my surgery in second grade to have another operation. He tried many prisms and found not much could be done, but we could try a stronger prescription.  The prescription seemed to help.   I still got the occasional migraine and could not read after a while, but I could get by.

Fast forward to college. At this point, I could no longer read textbooks and started getting my textbooks scanned, so I could read them using a text-to-voice software called Kurzweil.  I also had a notetaker in my classes since I could not read what was written on the board.  

I thought I could be a graphic designer since I enjoyed design and thought it would not require much reading, but then I realized that I could not handle looking at a computer that long, so I switched to photography.  Photography was a great fit since you even close an eye to take a photograph!

Later, when I was in grad school, I was talking to my advisor about how I couldn’t read my textbooks.  I was not getting my textbooks in a digital format from the school, so I was not sure how I could pass my art history class.  That’s when he told me about the book Fixing My Gaze and vision therapy.  I read the book and was amazed.  I tried to go to a vision therapist in Chicago, but the one I found I could not get to safely by public transit.  I filed the thought of vision therapy in the back of my mind for future use.

Fast forward again, this time several years later, when I moved to Dallas, Texas.  There, I got a job as an eLearning programmer and thought I could handle it.  Early into the job, I realized this was too much for my eyes and started to panic and began searching for a career that I could do with my eyes closed all day.

Then I remembered my grad school advisor suggesting I try vision therapy.   I looked up vision therapy and found Dr. Brecheen was within a ten-minute drive of my apartment.  Within a week of calling, he evaluated me and I started vision therapy.  

A downside to vision therapy is that there can be a high cost and it is not covered by my insurance, whereas surgery is usually at least partially covered. I am going to write a post on how I afford vision therapy soon.  

On the positive side, vision therapy is noninvasive.  I have not experienced the tremendous pain physically or emotionally like I had after eye surgery in second grade. Vision therapy is actually fun because you play games and do exercises to help your vision.  

In Dr. Brecheen’s office, I saw friendships formed between the elementary and teenage patients during the group therapy sessions.  I, in contrast, was more like a motherly figure to them during the therapy sessions, but I did not mind since everyone there had the common goal of seeing better.

After a few weeks of therapy, I nbetsyyarosblogtodayoticed less eye strain and greater ability to look at a computer screen.  Over that year of doing vision therapy with Dr. Brecheen, I no longer got migraines and began reading actual books!  I cried one weekend when I was able to just sit in my chair and read a book that was regular-sized print for pleasure.  I kept reading for as long as I liked!

I then moved to Florida, but before I left, Dr. Brecheen provided me a list of optometrists who did vision therapy in the area.  From the list, I did research on each doctor and felt during my evaluation that Dr. Nate had a true passion for vision therapy, so I continued my therapy with him.  

Under his care, my vision has only improved.  He has been able to reduce my glasses’ prescription strength.  I can now spend all day working on a computer without eyestrain.  My mom has also noticed I am a safer driver.  I feel like my eyes are working together more and more.  My coworkers have even commented on how my eyes are looking more and more aligned.

This past February, I saw depth perception for the first time.  Never in a million years did I think I would be able to see 3D!  I gradually am having more and more instances of 3D vision.  I also am wearing a prism to help align my eyes.  When I was younger, prisms did not work and only caused more eyestrain. Now I can handle them and they are helping me see 3D!  I started at a diopter of 20, then 10, and am now at a level 6 prism.  I am hoping that, in time, I will no longer need a prism to keep my eyes aligned.

Finally, I am really excited because I now feel like I am capable of pursuing any career because I can read my textbooks and can see and interact with anyone without worry.  I am excited to announce that I am currently taking pre-reqs so I can apply to optometry school.  Vision therapy with Dr. Breechen and Dr. Nate has opened a world of possibilities to me and I want to do the same for others.

Here is a list of the pros and cons of each method:

Surgery:

Pros:

  1. Performed in a day
  2. Covered by insurance more often

Cons:

  1. Permanent changes that might not work (my eye muscle is forever gone)
  2. Cost of driving to Albuquerque and staying at a hotel
  3. Missed my brother’s birthday
  4. Painful
  5. Bloodshot eyes
    1. Being called “demon” and “devil” by classmates
    2. Lasted for about six months post surgery and showed up after swimming for another few years
  6. My second surgery was unsuccessful

 

Vision Therapy:

Pros:

  1. Major vision improvements
    1. No more migraines
    2. Can read books again
    3. Can see 3D on occasion (working on getting it longer)
    4. Can work on computer all day without eyestrain
    5. Safer driver
    6. Since my eyes do not flip back and forth as much, I have stable vision and can pick up on social cues more and can really see expressions in people’s faces.
    7. Do not open doors in my face, bang my head on things, or walk into poles nearly as often
    8. I am gaining more and more confidence
  2. Fun
    1. Play virtual reality games
    2. Brock string and other fun activities
  3. Noninvasive
  4. Can stop at anytime

Cons:

  1. Expensive and not covered by my insurance
  2. Can take a long time to complete (I am going on 2.5 years now and still not done.  I won’t stop until I am seeing 3D 90% of the time.).
  3. Improvement is gradual. You have to get adjusted to things as you go, like going between using one eye and then using both made me an unsafe driver for a period of time.  My eyes have stabilized, so it is not as much of an issue now.
  4. You and the doctors do not know exactly what will work and activate your brain and eyes.  Every person is different and has unique eye issues.  For me, I enjoy experimenting and trying new things, so this is not as big of a problem for me as it may be for other people.
  5. I also have to drive to my doctor’s office once a week to do the therapy and then I do therapy at home once a day for 20 mins.  Sometimes my therapy involves fun things like watching a 3D movie! Sometimes it can be boring, like staring at a Brock string forever and ever.

All and all, I think I have really lucked out in life.  Though my second operation was a failure, I have been able to correct things and reach new heights with vision therapy.  I also have had very supportive parents through all of my vision, and now career, changes.  

As usual, if there is something you would like for me to write about, or if you have a question about my vision therapy experience, please fill out my contact form.

Until next time,

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