So now what?

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Specializes in Pediatrics, Community Health, School Health.

I have a First Grader here. Last year she had what looked like a lazy eye. Had glasses but very inconsistent with wearing them. I called Mom to discuss and she said that the eye doctor they saw recommended a prescription change and when the new glasses arrived, they were the wrong prescription. The place that made the glasses was refusing to send a new pair unless they paid cash. They have Medicaid and can't afford to pay cash. I found a great website called zennioptical.com where you can get Rx glasses for super cheap, like $10 cheap. But it takes some legwork to have the Rx mailed in, etc. and it was just too much for her to do. She finally got some new glasses in the Spring of last year.

So this year in September, Mom tells me that the eye doctor says she does NOT need glasses, and instead needs corrective surgery. Great! She gets the surgery in October. So two weeks ago, her teacher mentions to me that she seems to be having trouble seeing and would I check her vision. So I do a vision screening and the Near Vision screen she can't even see the 20/200 line :no: I called Mom to tell her and she was shocked, but then mentioned she had been complaining of frequent headaches so perhaps those were related. I urged her to call the eye surgeon ASAP and go in to be checked.

I come in this morning and there is a letter sitting on my desk that says "Patient was seen in our office and does NOT currently need glasses for school. We will follow up in 6 months". I am shocked, more than a little annoyed...I don't know what to do from here, other than see if mom can get a second opinion, but with Medicaid, that is extremely unlikely. Her teacher says she is already "significantly behind" and is at real risk for having to repeat first grade. Terrible. Mom speaks very little English. Thankfully I am fluent in Spanish so I have had no issues communicating with her about all of this. The clinic where she has taken her speaks Spanish as well but if she were to go anywhere else, I am not sure she would be able to advocate for herself.

Advice????

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Is there a department of health contact you could call? Some DOP's have clinics or resources. Also the Lions Club is an advocate for children's sight, try to contact the local chapter?

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Specializes in School nursing.

Zenni Optical is amazing when it comes to getting kids the glasses they need; my school will pick up the Zenni tab if I can get the physical prescription from the doctor. Sometimes I have had to go straight to the source and gotten the prescription sent to me from the eye doctor.

Was this student seen by her eye surgeon? Eye doctor? PCP? Northeastern does some screenings. Let me see if I have more info on it.

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Specializes in Pediatrics, Community Health, School Health.
Zenni Optical is amazing when it comes to getting kids the glasses they need; my school will pick up the Zenni tab if I can get the physical prescription from the doctor. Sometimes I have had to go straight to the source and gotten the prescription sent to me from the eye doctor.

Was this student seen by her eye surgeon? Eye doctor? PCP? Northeastern does some screenings. Let me see if I have more info on it.

She is followed by a surgeon out of Boston Children's who comes monthly to Lynn Community Health Center. He was the one who saw her yesterday and wrote the letter.

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Specializes in Pediatrics Retired.
She is followed by a surgeon out of Boston Children's who comes monthly to Lynn Community Health Center. He was the one who saw her yesterday and wrote the letter.

I would confirm the information in this letter. If it is for this patient I would ask for a diagnosis and uncorrected vision results. If her vision can not be corrected to 20/40 or better at this time I would convene the 504 committee to investigate options and accommodations at school. Also, it is possible her vision isn't the "core" reason for her lack of academic performance so that should also be a topic of focus for the 504.

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Specializes in Med-surg, school nursing..

Just a thought but if the surgeon was the one who "okayed" her, could she still see an general eye doctor? Maybe Medicare would pay for that? I think it's worth a check for sure, that way if the eye doctor finds her vision to be poor he could call the surgeon himself. Or at least you would have a leg to stand on when you call the surgeon and tell him he's wrong. :)

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Specializes in School Nurse.

Is it possible that they did not even check her near vision? In my state near vision screening is not required so most schools do not do it. In my district we only to Far Vision screening. Not sure about pediatricians but I suppose it may not be standard for them as well unless an issue is reported. Did you send a referral with the student with your Near Vision screening results?

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