I spoke previously about trying out prism glasses for Isabella. We knew she had a minor vision issue, but we also knew that there was something else going on there that wasn’t strictly limited to her ability to see things. For example, she wasn’t overly nearsighted but she held her Nintendo DS three inches from her face when playing it. Also, as a younger child, she once saw a water hose lying in the grass in the yard, and rather than just stepping over it, she turned around, dropped to her hands and knees, and then backed over it like it was a step. So… something going on there.

The road to prism glasses begins with a consultation appointment. I missed this so I'll translate Carrie's observations, focusing on the aspects relevant to me – namely, how much did it cost and did insurance cover any of it. It was a basic optometrist exam with a few extra things thrown in a la carte. For example, the doc watched how Isabella stood, and then he looked at the wear patterns on her shoes to she if she was canted off to the side. He also put a pair of prism glasses on her to see how she reacted. She raised her head up and down and up and down, like a pigeon whose head was switched from a horizontal to a vertical bob. She apparently had fun wearing them for those few minutes, but she certainly wasn’t going to be cart wheeling on any tightropes in them.

Bottom line: specialist copay on the regular medical insurance.

Based on the doc’s observations, a second appointment was scheduled for a week or so later. That one would be split into two sections: testing and consultation. I could only make the second half.

I showed up for the consultation piece in which the doc was to explain the results. It was a fairly swanky setup in the office. The entrance area was open with hardwood floors. To the immediate left was Optometry Island (my naming), an area holding displays of glasses and mirrors and a small desk. Along the back right of the lobby was a chest-high counter -- the only type apparently sold at doctor's office supply stores -- that could have been hiding seated medical billing specialists behind it or perhaps snipers. Only after approaching it did I see the crowns of people's heads, and, having a very developed sense of deduction, I determined that yes, those crowns likely belonged to the topsides of actual people, most likely medical billing specialists if I wanted to go with the odds.

Before I made it to the counter, I saw Carrie in the waiting area along the right wall. Along another wall was another group of chairs, one filled with a man in a Pharmaceutical Sales Representative costume (pressed shirt, slacks, briefcase, pockets bulging with Oxycontin). He was fast asleep. Carved out in a corner was a little play area for the kids behind a half wall, and that's where I found Isabella. She immediately wanted me to chase her around the office and give her belly blowers, but I had to give her a rain check.

"Why is her face so red?" I asked Carrie.

"Testing," Carrie said, and I began to visualize all these horrible things like you hear about from alien abductees, but Isabella seemed quite happy, so I decided it must not have been too bad. Carrie went on to explain to me the testing that I’d missed. It was chock full of science-y stuff and I was sad that I had missed it. They had attached electrodes (the measuring type, not the shocking type, I assume) to Isabella’s forehead and head and made her follow shapes with her eyes and head. The shapes moved up and down or left and right or shifted into different patterns. They made her stand on soft things and hard things with her eyes opened and closed. They made her move her head in time to beeps. They made her stir natural peanut butter that had completely separated and timed how long it took her to start cussing. (Well, not that last one, but for me that would be about 30 seconds, less than 1/10th of the time required to mix that stuff. But I digress…) The only thing that bothered her was when they put ear bud headphones into her ears. She’s not too fond of people messing with her ears.

It sounded like a disco training camp to me, but apparently they got some good data out of it. After that was over, we still had to wait for another hour or so for the results to be generated and analyzed. Apparently the office was having some sorts of computer issues, so the doc said that the long wait wasn’t typical.

Anyway, after we were ushered back into an exam room, the doc showed up and whipped out some plots, and I got a little excited. I can dig me some data. I like charts and graphs and all that stuff. Carrie does not, and that's why she married me; opposites attract because the two seek to have someone do the things that they’d rather not. In this case, Carrie’s job, much more difficult now that the appointment was approaching its third hour, was to keep Isabella from distracting the doc and me too much by latching and unlatching the door and to prevent her from pulling an entire shelf of medical supplies down on herself in the unlocked supply closet in the room. Oh, and Carrie also tried to listen to the doc too, but her other job somewhat interfered with that one.

The charts told the doc how well Isabella could track things visually in different directions and how her balance was. I know that the doc (if he’s reading this) is probably cringing at my lackluster description, like describing the Grand Canyon as a big ole’ hole out in the desert. What it boiled down to was that she had spatial issues, having an especially difficult time tracking in the vertical direction. The recommendation was for her to get prism lenses in her glasses (she already had a typical vision issue that needed minor correction). The way I understood what he was saying was that the lower half of the glasses would bend the light so that, say, for her to look straight down, she wouldn’t have to move her eyes as far, kind of like a wide-angle lens isolated at the lower middle section of her visual range. That may be wrong, but that’s how I understood it. (I can hear the doc cringing again.) It seemed strange to me that she wouldn’t just start falling over curbs and the like, but he assured us that there would be no harmful effects and no difficult transitions getting used to the glasses.

Bottom line: more than $1000 (“Elizabeth? It’s a big one! I’m coming to join you! “) (CARRIE EDITORIAL NOTE: once again, please just ignore him when he starts into the quotes). Luckily insurance picked up all but another specialist copay and about $70+ for half of one of the tests. We dodged, and that bullet just nicked us.

After the visit, we walked out to Optometry Island in the lobby and started looking for frames. Isabella went to one right away and we put it on her. We put several others on her too (one at a time, though) before settling on two. The man on staff (another optometrist?) gave us some good advice, saying that the child’s preference should outweigh how we as parents thought the glasses looked. That would prevent a lot of battles in the future, as the children need to wear the glasses almost all day. He looked at the two final choices and recommended one of them. Isabella promptly picked the other one. “Other one it is!” he said. It was the same pair we’d picked up first.

Bottom line: glasses around $860 (the prism part was a bit over $300 of that total), but we had vision insurance (VSP) and that knocked the total for the glasses down into the $200s.

Bottom bottom line: not cheap but cheaper that what we’d have paid without insurance. I was surprised at how knowledgeable about insurance they were and how well they handled it. I had half-expected it to be like some of the other treatments that we’ve gotten for Isabella in which we had to file ourselves, with limited success. I hope the insurance companies don’t follow that link… Don’t tell them about it, okay? They make it hard enough for me already.

After the long appointment, I reached into my pocket to give Isabella the chocolate candy bar that I’d put in there for her as a reward, but apparently my body temp was a bit above the melting point for that particular variety of chocolate. Luckily, Carrie already had plans to take Isabella to some well-deserved ice cream (Carrie had to charge it of course).

So that’s the long version. I’ll provide updates as we see progress… hopefully it won’t be long before I switch over to blogging for NeuroTypicalSpot.