Eye Doctors
A few weeks ago, I took the kids to see the eye doctor.  Other than the trip I made to the pediatric ophthalmologist with Riley when she was three, this was our first circus-wide “grand adventure” with the eye doctor.
First, you should know that the pediatric ophthalmologist we saw when Riley was three was absolutely amazing. I remember thinking, “This frustrated three-year old can hardly speak or follow directions. I’m not even sure how much she understands when I talk to her. She’s afraid of noises and reacts to all new people by putting them behind an iron wall on the other side of which exists only herself and the toys she is silently lining up in rows. How in the world is this guy going to figure out how well she can see?!” Skeptical doesn’t even touch how I felt about the appointment, but the school system would not proceed with the evaluation until we saw this guy. So, we went.
I walked into Dr. Board‘s office and could not believe my eyes. The kids’ side of this office looked like every child’s dream. There were trees growing out of the walls, play houses with fully-equipped child-size kitchens, beautiful fish tanks, racks of books, a kid-sized grocery store in the corner (it’s awning was built into the ceiling), and baskets and baskets of toys. I felt like I was visiting the Marbles Museum in miniature. Instantly, I felt a little more at ease. I knew just by looking around the waiting room that this doctor knew a thing or two about how to relate to children. Still a little concerned that autism would derail this man’s expertise, I waited anxiously while Riley went nuts exploring Adventure Land.
In the office, Dr. Board seemed completely unruffled by his failed attempts at eliciting appropriate responses from Riley. I discovered that pediatric ophthalmologists (or at least this one) have a plethora of amazing tricks with which to expertly glean information from nonverbal children. A bird I had not seen when we walked in the room cuckooed and flew out from the wall. Lights danced on the ceiling, invisible bells tinkled, hidden toys popped out of interesting places, and Riley was very happy and very, very cooperative. In half an hour, Dr. Board had thoroughly examined her eyes, filled out the forms for the school system, and sent us packing.
So, when Kevin and I agreed with the pediatrician’s suggestion that it was time to begin annual eye exams for the kids (Kevin did get his first pair of glasses when he was in the third grade.), I wasn’t overly concerned. In fact, I was all ready to make three appointments with Dr. Board and call it done. Then Kevin went to see his eye doctor.
Now, Kevin’s eye doctor is not a bad guy or even a bad doctor, but pediatrics are decidedly not his area of expertise. That is not what he told Kevin.
During Kevin’s eye exam, he asked a simple question. “How old should kids be when they have their first eye exam?”
This launched quite a discussion about our kids, their ages, their eyes, and their idiosyncracies.  “Oh bring them in,” Kevin’s doctor said blithely. “Kids are no problem.”
“Well, our oldest two are autistic, so I think my wife is just going to take them to the pediatric opthalmologist she used a while back.”
“Listen, I started out working with special needs kids. I worked in a school for the blind and disabled for years. It’s where I met my wife, actually, and she teaches autistic children. Well, she teaches a trainably mentally disabled class, but a lot of those kids have autism on top of everything else. Really, bring them in. I’ve worked with special needs kids for years. It’s my specialty. Not a problem.”
It was a problem.
Kevin naturally thought that since he’d been seeing this doctor regularly since we moved to Raleigh, and since his doctor seemed to know so much about special needs kids (“His wife even teaches some kids who have autism.”), we should give him a shot first. I was reluctant, but agreeable. Maybe this guy had a special room for kids or something that was as amazing as Dr. Board’s Wonderful World of Toys and Special Effects.
He didn’t and it wasn’t.
I had even talked this whole thing up with Zoe, who is always immediately skeptical about doctors. She had thoroughly interrogated me, repeatedly squeezing in “And he’s not going to give me a shot?” everywhere possible in the conversation. “No, no,” I’d said. “It’s going to be fun. He’ll get you to look at all kinds of neat things that pop out from the wall and bounce up under your feet, lights on the ceiling…Zoe, it’ll actually be a lot of fun.”
“And he’s not going to give me a shot?”
So, the waiting room in Kevin’s eye doctor’s office consists of six chairs crammed too close together in a tiny alcove. The space is all dedicated to shiny, breakable displays featuring all the latest in brand name eye glasses. I sat elbow to elbow between two very sweet elderly men, who didn’t complain once despite all the times the kids stepped directly on their toes or pressed hands on their thighs for balance as they engaged in animated competition to be the person allowed to plop his or her rear square on top of the stack of three clipboards I held in my lap. I alternated between trying to write our life’s history in triplicate on the clipboards and refereeing the contest. Intermittantly, I’d convice them to squeeze into an unoccupied corner or sit on my feet while I scrawled dates and checked boxes. I’m not sure if Adam actually had to go to the bathroom or just finally got tired of the sensory nightmare in the alcove, but when he asked, I pounced on the opportunity and locked all four of us in the bathroom for a few minutes (Where, I might add, there was just one toilet.)
When we walked out, my papers were filled out, and the assistant waited to take us back to the exam area. The assistant was very kind, and had no problem at all getting Riley and Zoe to look into the diagnostic machines and the neat camera that took digital images of their retinas. Other than having to repeat, “Look straight ahead, Sweetie” and “Look at the window, look at the window” over and over, she really didn’t have to work too hard to get what she needed from the girls. Adam was an entirely different story.
When she said, “Look straight ahead,” Adam looked straight ahead, just not into the machine. When she said, “Look at the window, honey, look at the window,” Adam started looking around. I could see the way he was wrinkling up the space between his eyes, and I knew exactly what he was thinking. Okay, so where’s the window? She had no idea that making such a request of a literal, autistic boy in a windowless room would create an extremely frustrating situation for him. He’s a smart kid. It was clear to him, having watched his sisters, that he was supposed to look into the machine, but the window? And the machine made this obnoxious clicking noise which made Adam move backward to investigate it more closely. Then he noticed the monitor she was looking in and wanted to see what she could see. Adam had no difficulty looking into the machine. The problem was that she wanted him to look a certain way, and all of her directions were just extremely confusing to him. No amount of gentle direction on my part seemed to help her to guide Adam in a way that made sense to him.
Then we went to the exam rooms.
In this doctor’s office, there is no such thing as a kids’ exam room. The room we walked into was decked out in all the muted gray and tan it could stand, and the only toy to be seen was a bland brown dragonfly attached to the ceiling above the exam chair (So that they could say, “Just look at the dragonfly” while they put dilating drops in the eyes.). Adam sat on my lap, while Riley had her eye exam. She did an excellent job. I marveled at the young girl she’s become. She was completely at ease and followed the doctor’s instructions without hesitation. Before we entered the room, I’d been told out of her hearing that the diagnostic tests showed Riley to be mildly far-sighted, but that the doctor would see how she fared in the actual exam. I had deliberately not told the doctor that Riley is also autistic, because many times now she can handle herself well enough without having any extraordinary measures taken on her behalf. I’ve also had plenty of experiences with doctors who hear the word autistic and immediately stop trying to talk to my children. These particularly uninformed professionals then just start rudely doing things to the kids without explaining what they are doing, and the kids (right on cue and also for obvious reasons) become extremely agitated. So, I waited to see how Riley could do on her own.
“Do you think you need glasses today?” The doctor asked her, while examining her eyes.
This is going to be interesting, I thought. “Yes,” Riley said simply.
“Why? Do you have trouble seeing up close or do you have trouble seeing far away?”
“I have trouble seeing up close,” Riley said immediately.
The doctor spun his instruments around in front of Riley’s face and started trying different options. “Is this better or is this better?”
“The second one is better,” Riley said.
“Is this better or is this worse?”
“Worse.”
And so it went between the two of them.   Another assistant came and got Zoe and took her to another exam room. I can’t tell you how wonderful it is to know that one of my children will be able to handle an exam like that and not have to worry. I sat there thinking, Wow. This feels remarkably normal. And then, Adam was bored. While the doctor explained that Riley had answered his questions exactly as he would’ve predicted based on his initial diagnostic tests, Adam decided to get the party going. He started beating out a distinct rhythm on the office wall.
“No, don’t hit the wall. It makes the eye charts vibrate,” the doctor told him.
So, Adam looked at the mirror on the wall, reaching toward it as he danced.
“Don’t touch that mirror,” the doctor said. Then, looking at me, he said, “Each one of those mirrors is worth over $200. They’re very expensive.”
What a far cry from the Wonderful World of Toys and Special Effects, I thought.
I smiled at Adam and beckoned him to come back over and sit in my lap. The doctor talked and talked and talked, explaining that since Riley had said she had trouble seeing up close he thought she could use some reading glasses for doing school work and working on the computer.
Then, he asked Adam to sit in the chair. “So, what’s unusual about Mr. Adam?” He asked me.
That’s a diplomatic way to ask, I thought.
I explained the situation, and he reiterated that he’d worked with special needs kids before. No problem.
There is a difference between being comfortable with special needs children and being equipped to conduct an exam on them, and that difference quickly became apparent. This doctor had absolutely zero magical ways to get my son to look where he should look or to make him feel at ease or to convince him that looking at the bland dragonfly and allowing drops to be placed in ones eyeballs is actually a good idea.
The exam was over almost as quickly as it began. “Well, we didn’t find out much today,” the doctor said.
How illuminating, I thought.
“My philosophy is that at least if we don’t create an uncomfortable memory for our special children (OUR special children?!), maybe they will be more willing to allow us to do more next year. Or, if you like, we can try again next week (Definitely not.).”
Realizing that our insurance pays for one exam per year and that diabetes makes this a particularly important exam for Adam, I immediately vowed that next year’s appointment (at least for Adam) would be made with Dr. Board.
As we left the exam room to pick out Riley’s glasses, Zoe came trotting out of the one next door. Apparently she is only very slightly far sighted and needs no glasses, as yet. Adam? Hmm…well…he’s definitely not blind.
On the way home, Zoe blurted (in a very accusatory tone), “Mom? Why did you tell me that would be fun?!”
“Umm…well…I thought it would be.”
“I didn’t think that was fun at all. Those drops in my eyes were hot.”
“Yea. Well, I’m sorry. I took Riley to a different eye doctor a long time ago and it was fun. I thought this might be fun too.”
There was a long, pregnant pause from the interrogator in the back seat.
“Mom, did you think that was fun?!”
Ah, well. I think next year maybe I’ll take all three of the kids to see Dr. Board.
(If Kevin had taken this picture, there would be no red eyes. Obviously, this is my amateur work.:)) Isn’t she beautiful?:)
