Lazy Eye- Update back from our appointment

[ValiantJoy07]

UPDATE: Thank you so much every one for your input... The appointment was a night mare in the sense that RJ screamed the whole exam. :bag :banghead DH came with me and we both left physically and emotionally drained (doesn't help that the girls had us up all night :yawn).


I'm exhausted.
The doctor said it was definitely strabismus and he wants to wait 8 weeks to see if it improves or gets worse, or stays the same and then decide if we need to do patching or if we'll just wait some more. He doesn't think she'll need glasses for theapy but he wasn't able to do the official vision screening untill he can see her when she's more calm.
Just wanted to give an update.

I feel like I have a lot of questions lately. :O

So dd1 has been having issues with her right eye where it wonders. The pedi yesterday was trying to see it wonder but it only does that if she's looking to the side it kinda goes haywire and goes WAY to the side. :-/ Over the screaming children I didn't thin to mention that...She said she couldn't see the lazy eye- but it's THERE it's worse when she's tired.
Anyway, We're taking RJ to the optomologist (sp?) next week to get it checked out. I've heard they do glasses first to correct it? Even if the vision is fine they use glasses to correct the issue?:think

Just wondering if some mama's who've BTDT could give me an idea of what we might expect as far as thearapy goes? I'd like to give DH a heads up of what we might expect- he tends to need warning when it comes to new things. I would like for him to be able to be as positive as possible about whatever the doc shares with us...He doesn't mean to be negative but often he doesn't think about how much dd understands now- and emotions/attitudes she picks up on. :shifty He's getting better...But having an idea of what others have been through should help a lot.

TIA!!:heart

[Little Forest]

I would definitely recommend that you see an optometrist, one who specializes in pediatrics and vision therapy. (If you PM me your town I might see if I can get a recommendation in your area.) Optometrists have more of an emphasis on the functionality of the vision and the eyes working together, not just the appearance of the eyes being straight. Vision therapy can retrain the functioning of the eyes together when it is needed and it works but unfortunately ophthalmologists have very little emphasis on this. (For full disclosure, see my siggy. I am not an unbiased source. ;))

By the way, the lay term for what you described is an occasional "eye turn" with the medical term being an intermittent strabismus. Definitely relevant information that you notice it when she is tired, by the way, but I don't think pediatricians really do not know so much detail about this condition.

"Lazy eye" is the lay term for amblyopia, which many times goes along with strabismus but really two difference things, which means that the eye cannot see as clearly as normal with the best correction (as in glasses) because it has not had a chance to develop normal vision. Not that I would expect any lay person to actually know this, but now you do.

The things to be tested with an eye doctor are the actual alignment of your child's eyes, the refractive error (how much power the eyes need to be in perfect focus), the visual acuities- how well the eyes see (as in 20/20), the binocularity which is the 3-D vision which tells how well the brain puts together the information from both eyes.

Your child should have some strong drops which force the focusing mechanism to relax while the refractive error is tested. This also allows a complete view of the inside of the eye for the doctor to check out the health of it.

Glasses will only be prescribed and would only work work if there really is a need for them. I would hazard a guess that with an occasional eye turn that there is very little chance of surgery being on the table.

[HomeWithMyBabies]

Peanut's intermittent esoptropia was diagnosed when he was seven months old so we've been at this for awhile. So far he's not been a candidate for surgery.

We see a pediatric ophthalmologist, they are trained in the medical and surgical treatment of strabismus. It was important to us to have his opinion should we ever need to consider surgery, and because an opthalmologist is trained to diagnosis and manage developmental abnormalities which were a high possibility with ds (thankfully his eyes are structurally perfect). He is very conservative has preferred to monitor ds and see if it resolves. He recommends patching. Ds's issues have just recently improved to the point where his eye turning only occurs when he's looking up close, so he's become a candidate for bifocal glasses. :tu

We had a fantastic experience with an occupational therapist who was certified in functional vision therapy. She helped us address the neurological issues that cause the strabismus. She started with us when ds was 15 months old, and significantly delayed, with vestibular based techniques that can be used on any level of ability. We don't have any developmental optometrists around here who can do exactly what she does so we felt very lucky to find her.

[trustingGod2]

The drops are just awful we had to pin ds down 3 days is a row to give him the drops then saw the dr. on the 4th he's had glasses for 3 years now he was 2 when we started I would shy away from patch therapy if that's what they want to try I haven't heard good reports on it ds eye seems straighter they said by age 8 he should be w/out the need for glasses.

[Little Forest]

I wanted to add, if patching is prescribed to your child, it is very important to do it. The purpose of it, the vast majority of the time, is to force an amblyopic eye to be used which develops the connections from the eye to the brain and in time will allow the potential vision to improve. (This is the correctable vision, what you can see with the best Rx lens in place. It is not meant to be able to reduce the need for glasses, by the way.) Patching is the only way to do this.

If you don't understand, press the doctor to explain things to you. Doctor comes from the Latin word for teacher, afterall. Seek a second opinion if you would like. But please, don't disregard treatment plans because doing so can sabotage your child's vision.

I am shocked to hear that any practitioner is using drops (presumably atropine) 4 days in a row before exam. Completely outdated protocol and completely unnecessary and horrible to have to put your child through.

I hope I do not offend with my bluntness.

[ValiantJoy07]

I would definitely recommend that you see an optometrist, one who specializes in pediatrics and vision therapy. (If you PM me your town I might see if I can get a recommendation in your area.) Optometrists have more of an emphasis on the functionality of the vision and the eyes working together, not just the appearance of the eyes being straight. Vision therapy can retrain the functioning of the eyes together when it is needed and it works but unfortunately ophthalmologists have very little emphasis on this. (For full disclosure, see my siggy. I am not an unbiased source. ;))

By the way, the lay term for what you described is an occasional "eye turn" with the medical term being an intermittent strabismus. Definitely relevant information that you notice it when she is tired, by the way, but I don't think pediatricians really do not know so much detail about this condition.

"Lazy eye" is the lay term for amblyopia, which many times goes along with strabismus but really two difference things, which means that the eye cannot see as clearly as normal with the best correction (as in glasses) because it has not had a chance to develop normal vision. Not that I would expect any lay person to actually know this, but now you do.

The things to be tested with an eye doctor are the actual alignment of your child's eyes, the refractive error (how much power the eyes need to be in perfect focus), the visual acuities- how well the eyes see (as in 20/20), the binocularity which is the 3-D vision which tells how well the brain puts together the information from both eyes.

Your child should have some strong drops which force the focusing mechanism to relax while the refractive error is tested. This also allows a complete view of the inside of the eye for the doctor to check out the health of it.

Glasses will only be prescribed and would only work work if there really is a need for them. I would hazard a guess that with an occasional eye turn that there is very little chance of surgery being on the table.

Thank you so much that was really informative!

---------- Post added at 08:24 AM ---------- Previous post was at 08:20 AM ----------

Peanut's intermittent esoptropia was diagnosed when he was seven months old so we've been at this for awhile. So far he's not been a candidate for surgery.

We see a pediatric ophthalmologist, they are trained in the medical and surgical treatment of strabismus. It was important to us to have his opinion should we ever need to consider surgery, and because an opthalmologist is trained to diagnosis and manage developmental abnormalities which were a high possibility with ds (thankfully his eyes are structurally perfect). He is very conservative has preferred to monitor ds and see if it resolves. He recommends patching. Ds's issues have just recently improved to the point where his eye turning only occurs when he's looking up close, so he's become a candidate for bifocal glasses. :tu

We had a fantastic experience with an occupational therapist who was certified in functional vision therapy. She helped us address the neurological issues that cause the strabismus. She started with us when ds was 15 months old, and significantly delayed, with vestibular based techniques that can be used on any level of ability. We don't have any developmental optometrists around here who can do exactly what she does so we felt very lucky to find her.

Thank you for sharing!! I've been watching her the past few days and it seems like she does it when she's looking at anythingin motion- trying to follow things. We've been playing "eye doctor" with a play spoon from her kitchen- I practice putting things near her face and having her follow the spoon and say "it's a little light" trying to prepare her for some one being near her face (she gets so anxious about strangers looking at her or touching her :nails)...I'm excited to get this looked at. My grandmother mentioned yesterday that she had a lazy eye when she was dd1's age...it corrected itself- I dont' plan on letting it to that, but good to hear that this might be one of those genetic thigns.

[HomeWithMyBabies]

Strabismus can be hereditary. :yes

There are areas of concern with patching therapy, so it's important to research it for yourself if it's prescribed. I do believe patching saved my son's vision in his left eye when he was an infant. We used it when his vision was significantly deficient in that eye. However, patching does nothing to directly address how the eyes work together, which is generally a neurological issue. When my son's vision was close to equal or equal in both eyes it was the OT that helped him to bring them together. For us (and this is simply my experience and not to be taken as any kind of advice) both approaches had their place at different times.

[ValiantJoy07]

:bump for update

[CakeLady]

DD has esotropia/amblyopia. We see a pediatric ophthalmologist and :heart him. DD patches 4hrs/day and has glasses. When we finally realized what was going on, see was pretty much blind in the one eye.

We had a whole host of other neurological issues steaming from this.

I hope you get some answers soon.

:hug2

[Little Forest]

Sorry to hear it was so traumatic for you and her! I was thinking about you and wondering so thanks for the update.

I still don't think it is bad advice to seek a second opinion from an optometrist who specializes in pediatrics and see if they might have other tricks to help the exam go a little more smoothly.

[ValiantJoy07]

Sorry to hear it was so traumatic for you and her! I was thinking about you and wondering so thanks for the update.

I still don't think it is bad advice to seek a second opinion from an optometrist who specializes in pediatrics and see if they might have other tricks to help the exam go a little more smoothly.

Thanks... The thing is the optomestrist isn't covered by our insurance- but the opthimologist IS. :scratch But we did go see a pediatric opthimologist he specializes in children under 2, he was very understanding...Dd1 just has an extreme fear of doctors- or really any adult that isn't MOmmy/Daddy/Nana touching her before she's warmed up to them (usually takes about 20-30 min). :( Some times I wonder if it's not residue left over from her trauatic birth and traumatic treatment by the medical staff at and after her birth.:cry

[Little Forest]

Thanks... The thing is the optomestrist isn't covered by our insurance- but the opthimologist IS. :scratch But we did go see a pediatric opthimologist he specializes in children under 2, he was very understanding...Dd1 just has an extreme fear of doctors- or really any adult that isn't MOmmy/Daddy/Nana touching her before she's warmed up to them (usually takes about 20-30 min). :( Some times I wonder if it's not residue left over from her trauatic birth and traumatic treatment by the medical staff at and after her birth.:cry

I have been out of the country for awhile and have almost forgotten about all the headaches of medical insurance.

I thought that in all the states by now optometrists are allowed on medical panels for the insurers meaning that they are providers who can bill for medical diagnoses. For example, if you have Blue Cross Blue Shield, there will be optometrists who are providers for that.

They would not cover routine exams but if an exam it is covered by an ophthalmologist because of a medical diagnosis which your girl has, it should also be covered an optometrist on the insurance panel too. Just FYI even if you don't want to go that route now.

I hope that it goes better for her the next time though!

[ValiantJoy07]

I have been out of the country for awhile and have almost forgotten about all the headaches of medical insurance.

I thought that in all the states by now optometrists are allowed on medical panels for the insurers meaning that they are providers who can bill for medical diagnoses. For example, if you have Blue Cross Blue Shield, there will be optometrists who are providers for that.

They would not cover routine exams but if an exam it is covered by an ophthalmologist because of a medical diagnosis which your girl has, it should also be covered an optometrist on the insurance panel too. Just FYI even if you don't want to go that route now.

I hope that it goes better for her the next time though!

Oooh that's interesting! If he wants to do any thing at all (or even if we get more "wait and see" and I feel like some thing could be done) I think we'll look into a second opinion iwth a pediatric optometrist if it's covered by insurance. We just don't have an extra $99+ if it's not- but a co-pay we can swing. :) Keeping this in mind. She's been rubbing her right eye when it goes out- I think since hte appointment she can see when it's going out and she tries to fix it- a good sign?
:nails

[Little Forest]

She's been rubbing her right eye when it goes out- I think since hte appointment she can see when it's going out and she tries to fix it- a good sign?
:nails

Yes, it is very good if she has an awareness of it happening. I hope you give us an update after the next time she is seen.