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Mumsnetters aren't necessarily qualified to help if your child is unwell. If you have any serious medical concerns, we would urge you to consult your GP.

Lazy eye, squints, glasses etc.....

(936 Posts)
cheekyginger Thu 01-Sep-11 22:38:05

Im an orthoptist (binocular vision specialist) and a mummy.

I thought i would start this thread in case anyone was wanting any advice, re-assurance, opinions about any eye problems that you wee ones are having.

Rowgtfc72 Sat 17-Nov-12 08:00:45

Thanks cheekyginger . Dd has just been to pick some new glasses and as her head is too big for kids glasses shes come away with some teen FCUK purple ones and is over the moon ! grin

OhThePacesYoullGo Sat 17-Nov-12 13:34:43

Hi cheekyginger, a genuine thank you for setting up this thread.

Both my twin dds have a squint and have been seen by the hospital until recently when they were signed off due to having their 7th birthday in August. Both have glasses for their squint and farsightedness. Dd1 did have surgery to correct the squint in her right eye and it has made a tremendous difference. Dd2 has had no correction, because hers isn't so prominent. Both the stigmatism and farsightedness since dd1s op have always been remarkably similar, or so the hospital consultants have informed me.

Sorry just giving some background due to the relevance it has on my question.

Dd2 has recently been screened for dyslexia and it came back as strongly at risk. Due to this we took her for an overlay assessment. The results came back that an overlay wouldn't help at this time. They did say that both eyes are fighting for dominance, and that there is no dominant eye. Due to this he recommends bifocals.

Do you think the bifocals will make a difference to her ability to read and write? Is there a known link or any studies to the lack of dominance and visual stress and the reading and writing? Lastly, dd1 is on the list to also have a screening for dyslexia in December. In your opinion would it be best to wait for the results of the test before taking her to have a overlay assessment or to do that ASAP? Or should I just ask for bifocals for her as well?

I'm also a little confused as to why the hospital didn't pick up the bifocals first. I've always been informed that the squint they have is the best squint to have due to it being both eyes and neither eye having to strain due to the other taking turns. Shouldn't it have been mentioned that they or dd2 had no eye dominance and the impact it could have, or do you think it was something they don't check for?

Sorry for the epic post.

Cene Sat 17-Nov-12 13:42:30

Hi CheekyGinger,
My 6 yr old daughter has just had an eye test at the local opticians. We have been told that she will need to wear glasses (hopefully) on a temparary basis. Her left eye is slightly less focused than her right eye. On the prescription in the Cyl box it shows +0.75, when she was first checked a year ago it was Cyl +0.50. Now the optician wants to try glasses to correct her left eye and prevent it from becoming Lazy? She will have to wear the glasses all the time but hopefully only for a year or so. Does this sound right? I have never heard of only wearing glasess temporarily before.

Many Thanks

cheekyginger Mon 19-Nov-12 21:30:48

I can honestly say i have never heard of using bifocals if the eyes are "fighting for dominance". Bifocals can be used in some very particular types of squints that have binocular vision. But from what you describe your daughter has a constant squint that is now smaller after her surgery. If your child has a constant squint then bifocals will not help.

Who did this overlay assessment? A behavioural optometrist?

I would strongly advise against bifocals in this age. There is no evidence in any literature that recommends bifocals for reading problems in children. Your child may have an alternating squint and will therefore not have a truly dominant eye. But this in itself will not cause reading/writing problems.

We carry out an overlay clinic in our department and are often confronted with parents wanting to do the right thing for their kids. The rate of reading test that is used to see if overlays help is fairly accurate and if there is not a significant increase in reading ability then coloured overlays will not help.

I imagine that you have paid for some of this angry? I can only recommend that you don't pay any more!!!! I get so angry that mums and dads are taken advantage of!!

Sorry if this has turned into a bit of a rant!!!!

cheekyginger Mon 19-Nov-12 21:46:27

Hi Cene,

Has your DD got a prescription at all in the other eye or is it all zero's?

This is a really really mild prescription. She probably would have been fine just to have her vision monitored and hold off giving her the glasses. However, they certainly wont do any harm.
Is she wearing them? Dont worry too much if she doesn't wear them. Just keep your regular eye checks and if her vision was to deteriorate then they should be worn more often. smile

OhThePacesYoullGo Tue 20-Nov-12 19:43:10

Thank you, yes it was a behaviour optometrist. The 'fighting for dominance' admittedly could have been my dds dads interpretation of the opticians words. He was present during the 1 hr long assessment and I'm trying to make sense of it from his feedback. Having interrogated questioned him again he 'thinks' those words were used. hmm

Both girls have alternating squints and I'm aware that they can't see in 3d although nothing has ever been mentioned in regards to binocular vision, so I'm 99% sure they / she doesn't have it. I'm back at the opticians again tomorrow and your reply has given me great food for thought and a list of questions to be addressed.

Thanks again for your advice thanks

cheekyginger Tue 20-Nov-12 20:17:00

No worries Ohthe,

Good luck to the behavioural optometrist (BO)!!! When you arrive with your questions.

The fact that your DD's dont have binocular vision will not have any relevance on their ability to read/write etc. Some children with dyselxia can have Meares Irlen Syndrome which can benefit from coloured overlays. You said she was already assessed for this but you might find this link useful.
Other problems can include problems with tracking along a line of text. Which can be treated with exercises, NOT bifocals.

You could ask the BO if the bifocals will make your DD's accommodation lazy and and cause more problems in the long run?
If the bifocals are being given because she has an accommodation weakness, why are exercises not being tried first. Bifocals for accommodation weakness are only given as an absolutely last resort in children.

cheekyginger Tue 20-Nov-12 21:21:17

Hi OhThe

Have a look at this article if you get a chance to before your appointment.

I had a wee search online just to make sure what I was telling you was the truth. Have a look specifically at the conclusion section of this article basically saying that there is no definitive evidence that ocular dominance and reading problems are related.

shallweshop Fri 23-Nov-12 13:39:28

Hi Cheekyginger. You have helped me in the past and I am hoping you can give me a bit of advice on my current problem. DD (8) is long-sighted with her left eye being quite a lot weaker than her right (think its something like +6.50 vs +4.0). We have patched in the past which helped correct the lazy eye a bit but it had slipped back slightly on her last eye test and we have a new prescription to try and rectify this.

The problem is that she absolutely hates wearing her glasses and the older she gets, the more I have to battle with her. She was taking them off at school so I had to have a stern talking to her about that. In the hope that she will not go behind my back on this, I have agreed that she can take her glasses off just at playtime as long as she puts them back on the minute she gets back to class. I am now worrying that I have made the wrong decision and that I should just insist on her wearing them 24/7. Do you think it will hurt for her to have a small break from them in the day as long as she is wearing them for her classwork?


TTurnip Sat 24-Nov-12 20:23:18

Hi - this is the first time I have been on a forum but I am so in the dark with this one I need help. After a routine eye check at school (age 5) my daughter was referred up to the eye hospital with poor vision in her left eye. She had shown no symptoms/complaints at all until now and had no squint or noticable eye issues. The eye hospital have given her a +7.5 in her left eye (+1 in her right) - this is a real shock and I really want to understand whether this will get better in time with glasses, or in fact worse. From reading up - this prescription seems horrendous, but I can't believe that I've never noticed the problem if its so bad... help...

Tgger Sat 24-Nov-12 22:19:35

I'm sure cheekyginger will be on soon to give you expert advice but I just wanted to say don't feel bad in not noticing- it's very normal with kids not to notice, when they are young and don't know any different you won't necessarily notice..

From the prescription it looks like one eye is not bad at all, whereas the other is a strong prescription. If it's any consolation at the same age DS was given a prescription of +5 in one eye and +5.5 in the other. He also has a squint and a lazy eye. We hadn't noticed anything. The lazy eye is now much better after patching (one line less than normal last appointment) and the squint is corrected by his glasses.

I won't offer any more advice as I am not a professional just a parent having gone through some of the same trauma- it does feel traumatic at the time, but we adjusted pretty quick..... advice for us was DS would probably need glasses life-long, but his eyes may or may not improve a little as time goes on. The main priority for him was sorting out his lazy eye as much as possible as this needs to be done before eyes mature (6-8).

TTurnip Sun 25-Nov-12 20:09:03

Hi - thanks so much for your reply - I always thought myself quite level headed but this has really troubled me. My daughters now aware of the issue now and will cover one eye and explain how little she can see!! It doesn't seem to have worried her too much and shes looking forward to getting her "pink glasses with princesses on the side" tomorrow. I am still keen to look into any possible exercises / techniques for improving her sight if at all possible - thanks again (:

shallweshop Sun 25-Nov-12 21:58:36

Again, another non-professional reply but similar experience. DD's lazy eye picked up at routine school eye test, had no idea how bad her left eye was (+6.50) or that her right eye was doing all the work. I felt so guilty but there was absolutely no indication before the school test that anything was wrong. We have been through patching and it has helped to improve her vision in her lazy eye.

TTurnip Mon 26-Nov-12 18:10:01

Thanks for the message. The optometrist at the eye hospital did not mention a lazy eye, but did say that the brain is still able to be 'trained' into using this eye - but I am not sure if that will actually make the eye better? All very confusing. There was also no mention at all of patching. My daughter has another appointment in 8 weeks so I'll be sure to take a list of questions !!

Tgger Mon 26-Nov-12 21:10:26

Hopefully cheekyginger will be on here soon to give you some professional advice grin. I would have thought that if they thought she had a lazy eye they would have said this to you already and mentioned the patching treatment that should follow at some point if this is the case- we learnt straight away that DS would need this and took home relevant leaflets. Mind you he has a squint and the two often go hand in hand (eye became lazy due to squint). They didn't start the patching treatment until he'd been wearing his glasses for a couple of months. Also to try to explain-with glasses on his lazy eye was still rubbish (due to being a lazy eye...) to start with and his vision with the glasses on was still about 4 lines less than normal sight (pretty bad if you think of those letter charts). After patching it has settled on one line less than normal sight (with glasses on)- a pretty good improvement really. They've stopped patching for now, but he has a check in January to check and we may or may not have to patch again then.

seaside72 Tue 27-Nov-12 21:41:14

Hi cheekyginger

Just found this thread and like lots on here my DS (4.10) has just had his first eye test at school. It has come back saying "reduced vision in left eye today" and we will be referred. Like many others I am now panicking and tonight DH and I asked him to cover his right eye and it seems really bad. He is basically guessing what he can see unless it is pretty close. I have booked another appointment with the optician tomorrow as with Xmas I am not sure how long until we get the referral.

The main thing that is worrying me is that I have also just gone back through our photos and I am sure he has a small white patch on that iris that shows up with the flash sometimes, it actually is more noticeable when I have tried to "correct" the red eye as it does not get corrected IYSWIM? This is really bad isn't it? Everything I look up about this is awful, no one seems to say this can mean nothing or is harmless. I am petrified of the worst and all sense of reason has left me.

I think I had better make a docs appt too to cover all bases. I just wondered if you had any experience of this at all.

Many thanks

dixyde Tue 27-Nov-12 23:14:28

Hi seaside72 iI am not a professional, but had this experience myself with dd1 age 5. I was told by the optician that because she was more longsighted in one eye than the other, the light reflected off her lense differently and so gave a white look to it. Despite this I would recommend getting it checked with an optician as it is possible it could be something else. I just wanted to put you mind at ease and let you know that it is prob nothing. Hopefully cheeky can confirm this for you. X

seaside72 Tue 27-Nov-12 23:36:05

Ahh - thank you dixyde, it is good to hear that it is not always something awful, googling obsessively tends to fill me with fear that all outcomes are scary. Will see what optician says tomorrow and then gp too.

cheekyginger Sun 02-Dec-12 20:37:39

Hi TTurnip,

Looks like you got lots of sensible feedback already!!! grin

By the sound of it your LO is Anisometropic, which is the fancy name for a difference in prescription between the two eyes. Yes she will have amblyopia which is more commonly known as a lazy eye (in your DD's case it would be called anisometropic amblyopia). However children can have a lazy eye even though the eyes are straight. The vision will be lazy as the eye with the +7.00 will have had always been blurred therefore the vision cells in the brain for that eye will not have developed properly.

But don't panic. The visual system of the brain is very flexible up until the age of 8-9. It's very likely that your DD will need patching, but they will explain that at your next appointment. Your first appointment would have been with the optometrist and they may not have been happy to discuss patching as they dont actually prescribe it. Your next appointment will be with the orthoptist who should be able to explain it all. Patching may not be started until the vision stops improving with the glasses. Once the vision plateaus that is when patching is started.

Good luck with the glasses.

cheekyginger Sun 02-Dec-12 20:45:11

Hi seaside72,

How did it go at the opticians?

In 99.9% of cases a white pupil in a photograph is nothing sinister.

It is likely that he will need glasses if he failed his vision test at school.....but your optician is the best person to see TBH, they do a much more thorough check than the GP would do, purely because they are trained so well at checking the eye grin

cheekyginger Mon 03-Dec-12 21:45:16

I got a hug of a patient today! grin

Told a lady she could still drive and she gave me a big hug.....awww nice to give people good news.

seaside72 Mon 03-Dec-12 23:27:46

Thanks cheeky

Opticians was lovely and could see the fear and panic me and Dh were feeling. She said same as you and said the retina and vessels all looked fine, She has referred us to the hospital where DS will have the drops for a more thorough examination.

Strangely she gave DS the exact same dx at TTurnip - +1 in the right eye but +7 in the left. And like TT we have never noticed anything with the left eye, ever. His reading is great, hand eye coordination, tennis etc. No sign of the eye wandering.

We are still feeling a bit sad and shocked as I have 20/20 and DH is very slightly short sighted. My mother is farsighted though so I guess it has just skipped a generation? I really hope the +7 may be able to improve a bit in the next few years for him.

TTurnip - we will have to keep in touch and compare notes smile

cheekyginger Thu 06-Dec-12 21:58:50

Hi seaside72, it's true that these things can be passed through the family, but they can also just happen spontaneously too.

That's why vision screening is so important as these things are best picked up at this age. Good luck smile

sassytoo Thu 06-Dec-12 22:09:04

DS aged 6 has been wearing glasses for about a year. He had an eye test last weekend and his good eye is now the same as his weak eye, both +2.75. The optician said this was good but I don't understand, doesnt it mean that his better eye is getting weaker or is it better to have both eyes the same? Also with this strength prescription is it a possibility that he will grow out of it? Thanks in advance for any advice you can give.

TenPercenter Thu 06-Dec-12 23:08:44

I had the same as you seaside, noticed a white eye in a photo, googled and panicked. Ds was only 6mo though, it was fine, he had the drops, no scary diagnosis, he was longsighted.

Now at 3, has glasses and a patch, he was also diagnosed with a lazy eye a couple of months ago, he has only had the patch for a month and already it has reduced from all day, to half a day.

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