8 month old developed serious squint over night? please help

[peekabooo]

my 8 month old son has been fit and healthy since birth, he learned to focus his eyes from being one day old and has always seemed to have perfect eyesight which i fully expected as everyone in both sides of his family does...anyway he had a fall into a metal pole last week. it bruised above his left eye but after about a minute of crying he was back to his normal self, so i didnt think it was anything serious, then when he was at my parents 2 days after this incident, he fell from the sofa onto a carpeted concrete floor, we took him to a&e to be checked out, tho no visable injury was present, and they said he was fine and sent him home. the following day he wakes up with the most terrible squint in his left eye, basically his left eye is looking at his nose and will not move at all from this position. too him straight back to a&e who said to see gp following day, did this and they sent us to ophthalmologist straight away, they were baffled and he was looked at by at least 5 of them before being put on childrens ward overnight and having a ct scan the following day which showed nothing abnormal...then went back to ophthalmologist who seemed to disbelieve me that this has come on a sudden as i had said and asked to bring pictures of my son before the squint to the next appointment which he made for 2 months later!! he said it would have been caused by bad eyesight and they will arrange for him to wear patches/glasses etc in time to come...but i think he is wrong as he always seemed to have really good eyesight and surely the squint would have taken some time to develop, not just literally appeared overnight? it has been 5 days now since the squint appeared and his eye has not moved from the corner since! im so worried that his eyesight is deteriorating all the time he is left with this squint as i know it does...please can anyone offer any advise at all on this??

[peekabooo]

i should just mention that this is causing my son great distress, he is turning his head to one side to make his eyes straight so he can see properly

[nevergoogledragonbutter]

how awful for you to not know what is causing this.

I'm sorry i have no experience/advice but don't want your thread to go unanswered.

[NormaSnorks]

It does sound a bit weird, however I have heard that a squint can develop very suddenly as a result of a disease attacking a child's system e.g. after nasty chickenpox for example. May be the same thing can happen after a fall?

You obviously can't leave it for two months Can you contact the opth. and insist on seeing them sooner?
Otherwise I would get back to your GP and explain that your child is in distress.

My son had a squint, and it has now been 90% corrected, and is not noticeable.

[peekabooo]

thanks ngdb and norma... iv heard the same too about coming on suddenly after a disease etc and im pretty sure that the fall did cause it, but this is what is making me think it is wrong that they are going to try and treat his vision rather than correct the squint (he said it would be years before they would think about correcting it as they would try glasses/patches when he's older first),but i think this will just make his normally good vision deteriorate and think it is pointless treating his vision when it has never been a problem before i have been back to gp though and demanded a second opinion which she also agreed i should have...but still 2 weeks away

[whattheheckdoIdonow]

Hi there
I find this very odd.

What exactly did the paediatrician who reviewed him on the paed ward say ~ was it a consultant?~ and what did he say about the ct?

This does sound [to me medically trained not in paeds or neuro]like a possible cranial nerve palsy or localising sign ~ is it possible the CT/MRI should be repeated ?was it too early to show something?

I can understand your concern about this happening after trauma.

Is he alert and responsive otherwise and feeding etc?

The only other thing I could suggest is back to A&E tomorrow,demand ask to see the paed on call as well as the casualty officer and ask the reg/consultant WHAT THE CAUSE IS!

That is very much you shouting at them not me shouting at you btw.

[freudianslips]

If you're not in London, there are some other specialist eye infirmaries around the country, generally one per major connurbation e.g. Sunderland Eye Infirmary; Birmingham Eye Hospital ... they will all tend to have walk-in A&Es if you don't get any further with getting a second opinion sooner.

[whattheheckdoIdonow]

I also think a consultant paediatrician needs to see him asap and he can send you to someone else if he is not happy.
Obviously what springs to mind is raised pressure from the bumps causing pressure on the cranial nerve[6th?]and the paralysis of the eye.
I think MRI is more sensitive than the CT and you need to feel all areas have been thought about before just treating it as a normal squint.
There are other causes but it does not sound as if any other investigations were done so go back and see the consultant paediatrician.

Stress the suddenness of it and it following trauma.

[lucykate]

my dd developed a bad squint overnight. on the friday her eyes were fine, on saturday morning, her left eye had turned in. she was 18 months old. until that point we had no idea she had vision problems. it was 2 months before we got a referral appointment for her to see an opthalmic optician at the local hospital. obviously, we didn't have the added anxiety of the bumps on the head your ds has had, but to answer your questions, yes, squints can appear suddenly, and yes, you can think a child has really good eyesight when in fact, they don't.

dd's left eye is pointing at her nose. from my understanding of squints, it's usually because one eye has poorer vision than the other. for a while, the brain tries hard to use both eyes, then one day, the brain recognises that one eye is weaker, so stops using it. the muscles in the weaker, now unused, eye relax, and it drifts inwards. it will stay there, until glasses are introduced. the lenses of the glasses (most likely a different prescription for each eye) compensate for the poor vision, making both eyes equal. the brain then realises it can see through both eyes, and begins to use the weaker eye again, muscles are flexed in it and the eye is pulled straight. sometimes this doesn't happen, and needs a little kick start, which is when patching the good eye happens, which forces the brain to exercise the muscles in the weaker eye.

dd was picking up crumbs from a patterned carpet a few days before the squint came, so it was a real shock. she has very strong lenses for both eyes.

from one of your posts - "they are going to try and treat his vision rather than correct the squint (he said it would be years before they would think about correcting it as they would try glasses/patches when he's older first),but i think this will just make his normally good vision deteriorate and think it is pointless treating his vision when it has never been a problem before" - the issue here is children's eyes are changing all the time until roughly the age of 14, and sometimes before that age, squints can correct naturally. if they operate too early to correct the squint, and pull the eye straight, when/if the eye corrects itself, you will end up with the eye pointing out as it's now been overcorrected iyswim.

sorry for the long post, i'm not a medical expert, but have learnt a lot about childrens vision over the years, both dc's have squints. dd's vision is by far the worst, we've done patching for 9 months too

[peekabooo]

thanks everyone, we live inbetween sheffield and doncaster so im going to have a look today for a specialist hospital...lucykate, thanks for the info, my case does sound very similar to yours (apart from the trauma). did ur dd's eye dr say they have heard of this before? (all the ones we saw were totally baffled and had never heard of it coming on so sudden)??

could anyone tell me what age treatment for a squint (glesses, patch etc) usually starts?...it would be good if it could just be corrected this way but im still very sceptical about the head injury

thanks again everyone

[Seona1973]

I noticed dd's squint at around 18 months and she ended up with glasses from then as she is long sighted. She had patching treatment to improve the sight in the squinting eye and now they are pretty much equal. She also had a squint operation at age 4 which has made the squint look much better. She will always have glasses due to the strength of her prescription. They can test eyes from a very young age and glasses can also be prescribed from an early age. They wont just give glasses willy nilly as they will check the sight in each eye first.

p.s. none of my brothers (3 of them) or sister or me or dh or his siblings wear glasses either so it was a bit of a shock that dd had bad eyesight.

[lucykate]

yes, everyone we've seen has said squints can appear all of a sudden. dd started wearing glasses straight away after her referral, i left the appointment and went straight to the opticians. the patching began when she was 5, she's been seen every 6 months to make sure her eyes were working together via her glasses, but at 5, the weaker eye started to drop off again, 9 months of patching for 2 hours a day sorted it out. we've never been offered surgery for her squint, she has double vision without her glasses and astigmatism too.

patching can be done at any age. it took dd a while to accept the glasses, 3 months or so, but pretty soon she realised that without them, she can't see! she has prescription googles for swimming too.

she was discharged by the hospital at the age of 6 and now goes to a normal optician. spongebob glasses from specsavers! ds still goes to the hospital, he's not wearing glasses atm, as the vision is fine in his right eye, his left eye is slightly squinting, if it gets worse, he'll have to wear glasses too.

i cried when i found out about dd's eyes, was gutted for her, but since then, it's become no big thing, she looks odd without her glasses now and says she likes wearing them (dd just asked me to add that!)

[peekabooo]

im glad it all worked out for your daughter lucykate and im sure she looks very beautiful and smart in her glasses

im a little worried about how they are going to find out if he does have vision problems though, as he just closes his eyes tight and turns his head whenever the opht comes near him with the light?? has any one got any tips on how to make a 8 month old stay still and keep his eyes open while they are being examined?

[jellybeans]

DS didn't squint till about 18m before that he was fine, I only noticed it on photos at first. Was told squints can come on suddenly when the various eye muscles come into play.

[danabu]

Hi, I'm an optometrist and what previous posters have told you about squints is about right. The eye dept will be used to dealing with babies and young children. The falls may just be coincidence. Does his left eye straighten up if you cover his right eye with your hand? Your ds is still young and by being treated early he has a really good chance of developing good vision in both eyes.

[lucykate]

they will be used to dealing with uncooperative children, they have lots of toys etc for distracting them. with both dd & ds, it was a case of drops in the eye to dilate it, then a quick look to establish the problem. it's wasn't until they were older that it was done with vision tests.

the hardest part is the drops sting a little, and you have to hold on to them while they go in. it's only for a few seconds though, it's over quickly, and it's a small price to pay for making sure their vision is ok.

i'm sure your ds will be ok, are you still worried about the bumps on his head?, how is he today?. like danabu said, try holding your hand over the un-squinting eye and give him something to fiddle with, does the eye that's squinting start to straighten up?, it should do as the brain realises if it doesn't use that eye, he can't see. if that's happening, then it is most likely his vision that's behind it. 8 months is a good age to catch it, ds had glasses at 8 months.

[peekabooo]

in reply to danabu and lucykate about covering the good eye to see if the squinting eye moves...it doesnt at all its just like its stuck in the corner?

[lucykate]

hmm, maybe, given he's had these knocks on the head, a quicker way to rule out eyesight and maybe get seen earlier than waiting for a referral would be to take him to an optician. i'm not 100% certain if they would see him given his age, but if you explain what's happened, maybe they would? some specsavers branches are open on a sunday, might be worth popping in on the off chance.

have just tried the covering the eye thing with dd, and her eye does go straight when i cover her good eye. but her eyes have a bit of training to do this, with the glasses/patching.

i know how stressful the not knowing can be, when dd's eye went, i worried that she'd had something like a stroke , scary that something like this can just happen literally overnight!

[peekabooo]

yes il try that tomorrow thanks....and i know, its really scary, u take it for granted that everything is all hunky dorey and then bang my world has been turned upside down...your quite right though, its the not knowing that is killing me the most

[whattheheckdoIdonow]

peekaboo ~ I still think it a bit odd his eye is not moving at all ~what did the paediatrician tell you re the cause ~ was it a consultant ?

[peekabooo]

yes we did see a paediatric consultant and he said he did not think it was caused by his sight and that he needed more tests to find out why it happened...then we didn't see him again and hospital sent us home with a promise for an mri in 2 weeks to a months time? i asked if there was any possibility to have this sooner but they said no so im still left worried and none the wiser on whats going on

[whattheheckdoIdonow]

Did he have any other tests in the hospital?

I think you should go back to A&E and then ask for paed referral and explain you don't understand what the problem is,it hasn't been explained and the eye is totally fixed.

It is possible this is an oversight and I think it would be wise to go back and get 2nd opinion.

If a second paediatrician confirms what they are doing is right then at least you will have tried to confirm what is going on.

But if the next DR thinks something is amiss and takes different action then it is better to go now than wait.

So go back to A&E tomorrow am.

[peekabooo]

when he was in last week they did a ct scan and checked his blood pressure/heart rate every so often, but thats about it. iv already been back to gp and a&e but they just tell me there is nothing else they can do before the mri has been done i have arranged for a second opinion from another opht at a different hospital...but they cant do it while friday! so it looks like im just going to be left worrying until then

[whattheheckdoIdonow]

Oh didn't realise you had been back a second time with the squint to A&E.

I suppose with something apparently sudden like this it would have been nice to have the MRI done as an in patient or straight away rather than having this gap.

Sorry you have this worry ~ lets hope you get the MRI date soon~is there a number you can ring or do you just have to wait?