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

[cheekyginger]

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.

Just saw your post now while searching for squints.

My DD (19 months) has just been referred to hospital for a squint in her left eye.

It appeared when she was about 6 months old (4 months corrected, she was perm), totally went a few months later and recently came back worse than ever.

Its there pretty much constantly, although notably worse when she is tired or concentrating.

Just wondered what the likely first step of treatment would be? She was referred 8 weeks ago and still heard nothing, my Mum wants to pay for her to be seen privately - worth it?

Can I ask about adults with a lazy eye? I had a lazy eye as a child and glasses from 2. Did patching etc but eye remains lazy, with the result that I have one short sighted eye and one lazy long sighted eye, and i get double vision if both are corrected. Eye hospital advised glasses to correct the short sight and nothing for the lazy eye, but that was 15 years ago and now my optician wants to start correcting the long sighted eye. I feel uneasy about that so wondered what you would advise

dd got glasses at 18 months after I noticed she was squinting in her left eye. She is long sighted and the sight in her left eye was poorer than in the right eye. She got glasses to help her see and had patching treatment to improve the sight in her right eye. The sight in both eyes is now pretty much equal but she will probably always need to wear glasses.

Therinmadness - if you have prisms, you won't have double vision with your longsighted eye corrected, and surely its better to be using it ?
I'm a squinting adult, but have both eyes shortsighted, and loads of prisms

Hi everyone,

Hi gabity:
Your LO will likely be assessed for glasses either at first or second visit. From what you describe your wee one might need glasses. When children are longsighted their eyes have to over accommodate to see near objects clearly, and in some cases this over accommodation causes a convergent (turns inwards) squint. If this is the case glasses may fully correct the squint or make it smaller, but this wont be known until your LO is wearing their glasses for a few weeks/months.
They will also try and get a rough estimate of her vision to assess whether the vision is getting a little bit lazy in her squinting eye. If they find that her vision is reduced over a few visits then she may require patching. A patch on the good eye that allows the lazy eye to work harder.
Hope this is kind of what you were expecting? Feel free to PM me if you want to ask anymore questions.

Hi madness,

From what you describe you should avoid getting the vision corrected in your lazy eye especially if you get double vision when it is corrected.
If you have never had binocular vision (straight eyes) correcting your vision in the lazy eye, in your specific case, will really confuse your brain!!! You cant develop binocular vision as an adult if you've never had it in childhood when your eyes are developing.
Prisms, that one of the other posters mentioned, wouldnt be suitable in your case as prisms are used to maintain binocular vision and by the sounds of it you dont have any, so for you, using one eye is the best solution.
Hope this answers your question.....

bump

hi madness -bit of thread butting but I'm an adult with a squint I have had all my life
I had 5 ops to cosmetically correct my squit but I've never had binocular vision -the last one was at 11 so 22 years ago and I was told that if my eye started to turn again then there was nothing more that could be done

4 years ago it had got significantly worse (I blame having kids lol) so mentioned it to my optician, she sent me to GP who then refered me to the hospital, and 4 months later I had a 6th op to correct my squint -so far so good!

I still don't see out of both eyes (I can see out of both eyes but my brain doesn't register both pictures so tend to flick from one eye to the other depending on where the thing is I'm looking at if that makes any sense) but cosmetically it has made a huge difference -might be worth askig for a referal back to the hospital if it has been a long time since you went and things change :)

Hi Cheeky Ginger, I think your thread is brilliant and also very kind of you!

My DD2 3.5yrs has limbal stem cell failure (with associated epithelial defects, corneal vascularisation, cell migration etc.) corneal scarring to the centre of her right eye, her retina (both eyes) is underdeveloped (macula is flat not dipped) and she is also long sighted one eye and short sighted the other. Vision is 1.8 and 0.8 logmar. No success with the 3D tests and often struggles with depth perception.

We are managing to keep glasses on and medicating with steroids and dry eye treatment.

I've noticed recently that when we are late for school in a rush and DD is walking fast she asks to be carried and says she feels dizzy. I've noticed in general she's slowed down, doesn't try to run about so much anymore too. I'm trying not to worry and my initial thought is that perhaps her vision or the image she sees becomes more blurred if she's moving around fast and that's what she means by 'dizzy'? Would that be a reasonable assumption?

We have an appointment at the hospital on Monday anyway so will discuss it then but thought I would ask as it has been really bad over the last couple of days.

Thank you!

Ooh just what I need today! What are the chances?!

Have just picked up DD (2.4) from nursery and they mentioned they've noticed her left eye drifting inwards when concentrating on something close at hand, which is something my mum and I noticed as well on Saturday. Her uncle, DHs brother, had a lazy eye as a child requiring a patch (that was never worn) and now glasses (that he never wears). It seems to my untrained opinion that DD seems to have a lazy eye herself. What do you think?

I'm planning on taking her down town tomorrow as I'm off work and popping into Boots Opticians who do my eye tests and seeing what they think.
Just wondered if you or anyone had any advice or if there's something I'm missing.

Thanks!

Hello Cheeky, how kind of you to start this thread.

DD is nearly 3, and since she was around a year we have been told that she will have to have surgery for her convergent? squint. She has just started wearing patches for a couple of hours a day but my question really is what should I expect from the surgery? Is there anything I can do to make it easier on DD?

My DS is 2.2 and has been blinking a lot, often during story time. It's not like fluttery blinking; he squeezes his eyes shut and then opens them again. We thought it might be hay fever in the summer and/or tiredness, but he's doing it more and more. Any ideas?

Hi cheeky,
I was just wondering about getting dd3's eyes tested again. Typically how often should children get their eyes tested? We live in the US, and they are screened at school with a letter sent home if any concerns. One time all 3 kids had "concerning" eye tests at the drs (annual check up) so I took them to opthamologist, only for all to be pronounced perfect. Anyway, dd3 has cerebral palsy, no previous problems with sight, but school nurse has now sent home a letter requesting a "proper check-up", with the reason given as "other" (Out of a list of eye problems). I know I need to ask her what "other" means, but do you have any thoughts on eye test frequency?

I would like to know...

DD is 5 and has prescription +1.5 in right eye and +6.5 in left..not good I know. Until recently she would not wear her glasses at all (she has autism)..is now wearing them for 2-3 hours a day..no lazy eye YET..could this be enough to stave it off? (we have no hope of managing patching with her)...

TIA

Another question Cheeky Ginger - thanks for offering advice!
My DD (6) has been prescribed glasses 6 months ago - one eye +3.5, the other +1. We are trying our hardest to make sure she wears her glasses all the time - according to the Optician, she is over the age limit where they try patching - is there anything else we should/could be doing?

And another question - how early can I get DS (2) tested to make sure we pick this up earlier if necessary?

bump

I don't have a question, but for the parents who are currently starting to deal with lazy eyes etc, I thought I'd post my experience.
Ds's lazy eye was spotted at a HV check at 39 months. To get a quick diagnosis, I took him to specsavers, where they literally diagnosed glasses which "he would have to wear for the rest of his life" and nothing else.
I asked to be referred to the orthoptists at our local hospital.
they did a much more thorough check, diagnosed glasses and patching. He had to wear his patch for about 18 months, and in that time went from only being able to distinguish shapes / letters nearly two inches tall, to now only having to have a +3 prescription on his glasses. (With his glasses on he has near perfect vision, without them he's still a bit longsighted but nowhere near as bad as he was.)
Wearing the patch was not onerous, but we did obey instructions as to timing rigidly.
We've been told that once he gets into his teens he'll not have to wear his glasses all the time (will be able to leave them off for nights out etc if he wants) and if he chooses to wear contacts in the future he'll just need one (which tickles me for some reason).
Just thought I'd post a positive outcome!

Another positive outcome here for lazy eye.

I am now in mids 40's . I have a lazy eye that was operated on when I was 18 months - had the patch during childhood , never needed glassed.

Went on to join police - passed medical no problem - during my career was advanced driver and firearms officer.

I now wear glasses for reading - nothing to do with lazy eye just old age .

Not been on for a while...oops!!!

Littlewhite I hate to say it but some convergent squints (turning in) dont appear until this age as thats when they really start to focus on things. The lens in your eye focuses from a very young age this is called accommodation, and when your eyes accommodate to look at things up close your eyes naturally converge. When children hit nursery they are suddenly doing alot more accommodating, and squints can become apparent. This means that your daughter might be longsighted and she should be assessed for glasses asap. Generally kids as young as your LO will be referred to your nearest eye clinic but this can be done by your optician.

martyrStewart squint surgery is either cosmetic, which will make the eye look straight OR functional to help some patients use the eyes together again. Your orthoptist/eye DR should be able to tell you which. If it is purely cosmetic it CAN get done at any age and its up to you.

damselindiss blinking can just be a phase that some kids go through. If you have a family history of squints or glasses it would be worth taking them to an optician.

wentshopping here in the UK (scotland) children get a eye test in their pre-school year at nursery (3.5 - 4.5) then there are no other official eye screenings. Its really up to you as a parent if you have concerns. Certainly would do no harm to get kids eyes checked when they are in primary 2/3 then before going into high school at approx age10/11.

Fanjo anytime she has them on will help towards preventing a lazy eye. It is quite a big difference between then eyes so the longer she can have them on the better. Do you see an orthoptist? Have they ever mentioned atropine as an alternative to patching??? You can pm me if you want more info....

Yanka I would get a second opinion tbh. We have attempted patching up to 10 yoa. If your child has a squint as well as the glasses this should be done with care. But if no squint, patching is always worth a go. Your visual pathway still has "plasticity" until the age of 9-11 ish!! DS 2, unless you have concerns wait till he's about 1 and ask to be referred to your local eye clinic.

THANKS FOR ALL YOUR INTEREST!!
WILL NOT LEAVE IT SO LONG NEXT TIME

wow - thanks for setting up this thread. My son got his glasses today and says that everything is blurry. Does that sound right? He has mild longsightedness with a 1.25 prescription in one eye and 1.0 in the other. He is 5.

Glad this thread has been helpfull!!!

schmee This is a very common problem!! When a child is longsighted and not wearing glasses they have to constantly overfocus their eyes to see clearly. In some cases like your son when they first get their glasses their eyes don't realise they can relax and let the glasses see for them. It can a few hours/days/weeks to adapt everybody is different.

Its not a massive prescription so encourage him to wear them mostly for closework initially and gradually increase the time he has them on.

Good luck x

Thank you!

cheekyginger, thank you for being so generous with your advice on this thread. dd is almost 10 and has worn glasses since she was 22 months old. her prescription is something along the lines of a +4.75 and a +5.25 (i can find the full details if you need them), she has a squint in the weaker left eye, astigmatism and double vision without her glasses, but she wears the glasses all the time.

my questions are, she's done 9 months of patching a few years ago which did help improve the left eye, would she benefit from any more? what is the long term prognosis for her vision?, her prescriptions seem to be gradually lessening in strength, how much improvement is realistic to expect?

Can I ask something please.....
Does binocular vision improve after the age of 8 ish?
DS is long sighted, and has astigmatisms. As he was discharged from eye hospital care, age 7, binoc vision was just beginning to work. Don't think optician checks for it.
Thanks.

deanery Our guidelines for stopping the patch are based on the child's vision. If the vision is static over 2 visits then the optimum level has been achieved. If your eye clinic stopped the patching after 9 months then they must have achieved the best level of vision and that's why it was stopped. Therefore there would be no benefit in doing any more patching.

Longterm, her vision should remain around the level that was achieved with the patching. Her prescription will fluctuate but it would be unlikely to reduce enough for her to manage without them. Contact lenses would be an option in the future if she wanted them. Whatever effect the glasses have on her eyes she can expect the same from contact lenses.

cupoftea Thats a tricky question! Most kids have their treatment to maximise their vision and their binocular vision(BV), and once this is achieved they are discharged to the care of a "high street" optician. So i would imagine your son has reached his potential for his BV. Most opticians do a 3D test of some kind which detects binocular vision. Hope that makes sense!