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.

Hi NeedsInspiration

Sorry I've not been on here since your last post. Have you been to the GP?

If you havent DONT PANIC you would be much better to take her to an optometrist. If she is longsighted then there is really no need to worry. TBH a GP would prob panic too, unless they have some experience with eyes.

Hi hiviolet,

When babies are born their eyes are really uncoordinated. Over the first 3-6 months this improves dramatically. Any squint that persists after the age of 6 months should be referred for further assessment.
Not many optometrists would be happy to assess a baby of that age!!!

Once referred she would be assessed by an orthoptist to see if she has a true squint or a pseudosquint (optical illusion caused by the bridge of the nose). If a true squint is suspected then she would be seen by an ophthalmologist (eye dr) and have the health of her eyes checked and a glasses assessment.

Let me know how the referral goes

Thanks Cheeky I have PM'd you :) Optician appt booked for Fri and then GP appt after to get a referral.

Cheekyginger - this is a fantastic thread, and really useful - I only wish it had been around a couple of years ago when DD's squint started.

Our story is that she suddenly developed a very severe squint at about 18 months or so (although with hindsight, it is visible in pictures before then). She has had two operations to reposition the muscles, and now wears glasses for slight longsightedness. She still has no 3d vision two years on.

Now her left eye is starting to drift up (was inwards before) although the opthalmist (? at the hospital anyway) didn't seem that bothered. Is this something which would be just corrected by a new specs prescription? or what?

Also, is there any mileage in eye exercises? It seems to a non-optician (i.e. me) that she has very weak eye muscles and so that this might strengthen them. Or is this too simplistic? She also has low muscle strength elsewhere and v slight hypermobility, so I don't think it's just her eyes. And if we do want to try eye exercises (I have an adult friend who swore that this was what sorted out her squint), who do we go to? I'd like to have a go, as it can't hurt and might help.

Thanks so much for your reply Cheeky, will update when we get a referral

Hello cheekyginger - thanks for starting this thread, glad I found it, wonder if you could help me understand something? The school nurse phoned me this afternoon to tell me my DS (5) has failed both sight and hearing screening tests :( Totally taking me by surprise on both accounts. She spoke over the phone and I didn't really understand what she was saying, but she said he'd bring a letter home today with explanations and to be honest I'm none the wiser!

The results say 3 metres/0.2 for both eyes. I'll be taking him to see the opticians but just would like to know in the meantime that this is not serious (hopefully!) tia

Hi Cheekyginger,

Thanks for answering our posts. Here is a question or two for you which I hope you don't mind answering. I have twins and one twin's eyes often turn in at different times and the other twin's left eye is a tiny bit turned in, maybe not at all. I am longsighted myself from early childhood. Basically, they are only 3 months old and I'm gutted that they've inherited my bad genes. Anyway, if and when they do have to get glasses, is it possible to have the lenses thinned? Its just that I see kids with glasses and the lenses are often so thick sometimes and I wonder maybe that their lenses can't be thinned for some reason. Also, my friend's daughter got glases last year (aged 2) and the prescription is quite strong and each time they go to the optician, they hope her prescription will be reduced, why would they put a strong prescription on her if she may not need this and reduce it rather than starting low and adding to it? Thank you.

Happy Mothers Day Everyone!!!

Hi onesandwich,

If your DD doesnt have 3D vision then exercises unfortunately wont work. To exercise the eye muscles and the control of the eyes, the eyes have to work together.

We would prescribe exercises to help control intermittent squints and strengthen binocular vision. This is generally given to older children and adults. But exercises are purely for horizontal squints. From what you describe your LO has a vertical squint. The ophthalmologist will likely just monitor this. If it was to worsen then surgery on that muscle could be carried out.

So unfortunately i dont think exercises would help....All you can really do at the moment is make sure her glasses are kept up to date and wait......

Hi casualty,

That Vision equates to 6/9.5

20/20 is the US measurement for perfect vision. 6/6 is the UK equivalent.

So in normal language, his vision is slightly reduced in each eye. Certainly nothing to worry about too much . Your optician will be able to give you a lot more information once your son has had the glasses assessment.

Hi April19,

There is no reason why you cant get the lenses thinned down. But the problem is the cost. The standard frames and lenses are generally free on the NHS but you have to pay an additional charge for the thinner lenses. This will vary form shop to shop. So i would recommend that you shop around if and when that time comes.
But remember children's glasses are broken regularly and therefore you will have to pay for the thinner lenses every time .

As for your friends child. I think they might have got the wrong end of the stick! When a child has a refraction (glasses check) the optician/eye dr get a reading from the eye, and then glasses are prescribed based on this reading. This reading will change as the the child grows. But the prescription can go up or down....

If you are still seeing your two squinting by the time they are 4 months. Mention this to your health visitor and get referred to your nearest eye clinic. That way you will be in the system so that glasses can be given as soon as required.

Cheekyginger - sorry not updated. Took DD to optician on Fri and he diagnosed a squint and her vision was

R eye 6/15 and L 6/11

They have referred her urgently to hospital orthoptist and we will apparently be seen within 2 weeks.

thanks for all your info x

Thanks so much cheekyginger, you've helped put my mind at ease :). He's got a test booked in a couple of days so will know more then.

Hi there - my daughter has an intermittent squint in her left eye. She was referred to the eye hospital at age 3.5 and goes every 3 months for a check up (she's 4.5 now) She was prescribed glasses for a slight long-sightedness in the left eye but it was very slight and they seem pleased that there is not much disparity in vision between the 2 eyes and that it has slightly improved over the months.

They don't feel the need to operate as it is intermittent and patching isn't appropriate because the vision is only slightly weaker in the squinty eye. Her squint can be quite pronounced especially when she is tired and we notice it in particular at the dinner table when she is sitting directly opposite us. She often peaks over the top of the glasses too and we see her squint when she does this.

I am slightly concerned that we are being asked to live with it. Are there no exercises she can do? Is this type of squint one that would respond to such exercises? Be interested to hear your response if you get a chance!

Hi cartblanche

Is it a convergent (turns in) or divergent squint (turns out)?

Ok I'm back. Just ordered DS his first pair of glasses. They are quite strong, prescription 5.5 or something (sorry, it's at the optician's!). He is long sighted and has a squint (and lazy eye). We have to go back in 3 months to see if a patch will help too- it probably will- I think the 3 months are to get used to the glasses.

I'm feeling a bit miffed as it seems "they are quite strong glasses"- not sure why this wasn't what I was expecting- at previous test it was mentioned he might not need glasses at all just a patch when clearly at this test it has gone the other way and warned that the glasses might take a bit of getting used to due to strength.

Ah well, DS (5.4) was very pleased to be getting glasses so at least he's happy!

Ah yes, just saw a thing about thinning lenses on pp. We were offered this for DS but I declined as I thought if we thin them now (£10) we'll have to thin them every time and this could get expensive, whereas if he gets used to the thick ones which I think he won't be bothered about (more adults are?) then cheaper!

our optician thins for free (the previous one we had charged for it - part of the reason we moved!).

What a wonderful thread.
Cheeky Ginger, I have two questions for you - first, do you think these symptoms could indicate that my dd has a convergence insufficiency? - she is 6 and learning to read well enough but "abnormally slow" according to the teacher, not just in her reading but in all pen and paper tasks like writing and maths too, she doesn't complain of headaches but she always complains of tiredness, she yawns and rubs her eyes a lot while reading, sometimes reads words backwards when tired or sees letters that aren't actually in the word, and has enormous difficulty keeping her attention focused on the page, but her comprehension is clearly fine and congnitively she is assimilating everything she should be.

• second - if not CI, are there any other sight-related problems that could be affecting her? Her distance vision seems fine. Is there anything I should emphasize in particular when we see the ophtalmologist next week, to make sure his evaluations includes all possibilities?

Thanks so much!

Hi CheekyGinger. Thanks so much for this thread.
My DD was under the orthoptist until the age of 2 for a possible squint - we have a very strong family history. They thought it was a pseudo-squint - I was never convinced as had a number of photos where the light reflection was very unequally reflected in her eyes, which I thought indicated it was a "true" squint. However, she seemed to stop squinting. She sees an optician regularly as she is marginally long sighted, and at the last visit he said she had mild / borderline convergence insufficiency. He suggested I did the "pencil pushup" exercise with her. When I bring the pencil close to her eyes in this exercise , one eye turns in more than the other. Is this normal?

I also think she's getting some symptoms from the CI. She reads well, but when tired misreads or misses out small words while still reading longer more complex words well. She also seems to mix up letters from adjacent words, again when tired or she's been reading a while.

Should I get another referral for her?

Thanks very much.

Sorry, back again. DS seems to be getting headaches for the first time ever. He is also reading a lot more. Do you think the two are connected and should it improve once he's got his glasses? Of course it could be the headaches are unrelated and he is a bit peeky, just he's never had headaches before...

cheekyginger - sorry just got back to this - my daughter's intermittent squint is convergent.

Does this make a difference in relation to eye exercises?

Hi Tggr,

Wait and see if the glasses make a difference to his headaches. Glad he is looking forward to getting them!!!
God luck with the glasses

You are quite right about the thinning. It is purely for the way they look....they dont perform any better than standard lenses. A +5 lens will look fine anyway.

Hi tigrou,

It may be a CI as you say. As long as her convergence is assessed then this will diagnose a CI.
The only other suggestion may be coloured overlays. Some children find a benefit when reading with an coloured filter over the text. The scientific evidence for this is a bit of a grey area so some ophthalmologists don't support it.
Good luck at your appointment

Hi ArcticL,

Reading problems are tricky to diagnose.

Any problems like convergence insf etc have to be treated first before going down the road of other things like coloured overlays etc (mentioned in my PP).

Does you LO had almond shaped eyes and/or a wide bridge to her nose? This may make it look as though one eye is turning in too much. With a conv insf i would expect the eye to want to drift outwards, as that is what you are trying to prevent.

A teacher also told me recently that larger words that conjure up images are easier to remember (vehicle, elephant etc), whereas words that have no images are harder to learn (but the and).....had never thought of it like that before !