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.

Hello

So pleased I've found this thread. I have a question about my DD aged 6.5 who has been monitored for a lazy eye since she was 18minths (inherited from DH).

Her vision is good but she has a head tilt - always has done, which is her way of adjusting her sight. She is not conscious of doing it and it's very difficult to get her to level her head (the hairdressers struggle to cut her hair straight!). She is under the care of a local eye unit who have said that surgery is an option to correct the muscle weakness but that it is up to us. My concern is not so much with her sight but the effect on her neck and shoulders of constantly tilting her head (albeit slightly).

We have n o real worries regarding her sight (and she's doing well at school with reading etc) and I'd obviously rather avoid surgery if possible but is it normal to let a head tilt go uncorrected? is this a matter for a physio rather than the eye unit?

Many thanks for any help anyone can give.

My daughter had squint surgery on Thursday, but this morning the eye operated on is looking worse than before the procedure. Inside of wandering in slightly, it is now swings right out even when the other eye is looking forward. We are seeing the consultant on Monday, but I am so worried. I will be heartbroken for her if they have made the eye worse than ever, as she was already very self conscious before the surgery, always wearing her hair over the eye with the squint. Is there any chance the eye will settle down, or have they completely over corrected? And if they have, will further surgery to correct again be possible?

My son is 5 and has worn glasses for the last three years. His left eye is ok but his right is longsighted (+4.5 I think it was). His right eye also has a squint. We found out a few days ago that he also has astigmatism in his right eye and that it shaped more like a rugby ball with his left being shaped like a football (as a promising sportsman he loved this explanation!). His eyes work independently of each other apparently.

I am messaging to ask what the long term outlook is likely to be.

Would surgery one day correct his sight / squint and allow him to live a life free of glasses / contact lenses? I ask as he is a budding footballer and we don't want anything to hold him back from having a chance of making it in a sport he loves and has played since being just one year old.

We are currently looking to get him some specialist eye sportswear, similar to what Edgar Davids used to wear, as we are bored of the weekly visit to Vision Express to have his glasses repaired / screws replaced etc after having his glasses knocked from his face when playing!!

Any help / advice you can offer on this would be most appreciated.

Many thanks.

Hi sassytoo,

It is better for the eyes if they have equal prescriptions as there is less chance of the vision being poorer in one eye. As a general rule anything over +3.00 is long term, so it will really depend on how his prescription changes as he grows.

Hi TenPercenter,
I would tend to say they are both important! The patch helps the lazy eye work harder but the glasses make the image clearer.

From what you are describing i would want to check the glasses and make sure the prescription of the good eye has been made up correctly. Or does the good eye only have a tiny prescription?

Sorry that's not really very helpful!!!

Hi Baubleswithdiamonds,
From what you are describing it sounds like she is using a compensatory head posture (CHP). This means she is doing this with her head to compensate for a muscle imbalance. It is normal to leave a CHP as it is if the patient is not having any symptoms. Is your DD complaining of sore eyes, sore head, sore neck or shoulders? If she is then it may be best to carry out the surgery sooner rather than later. If not then leave it till she is older. She may become more cosmetically aware of her head posture when she is a teenager and she may decide to go ahead with surgery then.
If the CHP is definitely because her eyes then avoid going to a physio. Yes she may be holding her head in a strange position but if she quite comfortable doing that then leave her be.
Surgery for this type of thing can be done at any age, so if she is quite happy then thats your answer

Hi LA37,

How did your appointment go yesterday? Sorry i was on here before now. Sounds like she may have had some muscle slippage. Are they going to re-operate to explore the muscle site and see what has happened?

Hi LeeP1973,
How bizarre, my nickname could be LeeP1979!
As you for DS.....what is his prescription in his good eye?

Thanks so much cheeky ginger, very much appreciated

Hi very quick question...DD 7 has astigmatism in both eyes. She was initially referred to the eye hospital when she was 5 to investigate possible lazy eye. No diagnosis of lazy eye but she was prescribed glasses and has a prescription of around +1/ -4.5 in one eye and around +1.5 / -5 in the other. She wears her glasses really well and they've become a part of who she is!

Anyway I'll get to the point ... Does astigmatism affect her depth perception? Reading this thread has got me thinking ( and feeling a bit guilty) as she'll sometimes 'barge into' her little sister. I thought it was carelessness but now I'm thinking it might be caused by imperfect perception of depth.

Also - what a genuinely nice thing to do to share your expertise in this way

Astigmatism shouldn't affect her depth perception. Only a squint will affect some ones depth perception.

There is a huge range of what is classed as "normal" depth perception. She may have slightly poorer depth perception than another child the same age that doesn't wear glasses.

No probs at all. Becoming a mum gave me a whole new perspective on my work. If i can do a little bit to help other mums/dads then why not!

Thank you

Thanks so much cheeky, that's a much clearer answer than I've had from the eye unit in five years! She is not complaining at all of neck pain etc so we will definitely wait before agreeing to surgery.

Thanks again

Hi cheeky,
DS longsighted and lazy eye, glasses are err +5.5 and +5 I think, with some other numbers to help sort the squint out.

Anyway...... we have stopped patching for the moment, but only since November, and in January it will be reviewed. He is just 6. At the last appointment with glasses on he could read the full chart with his good eye (left) and one line above normal in right eye (lazy eye).

So.... he has an appointment in early January, and I had relaxed about how things are with his eyes, lazy eye has improved a lot with the patching, glasses doing their job etc etc. Just until yesterday at the school carol concert. We were at the back of a big church. All the adults could read the carols on the OHP very easily- they were pretty big print. DS could not read them at all, he said they were too blurry . Oh dear...... (he is a a very good reader and singer and at the Harvest Festival when nearer the front joined in heartily reading from same OHP).

This has worried me. I guess he could have been tired and not felt like joining in, but this is unlikely. Hmmmm, guess I will have to wait until the next appointment but any ideas?

Hi Tggr,

Is he due to hav the drops in his eyes at the visit in january? If this is the case then it might simply be that his glasses are out of date and he needs a new prescription.
If he's not due a glasses check then mention ur concerns at your apt in January and they'll be able to reassure you.
Try not to worry....as long as he's ok with his regular class work

Hello.

Thank you for starting this, I'm sure you'll be able to advise me. I apologise if you may have answered something similar I have had a scan but as every story is individual I would like to discuss my sons eye sight. He is 4 and a half and I have not had any major concerns about his sight. He has always got quite close to the tv but I honestly thought this was a bad habit, hv said this at around two. He had not picked up reading very well and holds writing close to his face when smaller print, I had noticed this, but not to the point where I was concerned, just though it was cause he was learning, how niave. However his teacher had also noticed this so thought, ok time to take him to the opticians which we did on Friday. He has severe long sight of around +8 in both eyes. I know this is a really strong prescription because I too am long sighted at R +7.50 and L 7.75. I have a lazy eye which is disguised well with my lenses (I hope!) I was operated on at under 2 for a turn my left eye. I hate that I have passed this defect on to my son as I always found wearing glasses traumatic, I was teased and hospital eye checks were upsetting. My son has to return for drops to get an accurate prescription, as this was determined by the auto refactor. My question is really, will my sons vision always be so bad, or will it improve? I know he will never have perfect vision but if like to think that it will improve to a standard were he will be eligible for laser surgery one day. Like I have said it was not obvious to me there was a problem, I had not seen a turn and bothe and my family have been looking given my history. Sorry for the essay!' Wanted to give as much detail as possible!

Hi, thanks so much for this thread as I thought I was going mad with worry and felt like the only one :)
My daughter developed a squint in infancy and has had glasses since 9months. No problems at all, happily grew up wearing them. She's now 4.5 years and lively and healthy. Prescription hasn't changed much over the years, hovering around +6.5 both eyes. Up until recently her squint was completely corrected with glasses on, comes back soon as glasses off.

Anyway, why I'm worried is this. A few months back I noticed the squint now and again even with glasses on. She also started screwing up one eye sometimes, or even holding it closed to read etc. Always the same eye. I mentioned to eye doc who couldn't replicate in her brief appt and dismissed as tiredness or "worried mum". I remained unconvinced and she's just got worse over the intervening four months. Came to a head when she got new specs last week and handed them back in the shop saying they'd forgotten to put in the lense! She also often says glasses dirty when they're not. Decided to get a second opinion today so went to a v experienced local optician and he easily spotted the problem of screwed up eye and squint after administering drops. Her prescription hasn't changed however and he couldn't detect any difference between the "screwed up" eye and the other one when testing one eye at a time. He checked back of eyes and said they looked healthy to him.

He was clearly concerned though and made an urgent referral-we are going privately self funded to be sure of a quick appt.

What should I be worrying about? I can take it, I just need to know what "it" might be! Worried worried worried! Thank you

Hi
What a great thread, thank you so much.

My son is nearly 7 months.

He has seen a Paediatric opthalmologist 6 weeks ago, he had the drops in to dilate his pupil & we were told that he was significantly long sighted, had astigmatism, pale fundi, optic discs appear normal, deviated exotropia that's alternating in each eye although the right eye is worse at a 15 degree angle. They also said they couldnt ellicit nystagmus from the spinning around technique but that could be due to his longsightedness - his eyes don't appear to wobble.
He gave my son glasses +6.5 & +6 and said to wait and see if he improves, got appt on 8th Jan and he said if there isn't enough improvement then they will start neurological testing.

He was also seen by the Orthoptist who said he was starting to fix but not following but she thought he may have Delayed Visual Maturation.

If it is delayed visual maturation, could the long sightedness be resolved when the DVM resolves (if thats what it is) or will he always be long sighted.
We are of course praying that it is DVM.

With the pale fundi - what could this indicate? I googled it and Ocular Albinism came up and they do keep on mentioning how fair my son is. However my son is NOT sensitive to light, so could he still have ocular albinism?

Also there has been an improvement but some days he seems to see nothing other days he's responsive. He was tracking with his eyes ((like when being hypnotised) but I notice recently that he doesn't fully track with eyes but will look at it centrally and then as it moves to right will move his head to where it stops - is this a good thing or not or should his eyes keep fixed on it as it moves across like it used to although he wouldnt move head?

Sorry for all the questions, thank you for creating this thread

My 4 year old daughter has recently been prescribed+4.50 -0.50 x 180 in her r/e and +2.00 in the left this is her first sight test she has a lazy r/e we have the new glasses and she is to be seen in 3 months again, the optom said hopefully the numbers will even out, nothing about patching has been mentioned so far do you think she will need this? And with this type of prescription is she likely to wear glasses long term? Her dad also had a lazy r/e as a child and he wore glasses for around 2 years now he wears only for concentrated tasks x
This thread is brilliant so many parents have so many unanswered questions x
Thanks x

Hi. DS is 9 weeks old and since birth his left eyelid has been constantly swollen and the eye appears half open. We asked all the drs and midwives about it, a swab was taken to check for infection and was all clear. I've asked the HV more recently and no one seems concerned except me! Will this problem correct itself over time? Or does it warrant some further investigation? His eyes are also constantly watery and/or full of sleepy gunk, but the whites of his eyes are normal, his eyelids often look very pink and abit inflamed. Thanks in advance.

Hi cheeky

We returned to the opticians today. It wasn't much more successful than last time with the drops, when it came to recognising letters and shapes my ds was uncooperative although I'm convinced he could see at least a little. His prescription came out at r +8.75 and l + 8.5, which just astounds me that we haven't noticed before now at 4 years and 8 months! Anyway, I had totally come to terms with wearing specs and prepared to part with a pretty penning for thinning etc, but I've cone away with a heavy heart as I just don't like the specs we've gone with . A strong prescription has meant we were advised round frames, just like I was when I was little. But I just do t like round specs!! I know it's about his vision but its also about appearance abc I was hoping for something a little more trendy, who really wants Harry potter style specs on their 4 yo. There must be some trendy frames that can accommodate stronger prescriptions?

Hi, for the previous poster - my daughter has +6.5 both eyes now but has had +7 in the past and we've always had lovely specs for her with a bit of shopping around. Boots are brilliant and didn't give any problems with us buying the Disney Princess frames which are pink with Disney characters on the legs. They thinned the lenses for her as well at small extra charge but the glasses were otherwise free with voucher. The boys' range was brilliant as well with Ben 10 among others. We always have a second pair of plastic large lense frames with bendy legs for soft play etc but she wears the princess ones for most occasions. I think if you shop around you will have no problems. Interestingly the first optician we tried years back when first needed a script refused point blank to give her metal frames and insisted on these horrible huge plastic things with curly legs and I just said no thanks! Your child, your choice, I say and why shouldn't you want him or her to look their best? In that spirit I also tend to buy my daughter extra pairs during the year without the voucher so she has a bit of variety for parties etc. good luck sure you'll find something you're all happier with.

Strange to see this thread pop up in active convos. I posted on it at the start, I think maybe under a different name.

DS2 has had a patch for about 8 months now and his sight is almost the same in both eyes now, although with quite different prescriptions.

I'm so pleased with the improvement in his poor eye. At the beginning the pictures he was seeing were equivalent to the top level of the letter chart. He only wears the patch 2hrs a day too.

He will wear the patch for another 3 months and then hopefully he will be done. I'm very lucky that he is a very laid back boy and accepts his fate so well, even his teachers comment on how good he is with it.

I can't believe how stressed I was about his sight when this thread started. I think it is the parental guilt that gets to you.

Thank you dfghj for your encouraging words. I personally don't like character endorsed specs but would live with that for a better frame shape. I just take exception to round ones! The ones we have are rounder than I'd like but will live with them for 6 months and have a good browse in that time. They were free frames, but we paid £90 for the high index 1.74 lens. I personally think that's where the money's better spent. LemonBreeland is right, I just feel so guilty, he's got this from me and I hate that! .

I did mean to say that the guilt is crazy. We can't help it though. I felt guilt at not noticing DSes problems sooner. Despite the opticians saying to me that children compensate very well and it is difficult to tell they can't see well.

Hi CHeeky ginger

Hope you can help don't really know who to ask otherwise !! DD age 2yrs 9mths suddenly (honestly !!) developed a squint on new years day, everyone was shocked as it was so obvious but

sorry it posted before i was ready !! so obvious but so sudden. We took her to Gp and got appt at eyeclinic the next day. She was assessed by a nurse ? who did a test with pics to tell long/short sight, used a pen moving around, a torch and a strip of lenses etc. She said dd was v.long sighted and the squint was to compensate she said muscles were fine. She wanted to get sight test done there and then but no one was availible. She then applied drops and we went to see a doctor ? who then checked the health of her eyes using a thing on his head with a light. He then said we needed to go to the squint clinic in 4 weeks. The reception then said we may need to wait longer as there are no clincs (?) I'm concerned that if we have to wait too long to get glasses her sight may deteriorate further and lead to patching etc which may be otherwise avoided. Is that likely ? It happened so rapidly i'm afraid it will deteriorate rapidly ? What would you expect to happen next squint clinic or eye test ? Is it at the same time ? What comes first the chicken or the egg ?!? Any advice gratefully received. Thank-you