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.

dear cheekyginger an update from me. my boy has no squint and his eyes are absolutely fine, all perfect. thanks sooo much again for re-assuring me. As you said, babies deal with eye drops quite well. a quick cry and then fine. we had a very kind orthoptist and excellent Paediatric Ophthalmologist looking at him today. (relieved.... and still wondering what HV saw that noone else noticed...)

Great news Chislemum.......What clinic do you go to? Just wondering as our paeds clinic is on a wed?!

Hi Cheeky Ginger I posted just after Christmas but I don't think I've had a reply. Thanks for this amazing thread x

Hi cheekyginger how nice of you to start this thread! I've foud it while searching for info. In prob overreacting (I do that a lot) but DS is 12 weeks old (but was 7 weeks prem) and recently I e noticed he seems to be blinking/closing his left eye a lot more than his right one particularly when he's tired. Is this something I should worry about yet or just keep an eye on (no pun intended!)

Hi lauragriff, i'll have a wee look back and find you original post! Seem to miss them when i look up the thread from my moby!

Hi HoneyMum, think you should just keep an eye on it . As long as both the lids lift up and above the pupil when he is awake then there is no risk to the vision. If one eye was to start staying closed for longer spells then i would make an appointment with your GP just to be on the safe side.

It's probably just his little muscle getting used to working.

Thanks cheekyginger you're a star --especially for a neurotic first time
Mum who finds things to worry about on a Sunday evening!--

Hi lauragriff,

Sorry for the delay in my reply. How did your appointment go on the 8th?
You might have had all your questions answered, but here goes anyway...

Children with suspected DVM just have to be observed over time and see what they start to see. It's difficult for you as there is not anything in particular you can do to help. It's just a matter of waiting.
Children with ocular albinism are not always sensitive to light.

Im not saying what is happening to your DS is wrong. But we wouldn't prescribe glasses to someone of this age. We would repeat the glasses test after 3-4 months and see if it was changing. Most babies are longsighted purely because the eye is little and they "grow into their eyes" over the first couple of years of life. From the prescription you had written on your post you LO doesn't have any astigmatism he is just longsighted, and because it is so similar between the two eye this would be another reason we would hold off with the glasses.

DVM and longsightedness are not necessarily related. Repeated glasses checks will show if the prescription is decreasing over time.

I'll stop rambling now in case you had all you questions answered at your appointment

Thanks for the reply. We didn't see the consultant on the 8th as he had to leave so we only saw the orthoptistshe said he was born being long sighted and had astigmatism? She said he was using both eyes so there was no need to patch at the moment. Do you think I should question why he has glasses then? Although they do make a huge difference to his vision , he can't see hardly anything with them off I dont think. Could the glasses be detrimental in any way? Many thanks, this is such a worrying time for us xx

Hi again! My DS also doesn't look me in the eye intentionally or really track objects. Should I be worried about this?

Hi lauragriff,
If you feel that he is seeing better with the glasses, then no i wouldn't question that. If you were having a real battle getting him to wear them then that might be different. If he seems to like his glasses then just go with the flow.
The eyes are developing so fast at this stage his eyes could change quite a lot over the next 4-6 months. When are you due to back to see the Dr?

Hi HoneyMum,
Is he's not tracking by 16 weeks (corrected age i.e. in another 8-10 weeks), then speak to your HV. At your LO's age there vision is very basic at this stage and will be developing rapidly over the first 6 months of life.

Thanks cheeky. Mumsnet should have an award for lovely people like you calming my worried mums neuroses!

cheekyginger - we went to the Portland Hospital (we went private) in London and DS was looked at by Mr Saurabh Jain who is a Consultant Ophthalmic Surgeon at the Royal Free Hampstead. He was very nice and our little one was not scared at all.

I can recommend him and his nice orthoptist - friendly lady. I imagine you are like her.... efficient and lovely with kids.

Hi cheeky ginger just found your thread thank you so much for starting it. As background my ds who is now 6 had bilateral congenital cateracts found late just before his 3rd bday. He has lols and wears bifocals. We are still going to hospital every 3 months due in the main for last year eye pressures on the up and now around 22-26 both eyes. They do not seem very concerned but monitoring and he has a Goldman field test in march - have tried to find info on net as to what this will cover in a young child to not much luck do you have any idea or info thanks

Thank you for your reply we are seeing consultant on 26th Feb, he doesn't touch his glasses at all but this is also a concern as he'a still not reaching out for things etc even though his vision has improved, more worry as we think there are other issues praying its just linked to his vision and just delayed at the mo. Thanks for this amazing thread x

Hi focuson,
The Goldman field test is a test used to check the visual field of the eyes. TBH 6 years old is fairly optimistic for carrying out this test!! But its prob worth getting him used to the look of it. Have a look at this website I found. This can be simplified when testing children.
A field test is used to monitor the visual fields. If his pressures are high at times then there is a risk that he may develop glaucoma at some stage. And this test is good at picking it up as early as possible.

Thanks again for your lovely thank you's x x x

I posted on here about DS' eye sight problems back in November 2011 and I wanted to update cheekyginger and anyone else out there with a similar problem to let them know that there is plenty of hope for a good outcome once treatment has begun.

DS was diagnosed with severe vision impairment (amblyopia) in his right eye (lazy eye I suppose but they don't call it that at our clinic ;-)) after a routine school eye exam - he was 5 and we'd had no idea he had an eye problem up til this point. His left eye was perfect, which is why we hadn't noticed a problem.

He was given glasses alone for 4 months which improved his vision a fair amount and then in April 2012 to give his right eye a kick start we started patching. DS didn't like the sticky patches at all and although it was a game to get him to keep them on he wore them everyday for 3-4 hours from first thing to first break at school. The teaching staff were very supportive and his class mates thought they were fab, even making some themselves as they wanted a patch too!

After discussing the sticky patch problems with our (lovely) Orthoptist she gave DS a soft fabric patch which sat inside his glasses frame (from Kays Fun Patch). DS much preferred this patch as it was more comfortable for him to wear. Gradually over the next 8 months his right eye was improving at every eye test until he'd reached 'driving standard'. Basically the Orthoptist explained that the lazy element of his eye sight had been repaired as far as it would go and that we now had to see if his muscle would stay that way or if it would revert back without the patching.
So we reduced the patch wearing time to 1 hour, then 30 mins a day.

In the meantime DS had his 12 month check with the Optician and he was amazed at the progress DS had made, he even said to the Orthoptist "we like it when miracles happen" :-) !
His prescription in his right eye has been reduced by a significant amount and hopefully this will continue to reduce over the next few years.
We continued patching for just 10-20 mins every other day and at the last appt last week DS was told he could stop patching altogether!

So all in all I would consider my DS' story a success and although we have a long way to go and he's still wearing glasses it would seem that within just 13 months DS lazy eye has been repaired.

I know the soft fabric patches don't suit every child and the Orthoptist was worried that they don't block out all of the light like the stick on ones do but for us they worked as DS was more comfortable and so he kept the patch on for longer.

Anyway, just wanted to share a 'success' story for all those worried parents who are embarking on the patching mission!

My daughter is four and I have just recieved a letter to say she has been referred to an orthoptist at the hospital after her school vision screening test. I rang the school nurse and she said they have referred her because in her right eye she got 6/6 and in her left 6/12. I am worrying now, she has not got a lazy eye or a squint but does this mean she could develop one?

Great to here your news sparklejawsy! Sounds like you and your DS worked really hard .

The fabric patches are handy but the down side to them is children can be very good and sneaky at peeking. That's why it's good to start with the sticky ones first. So the Orthoptist can keep the fabric ones as a back up plan!!

Hi lovelylou, try not to worry it may just be that your DD requires glasses. 6/6 is the UK equivalent of USA 20/20 vision (UK measure vision in meters USA measure in yards). 6/12 suggests that her vision is mildly reduced in her left eye.

She will likely be referred to have a glasses assessment carried out and this will tell you if she requires glasses or not.

That is why children have their vision screened as parents will not pick up on these minor problems.

Could i ask something about lazy eyes. I had one (still do actually) as a child was first taken to opticians at 5ish after my teacher saw me squinting at the board. I had glasses til i was around 18 when i was told i didnt need them (i never really wore them anyway as was worried about being teased) mum was told it was too late for eye patch. Now everything is very blurry out of that eye, will it go wonky?
Also is it a heriditory thing, internet suggests it is but my local optician wont test my 3.5ds til he goes to school, and im a bit worried about it dont want him to end up like me.
Sorry for essay, any advice would be great thank you

Hi Cheekyginger,

Have been on thread before as cartblanche and playnicely.

Have been having a bit of a palaver with appointments with the consultant regarding my 5yr old DD. Eventually saw him back in October where he expressed his reluctance to operate, which I was fine with - said he would review in 3 months.

We duly turn up for our appointment with him last week and he asks "so what was the result of her recent examination?" to which I replied "what recent examination?". Turns out she should have had the strong atropine drops put in 48 hours before a thorough examination by the orthoptist BEFORE seeing him. So we were both sat there wasting each other's time!

Anyway, we've been sent home with drops which we're to put in Weds and Thurs morning and then she'll be back at the eye hospital on Friday morning.

I am NOT looking forward to putting these drops in. She hated the normal drops she's had previously and the nurse who gave me them had a very "knowing" look on her face when she said they "nip like putting shampoo in your eyes". Yikes.

Do you have any tips for putting them in? Is it best for her to be lying down, looking up, looking down, aim for the corner etc...?? Also, she has a swimming lesson on Thursday - do you think it would be best if she skipped it? Wondering if the chlorine might just aggravate an already aggravated eye or affect it negatively. Also wondering how much her vision will be knocked out on those first 2 days - the Consultant said she would struggle with close work and that reading would be out the window so I should warn her teacher. As it is, she's off school with a stinking cold so that might not matter so much.

(by the way her diagnosis is: Constant left/alternating esotropia with slight accommodative element - low hypermetropia
Potential for abnormal binocular single vision at reduced deviation)

Thanks!

Sorry 1 more question. Do you know anything about colour blindness, how its heridtory? My partner is red/green colour blind. I have a ds and dd could either be colour blind from him? As my son get confused with red/green not sure if its a coinsidence

Hi midastouch,
Your Lo will have a higher risk of having a visual problem if you have one. At 3.5 most opticians should be able to have a go at carrying out an assessment. So either go to a different optician or speak to your HV and get referred to your nearest eye clinic.
Im not an expert in colour vision defects....but i think your son should actually be fine as he will have got his X chromosome from you and the Y from his dad therefore should be fine as the colour vision gene is on the X chromosome (unless your dad was also colour blind and therefore you carry a defective X ). Your daughter will have gotten your husband's X chromosome which carries the colour vision defect therefore if she has a son then they have a high chance of being colour blind!!! Phew, need to go and have a lie down after that!

Hi Cartblanche,

Hope you get this in time. You could put the drops in in her sleep. Aim the dropper at the inner corner of her eye and squeeze a drop out. Then very gently pull the eyelids apart.
If you are doing it when she is awake. Lying on her back is your best bet as gravity will be working with you. Same idea though aim for the inner corner and then get her to open he eyes.
The drops will blur her near vision. The effects will start to wear off about 12 hours after the last drop (approximately!).
Swimming should be fine if her cold is better.

It sounds like they are trying to do a glasses check with the strongest possible dilating drops to see if they can squeeze out any more prescription. If they "find" more prescription then you might find that the squint is smaller with the glasses. Thats what they mean by "accommodative element" in her diagnosis. The glasses relieve her accom and therefore reduce the convergence of her eyes. The stronger the glasses the smaller it may make the squint. Does that make sense?

If you've got the drops in cartblanche your DD's pupils will look huge tomorrow!