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.

No probs at all sparkle. Glad to hear you got on ok. If he doesnt have a squint fingers crossed his vision will come up really well with just the glasses alone.

Good luck

I've found the thread really interesting, thanks. I have a more practical question, my daughter had the squint surgery on Thursday and currently requires eye drops 4 times a day, have you or anyone else got any tips for giving eye drops, my daughter hates it and is currently fighting me every time.

we only had to do them twice a day and it was a nightmare (involved holding her down on more than one occasion). Glad we only had to do it for a short time as it was very stressful.

Yep, we are holding her down at the moment lots of bribery, which isn't working, we've got to do them 4 times a day for two weeks then twice a day for two weeks. We are thinking of creating a sticker chart a bit like the ones for patches, so she gets a sticker each time to colour a picture. Any ideas gratefully received though.

I'm sure we only had to use them for about a week. Can you double check if it is necessary to do as many times as you have been told to? Is it one eye or 2 that was operated on (my dd had 1 eye done)

Thanks, she had both eyes done, we are going back to see the surgeon on the 9th. The eye drops are going a bit better now, a mixture of a new ring each time she is good for them and various audiences, cousins, pre school etc.

Hi mrsCF thats is longer than our depts protocol for post-op drops...but all depts do vary. U r doing everything u can by the sounds of it. Star/sticker charts and bribery r really ur only options.
Good luck

Hello... My 2 year old son has 'intermittent exotropia' with 20/20 vision.

Recenty when I turn on the lights he says that they 'sparkle' when to me it just looks like a light. Should I be concerned about this?

Thanks so much for your help!

Hi MissArizona, I think its probably just one of those things a 2 year old will say rather than be related to his squint. Some kids with Intermitent exotropia do tend to close one eye in bright sunlight but they generally are not symptomatic.

Think he's just being a 2 year old!!!

Hi Cheeky,
I have a 3yo with a squint and now lazy eye. When patching she cannot see anything to start with and then can see a bit but now very short sighted. i think it's like her brain turning that part of the optic nerve on.

I cannot get the patches on for more than about 30 mins / day. it is just too hard, she hates it so much. I have tried everything and nothing works.

Is there nothing else I could do instead? Will this improve? My understanding is that it needs to be patched in order for surgery to go ahead to strengthen the visionl; is that correct?

It is horrible.

Hi
My daughter almost 7 was initially diagnosed with a nystagmus at 5 mths which in recent years is rarely noticeable. Slight short sighted so started to wear glasses for this at about 2 1/2yrs. Aged 3-5 was patched for lazy eye. Her sight inthis eye improved - great news - no patches but then again started to detoriorate. Also has astigmatism. After a lot of tests - she was diagnosed with cone dystrophy last year. I was devastated initially - idea of blindness or close to that for my little girl was heart breaking. We have had regular tests since then and her 4 siblings were also examined. They show no sign of cone dystrophy or anything else even minor so now our consultant does not want to see her for 6 months to see how she gets on and he wil reexamine his diagnosis. The fact her 4 siblings were clear has thrown him. Have you any advice or suggestions. I am waiting to get a second opinion. Based in Ireland. Any advice really welcome

Hi noodlemacdoodle, (sorry for massive post!)

If a childs vision is very poor then they will object strongly to the patching. But unfortunately it is even more important that the patching is attempted to improve the vision.
Here are some suggestions;
You could create a patch box. Have a box of toys etc that she is only allowed when she has the patch on. Try and make it a positive time so that she will gradually start to patch for a little bit longer each day. How long have you been asked to patch for each day?
If there is some TV programmes she like let her sit on your knee and watch the TV. (TV is not bad for your eyes, it is bad for you brain if you watch too much rubbish like me ).
Put a patch on her favourite teddy/doll when she has hers on. But dont give up, 30 mins is enough to make a difference, but the more you manage to do in one day the shorter period of time you'll have to do it for.

Warning: TMI The medical term for a lazy eye (reduced vision) is Amblyopia. Amblyopia can be caused most commonly by a squint or having a stronger prescription in one eye causing a blurry image. It is NOT a problem with the optic nerve or the eye itself. It IS a problem with the brain! The cells in the brain responsible for vision (visual cortex), are understimulated. By putting the patch on the good eye you are stimulating the "lazy" cells in the brain and getting the brain learn how to see with the poor eye.

As for surgery. Generally speaking surgery is purely cosmetic. However, the better the vision the straighter the eyes tend to stay after the surgery, even if they do not work together. Therefore most orthoptists would treat the vision first prior to any surgery. The vision can only be treated up to age 8 whereas a squint can be operated on at any age.

Phew hope some of that helps!

Hi Brensky,

Sorry to hear about your daughters cone dystrophy. Has it been given any other name?

Im afraid i dont know a great deal about the genetics of eye conditions being a lowly orthoptist and not a Dr!! Do all your kids have the same dad? (sorry to ask personal a question )

This is the link for Visual Impairment Scotland which has got a lot of useful information on it. You might find some of it useful.

www.viscotland.org.uk/eyeconds/conedystrophy.html

Hi Cheekyginger hope you don't mind me asking but my son is 11 months old and since he was a few months old (if my memory is right) his right eye hasn't been following the left when he turns to look at something. (or it may be the other way around jeez sorry I can't picture it now he's not in front of me)He has an eye appointment at the hospital at the end of December. Does this mean he has a lazy eye?

Hi IQuiteLikeVodka

Hmmmmm thats a tricky one. Depends on what you are seeing

Does one eye look as though its turning in when he looks to one side? Do you ever see it when you DS is looking straight at you, especially when he's tired?

If not then it might not be a squint. It might be a muscle imbalance. There is a condition known as Duanes Retraction Syndrome (if you type it into google images you can see some pictures and see if it's similar to what you have been seeing) that is a congenital muscle imbalance. It results in one (sometimes both eyes) eye not being able to rotate outwards.

But dont worry if it is any of these things as you've noticed it nice and early .

Good luck with your appointment, give us an update once you've been seen.

Hi there!
Just found this thread which could be very useful! I just got a letter from school today saying DS (just 5) "was unable to complete the vision test", also says "failed" and that he will be referred to orthoptist.

Clearly at this point we have no way of knowing if there is a problem with his sight that needs addressing or whether he for some reason found the test at school tricky and failed due to this (eg saying the letters incorrectly- he doesn't/can't say the "l" sound for example).

My instinct is to take him as soon as possible for another eye test, but I wonder what the best course of action is. Is a test at a local Specsavers or equivalent good enough or is it best to wait for the school referral. Keen to get him tested sooner rather than later.

Thanks!

Hi cheekyginger Brilliant thread and you're so good setting it up

My 3 year old DD is under mcr eye hospital but hasn't been seen in over a year ( their appointment system isnt very good). Anyhoo, she was born at 24 weeks and had laser surgery at 38 weeks for grade 3/4 ROP. All good now but this is why she is still under the hospital.

Last time we went, I mentioned her right eye was turning inward. They had a look but said it seemed fine. Now nursery have mentioned it and my SiL. I'm getting a bit worried that it isn't being looked at. What do you advise I say when we go for her next appointment? What should I be looking for in a squint?

Thank you :)
I think it is just that one eye doesnt travel as far as the other,anyway I will look that up on google,thanks again

Looking at the info,it very much seems as if it in Duane's retraction syndrome as it is his left eye that doesn't move outwards,can't see it when he's looking straight at me,thanks again

Hi Tgger

We have "unable to complete vision the vision test on our forms" too. We would generally use that if the kiddie didnt co-operate with the test. Either shyness or just refusing to do it (the joy of working with kids)!! We use a matching letter test so the kids dont have to know their letters, and if they cant manage that we use a picture naming test.
Rather than going straight to an optician you could phone the orthoptic dept to ask what was found on the day??? Did you get a permision/information leaflet about the eye test? If yes, there should be a contact number on it.
There is nothing wrong with going to an optician (my DH is one!), but sometimes it can complicate things i.e. double referral or they might not find a problem but have used a different test.
So in other words i would say contact the orthoptic dept that carried out the test and find out a bit more info. Rest assured if it was anything urgent your son would be seen asap. Hope that helps

Hi Johnworf,
When you say that "they had a look", did you see an orthoptist or was it just the eye Dr? Do you have anyone in the family with a squint, lazy eye? As ROP doesnt in itself increase the likelihood of developing a squint.
For a squint at that age here are some things to look out for

eye turning in when tired, and noticing it more and more

eye turning in after focusing on small pictures toys etc

your daughter closing one eye when looking at small pictures

Things to ask at your appointment

Re-iterate that a number of people are noticing it and also let them know if you are seeing it more often

If there is a family history of suint etc, make them aware of it

If you havent already, you could ask very nicely if you can be seen by an orthoptist

If this isnt enough info feel free to ask for more, dont want to bore you with TMI

Hi IQuiteLikeVodka, if it is DRS dont be worried. Some of the photos that you will have seen make it look quite bad. But in general people with DRS will not actually force their eyes in to that position, so it will go un-noticed unless they show it off as a party trick when older!!!
When you go to your appointment you could tell them what you think it is, that'll make them fall off their seat!!

Glad this thread is appreciated

Thanks! Very helpful. Yes, I've phoned the number on the letter now, left a message, so hopefully they'll get back to me quite soon.

I have booked an eye test at optician's now, but it's not until a week on friday, so hopefully I'll have got through to school health by then and can cancel if I want to. DS is normally pretty cooperative with adults these days but there could be all sorts of things that might throw him so I hope I'll get an idea if this was the problem from a phone call.

Would you still refer kids who don't cooperate to the orthoptist? I guess this could be their policy. We didn't get that much info on the actual tests (or at least I don't remember that!), just a general info thing- it's the screening test they do in Reception for kids, height/weight/hearing/vision. The number was the school health team, but I'm hoping they have my son's test details so they can enlighten me a little!

Hi. She sees this consultant

It does turn in when she is tired but when I raised it last time, I was told that in young children, they can appear to have a squint when in actual fact, it's something to do with their nose being flat or that the bridge of the nose isn't prominent. I'm sure that's what they said.

Out of my 4 siblings, 3 have had a squint. None of my other 3 children have had one though.

Hi cheekyginger - it's early days for us but wanted to ask anyway.

DD is 7months old and we have a referral to an orthoptist in January. She appears to have a lazy eye but not sure. Sometimes the pupils aren't in the same place in each eye if that makes sense? Also one eye seems to be a bit smaller than the other one.

She was born face first (ouch) and slightly skwiff so maybe it comes from that?

What can we expect from out first appointment?
What are the possibilities for what happens next?
Also, what is an orthoptist?!

Btw, am I incorrect thinking that I can't take DD to an optometrist as we're under the eye hospital?

Hi johnworf, not to disagree with a consultant....but....pseudosquint which is what he/she (not looked at your link) is describing is noticed in babies not a 3 year old!!!! Look for pseudosquint on google images.....is that what you are seeing?
You have what i would call a strong family history so i would strongly recommend that you mention it is getting worse (a wee white lie if you have to) and ask to be seen by an orthoptist. The consultant may be so focused on the ROP that might not consider other coincidental problems may exist.