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 dawizzy7,

If her eyes are straight at times then she might have some binocular vision (there are various degrees of BV). Glasses and or surgery may help maintain this. So dont give up hope yet!

I will b away for a week visiting family, i'll answer any msgs later nxt week

Hello, found this whilst looking up squints and lazy eyes, hope you can help.

My son is 15 weeks old (and 2 days!) and we were looking through some photos and noticed his left eye was facing inwards in some photos. Since then we've been watching his eyes and this happens sometimes, but not all the time.

Is it too early to worry about a squint/lazy eye? Places online seem to be saying 3 months is when babies generally stop having crossed or lazy eyes due to immature eye muscles, control, etc. But... he's nearly 4 months now.

Also one of my nephews (my half-brothers son) wore glasses from a very young age and had a lazy eye, needed patches etc. Not sure if this increases his risk?

Wondering whether to bother seeing our doctor yet as she is next to useless and will probably send us away again!

Thanks...

Hello again.

I am hoping you can chat to me about an appointment DD has had today which has totally thrown me.

DD has anisometropia (+1.5 right eye, +6.5 left). She wears her glasses 8 or 9 hours a day.

I went to her orthoptics appt today feeling confident as she is wearing glasses well and doesn't APPEAR to have a lazy eye (she has autism and won't tolerate a patch).

However the orthoptist got really concerned when doing the tests. She said DD wasn't seeing the smallest pictures, but she couldn't tell whether it was I attention due to DD's autism.

She then asked if DD had seen the Visual Impairment team about support in school. This totally threw me as I did not for a minute think DD was visually impaired with her glasses on.

She wasn't wanting to commit and so didn't enlighten me much.

But what support is she talking about? How much is DD being affected? Could this be affecting her development?

We are to see consultant in 2 months, I am expecting bad news at that appointment.

Just totally feel rug has been pulled from under me, with no answers.

TIA

PS she is referring DD to the VIsual Impairment team about support in school now.

PPS DD has no squint at all. She does have very poor visual attention

Hi charbutcher,
The eyes can be fairly unco-ordinated up until about 6 months of age. However if you have someone in the family has a squint/gls from a young age it would be worth getting him seen by an orthoptist. Your HV should be able to refer you without having to go through the GP.
Is it always the same eye? Could it be a pseudosuint
You wouldn't be wasting any ones time even if it turns out to be nothing

Hi Fanjo,

Sorry to hear about your experience. Do you have a number for the orthoptic department? Can you phone and speak to someone and find out a little bit more information to put your mind at ease?
Based on her prescription alone she would not be classed as being visually impaired. There must be more to it.
Are they referring her to be assessed by someone that has more skills at assessing children with autism???
Keep encouraging her glasses as much as possible and if she seems visually alert to you try not to worry too much. How old is your DD?
Sorry to answer your question with so many questions !!

Thanks.

I don't think I will get more information until we see the consultant in October.

She is very visually inattentive indeed. I always thought that was just her autism but now am wondering. She does spot chocolate easily.

Maybe this made her present as visually impaired to someone unused to autism? We were told the referral was for support at school, not assessment.

The orthoptist did seem confused and worried though. Am wondering if DD did seem like a visually impaired NT child which confused things.

DD is 7 in October.

Hi Fanjo,

Try not to worry. I know that is easier said than done. The visual impairment team will be able to give you more information about what she can and cant see, think of this as a really positive assessment. Will give the school more information and make sure your DD is getting the most out of her education.
Post again after your appointment. Hope it all goes well x x

Thanks. I think I am looking forward to it.

Am always telling people to be careful with her around stairs etc so maybe this will back me up.

She is totally happy at least.

Thanks for listening :)

Hi my daughter is long sighted in both eyes been told mild and has a squint I'm very worried about this.. I just wanted to ask she's been giving glasses which she is doin really well with keeping them on etc i wanted to ask with the glasses make the squint worse with or without her glasses on been told shes looking at wearing glasses till she's at least 8 and then She mite not need them anymore I' worry the squint will get worse it only happens now and then any1 help with advice x

Also sorry my daughters 3 years old

the squint would normally improve while wearing the glasses and look worse when they are off again as the eyes try to focus again. DD's squint was noticeable while still wearing her glasses so she ended up getting the squinting eye operated on to correct it so it wouldnt show so much with her glasses on. She still squints with her glasses off though.

What strength of prescription was she given? DD's is around +4.5 and +5.5 and will need her glasses long term (forever probably!).

I dunno the prescription the lady at the hospital just said its very low prescription she said the problem is mild.worrys me so much I'm finding it hard to understand it all.

I find the hospital are not very clear explaining things to me I'm under moorfields did the surgery work? They haven't mentioned anything to me apart from putting glasses on and I think that's just coz she's longsighted not anything to do with her squint I mite be wrong but that's what I feel

they should have given you a copy of the glasses prescription with the values on e.g. dd, ds and myself all have glasses prescriptions but mine and ds have very mild prescriptions and only need glasses for close work/reading, etc.

DD's surgery was done at a local hospital i.e. not Moorfields

Hi cheekyginger, thank you so much for this thread.

My 3 year old son was diagnosed last year with Duane's syndrome, and has regular checks every 3 months but so far he has good vision in both eyes, he just cannot look to the left with his left eye. I know this is a life long birth defect that will never be corrected, but I was wondering if you had any information about how it will affect him as he grows up? Will he be able to drive or play sports? Thank you

No they dident give me anything I go back in a few weeks I will ask for it. Does your child were glasses all the time? Do they still squint? Sorry for all the questions

yes, dd has worn glasses since she was 18 months old and still wears them now at nearly 10 years old. She will probably always need them due to the size of her prescription. She only really squints when her glasses are off (which is not often) or when she is really tired. The first thing she does in the morning is put her glasses on and she doesnt look right without them

Hi Cheekyginger,
I just happened to spot this thread in active convos - what a great thing you're doing, giving your expertise on here .

Hope I can join in - I'm an adult (40) and have a lazy eye due to a squint in my left eye. The laziness doesn't bother me as I wear contacts but the squint does, for mainly cosmetic reasons (sorry if I sound vain but I feel really self conscious about it and always have, it really affects my self-confidence).

It's a convergent squint which has also been described as having 'disassociated vertical deviation'. My left eye goes up as well as inwards, especially when I look up at someone/something, or if I look at someone behind me in a mirror (for instance when at the hairdresser if I'm talking to stylist stood behind me, iyswim). Treatment-wise I had patching as a child, then surgery at age 7 or 8, then further surgery at age 20 after my GP noticed my squint and referred me to the eye dept. At that point the consultant said I should never have been discharged at age 7/8 as the surgery hadn't worked properly. Ironically, he didn't correct it either .

About three years ago I gathered all my courage and went to my GP and asked if anything could be done and was referred back to hospital (different consultant). I went a few times so they could measure, test etc and she said that the squint wasn't too bad but she could correct a bit more but would have to be careful not to over correct. She said she'd need to do two ops about six months apart - one to work on the horizontal convergent squint and one to work on the vertical deviation (which she felt was worse than the horizontal) and to avoid operating on muscle already operated on previously, she'd operate on the non-squinting eye. She said she'd put me on the waiting list but I never heard from the hospital again! I suffer from a lack of confidence and in my head I wonder if they thought it wasn't worth doing or they don't have enough NHS resources, so filed my notes away without telling me, which is why I never chased it up.

Is there any point me going back to my GP again and re-starting the whole process? I feel stupid that I let 2-3 years go by without chasing up why they haven't contacted me. Having a squint affects my self-confidence to the point that I don't like looking people in the eye, especially strangers, as I think that's all they can see, and it's affected my whole life in different ways. I'd really love to get it sorted but am dreading the hospital saying it's just not bad enough to bother operating on and I'm wasting their time.

If it helps, my prescription is as follows:
R - Sph -2.75, Cyl +2.00, Axis 85.0
L - Sph -0.25, Cyl +1.25, Axis 105.0

Hope you can advise and sorry for the essay .

Hi Kirsty2010,

There will be a few "ifs" in my answer! If your DD has a squint then they may trying with the glasses to see what effect the glasses have on the squint. Any child that has a convergent (turning in) squint, should have a trial with glasses (for lonsightedness) even if it is a mild prescription.

If the glasses fully correct the squint then the glasses may be required longterm. If they make no difference then surgery may be required if it is cosmetically poor. As a very general rule any prescription higher than a +3.00 will be long term (but weaker prsecription can also be longterm if they correct a squint).
ilovepowerhoop sounds like her DC has a partially corrected squint.

You will get more information at your next appointment. Even write a list of any questions you have before hand so that you make sure you remember on the day! Hope some of my answer makes sense .

Hi softkitty,

Squints can really affect your self confidence. We see adults on a weekly basis asking about cosmetic squint surgery.
It sounds like you have been "lost to follow-up". This is the nice term that gets used when someone has screwed up lost paperwork or not listed someone for surgery . Definitely don't take this blip personally!

If it is really affecting your confidence get back to your GP asap. Discussing the possibility of further surgery is not wasting anyones time. From what you describe the vertical squint is what you are most aware of, so one surgery may be enough. And if the consultant says no, ask for a 2nd opinion, IMO!

Hi Catree55,

As Duanes is a static congenital condition it will likely have no affect on what he can and cant do . Driving no probs, sports no probs.
As long as his vision is good and he doesnt have a significant head posture (does he turn his head when concentrating?) to maintain his binocular vision/3D vision then he will not require any treatment.

It will become his very cool party trick to show his friends

Hi thank u for your response my daughter has only had her glasses a week now she only squints now and then it's not all the time but when it does it turns outwards.i dunno if it's still too early but she still does it now and then even with her glasses on ... Would contact lenses be an option 4 her later in life thank u 4 this thread been very helpful 4 me

Thank you Cheeky , I'll get the school holidays out of the way then give the GP a visit. Will keep you up to date with what happens.

Hi Cheekyginger, what an amazing thread of information you are providing. I wonder if you can help me? My 8 yr old has recently been complaining of blurry vision when reading small words, I took him to the optometrist and he said that he is longsighted + 1 in both eyes, but does not recommend glasses at this stage. The optometrist felt that Mr 8 yr old is angling for glasses but doesn't really need them. ( A little girl in his class also has been complaining of blurry eyes and Mr 8 really likes her - it would mean a lot to him to have glasses if she gets them too. also his dad has recently gotten glasses and Mr 8 really likes the look of them.) I'm not sure how to proceed - Mr 8 yr old is really sticking to his guns and now refusing to even try reading smallish print because it is blurry - it feels like an act but could be genuine. Would you recommend glasses for such a small prescription?