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 Kirsty2010,

If it is an intermittent divergent squint then as a general rule they are kept under observation, perhaps even every 6 months or once a year. If the glasses are not very strong and they are not making a huge difference to the control of her squint then they may stop the glasses at some point.
Good luck at your next appointment

Hi minmouse04,

If your DS is persistent about his blurred vision then the optician would be justified to give a "trial" with the glasses. Opticians have to be careful that they are not giving out "nonsense" prescriptions.... However if your son has symptoms this shouldnt be an issue, even though your gut is telling you that he's faking it exaggerating his symptoms. And this prescription certainly wouldn't do him any harm.

Thank u ill keep u updated :)

Hi cheeky, I really need reassurance as I am making myself ill worrying. My two year old has an alternating squint and was told she may not have binocular visionI am reading so much that says quality of life without it isn't good and lots of everyday tasks will be difficult. Please tell me how bad it will be? Thank you

Hi "daisy1971",

The human body is extremely adaptable. If she has never had binocular vision (BV) then her little body will not know any different.
She may not manage to be a neurosurgeon that uses a binocular microscope or an RAF pilot, but in general this will not affect her in any way.
Losing your binocular vision as an adult is a whole different matter, so that might be what you are finding when you are "reading" about not having BV.

Yes its good to have binocular vision, and we do tyr and preserve it when we can but if children dont have it then they do adapt

Thanks Cheekyginger, the fact that it won't do him harm is a huge relief and it may mean that I do let him have a "trial" with some glasses. I am meeting with his school teacher in a couple of days to find out what is going on in class. I definately respect the opticians opinion, the trouble I am having is that my DS is refusing to read his level reading books because he says the print is too small and blurry.. can't have that going on for too long. Thanks once again for your advice.

Thank you for the reassurance. Which is the test they use at each appointment to test 3d vision? We usually have the pictures of the house, cup, duck etc and little pictures on sticks but unsure what each one tests what.

Hi cheekyginger,

I wrote to you a while ago, but I have some more worries about my daughter (who will be 7 in September)
She was found to have a lazy eye at 4 1/2. She had glasses and was patched until about 4 months ago so just under 2 years in total, when she reached her plateau. Her eyes didn't get to read the same line, I think her lazy eye was 2 lines off the better eye. So today I took her for a prescription check and she has gone from having + 3.5/5.75 to 3.75/6.25sph 0.75cyl 30axis. I was told that her full prescription would be 4.5/7 but she has gone in between for her glasses.
I asked if I could see how she sees, so she gave me 2 lenses which I could look through. It made me feel very sad as I didn't realise quite how difficult it must have been for her, but they did say that she wouldn't find it as difficult as I would be (being an adult) she is hoping that the extra strength glasses will help her go up one more line, which she said will show up by her next check up in 5 weeks? I just really worry for her when she is older as it will only get worse, not better and worry in case something happens to her 'good' eye?
Sorry if I'm rambling, it's just they don't really explain things at the hospital, just say do this do that and kick us out!

Just to add, her prescription went up as she was tested today with drops before her test, but last time they didn't use the drops. Is that not something they should have got right last time, would that have slowed her progress down over the last year? Also been told she has an astigmatism which didn't mention before :-(

Hi Cheekyginger,

What a helpful and amazing thread :) I apologise if you've already answered these questions further up..

My 4yo DD has just been diagnosed with lazy eye and i have a few things I'm not sure about.

She had just turned 4 thry fohnd refractive error RE +4.50 LE +0.50, no squint, just lazy eye in the RE caused by large uncorrected refractive error. :(

1. What is the prognosis at this age? I feel awful that I didn't pick up on this earlier.

2. the optometrist said that we should try glasses first and that sometimes patching isn't needed. We need to go back in two weeks. If there's been no improvement we'll start patching. Is this right? She might not need to patch at all? From my googljng it seems patching is the treatment of choice should we be starting now?

3. she is complaining that the glasses are giving her double vision ("but I can see two lights mummy- I don't want to wear them") Is the prescription incorrect? Or are her eyes just getting accustomed to the new lenses?

4. how long before the lazy eye starts to focus while wearing glasses?

5. will the prescription in the RE always be +4.50 or will it get a bit better as she gets older?

Thank you

Hi, My son has a bilateral squint and is slightly longsighted +2.0 approx. at reception age we took him to optician and he had perfect eye sight. 16 months later they noticed the squint. We went private a didn't want the long wait..... So he is under the care of an ophthalmologist but has also seen the optometrist who didn't advise anything if different than wearing the glasses.they hope he will grow out it. However in the last week his left eye as deteriorated rapidly so it is lost completely pointed in. We will intact the opthamologist but that takes time. We checked with the optician wo confined hi vision is no worse, the health of the eye is fine but clearly the squint is quite severe with him now favouring one eye although squint is present in both. It is so bad he now puts a hand over one eye to see and says he has the double vision even with glasses. He is on oxybutin/ditropan for a kidney condition (7.5mg a day) but no-one wants to get in to any discussion whether there is any link.

We haven't been unduly concerned before but we're quite worried with such a rapid deterioration.... Is this usual and what are his treatment options?

Thank you in anticipation!

Hi daisy1971,
The little pictures on the sticks are just to hold your LO's attention while the orthoptist looks for a squint. The 3D tests we use are [[https://www.google.co.uk/search?q=frisby+stereotest&source=lnms&tbm=isch&sa=X&ei=UzsJUp6KCYKd0QXHxYHgAw&ved=0CAkQ_AUoAQ&biw=1280&bih=687 frisby stereotest , TNO, and titmus fly. You can see most of them on this link

Hi mazza227,
All our kids (in the clinic) get annual glasses checks with drops in there eyes. The drops are recommended for children under 7 to get the optimum prescription. Hopefully this will not have held her back. You will see at your 5 week check if there has been an improvement.
When you go to your next visit you could ask them to write down what your LO's vision is and post on MN again. It will be recorded something like 6/6 or 0.000.
The prescription will stabilize over time

Hi Mrs Lion,
Are you also seeing an orthoptist?
Our protocols are glasses full time for a minimum of 12 weeks prior to starting patching.
Glasses are prescribed by the optometrist or ophthalmologist and then they are brought back in 2-3 months. If the vision has not changed at all then patching is started at this visit. Otherwise they are left for another 2 months.
Your LO has a reasonable difference between the 2 eyes so it is likely she will need some patching but you never know!
I would say that a 2 week review seem very soon to be reviewing her, however if she is complaining of double vision this is a bit unusual . Sounds like you LO should be seen by an orthoptist. Your optometrist should be able to refer you for this.
Her prescription might change a little as she grows but it is unlikely that she will grow out of it.

Hi Amanda1806,
Have you seen an orthoptist at all? Orthoptist specialise in assessing squints. It sounds like your LO needs to be in stronger glasses perhaps or even bifocals. But an orthoptist would be first first port of call. (Not dissing ophthalmologist or optometrist). You would get seen pretty quickly on the NHS if you mention the fact that you LO has double vision. You could go via your HV or get the ophthalmologist to refer you??? Not really sure how the private sector works.
Think it may just be a coincidence that your son has kidney problems. poor wee soul

Thank you for your reply. If my daughter has never had any of these tests which I know she hasn't what does that mean? She has an alternating convergent squint but her eyesight is ok apparently.

Hi cheeky,
Thanks for your reply. No she's not seeing an orthoptist but I think I'll ask for a referral. The double vision seems to have gone away since my post but I'll wait until next visit to asses properly.
Thanks again!

Hi cheekyginger,
I am also an adult looking for advice. I hope you don't mind. I had a squint correction at the age of 2. I do not have any other sight problems ( no short sightedness etc)apart from the lazy eye. I have no binocular vision but also no double vision. The squint correction was successful but over the years my eye seems to be slipping and is particularly bad when I am feeling tired or unwell. I am very aware that my eye slips but cannot feel it going so this worries me in social situations and I find myself letting people know I have the problem so that they understand why i do not appear to be looking at them properly. I would really like to sort this out, I don't know if glasses would help this??? What do you think?? I was told a year ago that it would not be sensible to try having another operation as there is the risk that the op could make the squint worse rather than better. Glasses with a prism were also mentioned but at the time I was unsure about glasses. Now I am wondering whether they are the answer. Many thanks for reading my question!

Hi cheekyginger I wrote to you awhile ago about my daughter I went to the hospital today she has a intermmited squint in the left eye and she is longsighted and her left eye is also the shape of a rugby ball as they said her prescription I found it out at last is right eye sph +2.00 cyl -1.75 axis 175 left eye is sph +1.25 cyl 1.50 axis 180 my daughter is 3 years old shes been wearing her glasses only 3 weeks now and already she's improved buy 3 more line on the chart of pics does this sound bad to you for her age and will she allways need the glasses? They told me the glasses won't do anything for her squint but there gonna keep montering that any advice would be appreciated ;)

Hi cheekyginger - as many people have said, what a great thread! Although I haven't read all of it

My DD has just got her first pair of glasses. She is long sighted with a wandering eye, I think it goes outwards. She got her prescription at the hospital and then I got the actual glasses at Boots, and then went to a "proper" optician for my DS's first pair of glasses as he wears hearing aids. The lady commented that DD's glasses didn't fit her properly and adjusted them for me. She also gave me a wearing schedule for DD, which no one else had done, so DD can get used to her glasses.

Anyway, to the point! DD has worn them about 3-4 times she has had them for 20 mins at a time. She looks over them rather than through them. I talked to her about looking through them and she said it looks fuzzy. I am not sure what to do about this. Should I persevere with making her wear the glasses until she is wearing them full time or should I see how it goes for a week and then contact the hospital?

We will be going back in September to see if the glasses have helped her wandering eye, or if she will need a patch. But obviously if DD doesn't think her glasses work, then I want to sort it out before then!

Oh - we could do with a wearing schedule for DS2! We've been making it up as we go along!. It's been 3 weeks and we've got him up to anything from 5 to 30 minutes, a couple of times a day, most days. If he's tired, he's very intolerant of them. He started looking through them, after a few days (we counted then gave him a chocolate - we found a slow count to 20 the most helpful for persuading him to look through them!) and finds everything most entertaining - especially the blackheads on my chin! We've had a setback, this week. I've started taking him out for walks with them on and he only went and clobbered his head on the wing mirror or a truck - cue scrabbling around for chocolate to persuade him to put them on again, the next day.

I have no idea how we're going to extend his wearing any further, though. He's non-verbal, so can't tell me how things look though them.

Is your DD just long sighted, or is there some cyl prescription in there, as well? If there is, then if they're not worn straight they might seem blurry.

Erm, i think she is just long sighted with a wandering eye. I don't know what cyl prescription is sorry
They aren't very straight when they sit on her nose though. Maybe I should get them adjusted again? Also, the Boots people did struggle to get her to look straight for measuring her eye in the middle of the lens. Probably because she has a wandering eye!
According to the lady in proper opticians she said it is illegal for anyone other than a qualified optician to fit glasses for someone under sixteen. i am guessing the person who fitted DD's glasses wasn't qualified. The "proper" optician said to let her wear them for 20mins for the first day while watching tv or reading and build it up to 40 mins the next day, can be spread out over the day. Day after, use the glasses for an hour, and then keep adding an hour until she uses them all the time. the optician did say that it might be difficult to walk to begin with as the ground will look funny!

I think you are doing the right thing for your DS. Just building it up slowly with bribery helps! How old is he?

Hi my 8 month old son has a turn in his eye. The doctors keep mentioning surgery but I was wondering if there's another option for him? I hate the thought of him going through surgery at such a young age

Wow cheekyginger you have been helping people here for two years! What a wonderful and generous person you are.
I hope you don't mind but I have a question too. My son had patching from 3.5 until 8 (recently), in one eye he is very long sighted and has astigmatism. He is now telling me that when reading he has double vision. He says he can see the words/letters properly if he concentrates very hard but it hurts his eyes very quickly, so he closes one eye. Is there anything that might help to improve his binocular vision? After years of patching and glasses it seems stupid to ditch his glasses just so that he can read.

Hi cheekyginger
You have given me advice before. My daughter has a lazy eye, long sight, astigmatism. she was patched under the hospital but they stopped as it started to affect her stronger eye. She was discharged last summer, 5 1/2, as they said her glasses were correcting the vision and squint as there was nothing more they could do.

Eye test this week at a high street optician who has referred her back to gge optician as her sterescopic vision is very very poor and he thinks she shouldnt have been discharged until at least 8.

prescription is -2 in good eye and -1.75 in weak eye. Any tips for when her referral comes through.

sorry that should read "referred back to hospital"

Hi daisy1971,
If she has an alternating squint she may not have any binocular vision. As she gets bigger they may be able to test her more accurately for this.

Hi givemewings,
If you have no binocular vision then prisms will not be of any benefit. Surgery may be an option it will depend on the actual measurements of the squint. If there is a risk of over correction or a risk of double vision (if the eye was straightened) then another option might be botulinum toxin. This can be injected directly into one of the eye muscles to cause a temporary weakness and allow the eye to change position. Worth asking your optician to refer you to your nearest eye clinic and get assessed so you know where you stand

Hi Kirsty2010
Her vision is improving really well! Her prescription may change as she grows. If it stays around this level she may always need her glasses for detailed work, but would manage ok without them for outdoor play/ sports etc.

Hi twotears and ourvye,
When kids are longsighted they get used to over focusing their eyes to see clearly. Once they get their glasses it can take their eyes a few weeks to stop the overfocusing.
We dont give "wearing schedules"! But we do advise to gradually increasing wear from 30 mins for a few days to 1 hour to 2 hours. Lots of close work while the glasses are on.
Dont worry too much about them looking over the top. Aim to have the glasses physically on their face. Once you have one that battle then gradually start encouraging them to look through the lenses.
And dont give up, even if you have a few bad days !

Hi helentres
Our doctors dont often carry out squint surgery on children that young to be honest. Has he had a glasses check? Any longsightedness should be corrected as this can change the angle of the squint. Are you in the UK? Sorry lots of questions!

Hi Jami74,
Cant believe it's been 2 years!!! Being a mummy has really made me want to help other parents, and make sure they know what is going on with their childs treatment . Thanks for your lovey thank you . Does he get the double vision when he is reading with his glasses on? If yes then they may need to be checked to make sure his prescription hasn't changed. If it happens when he doesn't have his glasses on then he may need to wear his glasses more? Not sure that will have helped! As long as his vision is the best it can be then this will encourage his binocular vision

Hi EustaciaVye,
If a childs eyes are stable then 5 1/2 is an acceptable age to be discharged. Did the optician phone the eye clinic to see what her level of stereovision was at discharge?
The prescription you have written down suggests that your LO is shortsighted with no astigmatism??? Is this definitely the prescription?