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.

johnworf you are free to take your child anywhere you choose. However the orthoptists that are based in the hospitals are the experts in squints lazy eyes etc. If you next appointment is not for a while that might be a good idea. If the optician find a squint then they will likely refer you anyway....

Thank you cheekyginger for starting this thread.

I too have a house full of eye issues - in fact, apart from DP we are all fully signed-up members of the Girly Glasses Gang!

DD1 has been under the care of the eye clinic at the hospital since birth. She was born at 32 weeks and had lots of eye tests prior to leaving NICU - I hated the clamps they used to hold open her eyes but she never seemed bothered about anything other than having to be held still.
Anyway, now at the age of 5 she has a prescription of +6.5 and +7.5; she has a convergent squint in her left eye which is also lazy. We have been patching since she got her first glasses at the age of 20 months. We are still patching although are now down to 2 hours a day. She does this at school - she started Reception this year - and, after some initial problems with not wanting to wear her patch in school, she is now mostly okay with it. There have been several appointments at the hospital (she goes back every 8-10 weeks) where they have hinted that we are getting close to not having to patch any more - we get excited... only for them to say keep it up and we will see how it goes.
Will we ever say good bye to her patches? (We have great patches made by Framehuggers which provide total oclusion of the good right eye.)
With her glasses on she has normal vision - she can read the letters on the 2nd row from the bottom. With her left eye she can now read the row 4th from the bottom - originally she could only see the letters/shapes on the 2nd row from the top!
She has no depth perception - we just had to get the hospital to write a letter to her school as they wanted her to remove her glasses for PE for health and safety reasons - hospital said she would really struggle without them (she puts them on first thing on waking and has been known to fall asleep at night in them!)
The hospital has never really mentioned about surgery - only to say that it could be an option in the future but they are concerned that it might affect her vision negatively. Her squint is almost wholly corrected with her glasses.
However, I do wonder what she can actually see without her glasses - we take her swimming but have struggled to get prescription goggles strong enough.

DD2, on the other hand, has prescription of +4.5 in both eyes. We have always figured this is not too bad - but it seems that is only in comparison to D1. Is +4.5 'bad'?
DD2 also has a squint but only goes to the hospital clinic every 4-5 months - does this mean she does not have a lazy eye? We have never done any patching with her.
We have never bothered with prescription goggles for DD2 - should we?

Sorry for long post - hospital people (opthalmologists, optometrists, opticians) are all great but I never seem to get the answers.

I am short-sighted and manage fine with my glasses!

Thanks cheekyginger. No idea when we'll next get seen so I think I will take her to the optician where I go

You're fab

Hi JKSLtd,

An Orthoptist, is a specialist in binocular vision. We train at university for 3 years, many of our classes overlapping with opticians. They specialise in the optice if the eye and we specialise in the muscle function/movement of the eyes.

We are often described as physiotherapists of the eyes?! We deal with children with squints, lazy eyes, and also adults with double vision caused by nerve palsies, thyroid eye disease and many other things.

Your first appointment will be quite straight forward. If it is just the orthoptist you are seeing a lot of the assessment is observation while getting your daughter to look and follow small pics. At 7 months it may be what we call a pseudosquint (mentioned in my prvious post to johnworf). If that's the case it will reduce over time as her nose develops as it is not a true squint.
If they feel that she is squinting then that will be different.

At 7 months they might simply want to observe her in a few months time. As the eyes are still developing and the occasional squint can be seen. It's difficult to say what will happen next until you've had your 1st visit. I'll still be doing this thread then as i will still be on Maty leave, so feel free to post again!!!

let me know how you get on johnworf.....to see if my verbal dr bashing was warranted!!!!

Will do

Hey cheekyginger found you! Marking my place ... Our next appointment is in feb. With orthoptist.

Thanks Cheekyginger, I'll be back

Hi Dysgu

Lots of things to answer!!!

Well for DD1: In our department patching is continued until the vision remains stable over 2 consecutive visits. If her vision remains the same at your next visit. Ask them if her vision was similar to her last visit, if it is then it is time to stop. This is evidence based practice i'm surprised she was been patching such a long time. It's not wrong by any means but seems a bit wishy washy.
As for squint surgery. If her squint is almost gone with her glasses on then surgery would not be an option as the squint that you see with her glasses on is what the surgeon would be aiming to correct, and if that's really small then surgery would risk overcorrecting it causing the eye to turn out the other way.....does that make sense?
As for swimming goggles, you could try
www.prescription-swimming-goggles.co.uk
If you cant choose the strength of each eye seperately then +6.5 OR a +7.00 for both eyes would be fine.

As for DD2. We would class +4.50 as a moderate prescription. She will need her glasses long term. She will be able to see without them for short spells, for swimming etc. So goggles are not essential. If she has never had patching then that would suggest she does not have amblyopia (lazy eye).

Your girls are both longsighted and contact lenses would be an option when they are in their teens.

Hello again,
Thought I'd do a follow up. Found out that DS could read the letters down to the line above the bottom line with his left eye, but "a few lines above that" for the right eye, hence the referral.

I now have a letter with a number to make an appointment with a local clinic and am going to follow up that rather than go to the local optician. We shall see what the next test brings! They have dealt with it promptly as you say.

Thanks for your help.

Our health visitor has referred her to the orthoptist. No idea how long we'll have to wait for an appointment but will let you know how we get on

Hi Tgger, thanks for updating it's nice for me to hear how you got on. Hope it turns out to be fine. He might just have gotten a bit bored by the 2nd eye!!

Johnworf, well done the health visitor!!! That will give you some peace of mind.

Hi,

Can someone offer some advice.
My dd is 5years old and has a very odd problem with one of her eyes. She raises her eyebrows and widens one particular eye, blinks lots and sometimes holds this one eye closed. When I ask her about it she says her eye feels strange, like its aching. Its all a bit confusing! She has no squint or lazy eye, but this is a constant problem which usually gets worse towards the end of the day. She has had an eye test and they confirmed her vision is fine. But I am concerned.

Thank you.

Hello, Just a quick(ish) question. How would you class an astigmatism of 2.5 with a prescription of -1.00.

Is that bad vision? A bit confused here. x

Hi klover, to be honest i don't really have any ideas. It could simply be a habit she has gotten into OR could be a visual problem, very difficult to tell without seeing her do it. Perhaps you could get a 2nd opinion? Where did she have her eyes tested? If it was an optician you could try a different one perhaps.
Unless another parent has experienced a similar problem thats all i can offer...

Hi tooloudhere, astigmatism is to do with the curvature if the eye. We generally explain it as "the eye is more like a rugby ball than a football". 2.5 is a moderate amount of astigmatism. Without the glasses the vision will be fairly blurry. No reason why someone with this prescription wouldn't have 20/20 vision with their glasses on.... Does that help?

yes it does, what if you add in nystagmus would that make actual vision worse or does it affect focus. All this in a very young child (just one) would you expect the astigmatism to get better with age or would you prescribe glasses now? thanks x

Hi tooloudhere,

Nystagmus is a tricky one as the overall visual potential wont really be clear until your LO is about 3ish when the vision can be assessed more accurately.

As for the prescription. At 1 the eye is still changing a lot. In our department we would probably hold off prescribing glasses for that amount of astigmatism just now and repeat the glasses check again in approx 3-6 months.

Hi klover your daughter may have a small recurrent erosion on her cornea, or dry eye, I'd go back and see then Optometrist and mention it. They can put some special dye in the eyes and look for it.

Many thanks, we have glasses but I am not sure that we are doing the right thing. It just seems so young.

tooloudhere, is your LO wearing the glasses? If he/she has taken to them well, then go with the flow. Wearing the glasses wont make him/her more dependant on them. Are you getting assessed regularly?

it is a bit early to say whether they are liked or not, we get seen by one person or another every 6-8 weeks for things eye related.

tooloudhere, you seem a bit disheartened about the whole thing..... try not to worry too much as they will have his/her best interests at heart. Good luck with your appointments.
If your still not happy in a few months time you have a right to get a 2nd opinion.

Hi Cheekyginger thank you for running this thread.

My ds is a +6.75 in both eyes.

He got a pair of glasses from specsavers in August that are not fit for purpose, the lenses keep on falling out, they don't stay on his face and they are downright useless. I'm taking them back in on a weekly basis. I have requested a new pair.

And have been told on top of the £125 we have already paid for these glasses to have the lenses thined etc, it will cost £250 for a new pair of glasses, or wait until next August.

Do you have any ideas, of how to get either Specsavers to give a new pair, or what we can do via the NHS?

Also in addition to this 2 specialists have recommended that he has a blue tint on his glasses for reading only, therefore we want/need to get him a reading pair of glasses, again is this possible on the NHS, and would we still need to pay £50 for the tinting?

We are finding glasses are costing us a fortune, he has a £30 pair of swimming goggles, £75 pair of sports goggles, and £150 pair of sunglasses.

TIA

Hi Multigrain,

Are you in Scotland?

If you have been attending a hospital specialist then i would have thought they would provide you with the voucher/prescription to take to the optician?
This should cover the cost of a basic pair of frames/lenses. You would then have to pay extra for thinning and tint. Thinning and tinting are not covered by the NHS.
In Scotland children under 16 glasses are free(Not sure about the rest of the UK TBH), unless opting for designer/sponge bob/spiderman glasses You would then pay a supplement.
Opticians in Scotland have the option of processing a "blue voucher". This is a replacement voucher for glasses that get lost or broken beyond repair. You would still need to pay for thinning/tint on top. You could take you DS's prescription to another opticians and ask for a quote to see if you can find it cheaper.

What a great thread! CheekyGinger, when my DS was born we thought he had a slight squint, but were told repeatedly that this is common in babies. He's now 3.6 and I don't think it's any better. My optician has said to bring him in, but I wondered if you had any advice about questions to ask or information about what kind of options would be available if he does have a squint? Is it likely to be something he could still grow out of? TIA.