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.

Thanks cheekyginger.

He didn't get glasses last year (not sure why looking back although possibly because they were equal then?). The optician (different one this year) said that if the weak eye improves sometimes he can manage in practice (and even do patching in some cases).

To be honest I'm not keen to go down the hospital route again as it was not very efficient and seemed an odd model to me (first referral with DD was to another optician in a local town where they did the drops again and saw an orthoptist from the hospital - then hospital 2 monthly, but appointments not sent out etc) PLUS I'm being seen at the same building for eye problems so feel like I should take out shares!

DS will get glasses after drops next week (poor thing doesn't really have a bridge yet so not sure how we are going to keep them on). He appeared not to have BV when tested on Saturday :( but optician said no squint apparent.
Very glad to have finished patching with DD but obviously would have liked to have achieved better vision in the weak eye.

I do wonder how he is managing to see anything with +6/8 - he can point out the duck in the Farmyard Tales books, even the mini ones, and has no problems with grasping etc? He can even form one or two letters pretty well already.

Hi BB,

Thats a shame you weren't happy with your DD's experience. I dont blame you for not wanting to go down that route again.

If your DS was attending our clinic this is what we would be doing:

Prescribe the glasses for full time wear
Why? The difference in prescription between the 2 eyes could be whats causing the vision to be a bit lazy, and whats making your DS appear to have no BV. If the glasses are worn full time he will be less likely to need patching.

Review in 6-8weeks
Why? To make sure he is tolerating the glasses and ensure the vision is improving. If no improvement of vision in bad/lazy eye start patching. If improvement wait till next visit.

Review in another 6-8 weeks
Why? If vision is not equal then patching is started.

Monitored every 8 weeks.
Why? The reason the visits are so frequent is to allow the vision to be monitored closely so that treatment can be adjusted accordingly.

It really concerns me that the optician is talking about trying patching in private practice . It is not illegal, but generally speaking optometrists (opticians) in the UK have only a very small amount of training in this area and as a general rule they refer to the nearest orthoptic department, as this is a very specialist area (unless they have a seperate degree in orthoptics of course!!).

Hopefully he is in his glasses at a young enough age that the vision may not require patching, and if the vision improves then he should achieve BV. And you can happily ignore all my "moanings"!!!!!

And the good news is.....if he doesn't have a squint there is no reason he wont achieve BV .

Thank you for your answers cheekyginger!

DS has just turned 3. I am so pleased because today he managed the 2 hours of patching! Hopefully we can keep this up every day!!! He is excited to get his new glasses today (action man) from specsavers, they are really cute.

This thread is fab

Thanks again cheekyginger you are brilliant giving your time like this.

I was a little surprised when the optician said he could do patching in practice as I had thought it was policy to be referred to the hospital. I'll bear your comments in mind, but am really hoping that the glasses will be enough.

I am still a bit annoyed about the different policies that seem to apply even within Lothian for screening - I think West do pre-school but East and Mid do P1 - which is why DD was caught so late. If she had been screened a year earlier she might have gained better vision in her weak eye as she was 5.7 by the time she was screened. I am tempted to raise it with NHS Lothian, but think we might just get palmed off.

Hi BB,

It's no problem . Still on maty leave and have a baby that is a good napper!!

It's also been a bit of an eye opener for me to read what parent go through and take away from their visits. Think i will be a different person when i go back to work!!!

As for the screening. Think they had major staffing problems that prevented Orthoptic-led pre-school screening in all areas of Lothian. I know that doesnt help you now but would worth talking to your local orthoptic dept and even your local MP. If more parents complain then the powers that be might get their fingers out and fund extra Orthoptic posts!! So we could have the 100% coverage we are aiming for in Scotland!!!

bump

Hi Cheekyginger

This is a great thread.
I have a couple of questions about my DSs as we got their eyes tested over half term.
DS1 (aged 8) is mildly longsighted +0.25 in one eye and +0.75 in the other plus a small degree of astigmatism. The optometrist recommended glasses for close up work because she was concerned that the difference between the eyes might be causing some problems. DS does skip lines when reading sometimes so is it reasonable that a difference of +0.5 between the eyes is enough to cause problems?

DS2 (aged 4.5) is seriously long sighted (+6.75 and +7 tested with eye drops). We have been given a referral letter for our GP to refer him to the local eye hospital (we're in England) to check for a lazy eye. In the meantime he has been given a much lower prescription of +2. I was wondering why he wasn't given the full prescription straight away?

Hi cheekyginger

Just checking in to let you know what happened when we saw the orthoptist.

Our initial visit confirmed that DD does indeed have a lazy eye and so we were given another appointment to see the consultant (of eyes? ) who would examine her after drops were put in.

So we saw the latter last week and he confirmed that she would need glasses. He's given her a prescription of +1.25 for both eyes and she'll be reviewed in 3 months time. He told me this was the maximum they could give her at this point.

No patching to start with and I think they're going with the 'suck it and see' approach. He did explain to me about the 3 types of squint - sorry I cannot recall the technicalities of it all but I'm sure you know what I'm on about - and the interim time until the next review will hopefully show which one she has and whether it's glasses or surgery she needs.

So pleased that I got this sorted finally. Thanks again for giving me the push I needed to get her a referral

thanks cheeky, you answered my question about my son's speech affecting his eye test a few weeks back, I've only just found it

His appointment letter has arrived for April, so will have to wait and see how he gets on, but it sounds like they will be used to it and hopefully will have time to make sure he understands.

Just thought I'd update on my DS. He had his appointment with the drops yesterday and was such a star with the pictures. His prescription has come out at +7 and +7.5 - actually not as bad as I had been steeling myself for so strangely positive. He can see the equivalent of the second bottom line with his +7 eye (corrected) but only between the third and fourth with his other eye. Again possibly better than expected as that is similar to the level of vision that DD has achieved in her weak eye (corrected) after 8 months of patching!

The optician is confident (with the usual caveats that every child is different etc) that because there is such a small difference between the eyes, that he has that level of vision in his weaker eye and his age that we will have a better outcome for him than for DD. The glasses should arrive in the next few days and then we'll see how well he wears them.

The optician explained really well about how it won't really improve what he sees in each eye, but just that he won't have to work like he has been to see it. I had been struggling to understand how he could have such a strong prescription and see anything! It certainly explains why he is often very tired and rubs his eyes. He also explained about why he has no BV yet (due to the brain not being able to develop this as it's working so hard just to see anything!) so again we are hoping that he'll get there too.

Will keep you updated.

Hope you are enjoying your ML! When do you go back to work?

Hi ChazsBA,

For DS 1, I think it's fair enough to have a trial with the glasses. It's unlikely that the small +0.50 difference would cause any difficulty but it's worth ruling it out. A good indication that the glasses are helping will be your DS will want to wear them!

For you DS2: TBH i dont understand why the optom has given such a low prescription. Some people think it helps kids to settle into their glasses by giving a weaker prescription, however this had been proven with studies that it is not required and just wastes a bit of time. It wont do your DS any harm it just means he will get his glasses changed as soon as they retest him at the eye clinic.

Hi johnworf,

Thanks for the update, and glad you got the referral. Good luck at your next review.

Hi buriedUC, im sure he'll fly through it in April, good luck.

Hi BB,

Thats good news about your DS's prescription. Hope he gets on ok with the glasses. Can take a few days for him to settle into them.
Fingers crossed that he wont need any patching....

I'm off till May BB. Taken the full year!! It's been great, but i am actually looking forward to going back to work, but not looking forward to putting my DS in nursery :-( I'm sure he'll love it, seems to be a sociable wee boy, just me worrying about it though!!!

Hi cheeky

Wondered if I could pose a question. It seems very minor when I've read some posts on here but my mind is worrying anyway.

Yesterday ds age 5 came home from school with a slip saying he had not passed the standard eye test (done at school) as one eye did not meet the required standard.
There was no other information on the slip about this but a sentence saying he has been referred to the local clinic to see an optometrist.

Now I am worrying about everything. Is it likely to be a lazy eye or a need for glasses or something else. How long will we wait for an appt and is there anything I can do in the meantime.
Ds is doing very well at school so it does not seem to be holding him back.

Thank you.

Hi cheeky

DS got his glasses yesterday and despite them making his eyes look HUGE, they don't look too bad and seem to be staying on his nose. We'll wait and see what nursery brings next week though as I do have some concerns about that ......

Just a little thing, when we were reading his story at bedtime last night he kept peering over them saying he couldn't see properly through them (to try and see the duck on the Farmyard Tales book). Should I be worried about this or will this just be him getting used to not having to work so hard to focus?

Thx

Should have added that I'm sure your DS will love nursery - both of mine have loved it and it really brings on their development and social skills (and you'll get used to leaving him although for me there is still, even after 6 years of doing it a teeny bit of guilt sometimes). DS has recently moved from the Tweenie (2-3) Room to the pre-school room and has just come on leaps and bounds.

Hi cheeky

Dd1 6.8 has been prescribed glasses today but her prescription appears very mild to me. The optician has given her +0.75 -0.5 180 in both eyes, given that all children start out longsighted does she really need these glasses? She is very distressed at having to wear the, and the optician didn't make himself very clear. TIA

Hello, what a generous thing to do OP!

I was wondering if you have any opinion on behavioural optometry? I feel desperately guilty that DD2's squint wasn't treated early enough to leave her with stereopsis and behavioural optometrists claim to be able to improve this.

Happy to share patching stories, tips, pats on the back etc ;o)

Hi whyme2,

The optometrist will carry out a glasses test (refraction) on your son. If the vision is unequal this is generally caused by an unequal prescription and can cause the vision to be lazy in one eye. Im sorry but i wouldnt be able to say if he will require patching or not. It all depends on what they find when they carry out the refraction.
Try not to worry. There is nothing you can do at the moment. You wouldnt have noticed any problems as his other eye will be compensating and he wouldnt be aware of it. Good luck with your apt

Hi BB,

From what you describe it is likely he is adjusting to his glasses. If he's still saying it in a few weeks let me know.

Thanks for your positive comments about nursery. Just got him booked in today for his settling in days in April...think he will love it! Just me that needs to take a chill pill!

Hi carrotcakeisace,

Does she have any symptoms? Sore head when reading, eye strain etc?

It's fair enough that they have given them a try, but as you said it is a mild prescription so if she really doesnt want to wear them i wouldnt push it. You are not going to do any harm by doing this. And it will NOT affect her school work etc.
Try and get her to out them in when doing close work at home and see if she feels any benefit from them. Some people find a prescription like this will help when reading for long periods.

Hi BeehavingBaby,

TBH there is really NO scientific evidence that behavioural optometry works. Some people on here may claim that they do have successful outcomes but unfortunately there is just no evidence to suggest they do .

Try not to feel guilty about your DD's situation. You'll find that it wont greatly affect her if she has never had BV. And these thing are completely out of your hands.
Children with squints develop suppression (ignore one eye) as a way of preventing double vision. If this suppression is tampered with then your DD could end up very symptomatic and risk wasting a lot of money. IMO steer clear of BH's.

Thanks Cheeky, we suspect she may be dyslexic (family history, a lot of trouble with reading etc) and this seemed to be the deciding factor for the optician. She was tested last year by a different optician who said that although she was longsighted it didnt need correction

Will let her try them and she can decide if she wants to wear them

Hi all, my son has severe long sight and has had a temporary prescription until he saw a consultant. His lenses magnify his eyes and I'm worried that now he has seen the consultant who says he will always need glasses and has increased his presciption that his eyes will be further magnified and the lense even more thick and heavy for him to wear. I have my own lenses thinned. Will thinning the lense help reduce the magnification for my son?
thanks for any help.

my dd always gets her lenses thinned so it should be an option for your ds