Optician's advice for Dd(5) - does this make sense to anyone?

[leeloo1]

Sorry, this is an long!

Dd (5 years old) had her 1st optician's appointment today (no eye problems/headaches we know of, just a routine thing - & DH & I are both short sighted, so we knew she'd probably need glasses sometime). From recollection, when reading the letters - with her left eye she could read the 2nd from smallest letters, with her right eye the 3rd from smallest.

He spent a long time checking her eyes in the dark with a torch (after putting in drops to dilate her pupils), so he seemed thorough, although he did take a long phone call (in the dark!) in the middle of the appointment.

The prescription he gave us is...

Right: Sph +1.25 Cyl -1.5 Axis 20
Left: Sph +1.00 Cyl -1.25 Axis 180

The astigmatism is unfortunate, but ok I get that, but... he said she's long sighted. But surely if she was long sighted she'd be able to read the far away letters.

He also had really quickly waved a ruler in front of her and asked her what the really tiny number was - which she correctly said was a 5. Could she have read that if she was long-sighted? I realise I should have asked this at the time, but I was really shocked & we'd been there a long time & the other kids were losing patience).

When I asked, when the prescribed glasses should be worn, optician said she should wear glasses for reading (she has no problem reading chapter books/writes ok) in the classroom, when using computers, watching tv etc.

The optician also said it could take up to 3 months for her to notice any difference from wearing her glasses - surely it should be instant? It always has been when I've had them.

Its a private optician, so would it be weird to go to a chain one and have her re-tested & see if the prescription is the same? Or can someone explain to me why she wouldn't be short-sighted?

(Disclaimer I'm feeling extra paranoid as they were really unhappy when I asked to take the prescription & voucher away with me - although I realise they get money for the frames they sell. Also they asked me to sign forms in advance & one of these was saying we'd received glasses - which I said I couldn't sign yet as we hadn't received anything & she said huffily 'oh ok you can sign it after).

Thanks in advance for any opinions.

I wasn't being funny lol on re reading I see how that comes across sorry east

Blue and yellow are nhs don't know about other one although I am on mat leave an it wouldn't surprise me if nhs had introduced another lol the rx sounds about right from what your saying I would def go speccies though and get it checked if not confident in test x what area do you live pm if want

The drops used disable the ability to accommodate and give a more accurate rx although prob won't be done on all future test x

Sorry, rx?

After putting the drops in (that made her pupils go huge) he just looked in her eyes with a torch. I asked if he'd put the correct lenses on for her so I she could see what the difference would be when looking at the letters whilst wearing them, but thats when he said it'd take 3 months for her to notice a difference...

will pm area. :)

The reason she wouldn't have been able to see at distance was that the astigmatism was interfering. These threads are the reason I hate my job - everyone walks through my door expecting me to be some second hand car dealer robdog type desperate for sales. I am in fact, a highly skilled and trained professional employed to test people's eyes and prescribe glasses if they should need/want them. We are all fully capable of writing the prescription we have just measured, we are not buffoons. And FYI, our employers actively discourage us (not that we need it!) from randomly prescribing for NHS patients because of audits, and the possibility of fraud. If you're not happy with certain parts of the eye examination, please go back to where you had the test and explain your concerns, without vilifying the profession as a whole.

Totally agree burn

Hi Burn, I'm really sorry I've upset you. Fwiw I had no intention of villifying anyone I just didn't understand the prescription (as I said in my OP) and was hoping someone (hopefully a professional) could explain it - which I think you & tealady have done.

"The reason she wouldn't have been able to see at distance was that the astigmatism was interfering" - that is exactly what I wanted to hear. That makes sense to me & if the optician had said that I'd have been happy.

So the astigmatism was interfering with distance reading & she's compensating which is why she seems to have no problem with close up work. Is that about right?

Tbh the whole appt process took 1.5 hrs, (including waiting for drops to work, the previous appts overrunning & 10 mins on his phonecall - when he left us in the dark - so I'd really pushed all my kids' patience & my dd was upset from the drops/dark/torch) otherwise I might have had the time & presence of mind to question him further at the time.

tbh, I've worn glasses/contacts for 25ish years & never had an issue with an optician (bar the cost!) so I have nothing against your profession, but I'm straightforwardly short sighted & when I get a new pair of glasses I can tell the difference - it doesn't take 3 months! But with my pfb dd who seemed to have perfect sight its worrying/unsettling/shocking to find out she may not do & the whole thing with asking me to sign the forms in advance unsettled me more. So I don't think its unreasonable to try to find out why she needs glasses before getting something that could potentially harm her vision if she'd been misdiagnosed.

Thanks for your input.

Astigmatism makes it difficult to focus properly, but using both eyes together helps a bit, so it can mask it. The problem with it is it can cause headaches and visual discomfort. The specs will help that but might feel a bit weird to your DD to start off with, after about a week or so they should feel good and clear though. Sorry for jumping down your throat, I see threads like this a lot and it always makes my heart sink! It didn't sound you had a brilliant experience though, a lot of the chains have 2 for 1 s and free sunglasses for kids so it might be worth trying somewhere else next time.

As you say op the problem is you don't understand the prescription. My dd is 5 and had just started wearing glasses and I found it tricky too! She is moderately long sighted (+2.5 maybe?) and has a lazy eye so I don't have the misunderstanding of her needing glasses.

As I understand it (from googling) longsightedness in children is different to adults. They have flexible lenses so can see close up if they try very hard.

I do think though in relation to the opticians burn it would be really helpful if stuff was explained better to parents. I only know that dd is meant to e wear her glasses all the time because I asked for example I wasnt told! I was bit shell shocked at the time they were given tbh and I didn't know about child longsightedness. I shouldn't have to find out myself through Google. Not having anything in writing was a problem also my dad was adamant she didn't need to wear them all the time.

Her prescription is astigmatism on the whole with a very small amount of longsightness, which is normal in a 5 year old. You can look at this from the fact half the - cyl part is used to cancel out the + is you were adding them together leaving only +0.50 of actual longsightness, quite a normal amount is a 5 year old.The prescription will be accurate because the drops used stop the accomodation, which is young children can give an inaccurate prescription.

The reason the optician said it can take 3 months for her eyes to improve is the brain gets used to the image from an astigmatic eye ( which is blurred in a way that you tend to get letters mixed up,rather than not be able to see them at all until they get very small).

If children are longsighted they rarely complain of not being able to see close up because they have lots of accommodation ( the ability of the eye to use the muscle that holds the lens to make it thicker to focus close up) - we lose this as we get older, hence being long sighted when you are older means things do blur close up, whilst as a child it means eyestrain and headaches from this muscle being constantly in use to a high degree when it should be relaxed at distance or slightly used at near with longsighted children tending to stuggle with too much closework there schoolwork can fall behind. But in your dd's case the longsightness isn't really an issue at all. All normal sighted young children have some longsightness as their eyes are small, which as they grow their eye grows as well so they grow out of being longsighted. The reason we get longsighted again once older is because the lens muscle loses its ability to get thicker - presbyopia i.e sight of old age!

Going back to failing the letters on the chart astigmatism will definitely mean she would fail letters on the chart and this can take up to 3 months for the brain to adapt to seeing them through the lenses in the different shape for your dd to see the smaller ones. I would expect the optician to see her again in 3 months to check this is happening.

You would need to pay for a second opinion as really if the optician has used drops the prescription will be accurate, you just need a better explanation of what is going on. You can choose to do this or you could ring her optician and ask them to ring you back just to clarify what her precription is and how the glasses will help her.

Your dh is wrong. No optician is going to give glasses to a child for the money, when they can be struck off the register for doing so and lose their livelihood. They were probably a bit huffy about you taking the voucher as the nhs fee for the longer eye test they did including drops is low and effectively they lose money as a business if everyone has eye tests with them,but buys glasses elsewhere. Particularly as with the drops the 1 and a half hrs test time this is usually the time to see 3 patients so 2 sets of fees lost for for dd's test to be accurate. With astigmatism they will want to moniter your dds vision, so you really need to find an optician you trust and revisit them not be going to several different ones.

If you still feel you can't trust the result you can ask your GP to refer to the hospital eye clinic, but they will just do the same test putting drops in.
Hope this explains things better. It sounds as if the long test meant communication wasn't perfect, so if you aren't happy please ring today.