Convergent squint

[gnoomi]

Hi, I'm hoping for some advice - my DD has been diagnosed with a convergent squint, we've been given eye patches (as of today, she has been happily wearing spectacles for about 6 weeks), but its sounds likely that my DD will also need surgery.

The main problem at this point is the eye patches - DD hates them. We know compliance is key to this being effective, and will be taking a zero tolerance (plus carrot) approach, but does anyone have any tips for making this easier? Our plan is a reward chart for each day (she has to do 2 hours a day), but also taking away screen time for not doing it.

The next is the eye drops needed for the eye checks: we've had them twice so far and each time has resulted in needing two of us to hold her down (to do it safely so that she doesn't hurt herself or us!) whilst the optometrist administers the drops. This is in spite of talking it through calmly in advance, lots of carrots offered and highly sympathetic and helpful optometrists. From what we can make out she'll be having this done pretty regularly (every 3 months or so), again, does anyone have any advice for helping with this?

DD is nearly 5 and is NT

Thanks

hotandbothered, indeed. Put our patients first and keep up to date and we wont go far wrong. I love my job more than I ever have before.
Best wishes
Over and out.

RapidlyOscillating - DD had a really extreme convergent squint and had patching followed by two operations to correct it. We were told by the hospital that she would have no binocular vision, but have done some vision therapy anyway, and this has definitely created some 3D vision. We went to the Dr Who Experience last week and she could definitely see the 3D film effects there.

Hello, the OP stated that her child is patching but the Dr. Is recommending surgery. She also states her child doesn't like wearing patches and how to help.

It goes much deeper then trying not to get the child to be compliant.

The fact is, that while patching, the good eye u r patching can cause vision loss to that eye and the eye that is Being patched, depending on how well or not well the child sees, can be very devastating to the child. Imagine wearing a ptch over your good eye and all u have to see is double or not much at all! So what I am saying is that there are other options than patching. Drs say it makes the eye stronger however they are only looking at the acuity and straightness. While other Drs look at the total visual processing system to determine vision.

Also another deeper issue, that I mention earlier, is that most folks are unaware of vision therapy and information is key. Would u prefer patching? Or getting to the root cause of the problem so that FULL vision can be restored? I stated above what vision is and asked questions to the PO or orthoptist with no response. I am not debating I am simply stating facts from both sides from my experience and others. While patching may be necessary, patching is not recommended for daily long hours and months or years.

it starts first with being informed about with eyesight and vision is. Then once understood the difference and how deep vision goes and plays an integral part of the body's overall functioning.

It also depends on the goals one sets for their child. Most Everyone wants the best for their child. Is the goal to get the eyes straight and that's it? Or to achieve eyesight 20/20 acuity? Or are the goals to get the eyes and brain to work together in order to have the body/vision function properly? In the end, it's the parents choice but making the best informed decision is the best.

I am Only informing and giving food for thought. The visual processing system is intricate, delicate and one of the most important of our body's system.

I wish the OP the best no matter the decision but I am very happy I have informed the OP of another approach to patching and that there are other eye care professionals that can help without surgery for the most part.

Late back to this thread. Yes, really my son has been wearing patches for 2 years now. Not continuously. ...we go to the eye dr every 3 months. I trust them and they know what they are doing.

Thank you everyone, for your advice.

I'm on my phone so can't name check, but I'd be really interested in the screen time information. We've been told it's congenital, but I still worry we've caused it somehow by allowing iPads etc.

DD has done really well with her patching this week - we've done after school, mainly she's watched TV and pottered, though she has worn it out too. Next week she'll wear it while there are some play dates happening, and there is a stay and play at school we'll take her to with it on. If she manages ok at that we'll start trying st school. At home she's got a reward chart and we are also doing mini rewards - a sweet for putting it on and one for taking it off if she does the full time! School are very supportive and helpful.

A silly question: is there anything anyone recommends for helping with removing the patch - ripping a plaster off the same area each day is already starting to build up (I'm also allergic to plasters so I'm concerned she might become so). Does soaking it or a moisturiser help?

And finally, as it's a while until we head to the hospital again, so I'm asking here! Will she be ok doing sports in it at some point? She really has little depth perception when wearing it currently and trips over/can't pick things up from the floor well , will this improve?

We used the material patches, they attach on to the glasses themselves, I will try and find a link.

kayfunpatch.com Lots of companies do them!

Thanks - we were advised that fabric ones were not as effective due to children 'cheating' and lifting it. Did you find this?

RapidlyOscillating - one thing I discovered from the vision therapy when I tried it myself is that my 3D vision is there, but fairly poor, so a lot of this is inherited I think.

We use Engaging Eyes online, which has one game all about 3D vision, you just need the red/blue glasses from eBay. It's £75. DD seems to have hit a plateau with 3D vision but I think that persisting with the exercises seems to help keeping the residual squint under control. We stopped for a summer and she was starting to drift a bit again.

We've been doing it for a while, but about a year ago we went to a vision therapist just to check that there wasn't anything else we could do. He did a raft of tests, said there was nothing else to add, and then told us that the whole thing could be counted as her annual NHS eye check, so it cost us nothing. So if you happen to be in the SW, PM me and I will give you his details.

It may be worth you trying gnoomi, the fun factor may outdo the irritation factor (if you see what I mean). My daughter had them for 3 years from being a 5 year old. The patching worked brilliantly. She didn't wear them at school, but as soon as she got home. She could only watch tv with the patch on (she loves tv!!!). She knew that was the rule and soon got used to it. I still have the 2 patches she wore (sentimental me!) I am so glad that we did it though, the eye that wasn't patched had virtually no vision when we started

Sorry gnoomi, I didn't mean that your iPad time had caused the squint. I just have a professional obsession with parents knowing the issues with too much screen time. We have an epidemic of myopia around the world at the moment and that significantly increases the risks of eye diseases such as cataract, glaucoma and especially retinal detachment. It is unlikely that your child will fall in to this category as the vast majority of convergent squinters are not myopic. Children should spend no more than 20 minutes on their devices without a break, even if it's a small one. When they break they should look far away and not go and do something else involving near work.

chopchopchop if you found some sort of 3D sight with red/blue glasses imagine what you may find if you had a proper vision therapy programme overseen by a knowledgable professional. I think it's very possible you may find more improvements

landrover not trying to disagree as it sounds that the only way you got your child to wear the patch was to watch TV but we categorically say to parents that we want children doing all sorts of activities when patched, especially if these involve movement. Personally, I feel it's not good to stick them in front of a tablet or TV for the entirety of their patching (not saying you did, mind!)

vtrocks good points about the difference between eyesight and vision. It took me a while as an eye care professional to nail that one and I wish I'd realised it earlier.

Good thread everyone.

Ha ha Bay, we did try not too . She is 13 now, braces are finished with as well!

Try not to! (watch too much tv)