Eyesight test

[markb2019]

Our 6 year old daughter has had two eyesight tests before with the last one about 18 months ago. Both times vision was 20/20 and no problems.

This time the optician said the eye sight has deteriorated (read on). She had some drops to open her pupils and same eyesight test again.

They said that the eye looks perfect, no problems seen, but the visual acuity isn't as it should be.

Daughter has never complained about poor sight and seems fine but she has had a bad cough this week (before her sight test).

They have referred her to the hospital and we are worried to death.

Anyone else experienced this?

Thanks

Why are you worried to death? Sounds like she may need glasses due to either long or short sight - did they say which it was? It's normal to be under hospital orthoptist care at that age too.

My dd was with the hospital from 18 months until age 8ish and then we just used a local optician. She is long sighted and still wears glasses now age 16.

I am a natural worrier - sorry. I like the line that worrying won't help, but can't seem to manage it.

The optician said that the prescription is

-0.5 -0.25 90.0
-0.75

So I understand the prescription isn't that bad. Note that my wife and I both wear glasses and have short sightedness.

They said they were referring as even if they applied that prescription the Visual Acuity didn't improve and he couldn't explain why.

Very slightly short sighted then. I wouldn't worry too much as the hospital orthoptist is the best place to go for child vision issues. Hope you dont have too long to wait

Sometimes these things can correct themselves over time. My daughter wore glasses for 2 years and they helped, she no longer wears them. That said glasses shouldn’t be anything to worry about, not to the extent that you seem to be.

Less likely for short sight to correct itself I think. Long sight can improve over time.

Weirdly enough I am ok with her wearing glasses - a few of her school friends do as do mum and dad. That's quite common and I think the earlier the better as I struggled through school for years instead of wearing glasses

I think the referral to the hospital is the worrying thing - naturally fear the worst going to hospital.

He said shouldn't take long for the referral.

It is good to know they didn't find anything wrong in the eye itself. Just strange how her eyes weren't responding to the prescription they put over her eyes.

Her pupils are still massive (expected due to the drops) and I have tested her reading at distance (with the promise of a chocolate) and she could do it...

What was the visual acuity score, usually a number like 6/6 or 6/36....

Visual acuity can be affected by lots of different things, many not serious, or those many are treatable.

I have congenital defects in both eyes, picked up when I was 4, monitored yearly till I was 17 then less frequently. Only when I turned 35 did my visual acuity start to worsen and treatment was needed.

What I would suggest is to prep for the Opthamology visit a little with DD, there may be a few different tests like:

• retina scan which is painless, looks into a machine, staring straight ahead without blinking and it takes a picture
• visual field, looks like a box, you rest your chin on a rest, stare straight ahead. You can blink but cannot move your head or look around. You press a button every time you see a light and it tests peripheral vision
• glaucoma test, again chin on a rest, eye open wide and staring straight ahead then a puff of air which makes you blink, it tests pressure in your eye.
• dilating drops and possibly orange dye. These sting but only for a few seconds, she is likely to find the bright lights in the hospital a bit hard to stand so sunglasses are useful.
• then just standard optician tests, reading the letters, looking in eyes etc.

Lots of waiting around. You are really unlikely to be seen at the time on your appointment slip, you'll move from room to room doing little 5 minutes tests then back to the waiting area. Her eyes may be a bit blurry so think about downloading some easy to watch tv or films to keep her occupied.

Thank you for the advice.

He didn't provide the VA score but I think I saw either 6/13 or 6/21 written down from memory. I went back to ask for it but they said "that will be sent to the GP".

She had the drops today and whilst the optician said they will sting, she was really brave and didn't complain... love her

It's very normal to be treated through the hospital due to her age.

• retina scan which is painless, looks into a machine, staring straight ahead without blinking and it takes a picture
• visual field, looks like a box, you rest your chin on a rest, stare straight ahead. You can blink but cannot move your head or look around. You press a button every time you see a light and it tests peripheral vision
• glaucoma test, again chin on a rest, eye open wide and staring straight ahead then a puff of air which makes you blink, it tests pressure in your eye.

I don't think dd got any of these tests at that age. She had the visual field test one when she was older and under optician care.

Thank you all - I really appreciate your responses

OP - They're unlikely to do the glaucoma test (they do it with anesthetic and yellow dye in the hospital) or visual field test.

They will put the drops in that make your pupils larger.

It may be that it is just a discrepancy between different methods of measuring visual acuity. So if it was measured using the pictures last time they tend to overestimate visual acuity.

However, I've had a patient fairly recently with exactly the same issue and almost the same prescription. She was referred and the hospital did lots of checks (they also did a MRI as a precaution which is standard procedure there if they can't find a reason for low vision in that hospital, even if there are no signs of anything untoward).

The hospital couldn't find anything wrong - basically no diagnosis. I ended up giving her the mild prescription and her visual acuity had improved 12 months later. I have no idea if they glasses brought up her vision or it was just a co-incidence.

It's standard NHS process that when kids need glasses they go to the Eye Clinic first, that's all. Then she'll be referred back to the optician of your choice, with a report, and they'll issue her glasses.

@AudacityOfHope
No it's not. We only refer if there is a problem, such as reduced vision, a squint or a health problem with the eye.
The OP's DD is being referred as her visual acuity (so the amount of letters seen on the board) is lower than expected for her age.

Ah Ok, it's normal in my area then. Perhaps it is in OPs too?

I'm hoping it is just a normal, belt and braces approach to something the optician can't explain.

Sort of like a general practitioner simply referring to the next skill level

@AudicityofHope - I think in some areas they are referred to a primary care eye centre if they fail school screening. But if an optometrist saw a 6 year old child in practice who just needed glasses, we would just prescribe the glasses. (As long as there was nothing else wrong).

The Hospital Eye Service would be completely overwhelmed if they saw every child who needed glasses. (And it would be utterly unnecessary).

Agreed, our 4 year old went in 3 days later and was prescribed some "corrective" glasses without referral.

My 6 year old (the one being referred) has had 4 tests to date:

• 3 years old at opticians - it was all about pictures at that point and no problems found. The optician warned us at this time that as both my wife and I have blue eyes and are both short sighted, our daughter, who also has blue eyes, is likely to need them in the future
• 4 years old at same chain but different branch of opticians - no problems found but can't remember if picture or letter tests. I think it just have been pictures back then
• foundation stage tests at school - no problems found and no idea on the extent of these tests
• the latest one at the same chain of opticians big one nearer to our home. The optician is saying that her eye sight has deteriorated since the last test they did 2 years ago (when she was 4) and they have an unknown cause hence the referral. This test was using the letter charts. He had used then drops to open the pupils more and found no faults in the eyes at all but said despite using the lenses for her prescription, her eyesight didn't improve whilst at the opticians

I have let her, for a few seconds, put my glasses on and her eyesight was instantly better.

She has told me that she finds the school shite board blurry and she sits 5 rows from it - we have moved her closer now and she can now see the board well. She told me that the board was less blurry in year 1 (last year) but then said that she was only 2 rows back which kind of explains it.

Assuming she isn't conning me, I think her eyes may simply have declined over time.

"White" board! Lol

Ah it's different where we are @underneaththeash

Although agree that it's unnecessary!

Shite board! 😁

Managed to get my daughter an appointment for 6 January at Moorfields - not too long to wait to get answers now...

Appointment at 0940 this morning - daughter excited, dad nervous!

Great news - daughter just needs glasses for a weak short sighted prescription.

Apparently becoming more common for unknown reasons but nothing to be worried about...

Totally recommend moorfields eye hospital...