Mild astigmatism, glasses?

[ChickensMightFly]

Took ds10 to the opticians today as he recently started an odd blinking habit which he does off and on at random times, I assumed it was just a bit of a habit but thought I'd better rule out eye problems.
Optician said it is just a common habit he'll grow out of, but she also diagnosed him with a mild astigmatism said he should get glasses.
She wasn't really interested in explaining her recommendation beyond the statement that he has a rugby ball shaped eye, she was one of those professionals who don't see why they should communicate their knowledge to the uninitiated, (if you're too stupid to have to ask you're too stupid to be trusted with a technical answer?) so I didn't really get answers to my questions, she just kept repeating he has a rugby ball shaped eye. I have no experience of glasses or glasses wearing so it's a whole new world to me.
She did say it was a very mild one and if he didn't get glasses it wouldn't be a problem as he isn't getting headaches.
So now I don't know what to do for the best. Could his problem get worse if he doesn't get the glasses or could glasses weaken the eye? Is having glasses more of pain than its worth if he isn't so bad he must have glasses?
What are your experiences please?

Did she give a prescription for the glasses that she was recommending?

Yes she gave a prescription which was
R +0.5 -0.75 180
L+0.75 -0.75 180

You can read info on it on nhs or other reputable websites.
Ask your son if he wants to wear glasses or suffer through. They are free for children so i dont know why you are so hesitant.
It will gradually get worse with age.
Astigmatism tends to run in families so im surprised at your reaction.

Hi, I work in the NHS in an eye clinic where we diagnose and manage eye conditions in children every day. Astigmatism is due to the eyeball shape (the cornea at the front is very, very slightly rugby ball shaped -this is very common and nothing to worry about) so it is very unlikely to change over time. Your child's prescription is very mild and I would agree with the optician that he doesn't need glasses. As long as his vision is normal and he isn't having headaches/eyestrain he does not need glasses. Most people have a mild prescription like this and don't notice any difference if it is corrected. Occasionally if someone has symptoms they can benefit from a mild prescription like this. If he came to our clinic and his vision was normal and he had no symptoms we would not give glasses and would discharge him. Hope that helps, if you have any questions, feel free to ask.

@SiSeniora

You can read info on it on nhs or other reputable websites. Ask your son if he wants to wear glasses or suffer through. They are free for children so i dont know why you are so hesitant. It will gradually get worse with age. Astigmatism tends to run in families so im surprised at your reaction.

I have been googling what astigmatism is so I am not just here asking people what I should do. The optician more or less said (I'm paraphrasing) that glasses might be good idea, but wouldn't really matter if you didn't get them, might help his vision, might not make any difference to him that he notices, could be hassle for him, might get headaches if he doesn't get them but equally might not and if he does get them or doesn't get them the astigmatism could improve of it's own accord either way (no certainty it will get worse with age or if he doesn't get glasses.

Basically the optician was so vague I was left with lots of questions but no answers.

On my side of the family no-one has ever needed glasses in childhood, only when well into middle age (I'm 44 and don't need them), my DH doesn't wear them (He's adopted so no idea what his family side would be like), so no experience in the family of using glasses as a child.

Until we went into the opticians my son believed his vision was perfect, he is definitely not suffering and doesn't get headaches or anything, I asked his teachers who said they can't see him struggling to see the board etc.

So my hesitation is because I hear that having glasses can be a pain in the bum so if he doesn't need them it seems silly to saddle him with that hassle/responsibility. Also if his eye muscles are 'helped' will that weaken them? With other muscles of the body not using them causes them to weaken (perhaps this is a silly question I don't know).

I obviously want to choose what is best for his eyes, so wondered if anyone here had anecdotes/experience that could help me frame my thinking before I jump either way.

It is a very very small prescription.

If he has no symptoms then I'd decline the glasses
See how his prescription is at next years eye check (kids qualify for a free eye test annually) unless he gets symptoms before then

I will show you dd's prescription as she does wear glasses :

R +3.00 -0.75 45
L +5.75 -0.75 140

The higher the numbers the stronger the prescription. She is long sighted in both eyes with slight astigmatism

@Wonderrwall

Hi, I work in the NHS in an eye clinic where we diagnose and manage eye conditions in children every day. Astigmatism is due to the eyeball shape (the cornea at the front is very, very slightly rugby ball shaped -this is very common and nothing to worry about) so it is very unlikely to change over time. Your child's prescription is very mild and I would agree with the optician that he doesn't need glasses. As long as his vision is normal and he isn't having headaches/eyestrain he does not need glasses. Most people have a mild prescription like this and don't notice any difference if it is corrected. Occasionally if someone has symptoms they can benefit from a mild prescription like this. If he came to our clinic and his vision was normal and he had no symptoms we would not give glasses and would discharge him. Hope that helps, if you have any questions, feel free to ask.

Thank You so much for replying. I am grateful his prescription is only mild, I'm sure other parents would wonder what my fuss was about but it is hard to trust advice from someone who can't really communicate their advice, and answers questions like a politician would (i.e the one they think you asked not the one you actually asked). I'm sure she was a skilled practitioner just not a particularly brilliant communicator (or maybe I'm not!).

But you only get one pair of eyes so I don't want to do the wrong thing.

Can I ask then,
If he got glasses to alleviate the eye strain is there any risk it could exacerbate / accelerate any deterioration that might be coming his way?

I think if getting them is a completely benign choice (apart from the faff which isn't the important thing) but not getting them could be detrimental that would obviously be the right thing to do.
Or is a case that his eyesight will go where it goes with or without glasses so they aren't influencing his clinical outcomes therefore the choice can be based purely on whether he feels a benefit?

Thanks so much again.

Long sight tends to get better over time so if anything his sight should improve rather than worsen. Its short sight that tends to worsen over time

Wonderrwall has given you excellent advice. DD was diagnosed with astigmatism in one eye when she was three. This was back in the day when there were pre school eye tests. I had no idea until then that she was struggling to see out of one eye.

As an aside, do you have regular eye tests? Even if you don't wear glasses you should still have regular eye tests because they not only check your vision, but the health of your eye. An eye test can also indicate other health conditions that you may not be aware of.

Thank You dementedpixie that's very helpful.

Thanks ginfordinner I don't actually! I think I will now though, I don't have difficulty but since this has popped up I have been reading round and thinking about not and agree it would not be a bad idea at all!

My ds had a slight + prescription at age 6 and his last eye test (age 13) showed he is now slightly short sighted but still doesn't have glasses just yet.

My kids got tested every year since dd was diagnosed with long sight at 18 months old. She has worn glasses since then (now age 17). They should get a free eye test each year and adults should get one every 2 years

If he would like to wear glasses then let him - I know a boy who can manage without, but wears them because he thinks they are cool! - but it is by no means essential for him at all.

My DD was very astigmatic in one eye and normal in the other so she had glasses from very tiny or the faulty eye would never have learned to see properly - the brain would have eliminated the confused messages. In her case it was essential, but in your son's case not.

I would not worry about it at all. Maybe go back in a couple of years to see how things are going.

Thank You - the replies are all helping to fill in the picture for me. I'm just so ignorant of all this.
That poor optician being faced with a keen but clueless mum.

I think you were unlucky with your optician as well. DD used to see an orthoptist at the hospital. She was lovely, and explained everything really well. DD's astigmatism was quite marked, and she had to wear a patch for a while.

Hi, I'm sorry the optician wasn't very helpful but they were probably vague because his preservation is very mild. In these cases there is normally absolutely no benefit in wearing glasses, however, occasionally someone can benefit if they are getting headaches.

Your son had no family history of glasses wear so it is likely that his prescription won't really change over time. Out of interest, have you ever been tested at the opticians? You or his dad may also have some mild astigmatism that has never affected you.

I would be interested to know what his vision test results were at the optician. This is the score they give for what size letters someone can see. Do you know what your son scored on that, because that is a much better indicator of whether he should wear glasses or not. If his vision is reduced glasses may help. If his vision is excellent they won't help and may be more trouble than they are worth (they can cause headaches / blurred vision while he adjusts and he may hate wearing them.).

Vision develops in children up to about 7 years old so as he is older he is not at risk of amblyopia (lazy eye). He does not need glasses to correct amblyopia.

To answer your question, he has a prescription that is within the range of "normal" and his eye muscles can cope with that easily (if they couldn't he would get headaches). They will not be strained without glasses. They also would not get weaker if he does wear them.

In clinical practice, this prescription would only be issued if the vision was below normal or if he was struggling with headaches/eyestrain.

If his vision is normal and he has no symptoms then he does not need glasses.

Your son's prescription can also be written two ways. If I write it the other way it is;
R -0.25 +0.75 90
L 0. +0.75 90

The first number is the long or short sight, the second is the astigmatism and the third is the angle of the astigmatism. You can see from this that he has 0.75 dioptres of astigmatism.

I've double checked the various optometry guidelines and in school age children 0.75 of astigmatism is the level where they will consider prescribing. As I said, in practice or very much depends on his vision and symptoms. If they are fine I would watch and wait but if he did start getting any problems with vision or headaches I would give them a try to see if they helped.

Thanks again Wonderwall it is this rounded perspective I was trying to get to with her yesterday.
The printed out prescription doesn't give a letter size score, but she did comment that he is only one rung below 20/20 vision, maybe that is the letter size indication?

"Vision develops in children up to about 7 years old so as he is older he is not at risk of amblyopia (lazy eye)." - This is brilliant to know because dr google was flagging this up. Sometimes to get the best out of dr google you have to know which questions to ask, which I don't.

That's why eye issues should be dealt with early (squint is often caused by a lazy eye where the vision is not so good i.e. a lazy eye isn't another term for a squinting eye but can cause a squint when trying to focus).

ah-ha! Yes, now you're talking my language - the recommended threshold for xyz and thus the basis for a decision (and everything else you said) is what makes sense to me. Someone just saying 'cos I say so' doesn't quite do it for me. Which perhaps she would find disrespectful as a qualified person etc but I'm sure we've all been on the receiving of bad practice from some professional or other and gauging the basis for someone's advice is all part of buying into what they are saying for me.

My mum on the other end will do anything anyone tells her so long as they look official, perhaps that's why I've gone completely the other way.

I really appreciate you taking the time to help me out with what is probably a really petty issue compared to the kind of problems you are helping each day!

Or does the squint cause the lazy eye, I don't know? They can go hand in hand anyway as dd had a squint and lazy eye and has glasses, had patching treatment for the lazy eye and an operation on the squinting eye (the same eye affected by the squint)

@dementedpixie

That's why eye issues should be dealt with early (squint is often caused by a lazy eye where the vision is not so good i.e. a lazy eye isn't another term for a squinting eye but can cause a squint when trying to focus).

Really makes you glad to be in a time and country where vision problems are understood and glasses are free for kids!

An operation! Oh my - you must have had to be brave when she went through that!