Any Orthoptics on here, Esotropia

[LambLamb]

Hi, I took my son to the optician where the diagnosed him with Esotropia. He is 9 and due to covid hadn't been to the opticians since 2019. He has been referred to an orthoptic consultant and told he will need glasses and to wear a patch to correct it. I have read though that 9 is quite late for a diagnosis, and correction treatment probably won't work. Also read that late onset is suspicious. Really just looking for reassurance. Thanks!

If he's needing a patch does that mean he has a lazy eye as well where the sight is poorer in one eye?

Has he had regular eye tests in the past?

What was his prescription?

Was there no sign of an esotropia in previous eye tests? Squints / esotropia are very common in children but are usually detected earlier if regular sight tests are attended. New onset at age 9 would make me suspicious and I'd probably refer more urgently.

Is the squint really obvious? What is the glasses prescription like? Much higher in one eye?

I think it would be worth having a chat with the optometrist about referral urgency and their rationale

He didn't go last year due to covid and booked this appointment months ago, such a long wait.
It's a very slight squint, no one except me seems to have noticed it, with the exception of the optometrist yesterday.

He said a very low prescription was needed but to hold off as we are hoping to get an appointment with the specialist next week and they may change it.
I'm so worried, I can't concentrate.

Has he had regular eye tests before that though?
How long have you noticed the squint for?

My DD wears a patch. She’s nearly 8 and I was told that the pathways to the brain become fairly permanent at that age so speed was important. She’s been using it for a few weeks and we recently went for her checkup, her eye has improved to the extent that she can already read a extra 3 lines on the chart. Your DS might find the patching doesn’t work quite as well as it would have done if he’d been younger but that’s not to say it won’t work at all. If they’re recommending it as a course of treatment then it sounds like it’s a workable option. Also you’re in the best hands now so if they have any concerns about it then they’ll let you know, try not to drive yourself mad with Dr Google.

I thought I noticed it for a few months beforehand, but when I asked others to look, was told they couldn't see anything so thought I was imagining it.

Crumble, pleased it is working our for your DD.

And yes, regular eye tests before that.

If you're seeing the specialist next week that's really quick and amazing! I wouldn't worry too much then.

Hope it all goes well

We are seeing a slightly different eye specialist tomorrow, as to see the orthoptic, we need to go via a different route it seems. Hoping to then follow up next week but pleased we are seeing someone tomorrow.

Another sleepless night.
He is having a computer game ban for now!

Please don’t ban him from computer games, provided that the screen is an arms length away and it’s sensible periods of time it won’t make any difference.

Although more common in young children a squint can emerge at any age. I had treatment for one in my late 20s that only emerged a couple of years before (Botox not patching at that age)

It’s hard to see a mild squint as the person often has control over it so when they look at you they straighten the eye.

Try not worry, although I appreciate it’s easier said than done.

My child has worn a patch for 3 hours a day since she was 2 for amblyopia. She's 5 now. It has worked amazingly well but obviously she was very young.

We were told that by age 7/8 the pathways to the brain are formed and that patching isn't very successful from this age so I'm surprised that it's being thought of at 9!

I would also seek a faster referral, with any eye condition the sooner the better.

I'm looking at him now (watching the football) and its barely noticeable.

I’m an orthoptist, it is less common for a squint to be diagnosed at this age but even so most squints picked up in older children do not have any serious underlying cause. It can often be decompensation of an underlying squint which means that there has been a longer standing tendency to squint that has previously been controlled but he is losing the ability to control it. Patching is not used to treat a squint but to improve amblyopia ( reduced vision) and is more successful the younger the child but can give some improvement in older children . There are lots of different types of esotropia and some are helped by wearing glasses to correct hypermetropia (longsight). Happy to answer any questions you have

Thank you Rodders.
My main questions are, is it too late to correct, though you have answered this one.
Will the glasses be permanent?
And could this have been caused by too close computer? He uses a switch, not a lot ( allowed it after school 2 days and at weekends) though sits with it close to his face.

What is his glasses prescription?

I doubt it has anything to do with using screens

I'm sure Rodders will be back, but I think the glasses treatment is to allow the eyes to relax so overcorrection isn't needed
My DC even had bifocals at one point! By the time the esotropia resolved, DC was near-sighted so needed to continue with glasses anyways.

My little boy has several eye issues, not the same as yours but i know how worrying it can be. Did you get seen by a high street opticians? My first port of call would be to call your hospital and ask to be transferred to Opthamology there and get a second opinion by the hospital optometrists. I would also join "for little eyes" group on Facebook, there is a lot of information there already but also lots of people sharing their own experiences.

My ds has eye issues including squint. We're expecting to do some patching up to age 11 as improvements are still possible.

@LambLamb

Thank you Rodders. My main questions are, is it too late to correct, though you have answered this one. Will the glasses be permanent? And could this have been caused by too close computer? He uses a switch, not a lot ( allowed it after school 2 days and at weekends) though sits with it close to his face.

Whether the glasses will be needed long term will depend on the strength of prescription and if they give good control of the squint. There are lots of variables and sometimes a small prescription will make a big difference to a squint and a high prescription not make much difference. With esotropia the first stage of treatment is to check for any longsight and if there is prescribe glasses to see what effect they have . If the glasses give good control then no further treatment may be needed, if the glasses do not give good enough control then other treatments that may be tried include prisms, exercises , bifocals ( used for a specific type of esotropia)and sometimes squint surgery. Computer use will not cause the squint but if a previously controlled squint has decompensated this can be made worse when children are very tired and have been doing lots of close work,unwell or stressed.