Can the hospital check eye health without shining a light in them?

[AnotherTrickyOne]

Hi,

I wondered if I could ask a question about how the hospital examine people's eyes if we go to the clinic there?

My son has a problem with his eyes just now. He can't look at screens even in his peripheral vision without getting severe pain in his eyes. He also can't read without severe pain. He is okay with sunlight and with ordinary light bulbs.

He's in a complicated situation, because he is out of school with anxiety. The anxiety is partly medical trauma from baby-years surgery and partly school trauma. It makes it very hard for him to access medical help.

Here is what happened:

He needed new glasses about 3 years ago but the new glasses (four different pairs) always caused distortion and motion sickness so he never made the transition.

Finally he entirely grew out of his old glasses a few weeks ago, and we went to a new optician who made up yet more glasses for him to try. While he was waiting for them to come, he had to do all his home school work with no glasses and his eyes got very sore. I think it was because he was sitting very close to the screen reading, and also doing that with his new glasses to try to get use to them.

The optican then adjusted the interpupillary distance on the glasses, which they had not managed to meaure before. The new glasses arrived and he can't put them on because the prescription change is too big to adapt too, and his eyes are really sore.

Sometimes he gets vision distortion like a fish eye lens (but only once) and yesterday we came out from visiting a neighbour and he had lost his 3D vision entirely, It took several minutes to get back to normal.

He hasn't used a screen or read a book for more than a week but it is getting better only a little and only extremely slowly.

He is worried about asking the optician to check his eyes because we think they would want to shine a light into his eyes.

I wondered if you think there is any way they could look inside hs eyes without shining a light?

We have been to see two opticians since this happened and they said it is just eye strain and dry eye and definitely not anything urgent. There is no redness or anything.

We are not sure about putting in artificial tears, because he does tend to have reactions to things.

We would just like to find a way to get his eyes better.

We have contact with an access nurse at the hospital and we will talk to her tomorrow. She could ask for use to go to the eye clinic, but she and I are just not sure if there is anything that they could do and we don't want to stress him needlessly. We'd have to walk there, which is a 7 miles round trip on foot, so if there is no point going, we're rather not.

I would be grateful for any ideas.

Thanks!

Thank you very much, this is all fantastically helpful.

I'll keep working on it here. I have written to the optican to ask about the new pair of glasses and the frame manufacturer to ask about another copy of the same frames.

Thanks so much for listening and giving such kind advice. I appreciate it.

Specsavers do teen sized frames. And also petite adult ones.

I would patch test some artificial tears as pp suggests. Using them would give a huge relief and also improve vision.

That's for blepharitis (which can sometimes cause dry eye), but not for dry eye itself.

OP - I jist started writing out a very long response. But basically it could be quie a few things and you need a practice with a good dispensing optician and optometrist.

As you already have the prescription, unless it's out of date. No more lights are needed. Although they will be if it is out of date and when it needs to be done again.

Oh and the hospital definitely can't do anything without shining a light in.

Have you asked about Cerebral Visual Impairment (CVI) ? A friend's son has it and the symptoms sound similar (he's also autistic).

@jetlag92 Thanks for thinking to respond. The prescription is very up to date.

The good news is that DS's eyes seem to be recovering on their own. he has started reading again, initially just a bit, but now he can read for quite long periods and be okay.

He still isn't able to look at screens even in peripheral vision, but I'm hoping that might improve too.

He's started trying a bit harder with the new glasses. His Scout leader has started politely enquiring about whether he is doing that, and that seems to be helping to encourage him.

At the same time, I have started trying to wear new reading glasses myself, so I now understand why it is so difficult for him, so that's helping a bit.

Still unsure about the screen problem but we do seem to be making progress. Thanks so much for your help.

@MrsMoastyToasty Thanks for mentioning about that. I do actually know another child with CVI. I don't think that DS has it because his vision problems are very intermittent and always come on when he is extremely stressed, or in response to eating the wrong thing.

I think if he had brain damage then it wouldn't happen the way it does and he wouldn't have such amazing vision when he's well.

There doesn't seem to be any test for CVI except as a diagnosis of exclusion, so I reckon that would be a long way off for us.

I think what DS has is PTSD with hypervigilance. He's responding very well to therapy and is telling me on a daily basis of all the memories that are troubling him. I have a large list now. He says it really does help to talk about them out loud.

Thanks for suggesting it though.

looks like this is past optician and he would need to see an ophtalmologist at an eye clinic (moorfields?). yes, eye examinations require shining a light, but without they will not be able to examine properly.

having said that, adjusting to glasses takes time. often up to a week. you need to persist that he does.

light sensitivity might come from un-corrected astigmatism but can have other reasons as well.

all the best

@AnotherTrickyOne i have extremely dry eyes, my optician told me that when they’re this dry your body puts oil into your eyes hence the distorted vision and the stinging. I couldn’t look at anything either and only had relief when I shut my eyes and used dampened cold tissues to wipe my eyes. Hyaluronic acid drops - despite the name acid - aren’t irritating at all. I’m on the regimen for blepharitis - campy heat applies to eyes, then massage upper and lower eye lids with eye wipes and then the hyaluronic drops. Full regimen at least twice a day and drops 4 times a day. It is gradually getting better. https://www.boots.com/hycosan-and-optase-dry-eye-kit-10359548 you can buy the bits of the kit separately I use eye wipes instead www.boots.com/blephaclean-plastic-free-daily-eyelid-sterile-cleansing-wipes---20s-10359748

I'm autistic. Shining a light in my eyes feels like being stabbed in them. It also causes me vertigo. I have been wondering for years about refusing to have the light shining test. But I'm in my fifties. My prescription is strong but apparently my eyes are perfectly healthy. It's just the way my brain processes light and pattern makes everything distorted.
I totally get the glasses being too strong thing. Also, sometimes the frames can feel like they get in the way. And light can reflect off them, further distorting vision.
Have you looked into irlens syndrome too ?

Thanks @Dryeyeshurt and @Trentdarkmore I will talk to DS about the dry eye thing and also Irlens. I don't think we have irlens but I also have light sensitivity, but only to LED. DS is okay with fluorescent, incandescent and LED lights but not with any kind of screen, which is pretty confusing to me.

You can get screen tint apps/programs. There might be something already on his computer in the microsoft/apple etc package. When I get headaches, I use a teal filter, which helps. I also have plastic framed glasses, as the nose bits of metal frames add too much pressure.

@HarryVanderspeigle Thanks, yes I'm well versed in all that because I can't use LED screens at all. I'm still on a fluorescent screen from the before times.