little four eyes

Zoe had another eye appointment today, this time to follow-up on her new prescription. Unfortunately, while the doctor (and I) could see that the glasses were helping with her eyes, as the doctor said, it was only better, not perfect. As in all the other appointments, the doctor had Zoe look at a toy up close, and she would hold lenses up in front of Zoe’s glasses to see if the stronger prescription would straighten out her eyes. Unlike the other appointments, none of the lenses made any difference.

Zoe's crossed eyes

So in essence, we’ve done as much as we can with glasses, and the doctor brought up surgery. I knew the possibility was there. When I was being honest with myself before the appointment, I knew that it was even likely, but it didn’t make it any easier to hear or think about. We asked a whole bunch of questions, and we’re satisfied that the surgery is our next step. The surgery is scheduled for a month from today. It is apparently an easy, outpatient surgery, probably less than an hour, with a recovery of one day.

I was really shaky and upset this morning after the appointment, but I’m slowly coming around to accept that this will be ok, that Zoe will be ok, and in fact, we’re hoping she’ll be better than ok, and her eyes will start to work together so that she can start developing binocular vision. That’s what this is about, right. This is about her, this is about getting Zoe what she needs for her vision. I keep trying to remind myself that we have so much to be grateful for, that she is healthy, that her strabismus is treatable, that we caught it early. But it’s hard, I had been so hoping that the glasses alone would be sufficient.

Zoe

I suppose one good thing is that the discussions with the ophthalmologist pointed out just how much I’ve grown to love Zoe’s glasses – which was not always the case. This morning, when the eye doctor said Zoe would still need glasses after the surgery, I sighed a little sigh of relief that she’d get the keep wearing them, because I think she looks so dang cute in those specs.

Still, I won’t lie, I’m nervous, sad, and trying not to freak out.  If anyone’s gone through eye surgery with their kid, I’d love some reassurance.

I know lots of kids wear glasses because of lazy eye and what not that causes their eyes to cross. But Sam is just really near sighted and has never had problems with is eyes crossing. Only, just this week he was sitting in my bed after just waking up that morning and talking to me. He hadn’t put his glasses on yet and I noticed when he looked at me, one eye turned in a little bit.

Could this just be from him trying to focus? As soon as I put his glasses on him, it went away. I don’t know what to think about it.

Knowing how few choices there are for frames for little kids — and that’s with us having a great children’s eye glasses store with better selection than most places — I can only imagine how much more difficult it must be to find good frames if your child has Down syndrome. Children with Down syndrome have different facial features, including smaller noses, wider faces, and a shorter depth from the eyes to the ears. This leads to frames that just don’t fit their faces well at all. Enter Maria Dellapina who is an optician and who has a daughter with Down syndrome. She created Erin’s World frames specifically designed to fit children with Down syndrome. They range in size from 38 to 43, with new models planned for babies and young children. While we don’t need these frames for Zoe, I’m very glad that someone has developed frames to fit the need.

Looking back, I’ve realized that I’ve taken fewer pictures of Zoe, and shared even fewer online. I’m pretty sure that this is largely because of her crossing her eyes, I’ve been more conscious about how she looks. Not that I’m ashamed of her, but I’m feeling self-conscious about whether I should have tried to get her in earlier when I noticed her eyes crossing again.

Zoe a few weeks before her eye appointment

Once we’d had the appointment and learned new she needed a new (pretty dramatically higher) prescription, it’s been even harder to see her eyes moving in, knowing (well, hoping) that if only she had her new lenses, her eyes would be straighter. I was also a bit worried that she wouldn’t like the new lenses. I know how thrown off I get when I get new glasses with a new prescription, and hers is a much bigger jump than I’ve had. I worried that all the gains we’d made in her wearing her glasses so well might be undone.

I needn’t have worried. The lenses came in on Wednesday, and Chris got them Thursday afternoon. Zoe had been sent home early from daycare for a fever, so she wasn’t feeling well to begin with, but she didn’t seem to have any problem with the new lenses. I could immediately see that her eyes looked bigger with the stronger prescription. I was worried that her eyes didn’t seem much straighter that first evening.

First evening with her new lenses (um, please ignore the messy kitchen)

They look straighter now, though they still are a bit crossed. We have a follow-up appointment in 2 weeks, so we’ll see how she looks then.

Second day with the new lenses

• too many to count: number of visits to the eye glasses store for adjustments
• 6 or 7: the number of lens cleaning cloths scattered throughout the house for all of Zoe’s glasses cleansing desires (we also have a box of disposable cleaning cloths to help clean our glasses after her “cleanings”)
• 5: number of lenses (replaced both for prescription updates, then replaced one for a scratch)
• 4: the number of small glasses cases we have (one for each car, one for her bedroom, one for daycare)

• 3: number of eye doctor appointments
• 2: number of times something came off the frame that we had to get repaired (once the ear piece, once the nose piece, both easy and quick repairs)
• …and probably the biggest surprise of all – 1: number of frames, I would have bet good money that she would have broken her frames at least once in 6 months.

A reader, Amber, posted a question yesterday about what size glasses she should get for her son. I said I’d post it here and see what you all think. So I’m counting on everyone to have an opinion (we all know what they say about opinions, right?) and to share it. Here’s the question:

My 12 month old has just been prescribed glasses. Though you can’t tell by looking at him he has a lazy eye, Amblyopia. I have been to two different places to try on glasses for him, but just can’t decide. Our doctor says that his percription will probably change again when he comes back in 6 months. So, I don’t know if I should just get the ones that fit him the best now or if I should try to by a little bigger so that we can simply change the lenses in December. What do you suggest?

It’s kind of funny that this question came up, since I’ve been thinking a lot about replacing Zoe’s frames, what with her prescription changing, and the last time we took her in for an adjustment, the woman at the glasses shop said she thought Zoe’s glasses were getting too small for her face. But Saturday when we took Zoe in, the guy at the glasses shop said the frames looked like they still fit. And since her lenses are still under warranty for doctor changes, we’ll only pay half of the replacement costs for the lenses, as long as we don’t change the frames. Well that was an easy enough decision. I guess it all depends on who you ask.

Here’s the answer that I sent to Amber, but again, I hope you all will chime in with your thoughts and experiences:

Here are some things to think about, though I’m kind of muddling my way through this myself. The place where we got Zoe’s eyeglasses recommended not getting glasses with the earpieces that curve all the way around the ear, rather get ones that look like adult glasses, where the ear piece just curves down but doesn’t make a full C shape (hope that makes sense). They said that the glasses with the C curve tend to get outgrown more quickly. I know that some places specifically say not to get frames that are too big, as then they won’t be comfortable and your son won’t be as likely to wear them, and there’s probably some truth to that. But I think you could probably find frames that are a little big that would still fit now.

Another thing to think about is what the warranty offered on the frames and lenses is. Zoe’s lenses are covered such that if a prescription change happens in the first month, the lenses are replaced for free, and if the prescription change happens in 9 months, the lenses are replaced for half price, BUT you must keep the same frames. So for us it was definitely worth it to get frames that would last, since her prescription has change (both within the one month time, and just now at 6 months). That warranty was standard at the shop, and not an additional charge. However, it’s also worth considering how hard your son might be on the frames, and whether those are covered if he breaks them. For us, the frames aren’t covered at all, if they break, we have to buy new ones. So, if the glasses places don’t offer a warranty like that, and you find inexpensive frames that you like that fit your son, it may worth just going with those, just in case the frames are broken.

Ultimately, I think if I were in your place, I’d get frames a little big and hope they don’t break, but if you know your son is the type to be really rough with things like glasses (and let’s face it, he’s 1 and why would he know any better?), maybe just get the ones that fit him now.

For reference, here is a picture of Zoe in her glasses on Jan 6, and again Jun 8, so you can see how she’s grown into the frames (they look really tiny in the Jun 8 picture, but they really don’t look that small in person):

Zoe in glasses, Jan. 6

Zoe in glasses, Jun 8

Zoe had her ophthalmologist appointment on Friday. I’d noticed that her eyes were crossing again, even with glasses, so I was expecting her prescription to increase, and indeed, it did. As her ophthalmologist was writing out her new prescription, she warned us that “this is going to look like a big change in her prescription. . . because it is a big change in her prescription.” Um, thanks for that. She went from +4.5 to +5.75 in the left eye, and from +4.75 to +6.00 in the right eye. I think it worried Chris more than it worried me, since I was hoping to hear that her prescription was off, and that’s why she was crossing her eyes again. Her ophthalmologist didn’t seem too concerned that her prescription had gotten worse, and didn’t see any reason why her eyes should keep getting worse, but I don’t think that made Chris feel any better. And once he mentioned to me how he was worried that her eyesight might keep deteriorating, I admit, I got a bit worried.

So I turned to PubMed and did a bunch of searches to try to find a bit of reassurance. The big thing I learned was reassuring – a study of 126 kids with Zoe’s condition found that all of the kids had their eyes get worse (need a stronger prescription) at first, followed by them getting better a few years later. The bad news being that the earlier the condition occurs, the worse their eyes get before getting better, and the younger kids also show less improvement. Link to the abstract for the study – I don’t have access to the full text, though I can easily get that if anyone is interested in it.

Along the way, I learned a lot about searching the opthalmologic and optometric literature – which may well be of interest only to librarians, but here goes: Read more…