little four eyes

Another request for help – I just got an email from a mother of a 3 year old whose ophthalmologist is recommending bifocals to correct strabismus that is persisting despite the glasses.  I know that some of you have kids in bifocals, and I feel like there has been some discussion of them before but my quick search didn’t turn much up.

So, what have your experiences with bifocals been?  Any things to watch out for or be aware of?

Dr. Bonilla-Warford of Bright Eyes News has a great post up with a list of resolutions for children’s vision.  My favorite is number 2: spend some quality vision time with your children, which includes talking to your kids about what they see.  I know Zoe isn’t quite verbal enough to really express what she sees (heck, I’m not sure I have the words to always express what I see, especially before coffee), but I do want to be sure to make a habit of talking with her about her vision so that if something changes, we can catch it early.  And as for number 4: bring their glasses in for cleaning and adjusting, well, our eye glasses place can attest to seeing us quite often.

For my part, my 2009 resolutions include:

1. Help Zoe pick out new frames
2. Teach Zoe to put her glasses on right side up
3. Be better at cleaning her glasses (they’re always so dirty, I hardly notice it any more).

How about you?

I’m re-posting this comment from Anna who is looking for anyone with ideas or experiences with their child getting clumsy after getting their glasses. -Ann Z

My 23 month old son, Frank, was diagnosed with Strabismus. Right before Thanksgiving we noticed his left eye turning in. We took him to the doctor immediately because there is a family history of Strabismus.

The opthamoligist said his eye sight is +3.50 in both eyes. He said patch and get glasses. Thankfully Frank has never been bothered by the patch and has never pulled. We ordered his glasses and they finally came in last week. He has been good wearing them so far, but the past 2 days he has become extremely clumsy. Yesterday he fell and scratched his face all up and scratched one lense very bad. Thankfully we got insurance on the glasses and they will replace the lens for free. Then this morning the babysitter calls me at work and says that he fell again and his glasses are completely bent and the lens fell out. Not only that, but the nose piece went into the corner of his eye and he has a cut.

This has made me a little stressed out since he has suddenly become so clumsy. Do you have any suggestions on what I can do to help him out and not be so clumsy?

These are exerpts from Sue’s blog about her daughter Mia’s first few weeks with glasses.  Mia and her twin sister, Cate are 2 1/2 years old.  Cate does not need glasses, but Mia does. – Ann Z

Mia in her glasses

Oct. 27, 2008 – Update on Mia’s eyes

I took Mia to the eye doctor today.   She was diagnosed as severely far sighted (can’t see things close up).  As a result, her brain and eyes are trying to compensate by focusing too hard up close, and it’s causing her right eye to wander and veer inward.  It’s very noticeable when she looks at you close up.  They recommend glasses.  She’ll be able to wear contact lenses around age 7, but will likely require corrected vision assistance of some sort, for life.  They don’t know what really causes this.  But the doctor felt that prematurity is certainly a common factor.  Thus, we’re getting Cate checked next week as well.

Mia was such a brave girl for most of the appointment.  She sat so well and cooperated way more than any two year old should, for a good hour or so.  At the end of the hour though, the doctor put eye drops into Mia’s eyes to dilate them.  Mia was surprised and scared, as we had to hold her down on the floor to get the eyedrops in.   The doctor then wanted to have us come back in 20 minutes, which is how long the eye drops take to work.  When we returned to the doctor’s office, Mia wanted nothing to do with it anymore.  She just kept saying “no, no, bye bye, go home”.  She kept covering her eyes with her hands and was crying and just beside herself.  She was in no sort of mood to select or get fitted for glasses.  She napped like a charm this afternoon, but was squinting for a couple of hours even after her nap.

Tonight, when Chris came home, he brought her a little puzzle toy as a gift for being so brave.  When we presented it to Mia, we told her that she did such a good job at the eye doctor.  We also said that we recognized she was scared there and that it wasn’t fun for her.   She repeated the word scared several times, as she put her puzzle together.  “eye doctor”…”scared”, “scared”…. So heartbreaking.  I’m so proud of her though.

Now comes the hard part.  How will she handle wearing glasses?  And as she gets older, how will the other children treat her?   Will some children make fun of her?  What will the impact be on self esteem? Read more…

We’re now past the one year mark with glasses – and into the age of the terrific (or is that terrifying?) twos – and Zoe’s throwing us a new twist.  She’s started refusing to take off her glasses when it suits her wishes and her mood.  I first noticed it at her eye doctor appointment last week.  It all went well, but she refuses to take off her glasses for her ophthalmologist.  She was fine having them off for the assistant who does the first set of eye tests, but not for her doctor.  As far as I could tell, she just didn’t want to doctor to be able to reach her eyes – I’m not sure if she still has memories of the surgery, or what it is.  It’s not the eye drops, since she gets those before she even sees her doctor.  Luckily the doctor was able to do the exam with Zoe’s glasses on.

And now she’s started not letting me take her glasses off if she doesn’t want to go to sleep at night or naptime.  The little stinker – she keeps getting smarter, and I have to keep up.  It’s certainly not the problem I expected to be having a year ago.

Since we have patched for many months and struggled with keeping it on daily, our PO recommended Aptropine drops.  The Atropine blurs the near vision in the better-seeing eye and has statistically shown the same improvements in Amblyopia patients.  The Pros of the drops is that the children do not have an option to take them off and therefore receive the necessary time strengthening their good eye, The Con is that is a chemical that stings upon placement in the eye.  In our hand-out is says “In some children, it is necessary for one adult to hold the child while the other gives the drop.”  Others have compared the feeling to how Chlorine would feel if put in your eyes. 

I was very nervous about putting eye drops in.  We would rather patch, but Elly is so stubborn and opinionated that unless she made the choice to keep them on, we would not be able to patch 6 hours a day every day.  My husband and I talked and we decided to be honest and tell Elliana simply what was happening.  Her eye is not working and we need to make it stronger.  We then gave her a choice. “Do you want to wear a patch all day or put eye drops that hurt in?”  She choose Eye Drops.

So, we had her gather her animals and dolly to squeeze, laid her down on the bed and warned her that it will hurt, but that it will be ok soon.  My dear husband put the eye drops in and we waited.  Elly pointed to her other eye and said. “Put the drops in this eye too.”  Ha ha ha – no, only one eye necessary. About 1 minute later, she said “owie, owie, owie” and tried to rub her eyes, but that was it.

I’ve noticed her coordination is off, just like when we patched.  We do rice pouring often and have never spilled any on the floor.  Today there was rice everywhere.  She also seems to loose her balance when she is walking and ran into a couple things already this morning.  So that must mean the drop is working.

I still worry (Yes, I am a worrier!) And we will ask her again tomorrow morning which she would like.  For now, the drops seam to be the better choice for us.

Did anyone else have this choice?  What helped you make the decision? How did your child react?

In the car on the way to the Ophthalmologist, Elly and I talk about what will happen in the Doctors Office and how I expect her to behave.  Our Pediatric Ophthalmologist sees around 60 children each day she is in the office so sometime the waits are long.  We are now on an every 2-4 week visit.  Here is how our visits go.

1. We check in with the receptionist

2. Then we wait in the waiting room until our name is called.  Today there was another girl her age with glasses and a patch to talk to.  Usually we walk to get a drink and read books since the wait is always long.

3. Tami brings us to the exam room and does a whole bunch of activities with Elly.  Lots of them involve stickers and covering each eye.  This time they used picture cards rather than lenses to asses her vision as Elly is old enough to name the pictures.  We are at an estimated 20/400 in her right eye today – our best so far!

4. Then I ask my millions of questions while I try to keep Elly entertained with snacks and toys.  I have found that I need to have my questions written ahead of time and have the doctor write the answers and big words that I know I will not remember.

5. After the initial assessment, we wait again for the Doctor.  When she comes it is more stickers and sometimes puppets depending on Elly’s focus.  Some times we sit in the chair and the doctor looks at her eyes through the phoropter

6.  Then the Dr explains her progress, concerns, and what our treatment plan will be for the next X days including worse case scenarios. Words like “severe” and “hardest to treat” are like knives in my chest.

7.  Once again, I try to keep Elly entertained again while I ask my second million questions.  Thankfully today, they had an information sheet printed out with information on our current treatment plan; Atropine Drops

8.  By this time, almost 2 hours after arriving at the office, Elly and I are overwhelmed and exhausted.  We get our very cool sticker and head back to the receptionist to pay and schedule our next appointment. 

I am always super exhausted and overwhelmed at the end of the visit.  During the visit I try to be as upbeat as possible, but have cried on the drive home multiple times.  Elly is always well behaved for the most part, I am well prepared with entertainment and talking about the visit before, but I am always worn out and emotional afterwards.   Any ideas?

Zoe has started pointing out whether or not characters wear glasses when we read books before bed. I’m not sure how to feel about that. I don’t want Zoe noticing every person and character that isn’t wearing glasses, but I think I may have contributed to it by pointing out whenever we read a book that does have a character in glasses. I want her to see that there are many people (if not many toddlers) in glasses, but not if it means she starts feeling strange when she sees that none of her friends wear glasses.

I have found if my toddler helps me make it, she is more likely to take more ownership over it and as a result take more care in it.  We have made doll beds, doll clothes, skirts and jumpers for her, a bed quilt, wall art, and even a rug for her bedroom.  Here are some links to great tutorials with detailed instructions on how to construct your own eyeglass case or patch.  We made an eyeglass case to keep in the car as the glasses just don’t seem to stay on in the car seat.  You could accessorize your glasses for every season! 

Felt Eye Patch – Super Cute and re-usable! Permission was given by Amy to use her image.

http://lucykatecrafts.blogspot.com/2008/02/eye-patch-tutorial.html?showComment=1228527420000#c1244160394634079161

Soft Fabric Eyeglass Case – I like the hard outsides, but Elly tries to smoosh the glasses in, so these are great for us.

http://bayoubags.com/2008/07/27/how-to-easy-eyeglass-case/

Foam Eyeglass Case – SUPER EASY!!!!

http://www.craftelf.com/Craft_elf_general%20crafts_Eye%20Glass%20Case.htm

We live in Wisconsin and for about a week now we have enjoyed (yeah right) bitter cold weather and snow.  This morning we had a freash coat of snow on the ground and the temp is in the mid twenties.   That means it’s warm enough to bundle up and head outside to play.  Let me tell you, glasses and snow do not mix!!! 

The falling snow flakes would land on Teagan’s glasses and melt, messing with her vision and frustrating her.   I found that keeping a hand towel stuffed in my pocket helped for the frequent times she came to me requesting I “clean them, please”.  Then there was the dredded phrase “Oops, I dropped them” followed by my “calmly” asking her not to move while I looked for a glasses shaped dent in the snow.  Thank goodness, we found them.  Then finally there is the fog that covers the lenses after coming inside due to the temp change.   I really have to keep an eye on Teagan then because she has been known to toss them on the floor deciding they are useless anyway.

Oh and while I was searching for the glasses lost in the snow my one year old, Taylor, managed to pull her boots off and was sitting in the snow in her socks (yikes!).  That was it.   Snow time over!!!  Time to watch a movie and for mom to have a cup of coffee!!!!!!  Is it summer yet?