It is not easy to put eye drops into a wriggling 2 year old who is screaming “NO MOMMY IT HURTS.” We have it down to an art. She chooses the “treat” for being brave. My hubbie and I both wash our hands. Then I pick Elly up and sit on a chair. I hold her arms down and pull the bottom of her eyelid down, while my husband holds the top of her eyelid up and puts a drop in. Screaming for 2 seconds follows, then Elly sits up and says, “I’m ready for my treat.”
2 months after starting atropine drops, I felt like I lost my child. Elliana was a sweet adventurous, kind little girl. The drops made her clingy, fussy, and scared. She stopped sleeping through the night and had frequent tantrums. I addressed these concerns both with our PO and the vision specialist from the school from the Deaf and Blind. They both talked about trauma. The treatment our PO chose for Elly’s condition is to make the vision in her strong eye weak (drops) or not at all (patching) Because she could see with her strong eye before, the treatment was in a nutshell, taking her vision away. For any child or adult this would be a traumatic experience. Each person deals with trauma in their own way. I think it was about 6 weeks into the atropine drop treatment where I thought, “there is no way I can do this anymore.” I talked about these concerns with the PO and staff. They told me that most parents stop treatment because it is difficult. As the parent, it is up to me whether or not to implement the treatment plan. I can continue drops and have her vision keep improving, find a way to keep the patch on, or I can give up and let stay visually impaired for the rest of her life.
For us, we felt it was important to work through all of this for the chance at her vision improving. We have acknowledged and are teaching her how to work through her newfound fears of sirens, being alone, and the dark. We have also worked at teaching her ways to calm her body when upset; deep breaths, yoga, hugging a lovey, and rocking with mommy. I will also continue to ask questions and make use of all the resources available. Our next appointment is Tuesday and I will ask about the contact lens and if it would be an option for Elly. It also sounds hard, but I am open to new challenges if they will be better for Elly.
Not all days are peachy, but it has been over 3 months since she began the eye drops. She is now sleeping through the night again. I can also tell her focus has improved as she is holding books and other objects further away from her eyes (about 6 inches away as opposed to 2) We are having less tantrums and her vision in her right eye has improved significantly. It’s not easy, but knowing that as parents we are trying everything in our power to strengthen and improve her vision, it’s worth it.
Couple of quick updates. First off, I’ve finally gotten around to getting the domain littlefoureyes.com. So now the title and URL of the blog match, which should be a lot easier to remember and quicker to type. Any old links or bookmarks should still work, though if you’re subscribed through an RSS reader, you may want to update the feed (http://littlefoureyes.com/feed). Secondly, I’ve started putting together an Amazon.com store for the site. I’ve tried to include items that would be useful or fun for someone with a young kid in glasses. Check it out, and let me know if there are other items you think would make sense to include. Finally, I’m working on a large post specifically aimed at parents who have just found out their child needs glasses. If there are topics or advice that you would give parents at the very beginning of the glasses game, leave me a comment!
This comes via Bright Eyes News (where I get almost all my vision-related news): an online vision acuity simulator – you can enter a prescription and see a simulation of what a vision chart would look like to someone with that prescription who isn’t wearing glasses. [Updated 3/1/2009: As Annie notes in the comments, the simulator will only show prescriptions between -5 and +5, any worse and you'll get a note that it's beyond simulation range.] As anyone who’s read this blog for a while knows, I’m fascinated by learning more about what Zoe sees. But nearly as interesting as the simulation were the following disclaimers:
The magnitude of the optical aberration (how blurry the image gets) depends on the width of the eye’s pupil, which changes all the time.
The brain and vision-related neurons make a lot correction work in creating an illusion of a sharp image with clear edges.
A positive spherical diopter [farsightedness] in prescription can be cancelled by the eye’s own lens, but with a constant load on the ciliary muscle.
Basically, this means that what the simulation shows for Zoe is not necessarily what she perceives when she isn’t wearing her glasses. For one, her brain is correcting some of the image, but more importantly, because of her accomodative esotropia, she can cross her eyes to compensate for some of the blurriness, it just means that if she does that, she’ll see double, and eventually her brain will turn off the input from one eye leading to amblyopia. (Many thanks to Dr. Bonilla-Warford of Bright Eyes news for helping me make sense of this).
Simulation of what Zoe might see without her glasses, using +4 and +4.25 as the prescription. From www.billauer.co.il/simulator.html
Another question from a reader – how often does your child go in for eye appointments? I’m well aware that the answers will vary wildly based on how long your child has worn glasses, and what their specific eye problems include. Still, I think it would be interesting to hear what the range is – and helpful for people trying to figure out how much to budget for eye appointments.
This post comes from Danielle, who’s daughter, Mia, had a cataract in one eye. If you’re new, you may also want to read Mia’s story and update. – Ann Z
Our daughter Mia just received an occluding contact lens that she will use as a means for patching her left eye. She began wearing a patch when she was 2 months old and once she turned 3 months old we began having problems with her screaming and rubbing the patch until she was able to remove it. We have tried stronger adhesive patches that caused a rash on her face and was starting to remove her eyebrow. Her PO suggested makeshift arm splints and we flat out refused to restrain our daughter. After we exhausted most of our options, and with consistent nagging and persistence, we finally got her the black occluding contact lens.
Mia wearing the occluding lens
The lens is just like a regular contact lens and needs to same care. When the contact lens is in her eye it completes occludes her good eye and works exactly like a regular patch. Our daughter was born with a unilateral cataract so when she patches her good eye it must be completely occluded; we could not use atropine drops as a method for patching. Mia received her lens yesterday and we began using the lens this evening. We were able to get over 2 hours of straight patching in; which is the longest she has had her eye consistently patched since she was about 3 months old. Mia is really good with people fiddling in her eye so she was pretty good for us when we put the lens in, however it took 5 tries before we got the lens in her eye. She also has brown eyes so the lens is not very noticeable.
If there are any parents that are having as much problems as we have had, please ask your doctor about the black lens. I have read up on the occluding lens and I have heard that the success rate is much higher than a regular patch.
I ran across Chelsea’s blog, Roots and Rings, this weekend (apologies for not posting earlier, I later got hit by a nasty trojan requiring the reformatting of my laptop – the two incidents are completely unrelated, I promise), and I was instantly hooked. Chelsea is not just a good writer who is fun to read, she is someone who started wearing glasses at 2 to correct her crossed eyes and farsightedness.
In the first post of hers that I came across, There are no words, she talks about what it meant to grow up always having worn glasses and to have always wanted, but never have had, good vision. In that post, she talks about planning for lasik surgery, it has since been postponed due to her amblyopia.
Since that post, she’s started vision therapy and patching each night. Her posts about that, starting with this one here, A little therapy never hurt anyone, are also extremely interesting, especially if you’ve ever wondered what amblyopia and patching might be like.
I found myself very drawn to Chelsea’s posts because they give some insight into what Zoe is going through today and what the future might hold for her (with the obvious caveat that no two people’s experiences are exactly the same). Zoe’s getting more verbal, but I still find myself wanting to ask her, “but what do you see? What is it like without your glasses? Do you ever wonder why your friends don’t wear glasses? Is there any way I can explain it to you?”
Luckily, Chelsea has agreed to an interview about what it was like growing up with glasses, what vision therapy is like for her today, and any other questions we have. That’s where you come in, do you have any questions you’d like to ask someone who has worn glasses since toddlerhood?
I had a dream last night that we decided to have a little four eyes meet-up in Australia. There were a whole bunch of us with our kids (in their glasses) about to head out into town, but then we ended up taking a train to South America. Dreaming about meeting you guys and going somewhere warm. Not too hard to figure that one out.
I do get together regularly with Ann W and her kids and tomorrow, Zoe and I get to meet Amomofelly and Elly tomorrow since they’re in town visiting family. I wonder if we’ll get any comments on two two-year-olds with glasses.
There’s been some discussion in the comments about exams under anesthesia, or EUAs, which are pretty much what they sound like: an exam of your child’s eyes while your child is under anesthesia. They are often done for pediatric IOP (intraocular pressure) examinations, or if a patient is unable to tolerate a complete eye exam within an outpatient clinic setting (American Optometric Association, Pediatric Eye and Vision Examination (pdf), pg. 20, 27 ).
We’ve never had to do an EUA with Zoe, so I’m borrowing (with permission) Danielle’s notes from her comments. Her daughter has had multiple EUAs. If anyone else has experiences or thoughts to add, please do. I’ve also added a few links at the end of this for more information. – AnnZ
They always schedule EUAs in advance and they are classified as surgery because your child will be put under anesthesia. The hospital where the exam is scheduled will follow the same procedure as if your child was having surgery. You should get a packet with pre-surgery guidelines and requirements. Some hospital require a pre-op check up and others don’t. Our daughter has had an EUA at Boston Children’s and at Mass Eye & Ear and both hospitals have different pre-surgery requirements. We always take our daughter for a pre-op check up with her pediatrician to ensure she is fine before she is put under anesthesia, even if the hospital does not require a check up. This helps give us peace of mind knowing she has been cleared by her doctor.
When you go in they will have surgery prep that takes about 30 minutes when they will weigh your daughter, take her vitals and receive all of her medical information/history. Try to take toys and other items that will comfort your daughter. Mia’s last EUA (at 5 months) was the first time they allowed 1 parent in the operating room while she was being put under. This was a first for us, it was so hard leaving the room, when I looked back she looked so limp and lifeless, it was so scary and heart wrenching. They will most likely have 1 parent in the room for your daughter. At Boston Children’s they do not allow a parent in the operating room until your child is 10 months old and up, they told us that before 10 months old children really do not have separation anxiety. Be prepared, we were not and it was so hard seeing her put under, the anesthesiologist told me that it is much harder for the parents than it is for the child.
I’m thrilled to unveil our new banner for the little four eyes site, by Scott Donaldson! I had been looking for a new header image for a while because as this site has grown, I don’t think of Zoe as the face of little four eyes anymore. She’s just one of many beautiful kids who happens to wear glasses. And that’s what I wanted to convey with the new banner – that there are many little four-eyed kiddos. As it turns out, Scott started wearing glasses when he was 5, so he had a fun take on my request for a banner that depicted young kids in glasses just being kids. Watch for more of his little four eyed characters to show up throughout the site in the coming weeks.
A community for family and friends of little ones in glasses. A place to share experiences, tips, tricks, and pictures.
If you just found out that your child needs glasses, you may want to start here, or browse our pages or post archives. Please comment on anything that catches your attention.
Write for the blog! More voices make for a better community. No long-term commitment or experience necessary - just drop me an email (ann @ shinypebble . com).
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