little four eyes

Melissa who blogs at Ask Miss Mommy, sent in this story of her daughter, Grace.  The story was also published on her blog. – Ann Z

Grace at 6 months

This is the story of Pumpkin (aka Grace). My second born, my baby. Kind, calm, happy baby with a fiery will that explodes with force. Grace came into the world fast, in the middle of the night, giving me only 2 hours to get to the hospital. She was immediately absorbed in nursing with a passion that has yet to diminish.

The focus of my little story, though won’t be on her birth but yet her darling eyes. Back in April 2009 (wow a year ago) I posted about Pseudostrabismus. We continue to monitor her eyes after that just to see what would happen. Would the periodic “real” crossing go away or increase? It increased and in January my baby got glasses.

My wish was granted and we headed back the next week for visit with Dr. M. This time I felt respected, as part of Grace’s team and not just an uninformed bystander. But I was still frustrated. Dr. M couldn’t elicit the crossing either. Finally at the end of the appointment, Grace was sitting on my lap looking at my necklace and she crossed. Never have I been so excited about a somewhat negative thing ever. Dr. M was able to see it in action and validate my concern that, yes it was an issue and true esotropia.

The thing about Grace’s vision is in order to see any crossing she has to be super focused (literally and figuratively) on something close up. Which she frequently is but it’s not the standard way they test vision. The “tests” are done too far away. Grace is also quite young to be given an Accomodative Esotropia diagnosis. It usually appears around 2 years old and she was around 14 months. So I was relieved to have a professional see what I was talking about and note how to test Grace’s vision for the future.

Grace got glasses in January with +200 prescription* (meaning she is farsighted within the mild category). Today we went back for a recheck. Her prescription has increased to +450 (which is now in the high hyperopia range). I’m still a bit confused about the long term outcome for Grace. As far as I know, the best case scenario is to lessen the strain on her eyes (the increase in prescription means her eyes are relaxing so that’s good) and to wean her from glasses as her eyes get stronger and she gets older. I’m trying to stay neutral and just take it one day at a time. We are also patching using a partial occulsion patch for 30 minutes a day.

*Many people post about prescription written as a “+4.5D” number. I was only told a +200 or +450 so that’s what I know. Anyone have words of wisdom on that??

Nicholas has normal baby vision and tracks like a 1 year old at 5 months!!!  We still see his eye turn in, but they think it is the skin folds and we will keep checking his eyes every 4 months.  They showed me how to tell by looking at where the light is in his eyes.  They are in the same place in both the left and right eye when they shine a light into his eyes.  Although I do not shine a light into his eyes, I now find myself checking all his pictures.  Yes, the reflection / light spot, is in the same place in every picture.  “Sigh”

Elliana had Bilateral Lateral Rectus Surgery in December to help her staighten her eyes out.  She is really having a hard time physically and emotionally adjusting to the new placement of her eye muscles.  She has been going to OT weekly and we are working on strengthening her vision and sensory integration.  This week, I am making her a body sock and a weighted blanket in hopes of helping her find her sense of place in the world and tone down the sesory overload.  We have tried several different perscriptions and are back to -1,-7.  This is undercorrecting her vision in hopes that her eyes will continue to pull themselves into a straight position and are really working hard.  They are still, however, overcorrected. 

We went in again this morning and they are turning in less than last week with this new perscription, but still turning in.  I understand that we have been telling her brain for so long that she has to work really hard to keep her eyes straight that now we need to teach her brain to relax them a little bit now that we have given her eyes a little help (surgery).  What does this mean? 

Back to patching.  ARGH.  Well, at least we have control over making a difference.  This time, we are patching 8 hours a day for this week, alternating eyes.  Next week, we get to drop down to 4 hours a day, alternating eyes and return to the PO in 2 weeks. 

They handed me a few sticky patches (tan) to get me started and I laughed =)  Elly is so spoiled with patches that she wrinkled her nose at them and said she will use her princess patches.

Keep us in your thoughts and prayers!   Not sure how patching is going to go after a 3 month break.

Shortly after Amomofelly posted about self-portraits of kids in glasses, long-time reader/commenter Annie’s daughter Aubrie (4) came home with a picture she drew at school of herself, wearing glasses.  Annie wrote that it was the first time she’d ever included glasses on a picture of herself.

Aubrie's self-portrait, complete with glasses.

Heidi also posted a link to her son Bennett’s first self-portrait with glasses, drawn just as he turned 4.  You can see his drawing here.

Any others?  I’m happy to post them here, or even start another gallery if we get enough.

It has been a while since we have had to atropine drop.  Last week, the ophthalmologist had us use the drops in both eyes for 3 days to get the most accurate measurement that they could.  These days were a reminder of why we ended up switching back to patching.

So, you may ask, how in the world do you get the eye drops in.  Well, we line up all the babies who are also getting their eyes dropped (for pretend)  Then we practice on them, telling them it will hurt a little and praising them for holding still.  When I get to the end of the line (Elly)  I hop on, hold her arms down with my knees, pry her eyes open with my left hand and drop with my right.  This is all done swiftly and in less than a second all the screaming, huffing, puffing, kicking, thrashing, you name it, is over.  I then tell her how brave she was and life moves on.

She really hated her glasses for about a week and a half until the atropine wore off, was a bearcat in her disposition, and expressed her distaste in the drops.  The good news is that the reading was the most accurate so far and resulted in a prescription changed.

Yeah eye drops and yeah no more eye drops.