little four eyes

A few weeks ago we left the PO’s office with some discouraging news.  Nicholas’s  left eye was not doing as well as in previous visits.  Upon reading the eye chart, he was only able to identify the figures to 20/50 R and barely 20/200 L.  We were 20/50 in both just 3 months prior.  While the prescription had not changed, the left eye was not doing as well as previously.  Our PO ordered increased patching, up from 2 hours per day to 4-5 hours per day.  We left with a deflating ‘we may have to discuss removing the lens at some point’ close to our appointment with the PO. 

(Our son Nicholas, 3yo, has Bilateral Ectopia Lentis (dislocated lenses), with a Rx of -7.5R and -18L and anisometropic amblyopia. He’s been in glasses since 6 months of age, and patched 2 hours daily until this point.)

Fast forward, we’re business as usual.  A couple mornings of increased objections, but we are able to achieve the required 4-5 hours, with assistance of his daycare staff, and a few well timed ‘Dr. Nelson says..’ to aid in overcoming any reluctance.  

(His repertoire of tactics has increased exponentially with age… “I have dirt/dust in my eye”,  “no patch today”,  “I just wore my patch already”, along with a host of grunts, groans, pains, and fits..real or feigned…but we always come out on top : ) despite his efforts.)

In the past 10 days or so, we began to notice some differing behavior.  A pirate squint here, pulling the weaker left eye closed there, some random grimaces and rubbing about the eyes, particularly the left.  We thought at first it was some transient adjustment to the patching…adjusting to the longer hours..or maybe light sensitivity (we were at the beach…so maybe the glare after patching was a bother?), but the behavior persisted.

Upon returning home, and an additional few days later, the behaviors continued…a definite change we agreed.  Better to err on the side of caution.  I left a message for the PO, voicing our concerns about a possible change in vision in the left eye.  Call returned, we were scheduled for a visit next day.  Meanwhile, our minds begin the process of what if, what next, and so on.  Has there been a shift of the lens?  Is the brain shutting down the left eye?  What if it’s time for the lens to come out?

To the doctor’s office yesterday… For the first time N went in, climbed up and sat down in the chair all by himself.  Lights here, look there, follow this, cover this eye, now that eye, put these on, etc .. 

We both sat waiting nervously for the doctor to voice some negative finding. 

“Ok now Nicholas, do you want to read the pictures for me?” 

There’s never been a response before, and then only after much reassurance a barely whispered naming of objects. 

Yesterday, “Yeah.”

 Left eye covered. “Bird, cake, hand, phone…”  20/30 Right. 

Now right eye covered. “… “ 

Uh, oh. 

Then, with a little encouraging…“Bird” 

Down a line..”Cake. Hand.”

Down again.. “a bird, a cake, a hand, a phone”   20/50 Left eye. 

From 20/200 to 20/50 in the intervening three weeks since increasing the patching. 

 In the end, the behaviors we observed were more a three year old being a three year old..living..learning..experiencing through his two eyes.  Correct to side with caution, was the PO’s counsel.  But all things considered he’s doing excellently.   We’ll take it and keep moving forward.

Go Patch!

eye chart

My name is George, my wife is Alexandra, and our son’s name is Nicholas. Nicholas turned two as of August of this year. Our experiences with glasses, patching, and pediatric ophthalmologists began when Nicholas was about two months old.

While changing his diaper one weekend morning, the sun happened to be shining in on his face when we noticed what can only be described as a slight ‘jiggle’ in his left eye. We looked, looked again, looked a third time…and as any new parents might do…we panicked.

Within a very short time we had placed a call to our pediatrician’s on-call, and after a worried discussion using descriptors like ‘jiggly like a sunny side up egg’ and ‘wobbly like jello’ we had the on call doc stumped. Monday morning we were in the doctor’s office and our pediatrician…also somewhat perplexed…agreed that our descriptors were well chosen. He had not seen the like before and referred us to a Pediatric Ophthalmologist.

What followed over the next couple of months are as follows:

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