little four eyes

Dr. Nate (of Bright Eyes News) and reader Amber both just let me know that COVD (that’s the College of Optometrists in Vision Development) is sponsoring a 30 minute web interview with neurobiologist Dr. Susan Barry entitled “School Crossings: A Neurobiologist’s View of How Our System Fails Children With Vision Problems.”    The free web interview is targeted at parents and educators and will be Thursday, August 26, at 9 pm EDT.  The interview will be recorded, but I don’t yet know whether or how it will be made available for people who are unable to attend the actual interview.  As soon as I know more, I’ll update.

From the facebook event:

Hear Dr. Susan Barry answer questions about difficult school experiences that resulted from her vision problems; how, for example, she was mislabeled as a low aptitude student and assigned to a special problems class, and what her mother did to help her child succeed. And more….. including what you can do to help your child succeed!”

Dr. Barry is the author of the book, “Fixing My Gaze” which talks about her experience growing up with strabismus, and never achieving stereoscopic vision until she started vision therapy as an adult.  The book is fascinating and her background as a neurobiologist is clear, as she explains the vision system in a very engaging and understandable matter (you can read my full review of her book).  I’m certain that the web interview will be very interesting as well.

More details: “seating is limited to the first 1,000 people to respond.  To register for this free event, go to:  www.joinawebinar.com and enter the webinar ID number, which is 547-423-251, your email address, etc.  Just follow the instructions from there.”  Again, as soon as I know more about the availability of a recorded session, I’ll let people know.

For all you parents who lovingly patch your little ones.  Make these, give them away, but just don’t sell them!  These are inexpensive, light weight, covering, re-usable, and have a smooth texture.  They can be personalized to fit your child’s personality and the shape of their glasses. The idea came to me late one night from trying all the patches on the market and they have worked well for Elly and hopefully may work for you.  It was designed for those of you in Miraflex in mind – hopefully it will work!  It can and should be adapted to best fit your child’s needs and glasses.  I can make each patch in less than 3 minutes and could make at least 50 of them for less than $5.00.  If you can tie a knot and push a needle back and forth, you can make these!

Materials

craft foam, needle, thread, scissors, knife, tape, and the pattern

The following tutorial will demonstrate how to make a right left eye patch.

1. First cut out your foam pieces, add any extra fun pieces that you may want.  Remember, the more you add, the heavier your patch will be.  Linked here (Patch Pattern) is a pdf pattern of the main patch pieces.

2.  Assemble the pieces and hold them together with your fingers to make sure you are making your patch go the right way.  Sew your embellishments on to the rectangular section first.

3. Then, using a simple knot and a straight stitch, attach the rectangular piece to the main patch on the bottom.

4.  Fold the V in until the edges are touching and stitch through all 3 layers; top, front, and over the glasses pieces. (see, your stitches don’t have to be pretty!)

5.  Then place a square piece of tape on the triangular side.  This is to make the opening where the temples go through just a little sturdier.

6.  Using a knife or other sharp object, make a hole large enough for the temples to fit through.

And you are done =)    Well, with the patch part… here is how they go on the glasses.  I told Elliana that it was my job to put them on and off for the safety of the glasses.  These patches will fit snugly and I put them on slowly.  I made 2 patches and they each lasted me over a month when put on by a parent.

First slide the temples in between the main patch and the rectangular piece.  If you have cables, making sure the ends get in the smaller hole is a little tricky.  Those with Miraflex, I think you can take the band off.  If not, e-mail me and I will think of something.

Then pull through until the patch sits comfortably on the glasses.  I trimmed with my scissors around the nose piece so the patch sits inside of the plastic and a bit from the top so it rests comfortably on their forehead (thats why it is easier to make the pattern bigger and cut to fit).  If you have the regular nosepiece, then you could make a vertical slit for the nosepiece to fit into

.

Last and not least, have your child try their glasses with the patch on.  Make sure it is not rubbing or irritating, trim with a scizzors to make it a perfect patch for your child.

Almost forgot… we learned the hard way… DON”T use red or dark pink like my pictures.  When they sweat the color comes off and turns the skin pink.  I would use light pink, blue, white, yellow and other light colors.  If you do make a patch, please send me a picture to post.  I have a couple more that we have been using daily – pictures of them to come later!

This question came in from Jacqui, who is hoping someone else may have experience with this.  -Ann Z

Our daughter Coco is longsighted with  both eyes +4.  Six months ago our specialist advised us that she did not require glasses because she was coping well and would probably require them later in life for reading and studying. We returned to him after a few months however as we noticed that one eye occasionaly turns out slightly when she is tired or focusing on us when we are close to her.

Anyway the woman who did some testing before we saw the specialist himself implied to us that putting her in glasses may cause the eye to turn in and she was concerned about this.

We went to see the specialist straight after and he made the recommendation that she does wear glasses in an attempt to straighten the eyes. He did say it was unsual that her eye turns out given that she is long sighted.

But now we wonder if the occasional eye turning out is even related to the long sightedness as our older daughter with normal vision had a similar eye that has strengthened as she has got older. I guess we are worried that we have put her into glasses unnecessarily and will that be causing worse problems for her now. i.e an eye turning inwards that can’t be straightened. She copes so well without glasses, staff at her preschool are not at all concerned and we see no evidence of difficulty.   She finds Wally quickly!

This story came in from Jennifer. -Ann Z

When I found out Bo has Accommodative Esotropia and would have to wear glasses, I was not concerned about how he would handle it.  I was concerned about how his brother and sister would handle it.  I have Triplets.  When Bo got glasses they were a little over 1.5 years old (they are currently 2.5 years old).  In August Bo will be wearing glasses for a year.  I can not even begin to count the number of frames he has had.  Just this week two pairs have been broken.  JUST THIS WEEK!  His glasses were broke over the weekend and he had an eye dr appointment on Wed.  So, I dropped his VERY broken glasses off. Since they were unfixable they had to order new frames.  Then, this morning I had to drive the hour back to the eye glass place to drop off his other pair and of course they are beyond fixable and another set of frames is being ordered.  He now wears a pair that the eye glass manager was nice enough to make us for free, but since those too are broke, they are ducktaped, holding the arm in place.  We live in a very small town and have to travel an hour one way to the eye dr and eyeglass place.

Bo, Anna, and Alex. Bo wears glasses for accommodative esotropia.

Having 3 toddlers the same age with one having something that the other 2 do not, is a major adjustment and hassle.  They have always had the same things and gotten the same things.  If one gets something, the other 2 get the same thing.  They always go everywhere together (I am a SAHM with no help and my husband does not get home until 6pm).  So, when Bo got glasses he did not want them and Anna and Alex did.  It is a constant battle.  I must ask a million times a day “where are you glasses?” and “where are Bo’s glasses?”  I will found them in a bed tangled up with sheets, or at the bottom of the basement stairs or stuffed somewhere.  MOST of the time whichever one hid or threw them will find them and bring them back to me.  BUT, times like this week I leave the room for less then 5 minutes (or even just turn my back) and I find them in pieces, looking like they have been run over by a truck.  Two pairs have ended up like that just this week.  Bo is great about putting them on and taking them off and handing them to me.  They all know his glasses is my button to push to get me upset.  If Anna or Alex get mad and Bo is anywhere near them, they sling his glasses off his face.  Anna and Alex also know this is the way to pick on Bo.  He has always been the quite one and the one to be picked on.  And taking his glasses is how they pick on him.

And then when I am told Bo will have to wear a patch an hour day my first thought was “great, stick a big sticker on his face.  Something else for the other 2 to be jealous over”.  We have tried everything from giving Anna and Alex play glasses and stickers, but nothing works.  I can’t turn my back or leave the room for a minute without worrying about his glasses.  I don’t want to have to take his glasses off everytime I leave the room.  Nor do I want to have to drag him with me.

We have been luckly enough to have found a wonderful group of people working at VisionWorks.   We had no vision insurance when Bo first got glasses.  The glasses at the eye dr were going to run about $300.  When all was said and done (taxes, warranty, special lenses, scratch resistant–yeah right!) I got 2 pairs of glasses at VisionWorks for $180.  They have been great, not making us pay for replacement frames and even ordering him an extra pair for free.  Like I said before, I can not even begin to count the number of frames we have been through.  His prescription is due to change in August and I am looking for sturdier glasses.  The ones at the eye dr can be twisted and rolled up into a ball and they bounce back in place.  My thought is to get those on the insurance and then get a replacement pair (or two) at VisionWorks.  I am very open to thoughts and suggestions on sturdier glasses!

It is an ongoing battle and I can only hope that it gets better as they get older. That one day (sooner than later) Anna and Alex will learn to leave Bo’s glasses alone and that Bo will learn not to let them take them off.  I know I have probably made my children sound like horrible monsters, but I promise they are not (only when it comes to the glasses)!

There are benefits to being awake nursing a baby at 3:00 in the morning, one of which that I have time to think by myself (well, without a chatty 3 year old)  This is the patch that I came up the other night / morning.  It is light weight, covers 98% of all light, easy to make and inexpensive.   All you need is the pattern, some craft foam, scotch tape, a needle and thread.  Would anyone be interested if I made you a tutorial?

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??

Glasses – Check

Occlusion – Check

Surgery – Check

Prism Adaptation – Check

Hmmm… is there something related to little ones in glasses that we haven’t tried yet????   Not that I know of!  We went to the ophthalmologist on Friday due to Elliana’s eyes becoming more over corrected. (major bummer) It appears that she is reacting atypically.  As time progresses her eyes are turning in more rather than becoming straighter as traditionally happens.  She now has a Fresnel prism placed on her glasses.  My first question was, “What is that?”  I understand that it similar to the prisms used in the exams.  I asked how it is different than a lens.  It does not affect the distance at which the light focuses on the back of the eye, rather bounces light in a different way (sorry, still not sure on this.)  Googling Fresnel Prisms on glasses has me just  about as confused.  The article Management of Strabismus and Amblyopia: a Practical Guide byBy John A. Pratt-Johnson, Geraldine Tillson says that “Occasionally, a patient with an acquired esotropia and the full optical correction in place may have a much larger angle esotropia on the prism cover test than appears to be present at a casual glance…the prism estimated as needed to neutralize the deviation is inadequate and more and more prism is required.”  It sounds like this treatment is rare.  We pretty much put a stick on prism over her strong eye because it may act as an occluder.  We go back on Friday for more tests and the article says something about testing for fusion with a synoptophore or the Whorth four-dot test. None of which I know anything about.  Unfortunately, we also have to put atropine drops in both of her eyes for the next 3 days in order to get a good read on her vision this Friday.  Since she is older and more verbal about her eyes – she is NOT a happy camper and has expressed her distaste for the eye drops and has screamed all morning.  2 more mornings of drops.  Wish me luck and let me know if you know anything else about the prisms!

There have been some questions lately on how my 3 year old daughter, Elliana, is doing 2 months after her surgery. I have been meaning to post an update and just haven’t had the chance.

My daughter is just one of many kids who have Lateral Rectus Eye Muscle Surgery and each child reacts differently.  Please remember that I am not an expert, just a loving parent, so this is by no means medical advice or how other children may react.

Our Ophthalmologist said that she appears to be adjusting harder than most and is struggling a bit.  I also just had a new baby (he is 3 months old) so the last 3 months have really rocked my daughters’ world.  She is now down to waking up with nightmares only 1 or 2 times every night and is having less bathroom accidents (Se was potty trained for a whole year prior to surgery)  Thankfully, her light sensitivity seems to have disappeared.  We have also started giving her temple massages, which seem to help relax her.

My biggest worry for recovery is that we would have to go in again for surgery.  We were told that 10% of our PO’s patients need to go in for “touch ups,” as the surgery is based on measurements, but each child’s eyes reacts differently.  They overcorrected her eyes because statistically, eyes will drift outward again following surgery.  Because of this, her eyes were crossing in a lot in the beginning.  They still seem to me to be inward, but the PO said it is because I am not used to seeing her eyes straight.  When her glasses are off (right before bed) her eyes are all over the place.  I am told this is normal.

Right now, I am still a little worried, but it seems like her eyes just need a little more time to get used to their new position.  The prescription in her stronger eye has changed from -1 to -3. I am told this is also normal as her brain is recognizing the weaker eye and making adjustments.  Here are some pictures to help tell her story.  I promise she is usually smiling from ear to ear, but HATES to look at the camera. 

The first picture was taken in December before the surgery.  The second picture was taken the day after and the third picture is from today – 2 months after the surgery.  The only way I could get her to look at the camera was to let her eat the candy from the candy necklace she just made =)

upset Dagny

When my daughter Dagny was five months old she would cross her eyes when she was upset about something. It was a phase that only lasted a few weeks and I was relieved when it stopped. At her one year well-baby checkup her pediatrician asked me if I noticed her right eye turning in. It was so slight that I often thought I might be imagining it but it worsened rapidly over the next few months while I waited for her optical appointment. Her eye crossing became a source of stress for me. Somehow I connected it to my failure as a mother. I know this is completely unrealistic but I knew it must be my fault. I felt as if people were judging her, and me, for it.

On the day of the appointment we sat in the waiting room for hours waiting to be seen. I was nervous the entire time and Dagny was beginning to get antsy. I was relieved when we finally met the staff. They were warm and welcoming. I found out that my daughter is farsighted and she was given a prescription for glasses.  We made progress and I was anxious to get the glasses. I rushed home and began calling optical stores in my area. There are many within walking distance so I knew we would be just fine but one after another the stores told me that they could not help me with a child of 15 months.

“We don’t have glasses that small.”

“I have never worked with a baby before.”

“Maybe you can call another branch. I am not really…uh…can you hold please?”

After making over a dozen phone calls I broke down and cried. I felt defeated. All of the emotions came out at once. I did not want my baby to face this obstacle so early in life. I never had glasses soI could not relate to her vision problems and I know that this will be something she will always have to deal with.

We finally found eyeglasses nearly an hour away. She has had them for a few days now. She wore them all day at first but she is already struggling with them. She bent them on day two and today scratched a lens. I am just going to keep smiling and putting them back on her face. We go back in a couple months to see if her vision has changed any. She still crosses her eyes. I was told that the glasses would correct this but I was not told if it would be instantaneous or gradually.

Dagny's new glasses

I will learn to accept this over time as I learn more about her condition and what I can do to help her. It’s not the worst thing ever and I am so glad that we caught it early. Besides it is the cutest thing ever when a 15 month old says “gyasses.”

I was just sent this question, and have no experience with this, so I thought I’d see if anyone else had dealt with this:

My daughter has been crossing her right eye for about six months and it is getting progressively worse. We finally got in to the children’s hospital and the doctor was shocked to find that the eye she is crossing is her stronger eye. Essentially she is favoring her weaker eye. Do you know of any other parents whose children did this? The doctor said it made no sense.

Her prescription is

Left eye
SPH: +3 CYL: +.5 Axis 90

Right eye
SPH +3.5 CYL +1 Axis 90