Double vision in child - CI?

[josie9499]

I'm new here and searching a bit. My DD is 7, and in past 10 days of whirlwind we found out she has been seeing double for some time. Always continued to function at high levels in school, read early, no signs to anyone. After she told me though, of course I was alarmed and things have since deteriorated. Before, she could see single (converge) at around 5 feet, but now she sees double at all distances. Both eyes. One eye is single but very blurry. She struggles very much to read now as a result.

Pedi opthamogist said vision is 20/20 and it looks like CI and to do pencil push ups. I wasn't feeling at ease, how can she function at school? How can she do these push ups if there is no point of coveragence?

We went to a neurologist, all signs from his exam looked good. He said an MRI is makes sense to rule out neuro but that he expected it to be clear. I felt short term relief but now of course worried on the MRI, sedation, etc.

I'm scared and searching and know I must just face the MRI first but does this even seem like CI? Has anyone experienced anything like this?

Thankfully the school is helping, they will let her listen to books but it all is making me sad and uneasy.

[maize]

:grouphug:  :grouphug: it is so scary when something is going on with our kids and we don't know what. I'm glad you are doing the MRI, definitely want to rule out neurological issues.

 

I think I would try to get her in to see another ophthalmologist if this one wasn't able to address things beyond suggesting pencil push-ups. Are there any research hospitals near you?

[josie9499]

:grouphug: :grouphug: it is so scary when something is going on with our kids and we don't know what. I'm glad you are doing the MRI, definitely want to rule out neurological issues.

 

I think I would try to get her in to see another ophthalmologist if this one wasn't able to address things beyond suggesting pencil push-ups. Are there any research hospitals near you?

Thank you, I'm just outside NYC so pretty sure there's a research hospital somewhere near; what do these do? I tentatively booked for a more solid pedi opthamologist but nothing till end of May. I guess I'm just hoping someone had seen this before and it was ok.

[shinyhappypeople]

Go here: http://www.covd.org/  You want a developmental optometrist.  

 

Pencil push ups? Really?  IF she has convergence insufficiency (which you won't know for sure until she's properly tested) then she needs vision therapy and trust me, there's a LOT more to VT than pencil push-ups.  

 

I'm annoyed on your behalf.  What a dismissive response by your ophthalmologist.  Good for you for listening to your gut.

Edited April 24, 2016 by shinyhappypeople

[wapiti]

I would see a COVD optometrist for an evaluation.  As you may know, vision therapy is controversial, and opthalmologists are usually against it. It's interesting that your doc prescribed pencil pushups though, as that was an early form of VT.  However, in the past few years, I thought research came out showing that pencil pushups are not an effective exercise.  IIRC, convergence insufficiency is the only issue for which VT is backed by research at the moment.  (Personally, I'd guess that VT will eventually be shown to be effective for additional vision issues as more accurate research is pursued; e.g. for tracking.)  ETA, PP beat me to it - VT is far more complex than pencil pushups.

 

However, I would also continue to look at the other angle, the medical side, with attention to the cranial nerves.  My dh had double vision following brain surgery, for example, when the nerves were disturbed.  It depends on the kid, but if your child could be very still, an MRI might be possible without sedation - go only to a children's hospital for that (BTDT).  (And going way, way, way outside the box, I might wonder about an inflammation/infection angle with regard to the cranial nerves, though I don't know how to figure that out.)

Edited April 24, 2016 by wapiti

[maize]

Thank you, I'm just outside NYC so pretty sure there's a research hospital somewhere near; what do these do? I tentatively booked for a more solid pedi opthamologist but nothing till end of May. I guess I'm just hoping someone had seen this before and it was ok.

 

Research hospitals may be able to provide more in-depth evaluation and treatment than many independent ophthalmologists. Maybe contact this center http://www.nyp.org/clinical-services/ophthalmology ?

[Arcadia]

Strabismus (squint) and amblyopia (lazy eye) are also common cause of double vision. Most ophthalmologist would have check and rule those out though.

 

ETA:

I have strabismus and lazy eye. Many relatives including buddy's have lazy eye at one point in time. Convergence issues does cause strain and double vision for them.

Edited April 24, 2016 by Arcadia

[Spryte]

Yes, agreeing that you need a developmental optometrist. Vision therapy was a turning point for DS. Worth every uncovered penny!

[josie9499]

Strabismus (squint) and amblyopia (lazy eye) are also common cause of double vision. Most ophthalmologist would have check and rule those out though.

 

ETA:

I have strabismus and lazy eye. Many relatives including buddy's have lazy eye at one point in time. Convergence issues does cause strain and double vision for them.

Had it caused double vision in both eyes in these cases? The opthamologist didn't give me much info other than 20/20, can't converge so could be CI. At that time she could see ok far away but now, just days later, it's double all distances. I can only hope the stress made it worse.

I am so thankful to have found this forum though!

[maize]

Had it caused double vision in both eyes in these cases? The opthamologist didn't give me much info other than 20/20, can't converge so could be CI. At that time she could see ok far away but now, just days later, it's double all distances. I can only hope the stress made it worse.

I am so thankful to have found this forum though!

 

Double vision nearly always involves both eyes-that is why it is double (you are getting one image from one eye and one from the other and they are not merging)

 

I do know one person who sees multiple images with each eye, that is very, very uncommon.

[Arcadia]

I do know one person who sees multiple images with each eye, that is very, very uncommon.

Astigmatism can cause that. When I am exhausted, I can see multiple images of the moon without my glasses with my left eye which has astigmatism only. My right eye is near sighted only.

[Arcadia]

Had it caused double vision in both eyes in these cases?

Each eye by itself is clear single image. Using both eyes is when the double vision issue happens. If it is purely a lazy eye condition, patching the stronger eye helps.

 

My DS10 has some tracking issues and one of the causes is that there is a range we don't use and don't think about. When reading or typing, he focus at a fixed near distance. When outside he look far away at birds and squirrels. The intermediate range (one to four car lengths away) is seldom used and he is weak at focusing in that range.

 

ETA:

He has mild astigmatism and near-sightedness.

Edited April 24, 2016 by Arcadia

[josie9499]

Each eye by itself is clear single image. Using both eyes is when the double vision issue happens. If it is purely a lazy eye condition, patching the stronger eye helps.

 

My DS10 has some tracking issues and one of the causes is that there is a range we don't use and don't think about. When reading or typing, he focus at a fixed near distance. When outside he look far away at birds and squirrels. The intermediate range (one to four car lengths away) is seldom used and he is weak at focusing in that range.

 

ETA:

He has mild astigmatism and near-sightedness.

Thank you. Each eye is a single image for her but blurry. Yet she had 20/20 vision. At least still a chance it's an eye condition. What is the difference between double vision due to strabismus and close doubling with CI or is it the same? The worsening concerns me but maybe it's the increased reading that occurred in first grade and suppression was stopping.

[maize]

I don't think I understand how her vision can be both 20/20 and blurry; is the blurriness just close up? did they check for astigmatism?

[Arcadia]

. What is the difference between double vision due to strabismus and close doubling with CI or is it the same?

Strabismus can cause convergence insufficiency but there are many causes for CI. So it is hard to tell what is the root cause(s) of CI without eliminating.

 

Eye strain does worsen the double vision. If she goes to school, what I would suggest is just no reading and a good night sleep today so her eyes are well rested for tomorrow.

 

I am a bookworm but my eyes are happy after a beach vacation and a few days off books.

[josie9499]

I don't think I understand how her vision can be both 20/20 and blurry; is the blurriness just close up? did they check for astigmatism?

[josie9499]

My exact words. He said one step at a time ( the opthamologist who I really was not that impressed with but we needed to get her in asap). They said no astigmatism (asked as my husband has one).

The neurologist also found it puzzling that she reports blurry with one eye (in each when looking one at a time). She can see clearer with one eye from a large distance so maybe that's how they come up with 20/20.

Edited April 24, 2016 by josie9499

[kbutton]

My son had mild strabismus because of his inability to converge. Also, not everyone's symptoms are exactly the same, or they can change over time. My son didn't always have the strabismus, but in hindsight, we saw that he'd always had the covergence trouble--we could see how he changed the way he did activities to suppress seeing double, but he did not have a lot of trouble with actual reading. The COVD predicted that once he read more crowded text with smaller font, he'd struggle, and he certainly did. He also tends to be a non-complainer and under-reporter of symptoms, and once someone described the symptoms, he realized he was not seeing like other people see.

 

Kids can be asymptomatic for a long time and then have stuff change on a dime--their brains are better able to adapt than an adult's until they suddenly don't adapt anymore. The COVD had to work pretty hard to see a consistent eye problem with one of mine, but then the results were seriously life-changing. She was glad that she followed up on her hunch--she had to fatigue his eyes to get him to start seeing double and such.

 

I really think if you get a COVD to explain this, you'd feel less stressed. By all means, have the MRI or whatever testing you need, but please also see a COVD optometrist. A lot of ophthalmologists are kind of biased against VT for some reason. A few will do some pencil push-ups and maybe some other convergence activitiies, but some kids need more or different work to get convergence. 

[Spryte]

Only have a moment, but my son had 20/20 vision and CI that resulted in double vision, too.

[OneStepAtATime]

I agree, you need to see a COVD.  There are a lot of detailed eye tests that can tweak out what is really going on and how to address it.  Some circumstances respond well to Vision Therapy.  Others do not.  Getting solid answers from someone who deals with developmental vision issues as well as visual acuity should help.  Make sure you are comparing apples to apples when you call around.  Write down exactly which tests they can run and what the cost is.  Try to find someone with experience and a good reputation.

 

FWIW, my son had more than perfect visual acuity and passed every standard eye screening with flying colors.  However, he also has a developmental vision issue that was not caught by any opthalmologist or standard optometrist.  He had odd, glitchy things that we attributed to other issues since his visual acuity was always perfect.  Finally, a local developmental optometrist found he had heterophoria.  DS did limited vision therapy and it helped but the eye doctor admitted he had limited experience and limited facilities.  DS and I are heading out of town for a more detailed exam with a much more experienced COVD next week.  What she can offer in the way of tests and how to address known and potential issues is exponentially greater than what the local doctor can offer.

[displace]

Fwiw, CI is about the only diagnosis where vision therapy is covered by health insurance (if it is covered). Definitely pursue treatment with a COVD.

[prairiewindmomma]

You absolutely need the MRI, and you need it pronto.

 

I have had three kids with double vision. In two of their cases, it was convergence insufficiency. We went on to do vision therapy, and have seen improvement.

 

My other child had a brain tumor. I share that not to scare you, but to impress that you should not delay a MRI.  In my dd's case, she had double vision, but she also had a slight in-turning of one eye as the tumor was impinging on the optic nerve. Her original diagnosis from an optometrist was amblyopia. We were delayed another six weeks before we got a proper diagnosis from an ophthalmologist, who confirmed her suspicions by doing the MRI.

[Spryte]

Prairiewindmama, I'm sorry you went through that. I liked your post sympathetically, and because I agree that ruling out everything is important.

Edited April 25, 2016 by Spryte

[josie9499]

You absolutely need the MRI, and you need it pronto.

 

I have had three kids with double vision. In two of their cases, it was convergence insufficiency. We went on to do vision therapy, and have seen improvement.

 

My other child had a brain tumor. I share that not to scare you, but to impress that you should not delay a MRI. In my dd's case, she had double vision, but she also had a slight in-turning of one eye as the tumor was impinging on the optic nerve. Her original diagnosis from an optometrist was amblyopia. We were delayed another six weeks before we got a proper diagnosis from an ophthalmologist, who confirmed her suspicions by doing the MRI.

I'm so sorry for what you went through but am also grateful to you for sharing your experience. Our MRI is Tuesday, so we pushed this from the beginning. Literally 10 days ago we knew none of this, now it's been dr after dr and insurance and expressing urgency and I couldn't agree more with your suggestions. My Dd has had double vision over a year or more it seems (she thought it was normal) but still it's gotten worse fast these 10 days so that has made me push for MRI and multiple opinions. The neurologist thinks there are no signs to be concerned but I won't feel ok until I hear the results. And if course will still wonder what is it then?

May I ask if any thing was noticeably different among your children in their experience with double vision? I appreciate so many of you for sharing stories and offering feedback.

[prairiewindmomma]

No, the scary thing about it is that that was their normal, and it was difficult to pick up that anything was going on.  It never occurred to them that there should be a single focused image because that wasn't their reality.  It's kind of like realizing that you can see individual leaves on a tree AFTER you get your first pair of prescription glasses.

 

Our dd with a brain tumor.....the first symptom we had was only a slight eye wander.  When we were talking about what her vision was like, she mentioned the double vision.

 

Our next kid in the lineup has dysgraphia and dyspraxia and a whole lot of other motor and sensory stuff going on. It was hard to sort that out in the mix, though when I asked him if he had double vision and explained what that was, he confirmed it (at age 5).  For him, the clues were that he had problems tracking text, and problems joining shapes in writing and other things that pointed to visual perceptual issues. This kid and my last kid have some cranial nerve issues, some we weren't sure if it was visual motor or visual perceptual breakdown.  The ophthalmologist did a very thorough eye exam and measured the CI.

 

Our last kid has primarily visual motor issues.  Her CI was fairly easily fixed.

 

If I were you, after you get the clean MRI, find a COVD.  We made more progress there than with the orthoptic computer program our ped ophthalmologist recommended.  

[PeterPan]

Oh my, I hope the MRI gives you good news!  Will it be soon?  My dd had CI and got VT, but there was never a where it just dramatically, rapidly got worse.  I'm glad you're getting complete testing.  Keep us posted!

[displace]

I hope the MRI was normal!