Surgery for a lazy eye?

[Mom2Two]

My son's doctor wants to do surgery for his lazy eye. Is this a safe and successful option or should I push for something else? :confused:

[MicheleB]

I am only speaking from my *own* personal experience... When I was 3, I started wearing glasses for my right eye, which turned in completely to my nose. I wore them till I was 10, at which time my eye was corrected. I remember the Dr. talking with my mother about surgery, but the doctor waited it out till I was ten and I'm glad! I've never had any problems with it since then, either. HTH!

[Valerie in MI]

My daughter has had four surgeries for lazy eyes (sometimes both eyes, sometimes just one) and her doctor has been recommending a 5th which we've decide to put off for awhile. I would recommend surgery because patching doesn't do much, but there is no certainty that it will fix the eye perfectly so your son may be in for several surgeries. They just move a muscle and hope for the best. It's kind of an blind art. Make sure that your doctor has done a lot of surgeries. I prefer using an eye doc. that specializes in lazy eye and not a jack of all trades ophthalmologist. My daughters first surgery was at 18 months or so and she's now 11 and still has one eye that turns out a bit. We're kind of used to it now and question whether its worth the expense and bother of yet another surgery. It's purely a cosmetic issue (it won't help your son's eyesight) so it's a question of how important a better appearance is too you.

[Kathy in MD]

If so, consult a developmental optometrist before doing surgery. Don't check this avenue out after surgery because surgery leaves scar tissue that can interfer with VT.

 

Vision therapy will train the eye muscles to work together and has a good success rate in correcting strabism. It may be that your dc's problems are too severe, but it's worth looking into. After VT, you'd need cognitive therapy to train the brain to use the improved imput. Some DO's do include cogntive training as part of VT. You might want to look for one of these DO's, though I understand they're rare.

 

Most insurance will cover VT under these circumstances because eye surgery is covered and VT is usually less expensive than surgery. If your insurance isn't accustomed to covering VT under these circumstances, your DO may need to send them a letter, but it's doable.

 

I'll warn you right now, your opthamologist will probably be against it. There's a big turf war between opthamologists and DO's. Opthamologists are just starting to enter the VT field, but they are starting from scratch and calling it opthotics instead.

[Claire]

My son's doctor wants to do surgery for his lazy eye. Is this a safe and successful option or should I push for something else? :confused:

 

Please read this article on lazy eye. I agree completely with Kathy in MD about finding a good developmental optometrist first. You can find board-certified DOs in your area at COVD.

 

I would never consent to surgery for lazy eye before trying vision therapy with an experienced developmental optometrist.

 

Do remember that all doctors in a specialty are not created equal. Some graduated with C-averages and are business-oriented, while others graduated with A-averages and are people-oriented. If you have a choice of DO's, I would call each office before making a decision. Also, for more info on DO's and vision therapy, try posting on the Special Needs Board.

[Claire]

Oops! Sorry, this *is* the Special Needs Board! I forgot I was reading under "New Posts".......

[Mom2Two]

I found a DO that is 47 miles from us (the closest one). How many times a week would we have to drive there? I'd be willing to do once a week, but more than that would be tough. I am willing to try anything but surgery. We aren't concerned with cosmetic appearance right now, just getting his brain trained correctly so he isn't just seeing out of one eye. I ordered some patches for him to start using. What do some of you think of patching?

[Kathy in MD]

warned me about.

 

VT can be done many ways. I live relatively close to a good DO, and went twice a week. Some DO's will develop home programs with supervision. Others will offer a computer-based therapy if it's appropriate.

 

If you do go with in-office therapy, the actual therapy will be provided by the DO's trained staff. This staff will be accustomed to working with both adults and children. If your child is difficult like mine is, ask for their best therapist for difficult children. This is especially important for the initial sessions.

[Claire]

Talk to the DO about it. I don't know specifically about lazy eye (we did vision therapy for different problems), but many of the exercises can be done at home if the child is cooperative. Some DOs are willing to design primarily home-based programs. I know a couple of mothers who would go in once a month to get trained in new exercises, then go home and do the exercises every day between appointments. However, DOs vary in how willing they are to do this. You may want to check in a wider area for DOs and call each clinic before deciding where to go for the initial evaluation. Distance from your home is probably not the highest priority, although it certainly will have an impact on your decision-making.

 

If you read the article, you will see that patching alone frequently does not completely restore the eye, plus improvements are more likely to be temporary in nature. I personally would not consider patching only unless there were no other options.

[Osmosis Mom]

I have two dds with farsightedness and lazy eyes. It began when they were less than 18 months and now they are six.

 

We have been seeing an excellent opthamologist now for about 5 years who is dead-set against surgery as long as any prescription of glasses can straighten the eyes. She has a lot of experience in this field and feels confident that their eyes might get straight. I actually meet a preteen patient of hers in the waitingroom whose eyes had straightened out.

 

 

I recently asked the doctor if contacts would straighten the eyes like glasses which she said they would so I feel OK about approaching their teen-years with misaligned eyes (if that should be the case).

 

I am persoanlly not at all convinced in surgery and knwo for a fact that there are crack-doctors pushing it (we had such a one at first). I also tried VT with a socalled recommended doctor, but that was absolutely a joke (not saying VT is, just that it certainly can be). We have never done patching.

 

Oh, yeah, my younger sister had a misaligned eye that got straightened with glasses. She is 23 now and has the most gorgeous eyes you can imagine although she does seem to cross when she is really tired.

 

Did that help?

[SheilaZ]

My son was diagnosed at age 3. He first worse glasses to correct his far sigtedness.

They didn't fix the issue so we found a pediatric opthalmologist.

 

DS's vision was very bad in his turned eye so he started patching 8-10 hours a day for 6 months. That brought his vison up to 20/35 in both eyes. But he still had a lazy eye.

 

He had two eye surgeries. One for both eyes and the other to correct an over-correction. (He walled out after the first surgery.) But he still has problems with his eye alignemt when he is distracted or very tired. He's now 9 years old, wearing his glasses without a prism but facing a third surgery.

But....he also has 4th nerve palsy. He has vertial alignment issues as well as horizontal.

 

I don't regret what has been doen so far...but I wish it had been more successful.

[Lisa in CO]

My daughter was diagnosed with amblyopia at age 3. Her eyes have never turned out or in--she would just turn her entire head to look at things. The pediatric opthamologist wanted to put her in glasses right away. The developmental optometrist wanted to use patches first. We went with the DO even though our insurance wouldn't pay for it. We patched for 8 months, and her vision in her weaker eye returned to almost normal. We did vision therapy for several months because her brain still wanted to use those eyes separately.

 

She is now seven. She wears glasses to correct far-sightedness in the weaker eye, and we are doing VT to keep her eyes working together. She has had more difficulty learning to read, but she is tough and a hard worker, and I think she'll be just fine!

[Mabelen]

My 11 yo dd was diagnosed with intermittent strabismus at 9 months old. You could only notice it when she was tired, but it was there. She was under observation for a year and she was released because her vision seemed to be developing fine. This was in the UK.

 

After relocating in the US I took her back to the ophthalmologist for regular checkups, every 1 or 2 years.

 

We noticed an increase in her wondering eye around age 8 again. She also said she was having double vision at times. We went back to the pediatric ophthalmologist and just took a wait and see approach with the possibility of surgery in the future if things did not resolve themselves. After a year he recommended surgery.

 

At this time I looked into VT, and she started therapy.

 

She has had once weekly therapy for the last almost two years. We are now on a two month break to see if the gains she has made are kept without ongoing therapy.

 

She is no longer complaining of double vision and we have noticed a decrease of her wondering eye. The therapist explained that my dd will always have this tendency, but the therapy is supposed to teach her to control it. Repeated therapy will achieve her to do this almost unconsciously.

 

For us I guess VT is working, but it is very costly in terms of time and money.

 

The reason why we looked into VT in the first place is because I had had two surgeries for strabismus which didn't fix the problem. Granted, this was a very long time ago and in different countries, but still I wanted to exhaust all other venues before resorting to surgery.

[Claire]

My son's doctor wants to do surgery for his lazy eye. Is this a safe and successful option or should I push for something else? :confused:

 

One thing I forgot to ask is if the lazy eye is due to strabismus. If so, I would *definitely* recommend trying vision therapy first. Surgery for strabismus typically results in cosmetic correction but not better vision. Here is a link to a description of treatment options for strabismus . Strabismus can lead to lazy eye.

 

My dd had beginning amblyopia (lazy eye) diagnosed by her opthalmologist at age 3. In her case, the lazy eye was caused by a huge discrepancy in the visual acuity of the eyes. The weaker one was getting used less and less. The opthalmologist gave her eyeglasses that equalized her visual acuity, and the amblyopia reversed just from doing that. Otherwise we would have had to patch also.

 

I wanted to clarify that strabismus and amblyopia are two different eye conditions, although they can be related. A child can have strabismus without amblyopia, amblyopia without strabismus, both conditions or neither.

[kfrench]

I had surgery when I was 5 for crossed eye's it did not correct it the doctor wanted to oporate again but my parents opted out. My mom had the surgery when she was a kid and it did work. I also think that if the surgery is done very young like below two that they can help the eye's to work together but not positive on that it. I felt a lot of stigma going around with at patch on one eye. I had to put up with names and stares growing up but I forget about it now. I did do vision therapy in my teenage years but my eye's were so different one is very far sighted and the other near sighted and one eye higher than the other so I ended up just seeing double. I can turn off the double vision- my eye turns in or I can turn it on if I want my eyes to look normal for pictures etc. I use one eye to read and the other to see far away weird. I can say that if my kids had lazy eye my first choice would be vision therapy and surgery second. If they were still young. I can see why they do the surgery it sucks having people not know if you are looking at them or off to side and the mean things kids can say. Luckily none of my kids have that though 2 have had issues with their eye's not tracking correctly together. The VT guy even asked me if I wanted to try VT again but I opted to just look weird. Until someone brings it up now that I am adult I don't even remember my eye's do that.

 

kris

[Guest Wendy]

I have BTDT with my dd and myself. I have a lazy eye that was not detected until age 12 or so. It is generally not correctable with vision therapy (patching or dilation of the "good" eye with atropine drops) after about age 7. In looking at your son's age (I believe it was 8?), he is right on the cusp of vision therapy no longer being a viable option. I would assume that the ophthalmologist is recommending surgery so that your son can recover vision in that eye before it is too late. I would certainly research and retain a surgeon that is board certified and does LOTS of these on a regular basis. At this point, surgery would be vision salvagable and not merely cosmetic. I would at least consider it for this reason.