Ds failed his vision screening at the pediatrician

[HollyBee]

Both eyes together tested 20/20 (barely). Left eye: 20/20. Right eye: 20/50 (!)

 

Obviously, the left eye is compensating for the right eye. It was interesting, though, that just before they tested him, he said, "Hey Mom, did you know that eyes work by one eye seeing far away and the other close up?" And I'm thinking to myself, "What...?" Well, this would explain why he thought that. He can see distance with his left eye, but only close up with his right eye.

 

We have an appt. with an optometrist next week. Does anyone have experience with this sort of thing? Do you think they'll recommend glasses even though he's seeing pretty much 20/20 with the two eyes working together?

 

I wore glasses/contacts for years (had Lasik in January), but my eyes were pretty close in prescription. I've never known anyone with a difference this significant.

 

Oh, and he's 11, and a voracious reader (if it matters). He has headaches occasionally, definitely way more than his sister, but not to the point where I was alarmed or concerned. He's never failed a vision screening before, but I'm a bad mother and he hasn't had a physical in 3 years (but that's a whole 'nother thread).

 

Thanks for any insight! (ha ha)

[itsheresomewhere]

Don't feel bad. DS just failed his routine eye exam. He has been to a different one repeatedly but our old came back on our insurance. We went and he is nearsighted.

 

Back in the dinosaur age, I originally had glasses for my one eye that was bad. One was a plain glass lens and the other was prescription. Over the years, both eyes needed glasses.

 

DS's vision said he is 20/50 without glasses.

Edited October 27, 2011 by itsheresomewhere

[jplain]

Eh, 20/50 isn't so bad. But yes, the optometrist is likely to recommend glasses. If s/he doesn't, get a second opinion from a pediatric ophthalmologist.

 

When one eye is compensating for the other, a condition called amblyopia may develop. In that situation, the brain begins to ignore the input from the eye with poor vision, and eventually may stop paying attention to it entirely. Ideally, amblyopia is caught and treated (with glasses and sometimes patching/eye drops) by age 7 at the latest. If it goes untreated, the result can be permanent low vision (blindness) in that eye, regardless of whether or not corrective lenses are worn. It can also cause the weaker eye to start "wandering," which is often the most obvious sign that there's a problem.

Edited October 27, 2011 by jplain

[In The Great White North]

I would be ecstatic if my eyes were 20/50! They will probably prescribe glasses to retrain him to use both eyes, but since he can see without them, he'll probably have all sorts of excuses to not wear them. And lose them. Have fun.

 

BTW, the biggest difference between the eyes I have ever heard of was more like 20/20 and 20/650. His are no problem at all.

[Hwin]

I'd get glasses if they recommend it, and he can use them as needed. I am a person who is perfectly functional without glasses but SO glad to have them on certain days.

[iamrachelle]

I agree! My 8 year old DS is 20/60 in one eye and 20/100 in the other. He started wearing glasses when he was four... we actually found out he needed them completely on accident. (Long story.) All this to say that there is nothing to worry about. For what it's worth, we've never had any trouble with him not wanting to wear his glasses either. He loves to be able to see (LOL) and he doesn't have headaches when he wears them.

[Perry]

Please, please see an ophthalmologist instead of an optometrist. I have this, and my son does too. Glasses may actually be contraindicated, although an optometrist is likely to prescribe them anyway, possibly making things worse, or at least very unpleasant.

 

Anisometropia

 

Anisometropia ( /ænˌaɪsəmɨˈtroʊpiə/ US dict: an·ī′·sə·mə·trō′·pē·ə) is the condition in which the two eyes have unequal refractive power; that is, are in different states of myopia (nearsightedness), hyperopia (farsightedness) or in the extreme, antimetropia (wherein one eye is myopic and the other is hyperopic), the unequal refractive states cause unequal rotations thus leading to diplopia and asthenopia.

Anisometropia can adversely affect the development of binocular vision in infants and children if there is a large difference in clarity between the two eyes. The brain will often suppress the vision of the blurrier eye in a condition called amblyopia, or lazy eye.

The name is from four Greek components: an- "not," iso- "same," metr- "measure," ops "eye."

One study estimated that 6% of those between the ages of 6 and 18 have anisometropia.[1]

 

Spectacle correction

 

For those with large degrees of anisometropia, spectacle correction may cause the person to experience a difference in image magnification between the two eyes which could also prevent the development of good binocular vision.

The solution for spectacle wearers to the problem that spectacle correction may cause the person to experience a difference in image magnification between the two eyes is spectacles incorporating iseikonic lenses. Iseikonic lenses present adjusted image sizes to the eye compared to standard lenses. The formula for iseikonic lenses (without cylinder) is:

Magnification = 1/(1-(t/n)P) X 1/(1-hF)

where: t = center thickness (in meters) n = refractive index P = front base curve h = vertex distance (in meters) F = back vertex power (essentially, the prescription for the lens)

(see Practical Optical Dispensing by David Wilson)

If the difference between the eyes is up to 3 diopter spheres iseikonic lenses can compensate. At a difference of 3 diopter spheres the lenses would however be very visibly different - one lens would need to be at least 3mm thicker and have a base curve increased by 7.5 spheres.

 

Contact lens correction

 

The usual recommendation for those needing iseikonic correction is to wear contact lenses in their normal prescription since the effect of vertex distance is removed and the effect of center thickness is also almost removed, meaning there is minimal and likely unnoticeable image size difference when wearing contacts. This is a good solution for those who can tolerate contact lenses and for whom the contact lenses create sufficient acuity.

 

Edited October 27, 2011 by Perry

[abbeyej]

Don't beat yourself up. Kids' eyes can change *very* quickly at this age. It's entirely possible that even if you'd had him checked out 6 months ago, nothing significant would have shown up. Now you know and you're dealing with it. :)

[gardenmom5]

story of my life.

 

okay, his eyes are NOT working together. (if both eyes were uncovered for the "both eyes 20/20", he was only using his left eye). With that much divergence between his eyes, they are *incapable* of working together to develop binocular vision. that is required for depth perception. (It can also be the cause of his headaches). do mention the voracious reading to the OD. it can GET WORSE if it is not adequately treated NOW. I will be blunt, some kids go blind in the weaker eye becasue the brain shuts down the input from it. You need someone who will not just 'prescribe glasses', but will figure out and treat the CAUSE of this significant difference. (It could be as simple as an astigmatism in one eye only, or something much more complex)

 

Take him to a DEVELOPMENTAL optomitrist. no if's, and's, or but's. that is an absolute. this isn't just an "oh, he's nearsighted/farsighted and needs glasses". save yourself (and your son) major grief.

 

I've seen regular optomitrists (and opthlalmologists). Only a very few have had a clue how to adequately treat me, but they try anyway. some have actually casued more harm than good. I now go to a pediatric developmental optomitrist. I'm one of her very FEW adult patients - because near/far sightedness is the least of my vision problems. I told dh, I don't care if my insurance doesn't cover her, I *ain't* goin' nowhere else!

 

Both eyes together tested 20/20 (barely). Left eye: 20/20. Right eye: 20/50 (!)

 

Obviously, the left eye is compensating for the right eye. It was interesting, though, that just before they tested him, he said, "Hey Mom, did you know that eyes work by one eye seeing far away and the other close up?" )

Edited October 27, 2011 by gardenmom5

[Parker Martin]

My eyes are like this. I've always worn glasses. No big deal

[Truscifi]

Ds tested at 20/50 this past year as well - nearsighted. He also gets migraines, so our doc referred us to a ped ophthalmologist. She determined there were no other eye issues and said at 20/50 glasses would definitely help him see better and if he were in ps and trying to see a blackboard across the room he should get them right away. But since he is homeschooled and doesn't need to see far away at this point glasses were optional.

[gardenmom5]

Please, please see an ophthalmologist instead of an optometrist. I have this, and my son does too. Glasses may actually be contraindicated, although an optometrist is likely to prescribe them anyway, possibly making things worse, or at least very unpleasant.

 

Anisometropia

 

 

Only a developmental - not even all opthlalmologists adequately treat this. I know, I've been there.

[LittleIzumi]

I agree with the developmental optometrist, specifically a COVD optometrist. With that much difference and how your ds is using his eyes differently, I think he would really, really benefit from vision therapy to train his eyes to work together properly. Dd has a similar prescription, one weak eye and one that is 20/20, and one eye has mild amblyopia (doesn't quite move in sync with the other eye sometimes). Her ophthalmologist gave her glasses and said she was fine, despite her strange reading difficulties. Her COVD doc tested her and gave her vision therapy for convergence (using both eyes to read the same letter together at the same time) and tracking (following along the page), both of which were awful, and some 3-D perception and motor issues. She is almost done with therapy now and the change is AMAZING. She went from being angry at the idea of even reading an easy reader page to reading chapter books (slowly, as she has no stamina yet, lol) in two months.

 

http://www.covd.org/default.aspx

[HiddenJewel]

Please, please see an ophthalmologist instead of an optometrist. I have this, and my son does too. Glasses may actually be contraindicated, although an optometrist is likely to prescribe them anyway, possibly making things worse, or at least very unpleasant.

 

Anisometropia

 

My dd16 has anisometropia with major differences in the eyes. The OD she just saw said NO contacts because of her K-Reading measurements. He also said she MUST have equal ocular curves on her glasses so that the images are brought to the same size. This is where the curve on the inside is the same which makes the outside curve different. Contacts would not allow for the images to be corrected and it could cause the brain to use just one eye and shut down the other one. (If I am remembering correctly how he explained it.) Of course, we were fortunate enough to get an OD who had done extra study on anisometropia.

[Parker Martin]

Last time I went to a new optometrist, she asked if my parents had eye patched my eyes during my childhood to keep my bad eye functioning. They didn't. She said she was surprised that my brain didn't turn off the input from my bad eye.

 

I don't know anyone who just wore glasses and ended up blind in one eye as an adult. I just wore glasses, and I played sports all through school into high school.

 

When did people start doing all this special vision stuff?

[Perry]

I don't know anyone who just wore glasses and ended up blind in one eye as an adult.

 

My dad did.

 

I couldn't wear glasses- the difference in magnification was awful. I felt like I was seeing double, I had headaches and was sick to my stomach. I saw several different eye doctors, had several different prescriptions, and no one really knew what they were doing. I now have an eye doctor that I know well and trust, and he says because of the large disparity, glasses would never have worked, although contacts would have. It's too late now though, as my brain has sort of shut off that area for distance vision in my left eye. But as long as both eyes are open, my vision is mostly fine. I see well close up with my left eye, and I see well long distance with my right eye. The only trouble I have is seeing things that are about 3-4 feet away. I have to be either closer or farther than that.

 

My right eye is about 20/40, and left eye is worse than 20/1000.

[choirfarm]

Umm.. no one has brought this up so I will. My oldest was in 4th grade and at his annual eye exam, one eye was worse than the other one. He told me that generally the other eye catches up to it and told me to wait on the glasses. He made an appointment... I can't remember ( this child is a junior now) maybe 3 months from then... 3 or 6 months. By then they had caught up. He then prescribed glasses. He said that was fairly common. BTW, this is the same doctor that did vision therapy for my youngest one, so he is for vision therapy. Apparently he sees this a lot.

[Lolly]

One of my girls has a bit of this problem. Optometrist put her in contacts/glasses. Opthamologist said the contacts presented a bigger risk of infection than they would give in help. Glasses were more an annoyance than they gave in help. If she were in a classroom situation, he would say glasses for reading the board only; otherwise, just don't worry about it. Since she isn't in a classroom, just don't worry about it.

[gardenmom5]

When did people start doing all this special vision stuff?

 

I wasn't patched, but I did get ointment in my "good" eye to make it blurry. that was the 60's.

[LittleIzumi]

Last time I went to a new optometrist, she asked if my parents had eye patched my eyes during my childhood to keep my bad eye functioning. They didn't. She said she was surprised that my brain didn't turn off the input from my bad eye.

 

I don't know anyone who just wore glasses and ended up blind in one eye as an adult. I just wore glasses, and I played sports all through school into high school.

 

When did people start doing all this special vision stuff?

 

I know of someone (a friend's brother) whose brain did indeed shut off the input from his bad eye, and he has been completely blind in that eye from late childhood.

[PentecostalMom]

Please, please see an ophthalmologist instead of an optometrist.

 

:iagree:

Because an optometrist misdiagnosed 5yodd and we ended up at a pediatric opthamologist anyway. It would have been less stressful on all of us, had I taken her there first!

[Parker Martin]

My dad did.

 

I know of someone (a friend's brother) whose brain did indeed shut off the input from his bad eye, and he has been completely blind in that eye from late childhood.

 

For huge disparities where one eye is already nearly blind, sure. But for a disparity like the one described by the OP? I would be extremely surprised.

[HollyBee]

I appreciate all the opinions here. After weighing the options and possibilities, I decided to get a referral to a pediatric ophthalmologist and bypass the optometrist, just to make sure we cover all our bases. Hopefully we're not dealing with anything major.

[HollyBee]

I just had a thought hit me, though, this afternoon. Dh's grandfather (ds's great grandfather) has a lazy eye. Like, it REALLY turns out, and I still try to figure out which eye to look at! I have no idea if it's always been like that, though I suspect not, and I also don't know when it manifested.

 

Can something like that skip a couple of generations? My FIL doesn't have any issues (that I'm aware of) and neither does dh.

[TranquilMind]

Don't beat yourself up. Kids' eyes can change *very* quickly at this age. It's entirely possible that even if you'd had him checked out 6 months ago, nothing significant would have shown up. Now you know and you're dealing with it. :)

Right. My oldest got three new prescriptions just last year!