strabismus, glasses not working

Hi I wrote on March 15 regarding my son. Here is the link in case is of
any use, there were a lot of nice people helping me.

http://groups.google.com/group/sci.m...71523d8d36a772

To make the story short:

My four years old boy was diagnosed with strabismus and amblyopia. He
started crossing (in) his right eye when he was almost 4 years old. The

ophthalmologist prescribed glasses OD +2.25 (sphere) OS +1.75 (+0.25)
and then advised us to patch him 2 hours a day, and do some manual
activities while patched. We did this for 7 months, the amblyopia is
gone for now. Both eyes are 20/30.

The doctor has raised the prescription twice, so in 8 months my son has
needed 3 different prescriptions, why didn't the doctor go all the way
since day one?

Anyway, my son has been wearing the last prescription, 3.25 in both
eyes, for 5 days now and we noticed today, as he was watching TV, that
he still crosses his right eye.

Is that that he may need a little more time to get used to the new
prescription, and then he won't cross? Or this is just wishful
thinking, and he'll need surgery?

And how useful will be vision therapy in his case?

Dr. Robbins, Dr. Grant? Anybody

Thanks

Bogo wrote:

>
> Anyway, my son has been wearing the last prescription, 3.25 in both
> eyes, for 5 days now and we noticed today, as he was watching TV, that
> he still crosses his right eye.
>

Are you sure it's crossing? Might just be epicanthus which often gives
little kids that appearance and often fools the parents. Need to have
it checked by someone who can tell the difference (o.d. or o.m.d.) to be
sure.

w.stacy, o.d.

Bogo,

Bogo> ophthalmologist prescribed glasses OD +2.25 (sphere) OS +1.75
(+0.25)
and then advised us to patch him 2 hours a day, and do some manual
activities while patched. We did this for 7 months, the amblyopia is
gone for now. Both eyes are 20/30.

Bogo> The doctor has raised the prescription twice, so in 8 months my
son has
needed 3 different prescriptions, why didn't the doctor go all the way
since day one?

Otis> I think he wanted to avoid having your son develop more
hyperopia
from the +2 diopter lenses.

Bogo> Anyway, my son has been wearing the last prescription, 3.25 in
both
eyes, for 5 days now and we noticed today, as he was watching TV, that
he still crosses his right eye.

Otis> It is interesting that your son's eyes responded to a
+2.00 diopter lens -- by chaning in a positive direction -- by
+1.00 diopters in 8 months. This is not supposed to happen.

Otis> It may be that an operation is the only answer.

Otis> Perhaps Dr. Robins can render an opinion.


Dr Judy wrote:
> Bogo wrote:
> > Hi I wrote on March 15 regarding my son. Here is the link in case is of
> > any use, there were a lot of nice people helping me.
> >
> > http://groups.google.com/group/sci.m...71523d8d36a772
> >
> > To make the story short:
> >
> > My four years old boy was diagnosed with strabismus and amblyopia. He
> > started crossing (in) his right eye when he was almost 4 years old. The
> >
> > ophthalmologist prescribed glasses OD +2.25 (sphere) OS +1.75 (+0.25)
> > and then advised us to patch him 2 hours a day, and do some manual
> > activities while patched. We did this for 7 months, the amblyopia is
> > gone for now. Both eyes are 20/30.
> >
> > The doctor has raised the prescription twice, so in 8 months my son has
> > needed 3 different prescriptions, why didn't the doctor go all the way
> > since day one?
>
> Why was the prescription increased three times? sometimes the child
> doesn't manifest the full amount right away, sometimes he would be
> seeing blurry with it and thus would refuse to wear the glasses. By
> increasing over time he eventually accepts the full amount.
>
> >
> > Anyway, my son has been wearing the last prescription, 3.25 in both
> > eyes, for 5 days now and we noticed today, as he was watching TV, that
> > he still crosses his right eye.
> >
> > Is that that he may need a little more time to get used to the new
> > prescription, and then he won't cross? Or this is just wishful
> > thinking, and he'll need surgery?
> >
> > And how useful will be vision therapy in his case?
>
> He may still need stronger glasses. If not amblyopic unlikely to need
> surgery, but you would have to ask his doctor who has the full details
> of his case. Vision therapy might help if he is not strabismic most of
> the time. Again, his doctor could advise.
>
> Dr Judy

perhaps you should tell us exactly "what is supposed to happen" in this
situation and explain why you believe that.

you know you have no credentials or experience to suggest what is
supposed to happen in such a situation so why do you render advise?

PS-- what has ever become from the investigation by the State of
Pennsylvania against you for practicing medicine without a license?

(E-Mail Removed) wrote:

> Otis> It is interesting that your son's eyes responded to a
> +2.00 diopter lens -- by changing in a positive direction -- by
> +1.00 diopters in 8 months. This is not supposed to happen.

On 8/15/06 3:08 PM, in article
(E-Mail Removed). com, "Dr Judy"
<(E-Mail Removed)> wrote:

>
> Bogo wrote:
>> Hi I wrote on March 15 regarding my son. Here is the link in case is of
>> any use, there were a lot of nice people helping me.
>>
>> http://groups.google.com/group/sci.m...ead/a60a380fa3
>>
7f217e/1571523d8d36a772?lnk=gst&q=%22four+years+old%22&rn um=5#1571523d8d36a77>>
2
>>
>> To make the story short:
>>
>> My four years old boy was diagnosed with strabismus and amblyopia. He
>> started crossing (in) his right eye when he was almost 4 years old. The
>>
>> ophthalmologist prescribed glasses OD +2.25 (sphere) OS +1.75 (+0.25)
>> and then advised us to patch him 2 hours a day, and do some manual
>> activities while patched. We did this for 7 months, the amblyopia is
>> gone for now. Both eyes are 20/30.
>>
>> The doctor has raised the prescription twice, so in 8 months my son has
>> needed 3 different prescriptions, why didn't the doctor go all the way
>> since day one?
>
> Why was the prescription increased three times? sometimes the child
> doesn't manifest the full amount right away, sometimes he would be
> seeing blurry with it and thus would refuse to wear the glasses. By
> increasing over time he eventually accepts the full amount.
>

>>
>> Anyway, my son has been wearing the last prescription, 3.25 in both
>> eyes, for 5 days now and we noticed today, as he was watching TV, that
>> he still crosses his right eye.
>>
>> Is that that he may need a little more time to get used to the new
>> prescription, and then he won't cross? Or this is just wishful
>> thinking, and he'll need surgery?
>>
>> And how useful will be vision therapy in his case?
>
> He may still need stronger glasses. If not amblyopic unlikely to need
> surgery, but you would have to ask his doctor who has the full details
> of his case. Vision therapy might help if he is not strabismic most of
> the time. Again, his doctor could advise.
>
> Dr Judy
>

While this scenario is possible, I find it usually best to start with the
full cycloplegic refraction. I tailor the Rx to the situation - if
intermittently crossing, may do well with an under-plus. But, if crossed,
want to find out soon if it can truly straighten out. Rather than creep up
on it, I start at the full Rx. If it is not tolerated, THEN I back off, but
I seldom have to do this.

He may indeed need a stronger Rx if he is truly crossing, not just seeming
to cross. I am assuming he has had a cycloplegic refraction when this
started, and again recently to increase the Rx.


Dr. Robins

(E-Mail Removed) wrote:

> PS-- what has ever become from the investigation by the State of
> Pennsylvania against you for practicing medicine without a license?

HEY, JAN: if you're still out there and still reading.... I'm in
Beverwijk for a few days. I'd love to buy you a cup of coffee and say
"Dag".....

fast update:

The State sent me numerous additional forms to fill out providing
further details--names, addresses, dates, copies of text from the
Internet, etc.--in order to proceed. They, apparently, HAVE made
contact with a few of the parents who claim to have been 'advised
regarding medical treatment' by Old Doc Brown here.

Since I am traveling around Europe, the State is aware that it will be
a few months before I can provide the necessary documentation. They
said it's not a problem, and that they can proceed, as appropriate,
when I return and provide what they need.

Meanwhile, it surely does seem as though Old Doc Brown here is--if
anything--worse than before. Must be "staircase senility" at its
finest....

For those of you keeping score at home, incidentally, the Parisian
authority on BAK-induced ocular surface damage HAS CONFIRMED my
suspicion that I suffered extensive damage from the prolonged use of
cycloplegic drops preserved with BAK. I will see him again, in Paris,
in late September to discuss the results of the further cytology,
histology, and confocal microscopy. Initial evaluations revealed
"extreme levels of corneal nerve endings and innervation of those
endings," at least providing some functional information to explain the
hyperesthesia.

For the moment, he has me on a protracted course of Doxycycline and a
protracted course of a preservative free, European NSAID drop--neither
of which seems to be doing any good.

If none of this gets better .... I may have to go to Zinni Optical and
buy a pair of +2.00 readers. Maybe Old Doc Brown here was right after
all...... ;-)

Best to everybody,
Neil
(Normally English Spoken ... but not particularly well!)