Child needs glasses?

Hi,

I have a son who is 6 years old. He recently had his eyes tested at
Boots Opticians (UK) and had the following reading:

Right:
-Sph: +0.50
-Cyl: DS
Left:
-Sph: +0.50
-Cyl: DS

The optician was adamant that he needs glasses. I'm suspicious of Boots
Opticians because I have had pressure from them in the past to change
my glasses for a very marginal change in my eyesight. Needless to say
the ones that suited me cost £200.

My son doesn't want glasses (to put it mildly) and I have no doubt that
if we do get him glasses they will rapidly be 'lost' or broken - I'd
give them a life expectancy of less than one day.

I have read that if a child does not show symptoms such as constant
headaches and blurry vision, they should not be prescribed glasses and
that, anyway, almost all children have low-grade long-sightedness,
which they grow out of at about age 8-10.

I have also read that children below the age of l0 should have their
pupils widened with eye drops before being tested: the optician did not
do this.

My inclination is to hold off and have him tested again in a year or
two.

I'd appreciate any comments.

Regards

Emmett

 

Dear Emmett,

I am not a "doctor", but a
from the study of primate
eyes, refractive states
from zero to plus 1.5 diopters
are normal.

There might be some
"reason" for this "prescription",
but the OD should give you a
COMPLETE explanation.

Just my opinion.

Otis

 

Dear Emmett,

Subject: The second-opinion

The ODs on this site will provide their opinion -- shortly.

I would suggest holding off on getting the glasses.

I would strongly suggest that you personally
check your child's vision under your control.

(You have nothing to lose by doing this.)

You will find two eye charts on my site:

www.myopiafree.com

For that checking. I suspect
his distant vision is close to 20/40 or
better.

The ODs on this site don't like me providing
a layman's opinion. But I always suggest
that you be provided with a competent
second opinion.

Best,

Otis

 

Dear Otis,

Thanks for the feedback. I'll check him on your charts.

Regards

Emmett

 

According to Otis Brown, engineer, wearing plus lenses can prevent
myopia from developing.

DrG

 

Dear Emmett,

Subject: Child with refractive status of +1/2 diopter and
(potentially) 20/20 vision.

I also suggest you obtain a WRITTEN description
of WHY your child is being put into a +1/2 diopter lens.

Once you are clear on the REASONS, the
some further discussion would be in order.

The REASONS are far more important that
the use of any lens -- at this point.

Best,

Otis

 

Robert, that's silly. Any optometrist can also rule-out amblyopia, and
there are far more of them than pediatric ophthalmologists. Where do
you live?

DrG

 

DrG/Robert,

I live near London, where there is every sort of specialist going, so I
am sure that it's possible to find a pediatric ophthalmologist if need
be. It would be time-consuming and expensive though: specialists do not
come cheap in London.

Regards

Emmett

 

I agree that the over-use of specialists contributes to the high cost
of healthcare. However, you have socialized medicine. If the GP
thinks you need to see a specialist it may cost you nothing.

Here in the U.S., optometrists are extremely well-trained, especially
in the diagnosis of amblyopia. Children half the age of your son are
regularly seen in my practice. Despite the well-meaning(or not so
well-intentioned) comments of Mr. Kopp and others, most of us do not
check our ethics at the door when we come to work each day. What Mr.
Kopp and others fail to mention is that pediatric ophthalmologists also
make a living....from surgery and treatments for -- and I bet you saw
this coming -- amblyopia. Some of them even own dispensaries and sell
(gasp) eyeglasses. I could tell some very interesting stories.

DrG

 

When my children were small, they are now 24 and 27, there was a
programme on television, one of the Watchdog type of things, which
investigated opticians and their over prescribing of glasses to
children. Just after seeing the programme, I took my son to an
optician and was told he needed glasses. I then took him to a smaller
non chain optician who said that was rubbish. So I'd say avoid the
optician chains and go for one of the little independents.

Ann

 

It wasn't a doctor, it was an optician.

 

At that age, for .5D, I don't think it's worth the battle. I'm speaking
as a parent, not an eye professional. I would watch him carefully,
especially reading, and let his teacher know so they will watch for
problems.

One year, I would say. And maybe a different optician.

 

Especially with only .5 hyperopia, which is completely insignificant in
a young child, no matter what. If there is an issue with amblyopia or
heterotropia, they are not due to the .5, that's for sure. Bogus advice
from the gitgo...

w.stacy, o.d.

 

Bottom line here, Emmett, is that if your 6 year/old child is
asymptomatic(i.e. has no headaches), has normal and equal acuities in
both eyes, is binocular, and has no trouble reading at grade level,
then such a small prescription seems to be a moot point, in my opinion.
I know that there are a number of good ophthalmic opticians in the
London environs who are not affiliated with Boots or similar.

DrG

 

As far as I am concerned, +0.50s is a homeopathic, insignificant refractive
error. When it is equal and bilateral, it serves no purpose whatsoever to
order it, except to pad the optician's pocket.


David Robins, MD
Board certified Ophthalmologist
Pediatric and adult strabismus subspecialty
Member of AAPOS
(American Association of Pediatric Ophthalmology and Strabismus)

 

You are correct that I don't have the chart in front of me. But I do
know that no matter what the "real" refraction is, +.50 O.U. is going to
do absolutely nothing for anything. I have no problem with getting a
2nd opinion, but to get all worked up about the +.50 is idiotic. Nothing
in the post suggests anything serious is happening.

Enough of this; I'm out of here for 2 weeks (sailing to Cabo San Lucas).

w.stacy, o.d.

 

Dear David,

I am pleased to hear you say that. But that begs the
question, why was the Optician "adamant" about
prescribing a "plus 1/2". Was he taught that
all "refractive errors" must be fixed, or
serious consequences will follow?
Perhaps Emmett could check on the reason
for this man's adamant requirement. It would
be worth it to here a more complete reason.

Best,

Otis

_________


Emmett> The optician was adamant that he needs glasses. I'm suspicious
of Boots
Opticians because I have had pressure from them in the past to change
my glasses for a very marginal change in my eyesight. Needless to say
the ones that suited me cost £200.

 

Hi Emmett,

At that prescription I would not prescribe spectacles UNLESS there was a
very good reason, which is not evident from your initial posting.

For a second opinion try the Institute of Optometry, 56-62 Newington
Causeway, London SE1. or Moorfields Eye Hospital, City Road, London or Great
Ormond Street Hospital for Sick Children. But I'd try the Institute first.

Regards


Ian Hodgson - Isle of Man

 

In the UK the term optician is used by the general public to refer to an
optometrist. It is only in the last 10 years or so that the term optometrist
has started being used in the UK because prior to that it was not a
protected title. The protected title was 'Ophthalmic Optician', a change in
the legislation protected both titles.

An eye examination may only be carried out by an Optometrist/Ophthalmic
Medical Practitioner/Ophthalmologist

Incidently Optometrists in the UK are not officially doctors as the degree
is first level ie a BSc some are but have a second level degree ie a PhD.
This is due to the education system, rather than the level of training. As
an aside some GP's are not in degree terms Doctors as they hold a Bachelor
in Medicine degree Doctor is a courtesy title.

Regards


Ian Hodgson BSc FCOptom - Isle of Man

 

Hypothetically now:

What would be the opinion of the child were myopic by ~0.50D, that is
to say, calling for a correction of -0.50D in each of the two eyes?

Another hypothetical:

What if the child had astigmatism to the extent of 0.50 diopers in one
or more eyes?