Forcing glasses on a cross-eyed child...

Hello,

I asked about cross-eyed syndrome before the holidays and would like to
repeat by appreciation for
all the input.

May I ask a related question?

My 2 year, 10 month daughter is very very inquisitive and stubborn.
Frankly I like her this way.

Her left eye tilts inward and she appears to have a cross-eyed syndrome.

The doctor is considering surgery. But this decision waits the outcome
of a CAT scan in a few days.
Until then, my daughter must wear glasses... yeah!, right!

She absolutely refuses.
So my wife and I have taken to bribing her:
no playdough, no TV, no cookies, unless she wears the glasses.
this pains me, and I am wondering if this whole escaped is worth it.

The doctor says we must assess if the glasses can correct the problem.
But I am wondering if this is the case for families in HMO's.
Namley: is there another method to determine the extend of the
cross-eyed and if surgery can
fix it pronto without having to make her wear glasses?

I am beginning to look upon this situation of making her wear glasses as
torture to this young
independent little girl. And I hate what it is doing to her.

I am willing to make arequest of the HMO, or even pay out of pocket,
just to get to the answers
as quickly as possible.

Thanks,
Tom

 

You might want to consider contact lenses. Many of the newer materials
can be worn for many consecutive nights without removal. Of course,
the parents will have to be shown how to put the lenses on and off and
how to take care of them.

nipidoc

PS: No, she's not too young. The youngest contact lens patient I've
ever fit was 9 days old. You do need to someone who has worked with
infants before. Usually one of the medical schools or schools of
optometry.

 

PS: If glasses or contact lenses correct the problem, I would NOT do
the surgery.

nipidoc

 

Hello,

I wanted to follow-up from home to my original post.

I am not asking for advice on what to do to correct the problem: glasses vs.
contacts

I am asking if there are expedited means to find out what the problem is...
means that do not necessarily require glasses.

For if the CAT scan proves another issue then it appears there would have
been no need to subject the girl to glasses. That is what I am trying to
ascertain... namely: is the glasses-route a convenience of an HMO that
dissuades
a more vigorous and expedited inquiry?

Tom

 

A fairly large percentage of children whose eye(s) turn inward have
farsighted prescriptions, and respond well to eyeglasses. Surgery would
seem ill-advised if the eyeglasses correct the problem. I'm not sure how
successful strabismus surgery can be in the presence of accommodative
esotropia where eyeglasses have never been tried. At the end of the day,
there will still exist a significant uncorrected farsightedness that will
hinder the results.

I regret that you would think of eyeglasses as torture. They have served
us well for centuries. If she is significantly farsighted, and her eyes
turn in, then eyeglasses are universally prescribed before doing surgery.

DrG

 

A fairly large percentage of children whose eye(s) turn inward have
farsighted prescriptions, and respond well to eyeglasses. Surgery would
seem ill-advised if the eyeglasses correct the problem. I'm not sure how
successful strabismus surgery can be in the presence of accommodative
esotropia where eyeglasses have never been tried. At the end of the day,
there will still exist a significant uncorrected farsightedness that will
hinder the results.

I regret that you would think of eyeglasses as torture. They have served
us well for centuries. If she is significantly farsighted, and her eyes
turn in, then eyeglasses are universally prescribed before doing surgery.

DrG

 

A couple of thoughts:

1) Sounds like an Atropinized refraction would be important here, no?

2) If accommodative esotropia due to high farsightedness /is/ the issue with
Mr. Impelluso's daughter, would she be well served with:
a) A prescription close to full cycloplegic, and/or
b) bifocals (to minimize need for accommodation while reading)?

3) I don't remember catching this on Mr. Impelluso's original post, but it
seems significant whether his daughter was /born/ with this strabismus, no?
If she's a true congenital esotrope (therefore no fusion developed), it
would seem that alignment is mostly a cosmetic issue. Is this right?

Neil

 

I agree with every statement, except the one concerning bifocals for a 34
month/old child. Obviously, we don't know whether the child is an
accommodative esotrope. However, we do know that the child is an esotrope,
and we do know that she has been prescribed eyeglasses. I simply connected
the dots.

The question was one of whether the prescribing of eyeglasses was simply a
bromide thrown at the child until such time as surgery could be done.

DrG

 

Until then, my daughter must wear glasses... yeah!, right!

She is INTELLIGENT, great Italian stubborn female ascendant!!!

It is sad that her parents are sto stupid in insisting, BRIBING HER!!!

How stupid you must become before you wake up to understand that this
approach is completely wrong, and worsens the strain which is at the
very base of her problem?

problem.

They won't.

All methods of surgery are just COSMETIC.

This is the result of hundred of years of practice.

You ask your surgeon to sign a paper to you in which he guarantees the
good rfesult.

he won't sign anything, because he cannot predict how the child will
react to the surgery.

Chances are that she will be able to produce more strain and again a
strabismus.

Of course it is a torture.
You are the torture in the first place.

I have counselled you how to proceed.

You do not trust me, and you do not trust your very child.

What kind of father are you?

You prefer to believe in the idiot doctors, instead to respect your
precious child.

Shame on you.

 

Sorry I can't provide any answers to the OP's questions. My first thought
upon reading the post was that this is almost more of a parenting problem
than a vision problem. Kids around this age (3) can be very difficult.
It might be useful to communicate with other parents who have had to get
their kids used to glasses. I would suggest the newsgroup misc.kids, with
a very specific title (because I know they used to get a lot of traffic),
like "Glasses for 3YO", and a request as to whether there are any more
specific groups to post to.

 

Another place to look for parenting help would be the Yahoo group ann-list,
"support group for people affected by nystagmus ". If they don't have it
immediately available, ask the group for help. There are many parents
helping eachother with their children's nystagmus and they can be quite
chatty.

 

As I recall, I did send you a followup asking more about your opinion.
You did not respond to that.

Now you do.
And you do so with quite vulgar language.

Unless you can rephrase what you have said, and explain why you did not
respond to me personal email, that I am forced to question your dedication.

FYI: here is the personal email on sent you on 12/7/04 at 5:46PM PST.
Why did you not respond to that... yet respond by insulting me?


HELLO!

I am the dad in this case.
here is a picture of my daughter one week before
http://kahuna.sdsu.edu/~impellus/sofia/sofia.html

PLEASE CONTACT ME AND EMAIL WHAT INFORMATION YOU MIGHT WISH!!!!

Please.. I am bit anxoius

Tom Impelluso
(*MY* mom is from Bari and my dad is from Syracus by the way)

 

Also... the original post did say NOT to email me from the source
of this email, but to:



That email is here, sent on: 12/6/04 at 7:47 PST

----------------------------------------------------

Hello,

May I please solicit some advice?

(first a detailed background and then 2 questions)

On Saturday morning, my daughter (2 years, 9 months) suddenly woke up...
cross-eyed.

We have been to a doctor and an opthamalogist, and will see them again
in a few days, but I would like further input if it is possible, please.

There are two other issues:

1) at the age of 9 months, she fell from her crib and fractured her skull.
There was slight bleeding above the perineurium and beneath the skull.
But all healed on its own.
There was never any fainting, vomiting or any symptom.
She has been fine since.

2) on friday night (night before she woke up cross-eyed), she and I were
playing games staring into each other's eyes (basically, going
deliberately
cross-eyed.

The opthamalogist said that my daughter is slightly far sighted (unlike me
who is very near sighted), and the far sightedness is asymetrical. In such
cases, children try to compensate (hence the cross-eyed), and that it is
remotely possible that our cross-eye game the night before might have kicked
it in (but that I should not feel bad, I did not cause this, and it would
have
happened eventually).

Well the doctor wants us to get glasses for a few days, and if it all clears
up... likely that was it... if not... a CAT scan.

Now my wife's friend - who has good intent - has just told me:
1) It should be an MRI not a CAT scan.
2) the analysis above does not hold water... does not make sense
3) There may be damage to the sixth cranial nerve.

OK... could I have some comments please.
I am worrying and would like to calm down.

Please do not email... I get much junk email. Please respond to the
newsgroup.
Or email to:


Thank you,
Tom

 

1: It is unlikely that the fall from the crib 2 years ago is what
caused this.

2: Can you post the prescription for the glasses that were prescribed?

3: Ignore Rishi. He's a charlatan who continuously advocates
disproven methods. He is no different than the snake oil salesmen of
days gone by.

4: Consider a 2nd opinion from a different doctor. This does not seem
like it's a surgical case.

5: You should consider removing the nude pictures of your daughter.

nipidoc

 

The idiot-man who's speaking about "disproven" methods, should explain
why NO PARENT who is intelligent feels happy to put eyeglasses on a
child.

I hope this Mr. X will prove himself intelligent and tries the only
PROVEN method that works, that is, the method of central fixation.
http://TheCentralFixation.com

 

In a previous reply, I stated that farsighted prescriptions are
frequently associated with a turned eye, called accommodative
esotropia, for which the proper treatment is eyeglasses. Therefore,
the physician who treated your daughter was following the standard of
care. The physician was also following the standard of care by
ordering a CAT scan.

It would seem to me that close head trauma sufficient to cause damage
to the sixth cranial nerve would have caused the eye to turn in at the
time of the injury, and not two years later.

If you are uncomfortable with the treatment, then get a second opinion.

DrG

 

The little boy in the picture looks hydrocephalic.. is he?

J