Glasses for 5 year-old twins?

Discussion in 'Glasses' started by Pat Coghlan, Aug 23, 2006.

  1. Pat Coghlan

    otisbrown Guest

    Dear Pat,

    As I said -- you will encounter strong opinions about
    a child's refractive STATE of +1.75 diotpers.

    There seems to be no overt problem -- that the OD
    could articulate.

    I would agree with the ophthamologist -- in his recommendation
    that no plus be applied at this point.

    None of us will know of your choice -- and that is up to
    you -- clearly.

    Also, was the recommendation that the child
    wear the +1.75 diopter all the time.

    Or was it ONLY for reading.

    You should ask the OD that quesiton -- and ask
    why.

    Otis
     
    otisbrown, Aug 25, 2006
    #21
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  2. Pat Coghlan

    Pat Coghlan Guest

    I negelected to mention that they actually saw TWO opthamologists back
    after the OD 2 years ago. Both suggested not getting glasses for them.

    I'm not *ignoring* the information from the optometrist. I go to her
    myself and she has me seeing very clearly :) However, my gut feeling
    is that it's not as cut-and-dry when it comes to young children -
    especially mine - that's why I'm also looking for input here.

    Reading isn't a problem. They've been able to read for about a year
    now, and would be able to read this message :)

    I just want to make sure that I make the right decision to give them the
    best possible outcome, which would include getting glasses for them if
    there was a risk of one eye becoming lazy etc.

    I didn't want to bring up the ethics issue, but ODs here in Ontario get
    a small fee from the province for an eye exam and make most of their
    money from the sale of prescription eyewear. She seemed very anxious
    for me to look at frames while we were in the office, but I'm not going
    to be rushed into a decision.

    I'm surprised at the number of barbs thrown in this discussion. While
    this may not be an *exact* science, but it is a science, isn't it???
     
    Pat Coghlan, Aug 25, 2006
    #22
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  3. Pat Coghlan

    otisbrown Guest

    Dear Pat,

    The refractive STATE of the eye will "move positive" if you
    place a +1.75 diopter on it -- and wear it all the time.

    In this case the childs vision went from about +2.0 diopters
    to +3.25 diopter in eight months.

    This is probably why the ophthamologist recommended that the
    twins not wear the "plus" at this point.

    But that is why their must be a second-opinion -- and that
    you have a choice in this matter.

    The "name calling" that goes on about your right to an informed,
    competent second-opinion is NOT PROFESSIONAL.

    Best,

    Otis

    ++++++++++++++++++++++

    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.med.vision/browse_thread/t
    hread/a6...


    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?


    Thanks
     
    otisbrown, Aug 25, 2006
    #23
  4. Pat Coghlan

    Ace Guest

    I want to point out that her own optometrists both opted NOT to
    prescribe your sons glasses. I am not a doctor and have no say in this.
    Otis isnt a doctor either and is marely explaining the eye from an
    engineer's point, not a medical point. What Otis is saying is to listen
    to your second opinion optometrist who said NO to glasses for your sons.
     
    Ace, Aug 25, 2006
    #24
  5. Pat Coghlan

    Simon Dean Guest

    Not that Im a doctor or nowt, but, I can read this message too. But with
    a pair of just weak reading glasses of about +.75 and an astigmatism
    correction of -.50 in each eye, I can see even better.

    The text it sharp, in focus, edges are no longer fuzzy.

    They *may* be able to read, but they will probably read better WITH
    glasses.

    You could do what I did, and just get a cheap pair made up and see if
    the kids notice anything different. You don't have to make them keep
    wearing the glasses!


    Not a good situation. In the UK, you're under no obligation to buy
    glasses from whoever did the eye test - well, maybe some of the smaller
    independants do (though Im not saying they're all bad). Over here, we
    have a chain called SpecSavers, who give you your Rx and I can then go
    away and get them from somewhere else if I want.

    You could find a different optician and see if the results agree if its
    that important?

    Cya
    Simon
     
    Simon Dean, Aug 25, 2006
    #25
  6. Pat Coghlan

    Pat Coghlan Guest

    The OD suggested that they be worn most of the time, else they would be
    tempted not to wear them since they can see okay without them.
     
    Pat Coghlan, Aug 25, 2006
    #26
  7. Pat Coghlan

    Simon Dean Guest

    Does the situation change when you become adult? I have a low reading
    for hyperopia, but the optician said I didn't need glasses, only if I
    had a problem.

    Why shouldn't the same apply to children?
     
    Simon Dean, Aug 26, 2006
    #27
  8. Pat Coghlan

    Ace Guest


    My point exactly. As long as they have no trouble seeing and no
    symptoms, glasses are useless. If I were hyperopic and glasses did
    nothing, why_would_I_wear them?
     
    Ace, Aug 26, 2006
    #28
  9. Pat Coghlan

    Simon Dean Guest

    I saw what you wrote to Ace. Yes, Children don't have a valid point of
    reference and do not know what's best for them.

    Sounds like me to be honest though. Im 29, and as I said in another
    thread, I think Im about +.75 in each eye, and ok, I have a slight -.50
    astigmatism, but even at these small values, the difference the glasses
    make are unbelievable.

    They really do bring everything into sharp focus and get rid of eye
    strain and ease fatigue.

    Cheers
    Simon
     
    Simon Dean, Aug 26, 2006
    #29
  10. Pat Coghlan

    Pat Coghlan Guest

    I also have slight astigmatism in roughly the same range, but only lost
    the ability to accomodate after about age 40. Prior to that, my vision
    was 20/17 in my best eye.

    Young children can probably accomodate such variations more easily.
     
    Pat Coghlan, Aug 26, 2006
    #30
  11. For small amounts, you are quite right. Your kids apparently have an
    amount of hyperopia that is on the borderline between a small and a
    moderat amount. We probably wouldn't be having this discussion if they
    were +.75 or +4.00. By far most authorities wouldn't Rx for the former
    and would for the latter for little kids. It's that pesky borderline
    situation that warrant discussion and consideration. The biggest
    problem on s.m.v. is that we have a couple of guys who disagree with
    mainstream modern eyecare and prescribing. I wouldn't have any problem
    with that, except that neither of them has any formal education in the
    subject, only some highly questionable self-education. If they could
    find a single o.d., m.d., or Ph.d. in the eye field come on this forum
    and support their positions, now there would be a good discussion.

    But they can't find even one to do so.
     
    William Stacy, Aug 26, 2006
    #31
  12. Pat Coghlan

    otisbrown Guest

    Dear Pat,

    You came to S.M.V looking for the second-opinion -- that was
    already confirmed by two ophthamologists.

    You can, if you wish, follow the OD majority opinion, and
    place the twins in a +1.75 dipoters plus -- which they will
    wear all the time.

    The opthamologists who SUGGESTED that you kids
    not wear the +1.75 diopters -- do not have time to
    post on s.m.v. The have job to do, and their own
    children and grandchildren to worry about.

    On most medical subjects (if the natural eye's proven behavior
    is even "medicine) you will find two opinions -- often profoundly
    contradictory.

    The point is to identify these opinions -- and make your choice
    accordingly.

    To read some more of this "second opinion" I would suggest reading:

    www.chinamyopia.org

    Steve Leung OD simply does not have time to come
    on s.m.v. He has his hands full helping his own children.
    That is how it should be.

    If you keep the "plus" off the twins, then their refractive STATE
    will "move" slowly down, to 1.5, then 1.0, then +0.75 then
    0.5 diopters. This is a normal process -- and you can monitor
    if you wish.

    Under specific circumstances, when their refractive STATE is +0.5
    diopters,
    and in school, I do argue that at that point, the plus could be used --
    for
    prevention.

    But these are the nature of scientific arguments.

    For now, I would consider following the advice of the
    two ophthamologists you consulted.

    Best,

    Otis
     
    otisbrown, Aug 26, 2006
    #32
  13. Pat Coghlan

    Pat Coghlan Guest

    Once we get an appointment, I'll post his recommendation and reasoning
    here. The last second opinion was 2 years ago. Now that they are
    turning 6 and starting grade 1, he may have a different recommendation.

    There's certainly no urgency to rush them into corrective lenses today :)
     
    Pat Coghlan, Aug 26, 2006
    #33
  14. Pat Coghlan

    otisbrown Guest

    Mike,

    Please keep the subject -- on topic.

    In case you forgot -- these are NOT COLLEGE KIDS.

    They are 5 year-olds with normal refractive STATES of
    +1.75 diopters.

    The optometrists recommend NO PLUS AT THIS POINT -- and
    you seem to insist that these twins wear a +1.75 diopter
    16 hours a day, 7 days a week -- forever.

    I personally think that is a bad idea -- for this SPECIFIC
    situation -- as do two highly qualified medical doctors.

    That is the issue for Pat to review.

    Otis
     
    otisbrown, Aug 26, 2006
    #34
  15. Pat Coghlan

    otisbrown Guest

    A wise choice.

    As long as the twins have good visual-acuity -- there is no
    reason to take any action -- unless the ophthamologists
    should recommend it.

    Otis
     
    otisbrown, Aug 26, 2006
    #35
  16. Pat Coghlan

    CatmanX Guest


    Actually, yo are ignoring the optoms advice as you haven't acted. The 2
    ophthals are only saying they don't need glasses as the eyes are
    straight and they can read the bottom line of the chart. They have
    taken no readings on how your children's eyes perform up close, which,
    to me, as a paediatric optom, is the major thing of importance here.


    Au contrair mon petite. The ability to read and the capacity to sustain
    the activity are 2 separate issues. One is the processing of visual
    code, the other is the ability to contract a muscle for a lengthy
    period of time. With a script of +1.75, your children have to do 50-60%
    more work to get things clear up close than the kid sitting next to
    them in class. Try putting a bag full of books on your back and walk
    around with it on all day and see how you feel. The problems we get
    from moderate levels of hyperopia are fatigue and avoidance, not blur
    and can't read. Additionally, there is the issue of the script. +1.75
    is not necessarily the full prescription. Thet may be +3.00 or +4.00
    and the optom has only given a script of +1.75, which is what I would
    do in the same circumstance.
    You can't give them a lazy eye from glasses in this case, nor will they
    develop one if they don't get them. This is not the issue for your
    children. The correct script will enable the to get maximal
    comprehension from the text they read, no glasses may well cause them
    to not get as much information from the text, which can lead to poor
    academic performance down the track. While I am not specifically
    advocating glasses here, this is the area which I spend most of my time
    on and an appropriate assessment of the children is critical. If you
    want a second opinion, look up a COVD fellow at www.covd.org that is in
    your area. http://www.covd.org/membersearch.asp?cn=CA


    I only think about the welfare of your children, I make no money from
    advice here, in my practice, I only concern myself with the welfare of
    my patient and what is best and make my recommendations. I only have a
    script of +1.00 and I actually stopped reading in grade 1 due to the
    same issue of eyestrain. I was 28 before I realised I had a problem and
    that I hadn't read a book since then.
    There is a lot of interpretation of what constitutes vision. We also
    have a few non-professionals here who like to scare-monger that you
    will damage your children's eyes. They post fictitious accounts and
    have no basis to make these posts, but they like to think they are
    saving your soul from the damnation of glasses. One absolute guarantee
    I can make to you is that reading glasses will not do any harm to your
    children in any way.

    All the best.

    dr grant FCOVD FACBO (Yep I am actually an accredited children's
    specialist)
     
    CatmanX, Aug 26, 2006
    #36
  17. Pat Coghlan

    Ann Guest

    They haven't been seen by the optometrist yet. The poster keeps
    telling you that and you just ignore it.

    Ann


    -- and
     
    Ann, Aug 26, 2006
    #37
  18. Pat Coghlan

    Ace Guest


    You have a spherical equivalent of only +.5 but for someone like you
    with poor accomodation, your vision will be blurry at all distances and
    you wont be able to read without reading glasses or plus. You might be
    able to strain to accomodate in the distance enough to pump out a
    couple 20/20 guesses but your eyes will quickly fatigue and your head
    hurt from the strain.

    I am not gonna label you as picky because its much worse to be
    farsighted than nearsighted. Myopes like me see perfect from near,
    whereas hyperopes see extremely blurry from near. Also myopes can go
    without correction and almost never get headaches, in fact to the
    courty(spell?) minus glasses *can* give headaches, especially if they
    are just a bit too strong! The reason is accomodating places a strain
    and being myopic relaxes all accomodation. When I get orthoK and reduce
    my -4.5 myopia, I will go without glasses most of the time like my -1
    bro never wears glasses except to drive.
     
    Ace, Aug 27, 2006
    #38
  19. Pat Coghlan

    Simon Dean Guest

    What the hell are you drivelling on about?

    Where are you getting this garbage from?

    Stop playing doctor and find a train track to play on.

    Cya
    Simon
     
    Simon Dean, Aug 27, 2006
    #39
  20. Pat Coghlan

    CatmanX Guest

    Sorry Simon, we know he is a deadshit, but can't do much about it.
    Sooner or later he will brainfart and implode.

    grant
     
    CatmanX, Aug 27, 2006
    #40
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