strabismus, glasses not working

Discussion in 'Glasses' started by Bogo, Aug 15, 2006.

  1. Bogo

    Bogo Guest

    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....st&q="four+years+old"&rnum=5#1571523d8d36a772

    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, Aug 15, 2006
    #1
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  2. 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.
     
    William Stacy, Aug 15, 2006
    #2
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  3. Bogo

    otisbrown Guest

    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.
     
    otisbrown, Aug 17, 2006
    #3
  4. Bogo

    p.clarkii Guest

    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?
     
    p.clarkii, Aug 17, 2006
    #4
  5. 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
     
    David Robins, MD, Aug 17, 2006
    #5
  6. Bogo

    Neil Brooks Guest

    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!)
     
    Neil Brooks, Aug 24, 2006
    #6
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