My daughter’s pediatrician first noticed a crossed eye at her 9 month check up. But, she only saw it once and thought maybe it was pseudo strabismus. Of course then I started to notice it more and more-then at her 12 month check up they referred us to several Ophthalmologists. We chose the only Pediatric Ophthalmologist in the area and it took over 2 months to be seen.
The eye exam was torture!
Mckenna, now 15 months, does not like strangers to touch her. They put drops in her eyes and then we waited and waited to be seen again. Once we were brought back she didn’t want anything to do with the exam. After laying her down and holding her arms down, the doc peeled open her eyes to look at them. I have never heard my daughter cry like that! I make my husband take her to her vaccine appointments! But the minute he was done touching her she was ok. I was still upset- but she was ok. He said that we should try glasses and for me to look up the eye muscle surgery on his website. I was very confused at this point. I asked about an eye patch and he said that that was for vision- that confused me even more! We scheduled a follow-up appointment and in a whirlwind it was over. Later that afternoon, after I calmed down, I realized that I hadn’t even gotten a diagnosis from the PO! All I could process was that he said her eye is crossing in and that she isn’t using it or else she would have double vision. The sad thing is that I work in the medical field!! Well, I looked up everything I could about Strabismus and Amblyopia. Since the rx he wrote out was for +4 in both eyes, I concluded that she was farsighted. Also that since her eye crosses in occasionally, seemingly due to farsightedness I figured it sounded like Esotropia. I called the doc back the next day and turned out I was right- Left eye Esotropia (possibly accommodative). The only thing that leaves me wondering is that he said she wasn’t using that eye- but the consult note doesn’t say anything about Lazy eye. Also, she does move that eye- and today her left eye was straight and right was pulled in. He did however write the rx as +4 for both eyes- so it is quite confusing. I will trust him though. My husband wanted to pummel him however.
I really do not want her to have the eye muscle surgery. I did see successful stories on this site though, so that makes me feel better. But, with Accommodative Esotropia, I have read that if glasses work that surgery is never to be done. Also, that if the eyes do not become perfectly straight they still would not be working together and could revert back to crossing or amblyopia, that is why multiple surgeries would be required.
My daughter is pretty petite and the PO had specifics about the glasses she should wear. Zyl plastic with no nose pads. OK? So we took her to Sears Optical and they gave us measurements for her glasses (they did not have anything that small). So I stopped by a few places to no avail and then began my search online. Needless to say I had a few 4 a.m. evenings looking for glasses. The Optometrist said that the temple length doesn’t have to be perfect- If a wire frames he could cut and curve them into cable temples; and with plastic frames although he cannot cut them he can still curve them to cable temples to fit around her ears. That helped a lot!! I did not want crazy glasses for her! I found a very stylish pair at www.icframes.com and they weren’t terribly priced. Once I am sure they fit I will buy another pair for a backup. Nice thing is is that we are getting the lenses for free!! Sears HOOKUP!! I am anxious for them to come.
We have been practicing with tinker bell sunglasses for a couple of weeks now. We put them on and I tell her how beautiful she is and I clap. Then she hands them to me and I put them on- they look much better on her! Today she actually put them on and crawled around for almost a minute! They were slipping so I think then she remembered they were there and she took them off. With her fitted glasses, our hope is that they fit snug enough that she forgets they are there. She even crawled over to her play area and brought me the glasses to put on her the other day!
Here is hoping that she DOES wear her glasses and that they help her!!
I talk quite a bit and I have loads more to say so bear with me.
Thanks again Ann for making this site! It provided me with a lot of information in my search the first nights of concern and confusion!!
For Little Eyes 
Yes, it’s confusing at first with all the terminology! I guess it is hard to measure the exact prescription for a baby (my daughter was 4 months at her first PO exam and 7 months with her first pair of glasses) so for us, it was a lot of trying out different prescriptions to see how it helps her strabismus. I can understand your point about getting answers from the PO. For us, we wanted to know exactly what has to be done, etc, and it seems that generally isn’t the case!
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Communication is such a key in feeling empowered to move on. My son has accomodative esotropia, dx’d at about 28 months – my understanding is that it’s medicalese for lazy eye ? anyway he is farsighted too and one eye would often turn in when he was doing close-up work – usually the right eye, but sometimes the other one too.
Patching has been a big part of our regimen – we started with 5 hours/day and were monitored every 2.5 months or so by the PO’s assistant, with an apt w/ the PO to adjust DS’s perscription. Patching time has gradually decreased and we are now on 1 h/day, with the possibilty that we won’t need the patch any more in a few months. My son’s eyes have really straightened out (though I still notice some crossing when he’s tired).
I don’t understand why patching hasn’t been discussed for you, although perhaps since you’ve discovered this with your daughter so young, glasses may be all that you need to correct the crossing? I believe just glasses work for many people, so let’s hope that’s the case for you.
Andie
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Andie, I did ask about patching and the PO said that that was for vision. I of course was confused at that statement because it was my understanding that glasses were for vision. But I realized later that I had the wrong idea about lazy eye. In my daughters case, her vision is poor and causing the one eye and sometimes the other to cross in to find focus. He mentioned that the one that crossed in the most “she wasn’t using” or lazy. Though she does use it and he didn’t mention anything about amblyopia in her consult report. Even with that, because he is saying she is farsighted, the hope is that the glasses will enhance her vision, decreasing the need for her eye to cross, and hopefully allow the brain to receive images from that eye more frequently. If we find that the glasses help with the crossing though he still sees some amblyopia I am sure that the next step would be patching.
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Thank you so much for posting this, those first appointments are so hard – I remember trying desperately to focus on what the ophthalmologist was saying while trying to hang on to a screaming child at the same time (she hated having the light shined in her eyes).
Andie, accomodative esotropia is not the same as lazy eye (amblyopia), but they are very closely correlated. Basically, having accomodative esotropia puts a person at very high risk of developing a lazy eye as the brain starts to turn off input from one eye to keep from seeing double.
Amblyopia “involves lowered visual acuity (clarity of sight) in one eye which can not be corrected by glasses or contact lenses.” (http://www.children-special-needs.org/vocvis.html), which is why patching is indicated, since glasses don’t completely solve the problem – the problem is more that the brain isn’t recognizing fully the visual inputs from the eye.
For Zoe, they determined at her first appointment, that both eyes were equally dominant, and her vision was correctable with glasses. So no patching for us, and I’m hoping that the glasses and surgery will have her eyes aligned so that she doesn’t suppress vision from one eye and develop amblyopia.
You asked about accomodative esotropia and surgery. You’re right, for purely accomodative esotropia, surgery is not indicated. Zoe has what I read referred to as “Partly accomodative esotropia” which means that part of her eyes crossing is due to being farsighted, but part of it is not. The surgery only corrects that cross that is not resolved by the glasses. So Zoe still crosses her eyes when her glasses are off.
Good luck with the glasses! I can’t wait to see Mckenna with them on, and I think it’s awesome what you’re doing to get her prepared. And how did you get that Sears hookup anyway??
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Ann Z- I understand about the eye muscle surgery for Zoe now since you said that the glasses corrected a lot of the crossing and for what it didn’t correct- the surgery fixed. I read that if glasses fix the crossing with accommodative esotropia then surgery is never recommended. But with Zoe it didn’t “fix” it.
Ah, I made an error in my original post. I said that I got her glasses from icframes.com however I actually got them from theyedoctor.com. I looked at so many!!! That is the site with the awesome search engine, that really helped out. You can pick the sizes, material (plastic, wire), shape, color and more!! The only real trouble I have had with ordering online is that I found that most of the sites are drop-shippers. They order from the manufacturer and then send them to the buyer, so it takes 2+ weeks to get the frames. It would take even longer if you ordered the lenses as well. The option for faster shipping would be a waste of money because you are only speeding up the shipment from the drop-shippers site. They have to still wait to get the frames from the manufacturer which you have no control over.
McKennas frames are supposed to be shipped to me today and I am really anxious to see if they fit properly. If they do then we are taking them to Sears ASAP to then be sent out to have the lenses put it- that is another 5 days- ugh!!
Oh, Ann- My husband is a Marketing Manager at Sears and is chummy with a lot of the guys there. Comes in handy!! We get great deals on stuff. Though I don’t think we really needed a BBQ grill that you can put 40 burgers and grill shrimp with. But, hey it was $150 for us vs. the original $480.
I will post information when we get the frames- and ofcourse a picture!! Even without the lenses- LOL!
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Ann Z, thanks for explaining about the link btw accomodative esotropia & lazy eye. It’s been awhile since I first obsessively researched everything, so I think I only stored up the info that impacts us directly.
I know my son is farsighted (that’s why we have glasses) and they were hoping just glasses would be enough, but his eyes were still quite crossed so we went onto the patch – with surgery in the wings if that didn’t work. The patch is to help the weaker eye get strong, so obviously one eye was weaker than the other. I wonder if the brain had started turning off signals and that’s why, or if it’s a physical thing and the eye has to work out its focusing muscles. Well, as long as it works!
Now that we are on 1 h/ day I see more crossing in the evenings than I used to. I am wondering if I should go to 2 h/day one day, and 1 h/day the next … or just keep on at 1h/day until I see the PO’s assistant. Or see if I can get DS to sleep more, so the eyes don’t cross so much when he is tired!
I’ve noticed DS’s lenses are pretty scratched up now, and the cable temple comes off every so often (we go into the optometrists’ and they glue it back on for us). I think we should get him a new pair … but w/ DH out of work for the past several months, now is not the best time. I feel guilty and sad about it. We’re in the phase of the job hunt again where we’ve been in suspense for a week plus, waiting to hear if *this* opportunity will be the one … so I keep putting off the new glasses in the hopes that we’ll have money coming in again soon (and benefits too). Not that DS has complained, but I can see the scraches when I clean his glasses. I know that’s kind of off topic, but I hope you don’t mind me sharing how this extra stress of my sweetie in glasses feels, when going through normal life …
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https://toddlerglasses.wordpress.com/2008/10/17/our-first-eye-appointment-eek/
If your child is +4 in both eyes, then I don’t think your child has amblyopia. Almost by definition, amblyopia means the 2 eyes are different. You can read about it here.
http://www.kidslike.info/how_to_treat_your_childs_amblyopia
The article has describes how one family treated their 6-year-old child with computer games and sports like homemade bowling. The child went from 20/400 to 20/20 in 4 months.
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