questions

MotherhoodandPotatoes asked for the questions we asked at Zoe’s eye appointment about the surgery, so here they are:

  • Would bifocals or a stronger prescription help? We talked about the possibility of bifocals, but she really felt like it wasn’t a problem of Zoe crossing her eyes more up close, or that a change in prescription strenght would make a difference.
  • What does the surgery actually entail? She showed us how they would get to the inner eye muscles (through the whites of the eye) to loosen them. The actual procedure is an in-patient procedure that should take no longer than an hour. She will need to go under general anesthesia.
  • What are the chances of needing surgery again? About 15 – 20% of those who have the surgery will end up needing another surgery, often not until their teens or later.
  • Is there a chance that you could over-correct and her eyes would point out? Yes, that is a risk, though it would require loosening the muscles too much. She didn’t seem to think it was an issue.
  • What is recovery like? Kids are pretty out of it for the rest of the day after surgery. Some are kind of tired the next day, but a lot of them are up and running around. Her eyes will probably be red for a few weeks after the surgery, and for the first week, we need to avoid swimming and only do sponge baths.
  • When should the surgery happen? In what kind of time-frame? She wanted us to schedule the surgery before the end of the year. Chris remembered that Zoe’s daycare will be closed the last week of August and my mom will be here to help anyway, so we decided to go for that time, even though we could have waited a bit.
  • Can we take Zoe to the state fair at the end of the week after the surgery? The State Fair in MN is a very. big. deal. Skipping the state fair should not be taken lightly. Luckily, her ophthalmologist didn’t think there would be a problem since we would be waiting 5 – 6 days.
  • Will she still need glasses? Yep, the surgery doesn’t change the fact that she’s farsighted, though her prescription may change.
  • Where will the surgery take place? We had our choice of the Phillip’s Eye Institute or the Children’s Hospital, but our ophthalmologist works more closely with the Eye Institute, and since we wanted to schedule right away, that’s where we’re doing it.
  • Who will do the surgery? She said she could do it, or she could refer us to someone.
  • Have you done the surgery often? Yes, she’s been doing the surgery for over 20 years, and does them regularly. We decided that since we like our ophthalmologist and since she knows Zoe’s eyes the best, we’d have her perform the surgery.
  • Will she have depth perception after the surgery? That the hope. That’s why we’re doing the surgery, and many children do develop depth perception after the surgery since their eyes are now working together, but it isn’t certain. She told a story about a boy who underwent the surgery almost 20 years ago. She recently heard from his mother, he’s in the army now and has been awarded medals for sharpshooting.

Questions I wish we’d asked

  • How do you determine how much or how little to loosen the muscle?
  • What percentage of children regain depth perception after surgery?
  • How often does the surgery result in over correction?
  • What exactly will we need to do right after surgery to care for her eyes? I assume we’ll learn this at the surgery, if not before.
  • How often will she need to be examined after surgery for follow-up? I assume we’ll learn this at the surgery or right afterwards.

Update: I called the ophthalmologist’s office to get some information about what we needed to do before the surgery and ended up asking to talk to Zoe’s doctor.  I asked about how she knew how much to cut the muscles and how likely it was that her eyes would be over-corrected.  (The fear of her over-correcting her eyes is for some reason my biggest fear).  She was very understanding and reassuring and didn’t make me feel silly at all for asking.  Basically she said she was following standard guidelines based on how much Zoe’s eyes cross, and that she was being conservative in how she approached it.  She reiterated that she really felt this was the best treatment for Zoe right now, and that Zoe will still need glasses afterwards.  I’m feeling a bit better after our talk.

how did you know?

It’s one of the most common questions we get when people ask us about Zoe’s glasses: how did we have any idea that she needed the glasses? At first, I got tired of answering that question so many times, but then it occurred to me that many of the people asking were parents, worried that maybe they’d missed some test for their child’s eyesight, or that there might be some sign they didn’t know to look for. If they have a child young enough, and seem like they’d take kindly to it, sometimes I tell them about the Infantsee program, but usually that’s not the case, and I simply tell them our story, that Zoe’s eyes were crossed enough that there was no mistaking it.

So how about you? How did you know your child would need glasses — or what led you to have your child’s vision checked? I imagine the answers will vary quite a bit depending on the different vision problems.

glasses aren’t enough

Zoe had another eye appointment today, this time to follow-up on her new prescription. Unfortunately, while the doctor (and I) could see that the glasses were helping with her eyes, as the doctor said, it was only better, not perfect. As in all the other appointments, the doctor had Zoe look at a toy up close, and she would hold lenses up in front of Zoe’s glasses to see if the stronger prescription would straighten out her eyes. Unlike the other appointments, none of the lenses made any difference.

Zoes crossed eyes
Zoe's crossed eyes

So in essence, we’ve done as much as we can with glasses, and the doctor brought up surgery. I knew the possibility was there. When I was being honest with myself before the appointment, I knew that it was even likely, but it didn’t make it any easier to hear or think about. We asked a whole bunch of questions, and we’re satisfied that the surgery is our next step. The surgery is scheduled for a month from today. It is apparently an easy, outpatient surgery, probably less than an hour, with a recovery of one day.

I was really shaky and upset this morning after the appointment, but I’m slowly coming around to accept that this will be ok, that Zoe will be ok, and in fact, we’re hoping she’ll be better than ok, and her eyes will start to work together so that she can start developing binocular vision. That’s what this is about, right. This is about her, this is about getting Zoe what she needs for her vision. I keep trying to remind myself that we have so much to be grateful for, that she is healthy, that her strabismus is treatable, that we caught it early. But it’s hard, I had been so hoping that the glasses alone would be sufficient.

Zoe
Zoe

I suppose one good thing is that the discussions with the ophthalmologist pointed out just how much I’ve grown to love Zoe’s glasses – which was not always the case. This morning, when the eye doctor said Zoe would still need glasses after the surgery, I sighed a little sigh of relief that she’d get the keep wearing them, because I think she looks so dang cute in those specs.

Still, I won’t lie, I’m nervous, sad, and trying not to freak out.  If anyone’s gone through eye surgery with their kid, I’d love some reassurance.

Eyes crossing?

I know lots of kids wear glasses because of lazy eye and what not that causes their eyes to cross. But Sam is just really near sighted and has never had problems with is eyes crossing. Only, just this week he was sitting in my bed after just waking up that morning and talking to me. He hadn’t put his glasses on yet and I noticed when he looked at me, one eye turned in a little bit.

Could this just be from him trying to focus? As soon as I put his glasses on him, it went away. I don’t know what to think about it.

Glasses for children with Down syndrome

Knowing how few choices there are for frames for little kids — and that’s with us having a great children’s eye glasses store with better selection than most places — I can only imagine how much more difficult it must be to find good frames if your child has Down syndrome. Children with Down syndrome have different facial features, including smaller noses, wider faces, and a shorter depth from the eyes to the ears. This leads to frames that just don’t fit their faces well at all. Enter Maria Dellapina who is an optician and who has a daughter with Down syndrome. She created Erin’s World frames specifically designed to fit children with Down syndrome. They range in size from 38 to 43, with new models planned for babies and young children. While we don’t need these frames for Zoe, I’m very glad that someone has developed frames to fit the need.

little crossed eyes

Looking back, I’ve realized that I’ve taken fewer pictures of Zoe, and shared even fewer online. I’m pretty sure that this is largely because of her crossing her eyes, I’ve been more conscious about how she looks. Not that I’m ashamed of her, but I’m feeling self-conscious about whether I should have tried to get her in earlier when I noticed her eyes crossing again.

Zoe a few weeks before her eye appointment
Zoe a few weeks before her eye appointment

Once we’d had the appointment and learned new she needed a new (pretty dramatically higher) prescription, it’s been even harder to see her eyes moving in, knowing (well, hoping) that if only she had her new lenses, her eyes would be straighter. I was also a bit worried that she wouldn’t like the new lenses. I know how thrown off I get when I get new glasses with a new prescription, and hers is a much bigger jump than I’ve had. I worried that all the gains we’d made in her wearing her glasses so well might be undone.

I needn’t have worried. The lenses came in on Wednesday, and Chris got them Thursday afternoon. Zoe had been sent home early from daycare for a fever, so she wasn’t feeling well to begin with, but she didn’t seem to have any problem with the new lenses. I could immediately see that her eyes looked bigger with the stronger prescription. I was worried that her eyes didn’t seem much straighter that first evening.

First evening with her new lenses
First evening with her new lenses (um, please ignore the messy kitchen)

They look straighter now, though they still are a bit crossed. We have a follow-up appointment in 2 weeks, so we’ll see how she looks then.

Second day with the new lenses
Second day with the new lenses

6 months of glasses in numbers

  • too many to count: number of visits to the eye glasses store for adjustments
  • 6 or 7: the number of lens cleaning cloths scattered throughout the house for all of Zoe’s glasses cleansing desires (we also have a box of disposable cleaning cloths to help clean our glasses after her “cleanings”)
  • 5: number of lenses (replaced both for prescription updates, then replaced one for a scratch)
  • 4: the number of small glasses cases we have (one for each car, one for her bedroom, one for daycare)
  • 3: number of eye doctor appointments
  • 2: number of times something came off the frame that we had to get repaired (once the ear piece, once the nose piece, both easy and quick repairs)
  • …and probably the biggest surprise of all – 1: number of frames, I would have bet good money that she would have broken her frames at least once in 6 months.

what size glasses?

A reader, Amber, posted a question yesterday about what size glasses she should get for her son. I said I’d post it here and see what you all think. So I’m counting on everyone to have an opinion (we all know what they say about opinions, right?) and to share it. Here’s the question:

My 12 month old has just been prescribed glasses. Though you can’t tell by looking at him he has a lazy eye, Amblyopia. I have been to two different places to try on glasses for him, but just can’t decide. Our doctor says that his percription will probably change again when he comes back in 6 months. So, I don’t know if I should just get the ones that fit him the best now or if I should try to by a little bigger so that we can simply change the lenses in December. What do you suggest?

It’s kind of funny that this question came up, since I’ve been thinking a lot about replacing Zoe’s frames, what with her prescription changing, and the last time we took her in for an adjustment, the woman at the glasses shop said she thought Zoe’s glasses were getting too small for her face. But Saturday when we took Zoe in, the guy at the glasses shop said the frames looked like they still fit. And since her lenses are still under warranty for doctor changes, we’ll only pay half of the replacement costs for the lenses, as long as we don’t change the frames. Well that was an easy enough decision. I guess it all depends on who you ask.

Here’s the answer that I sent to Amber, but again, I hope you all will chime in with your thoughts and experiences:

Here are some things to think about, though I’m kind of muddling my way through this myself. The place where we got Zoe’s eyeglasses recommended not getting glasses with the earpieces that curve all the way around the ear, rather get ones that look like adult glasses, where the ear piece just curves down but doesn’t make a full C shape (hope that makes sense). They said that the glasses with the C curve tend to get outgrown more quickly. I know that some places specifically say not to get frames that are too big, as then they won’t be comfortable and your son won’t be as likely to wear them, and there’s probably some truth to that. But I think you could probably find frames that are a little big that would still fit now.

Another thing to think about is what the warranty offered on the frames and lenses is. Zoe’s lenses are covered such that if a prescription change happens in the first month, the lenses are replaced for free, and if the prescription change happens in 9 months, the lenses are replaced for half price, BUT you must keep the same frames. So for us it was definitely worth it to get frames that would last, since her prescription has change (both within the one month time, and just now at 6 months). That warranty was standard at the shop, and not an additional charge. However, it’s also worth considering how hard your son might be on the frames, and whether those are covered if he breaks them. For us, the frames aren’t covered at all, if they break, we have to buy new ones. So, if the glasses places don’t offer a warranty like that, and you find inexpensive frames that you like that fit your son, it may worth just going with those, just in case the frames are broken.

Ultimately, I think if I were in your place, I’d get frames a little big and hope they don’t break, but if you know your son is the type to be really rough with things like glasses (and let’s face it, he’s 1 and why would he know any better?), maybe just get the ones that fit him now.

For reference, here is a picture of Zoe in her glasses on Jan 6, and again Jun 8, so you can see how she’s grown into the frames (they look really tiny in the Jun 8 picture, but they really don’t look that small in person):

Zoe in glasses, Jan. 6
Zoe in glasses, Jan. 6
Zoe in glasses, Jun 8
Zoe in glasses, Jun 8

putting the library degree to good use

Zoe had her ophthalmologist appointment on Friday. I’d noticed that her eyes were crossing again, even with glasses, so I was expecting her prescription to increase, and indeed, it did. As her ophthalmologist was writing out her new prescription, she warned us that “this is going to look like a big change in her prescription. . . because it is a big change in her prescription.” Um, thanks for that. She went from +4.5 to +5.75 in the left eye, and from +4.75 to +6.00 in the right eye. I think it worried Chris more than it worried me, since I was hoping to hear that her prescription was off, and that’s why she was crossing her eyes again. Her ophthalmologist didn’t seem too concerned that her prescription had gotten worse, and didn’t see any reason why her eyes should keep getting worse, but I don’t think that made Chris feel any better. And once he mentioned to me how he was worried that her eyesight might keep deteriorating, I admit, I got a bit worried.

So I turned to PubMed and did a bunch of searches to try to find a bit of reassurance. The big thing I learned was reassuring – a study of 126 kids with Zoe’s condition found that all of the kids had their eyes get worse (need a stronger prescription) at first, followed by them getting better a few years later. The bad news being that the earlier the condition occurs, the worse their eyes get before getting better, and the younger kids also show less improvement. Link to the abstract for the study – I don’t have access to the full text, though I can easily get that if anyone is interested in it.

Along the way, I learned a lot about searching the opthalmologic and optometric literature – which may well be of interest only to librarians, but here goes:Continue reading “putting the library degree to good use”

More on Costco

Happy last day of June!  I’m back from picking up Franklin’s SpongeBob glasses at Costco and have a report:  Costco is gearing up for the school year (as I’m sure many places are), so their selection of children’s glasses is really good right now.  I saw many styles to choose from and many more smaller sized frames than I’ve seen before.  You know the frame measurement, like 45, 46, 50, etc?  (If you don’t, that means the mm’s measured from corner to corner.)  Franklin’s two frames are 45 and 47…the 47’s are a bit big, but they’re the SpongeBob ones.  Anyway, I didn’t see many 45’s before but today they had several … even some 43’s and 44’s!  So, if you’re thinking about trying for that cheap second pair, now *might* be the time!  (and you know, I do shop other places, people must think Costco is paying me or something.  HA!)

request for advice

Just got this comment from Melinda, mother of Reid, who is in our photo gallery.  He just turned 1 and has been wearing glasses for 3 months.  I wasn’t sure if others would see it in the comments, so I wanted to repost it here:

I am still new at this and have yet to find a way to get Reid to keep his glasses on for longer than an hour or two. Any suggestions are greately accepted. I’m excited to have this blog favorited and know other parents that are dealing with young children and the adventure of glasses.

So, let’s have your best tips for getting kids to keep their glasses on for extended periods of time.

Just when a person starts to relax…

About a week ago now, Franklin came home with the weirdest glasses-related wound I’ve ever seen (look under his left eye).  Apparently, one of the girls at daycare somehow hit his glasses with her shoulder and jammed them right up into his cheek.  Details are fuzzy, but the resulting cut was very strange.  Has anyone else seen anything like this?  It was like the bottom part of his glasses cut into his cheek and left several slices or crack-like cuts.  The lenses don’t feel sharp, but I don’t know how else this could have happened.  We actually thought it would bruise worse than it did, it was mostly this little ridge of crease-cuts.  In all my years of glasses, I’ve never seen anything like it.  Maybe the glass created the cuts by rug-burn?  I’m not sure, it’s just weird.

And in another glasses-related incident, I congratulated myself this morning for having the foresight to purchase Franklin two pairs of frames.  He was outside in our back yard, took off his glasses (despite the nerd strap, errrrrr), set them on the concrete patio lens-side down, and then sat on them.  They weren’t just surface scratched, they had canyons of scratches dug into them.  I was so mad I just about lost it, but hey, what can you do?  LUCKY FOR ME, these were the SpongeBob frames we bought at Costco, so I marched them right over and they’re getting new lenses (for FREE) in about 2 weeks.  It made Franklin sad that he couldn’t see SpongeBob for TWO WHOLE WEEKS, so maybe this will be a good lesson for him.  We’re back to Jimmy Neutron in the meantime, and again, Thank You Costco.  🙂

dancing eyes

When Zoe first got glasses, I expected lots of questions from strangers, I worried that people would just focus on her glasses, and even make rude or unkind comments, I believed that most reactions would in any case, be well-intentioned.  What I hadn’t expected was the number of people who have said that they had had glasses, eye patches, and/or surgery to treat strabismus.  I always find myself searching their faces, trying to see if there is any hint of crossed eyes, which for the most part there is not.  Then I worry that I’m being rude, but I can’t help myself from looking for a glimpse of what may be Zoe’s future eyes.  One woman told me that she’d had glasses and two surgeries to correct her crossed eyes, but that her eyes still cross when she’s tired, and that it’s hard to look at people like Zoe (Zoe’s eyes were crossing a bit that day), because her eyes want to “dance along with theirs.”

(while we get lots of questions and comments, they have all been well-intentioned, or at least not unkind).

CNN story on glasses and eye patches for kids

I just found this story on CNN via the Bright Eyes blog. It’s about glasses and eye patches for kids. They talk about the Bjort & Company’s “Eye Patch Kid” video. I love the story about how the video came to be – their 2 year old son was resisting eye patches until he saw a pirate video, at which point he tried to put on the eye patch by himself. It confirms my longstanding belief that pirates really do make everything better. In any case, this led to the idea of making a video to help make wearing glasses and eye patches more fun. The article continues to talk about kids and contacts and LASIK surgery, neither of which I’m ready to even begin thinking about right now.

As an aside, Bjort & Company also have kids’ shirts and accessories for kids with glasses or eye patches (also others for kids with food allergies).

Poseur

Franklin in his new play house Well, I’ve been reading everyone’s posts lately and enjoying the new look and picture gallery (nicely done, Ann Z!), and I have to admit, I feel like such a poseur.  As in, “What am I doing on this site?”, I can’t even imagine what it must be like to deal with what most of you have gone through with your little ones.  Franklin didn’t need glasses until he was 3 and at that point, you can reason with a child and talk to them about glasses and why they need them.  I’m just amazed at the smart ideas you all have about dealing with your babies and their eyewear!  WOW.  You guys are my heroes, way to be good moms!

But then it occurred to me today that maybe there’s hope in my feelings of inadequacy.  As in “Hey, it’s such a non-issue in my family now, maybe this is what you all can look forward to!” (and I certainly hope so)  Franklin has 2 friends with glasses, and working with kids as I do, I see little kids with glasses all the time.  I have at least 3 kids who come to my storytimes at the library with glasses, and they’re all under 4.  In fact, I have this one little girl named Lucia who comes into my library with her hot pink frames w/ rhinestones, and I heard another little girl comment to her one day, “I wish I could wear your glasses, they are so pretty!”  The good thing is kids are getting diagnosed earlier and earlier with vision issues, so more and more kids are wearing glasses.  Especially with computer games and TV exposure (not that I would ever let Franklin play a video game or watch TV….HA, not), glasses are pretty much mainstream now.

My wish for all you guys with little Little Four Eyes is that these early years go well with minimal emotional stress, and that all our kids learn to appreciate how amazing it is that they can wear something as simple as glasses to fix something as major as vision.   But until then, GOOD LUCK and Thank God for warranties.