Vision Intervention Part 2: In Which We Head to the Doctor and Get a Diagnosis

by Andrea on August 7, 2012

This picture of my little Anabel was taken a week after we went to see a pediatric opthalmologist for the first time. We were headed to pick up her very first pair of glasses. It felt like a long time in coming. After all, it had taken me (her own mother!) months to realize Anabel had a serious vision issue that needed to be dealt with. You can read about that in “Part 1: In Which I Discover My Child Has a Vision Problem”.

When we finally saw the ophthalmologist Anabel was a month shy of 5 and a half. From what I could tell, the vision in her right eye seemed pretty good. Indeed, her visual acuity in that eye was determined to be 20/30. Not bad at all. The left eye was my concern. At home, I tried having her cover one eye at a time to determine what she could see. If  her “good” eye was covered and she tried to look at something with only her left eye, she simply couldn’t.

It turns out, the visual acuity in her left eye was 20/400! Simply put, this means the smallest letter Anabel could see at 20 feet away could be seen by a person with normal 20/20 vision at 400 feet away! Comparatively, if I can read a sign easily at 30 feet away, Anabel would have to be a foot and a half away from it to see it as clearly, at least with her left eye.

Thanks to the fact her right eye could see very well, Anabel had learned to compensate for low or double vision by squinting and blocking out the vision in the weaker eye and was able to function very well. Her ability to do so was one of the reasons it took me so long to catch on to the fact she had a problem at all.

Anabel has likely had impaired vision since birth. I couldn’t help but wonder how almost 5 years had gone by before we even noticed there was any kind of issue with her vision. It took a while for an obvious symptom like her crossed eye to manifest itself. Because her brain was receiving two different images from her eyes, she began to compensate in order to avoid double vision. Her eye began to cross in an attempt to focus.

Squinting was the only clue we might have picked up on earlier but nothing about her smile seemed abnormal. She was just cute. And she is our 5th child. None of her 4 older siblings wear glasses. Neither my husband or I wear glasses. Intentionally looking for clues to a vision problem simply wasn’t on my radar. But there were clues, albeit tiny ones. In reality, she squinted in an attempt to focus or shut out the visual information, and her brain began to ignore the left eye altogether.

Early intervention for children is so important! Because Anabel relied on the right eye alone, the vision in her left eye grew worse over time. Sadly, if we never intervened, she could eventually have suffered permanent loss of vision in that eye. How I wish we had her vision tested sooner! But hindsight, as they say, is 20/20 (pun intended) and I know that our story can reach other people and hopefully help someone else.

After a thorough examination it was determined she has astigmatism (she’s far-sighted) and strabismus, causing amblyopia. (For basic information about strabismus, see below). The doctor prescribed glasses and told me  to come back with her in 3 months. At that time, she would determine whether or not Anabel would need to patch the right eye (her good eye) and force the brain to pay attention to the left eye. Prescription in hand, my little girl and I headed to pick out her very first pair of glasses. And that’s when I made a big mistake.

To be continued in Part 3: In Which I Learn an Important Lesson About Buying Kids’ Glasses.

About Strabismus: Strabismus is when the eyes are not aligned correctly and point in different directions. The eye turn might be constant or it might come and go as is the case with Anabel. One eye might look straight ahead while the other eye may be turning inward (Anabel’s eye), outward, upward, or downward. Strabismus is commonly mistaken as lazy-eye. It’s actually not, but it can be one of the causes of amblyopia, which is commonly referred to as lazy-eye. For a child with strabismus, the straight(er) eye becomes dominant because the connection between the eye and the brain is functioning well. The weaker, misaligned eye continues to grow weaker because the connection between the eye and brain is not forming correctly. The brain will simply ignore or suppress the images from this eye in order to make sense of the images it’s receiving. This suppression is what leads to amblyopia and ultimately this could lead to permanent vision loss in the weaker eye if left untreated.  It can also impair one’s depth perception. For more information on strabismus and amblyopia visit the American Association for Pediatric Ophthalmology and Strabismus website.



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