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Medical Forum / General / Vision / August 2008Need Help - Desperate to Help 8 year old with myopia
Hello Everbody! First let me say Thank you in advance for your advice. You have no idea how much I appreciate it. I AM SO CONFUSED and don't know what to do.. Here is the story..Flash back to two years ago.. My daughter was 6 at the time and the school nurse called to say she failed the vision screening at school and referred her for further testing at an eye doctor. I panicked and immmediately made an appointment. She was diagnosed with mild myopia and a mild astigmatism (20/30 - 20/40 using both eyes). She had never ever complained about her eyes, doesn't sit close, etc. etc. None of the signs were there. The doctor assured me that the eyes were working together. The doctor said to come back in 6 months and have her fitted for glasses as she would be older and more cooperative (she wasn't really doing what he was asking of her and was growing impatient). I went home and scoured the internet for myopia advice and basically decided that glasses were not needed at this time. One Year later - Nurse called again - still failed but at the same level as the year before, she advised I take her to the eye doctor. I decided against it since her eyes hadn't gotten worse.. Now we are in present day. The nurse called again, Caroline really failed this time. She was 20/50 in one eye and she couldn't get her to cooperate for the other eye ( she guessed it was probably around 20/70 for that eye). She stated that she only had a simple machine to check and further evaluation was needed. when I picked Caroline up at school her eyes looked watery (she is bothered by allergies) and I don't know if it was allergies that bothered her or the nurses persistent tests. I brought her home and gave her my own test using a printed snellen test at 10 feet. She read the 20/40 line with both eyes together. The 20/40 line with right eye and the 20/60 line with her left eye. She did not like covering her right eye, her left eye began to water and she said it was blurry. I checked her for nearness - she read really tiny print at normal reading level with both eyes open and with both eyes individually. My daughter has never complained about not being able to see. She reads fine and her classroom is small so the board isn't far away, etc. etc. She doesn't squint, or tilt her head, or anything like that. Sometimes it is obvious that she can't see as far away as the rest of us, but that is okay. She isn't driving yet, so what is the big deal. I mentioned what was happening with my daughter's eyes to a friend who is an opthamologist. She immediately said that not having glasses prescribed is robbing her of corrected vision and the damage will be permanent, If I don't do something now then her attemtps at correction will be lost forever and they will never be able to correct to 20/20. I do not know what to do. My child is very active and glasses would be really difficult. She does gymnastics, dancing, karate, etc. etc. It would be a real problem for her. She is not complaining about her eye sight. I don't want her astigmatism and myopia to progress because I didn't get her glasses. If this was your child what would you do?? I want to do everything I can to help her get the best vision possible. Should I accept the minus lenses that I am sure the doctor will prescribe when she is seen on tuesday? Please help me make the best informed deccision possible. My biggest concern that if I don't get her glasses now that her brain won't grow will never be able to see clearly.. could that happen? Am I ruining her eyesight forever by not putting her in minus glasses right away? I am concerned that when she covers her right eye, she says her left eye is a little blurry for things like the eye chart and she doesn't like it when that eye is covered, not the same when she covers the left. I have charted her at 20/40 indoors with both eyes, and 20/70 in her left eye and she says it's blurry but she can read the 20/70 line with her left. Her right eye she can read the 20/40 to 20/50 line. thank you soooo much, allyson > Hello Everbody! > [quoted text clipped - 65 lines] > > allyson Vision is very complex. I am only assuming that your daughter has myopia, which is evidently progressing asymmetrically, as one eye is now worse than the other. Furthermore, her vision appears to be at the level beyond what I would consider "borderline." With uncorrected myopia, I am also concerned with the development of convergence insufficiency which can lead the child to bring the book close to her face in order to "crowd out" binocularity. This leads to reading with one eye only. If this were my child, I would take her to someone who comes highly recommended, and trust their recommendations. If glasses are advised, I would accept them. I would also be very careful about what I said in front of my child about wearing vision correction. Chances are she may have already picked up some negative "messages" -- subliminal and overt, about wearing eyeglasses. Also, it is perfectly OK not to wear glasses for physical activity. If it does become necessary to do so, there are many types of safety eyewear from which to choose, and then eventually contact lenses. As a child, I had to wear eyeglasses, and quickly learned how to avoid being hit in the face. DrG Thank you so much for your time. My biggest fear is that I accept the glasses with the notion that she wears them for seeing far away - not at school or at sports or close work but that she grows so dependent on them that she can't see without them at all and then sports will be difficult for her (it is so much her life that it would be devastating for her) She is highly functioning now with 20/40 vision using both eyes. If her eyes get worse while wearing the glasses, then she won't be able to go without them at all. She would be a good candidate for contacts due to her sports and level of actviity (this is a child that never is still and always doing something active), but I think she is too young (although she is a very mature 8 year old). She does not bring her close work to her and reads at what looks like a normal distance, she watches tv at a normal distance. There is no signs that her vision is poor other than failing a vision test. My concern is that one eye is a little worse and I don't want any permanent harm done. If I do nothing at this time and wait it out, will be vision decrease so that it won't be able to be correced with glasses. I am so confused and only want what is best for my child but I don't feel like I can make the best decsion without thoroughly educating myself. please help if you can... > her vision is poor other than failing a vision test. My concern is > that one eye is a little worse and I don't want any permanent harm > done. Very few people have exactly the same refraction left-and-right. Myopia, by itself, doesn't cause any neurological or other "permanent" harm, and she's too old to develop amblyopia or any other "uncorrectable" condition. > If I do nothing at this time and wait it out, will be vision > decrease so that it won't be able to be correced with glasses. No, that doesn't happen. Myopia may progress, and probably will, but her vision remains essentially perfect up close. > I am so > confused and only want what is best for my child but I don't feel like > I can make the best decsion without thoroughly educating myself. > please help if you can... I agree with Anne. Get the glasses and let her wear them when she feels the need. If she's like other myopes, she'll enjoy seeing the TV and blackboard better and decide for herself. I only recommend "full time wear" when it's likely they'll lose the glasses otherwise. -MT, OD Thank you so much for your time. My biggest fear is that I accept the glasses with the notion that she wears them for seeing far away - not at school or at sports or close work but that she grows so dependent on them that she can't see without them at all and then sports will be difficult for her (it is so much her life that it would be devastating for her) She is highly functioning now with 20/40 vision using both eyes. If her eyes get worse while wearing the glasses, then she won't be able to go without them at all. She would be a good candidate for contacts due to her sports and level of actviity (this is a child that never is still and always doing something active), but I think she is too young (although she is a very mature 8 year old). She does not bring her close work to her and reads at what looks like a normal distance, she watches tv at a normal distance. There is no signs that her vision is poor other than failing a vision test. My concern is that one eye is a little worse and I don't want any permanent harm done. If I do nothing at this time and wait it out, will be vision decrease so that it won't be able to be correced with glasses. I am so confused and only want what is best for my child but I don't feel like I can make the best decsion without thoroughly educating myself. please help if you can... >Here is the story..Flash back to two years ago.. >My daughter was 6 at the time and the school nurse called to say she >failed the vision screening at school and referred her for further >testing at an eye doctor. <snip> As a parent, I know what I'd do. I'd get the glasses so that she can see what good vision is like and then let her choose to wear them or not. There might be some activities where she would like to see better and then there might be others where it doesn't concern her. If you try to force her to wear them, you will both be miserable. Ann My question is this - If she chooses to only wear them for movies and tv watcing, will she be harming her eyes by not wearing them full time?? thank you soooo much for your time. In other words, by wearing the glasses for very limited amount - will it be harming her either way? >My question is this - If she chooses to only wear them for movies and >tv watcing, will she be harming her eyes by not wearing them full >time?? thank you soooo much for your time. In other words, by wearing >the glasses for very limited amount - will it be harming her either way? No. +++++++++++++ Reply to the list as I do not publish an email address to USENET. This practice has cut my spam by more than 95%. Of course, I did have to abandon a perfectly good email account... > My question is this - If she chooses to only wear them for movies and > tv watcing, will she be harming her eyes by not wearing them full > time?? thank you soooo much for your time. In other words, by wearing > the glasses for very limited amount - will it be harming her either way? No. -MT, OD Wearing properly prescribed eyeglasses has not been shown to be harmful. DrG What I meant to say was that if she chose to wear the glasses only part time would it be worse for her than full-time wear.. allyson >What I meant to say was that if she chose to wear the glasses only part >time would it be worse for her than full-time wear.. > >allyson No. +++++++++++++ Reply to the list as I do not publish an email address to USENET. This practice has cut my spam by more than 95%. Of course, I did have to abandon a perfectly good email account... > What I meant to say was that if she chose to wear the glasses only part > time would it be worse for her than full-time wear.. > > allyson A child has certain rights. For example, they have the right to see like you and me. Based upon the results of the eye examination, you should discuss your concerns with her eye doctor -- again, based on the findings. DrG > Wearing properly prescribed eyeglasses has not been shown to be > harmful. What are the causes of progressive myopia? > > Wearing properly prescribed eyeglasses has not been shown to be > > harmful. > > What are the causes of progressive myopia? Dear Dick, The correct answer is: 1. A confined environment -- confirmed with primate eyes. 2. An over-prescribed minus. That is my $ 0.02 worth. That is also the "second-opinion". Best, Otis www.chinamyopia.org > 2. An over-prescribed minus. wrong. never been proven. in fact Goss et al. shows that overprescribing minus DOES NOT cause myopia progression using human children. you know that! go away otis. things were quiet while you were gone. what's your address? pennsylvania's not that far from me. "Dick Adams" <bad.addr@nonexist.com> > What are the causes of progressive myopia? Medical myopia researchers say it's mostly (80-90%) genetic with a small contribution from lifestyle and environment. Virtually all myopes are born with normal vision, so you could say that virtually all myopia is "progressive", at least until it stops progressing and "levels off". There are epidemiological associations between myopia and near work, reading distance, intelligence, income, and length of education. Even so, attempts to modify the course of myopia using lenses or "exercises" have been proven unreliable. -MT > ... attempts to modify the course of myopia using lenses or "exercises" > have been proven unreliable. Could you point me to a review of such studies? Are there studies where children prone to myopia are required to read with reading glasses (like +2.5, also with prisms to set convergence at infinity)? TIA for any response. -- Dicky > Could you point me to a review of such studies? Sure. http://annals.edu.sg/pdf200401/V33N1p4.pdf http://www.optometrists.asn.au/gui/files/ceo865276.pdf > Are there studies where children prone to myopia are > required to read with reading glasses (like +2.5, also with > prisms to set convergence at infinity)? Refractive treatment must be measured relative to the subject's own refractive state. Because individuals vary, +250 lenses won't have the same effect on everybody. If you want equal stimulus for each subject, you must give the emmetrope +250 but you must give a -400 myope a special pair of -150 glasses for the same effect. It's accurate to say "+250 add" or "+250 relative to the cycloplegic refraction" There are studies that show bifocals DO retard myopia. There are other well-done studies that show bifocals DON'T. What is the preponderance of evidence, and bottom line, what's reliable enough for doctors to recommend? Nada. Everybody's looking. There's a guy who's patented bifocal contacts for myopia control. But good science doesn't recommend any treatment until it demonstrates consistent efficacy. None of the reviews find that myopia control techniques have done so, therefore my own humble opinion is they are "proven ineffective". -MT ----------------------------------------------------------------------------- 1.. Raviola E, Wiesel TN. An animal model of myopia. N Engl J Med 1985;312: 1609-15. 2.. Wallman J, Adams JI, Trachtman JN. The eyes of young chickens grow toward emmetropia. Invest Ophthalmol Vis Sci 1981;20:557-61. 3.. Wallman J, Turkel J, Trachtman J. Extreme myopia produced by modest changes in early visual experience. Science 1978;201:1249-51. 4.. Wallman J, Gottlieb MD, Rajaram V, Fugate-Wentzek LA. Local retinal regions control local eye growth and myopia. Science 1987;237:73-7. 5.. Troilo D, Gottlieb MD, Wallman J. Visual deprivation causes myopia in chicks with optic nerve section. Curr Eye Res 1987;6:993-9. 6.. von Noorden GK, Lewis RA. Ocular axial length in unilateral congenital cataracts and blepharoptosis. Invest Ophthalmol Vis Sci 1987;28:750-2. 7.. Gee SS, Tabbara KF. Increase in ocular axial length in patients with corneal opacification. Ophthalmology 1988;95:1276-8. 8.. Robb RM. Refractive errors associated with hemangiomas of the eyelids and orbit in infancy. Am J Ophthalmol 1977;83:52-8. 9.. Miller-Meeks M, Bennett SR, Keech RV, Blodi CF. Myopia induced by vitreous hemorrhage. Am J Ophthalmol 1990;109:199-203. 10.. Gwiazda J, Thorn F, Bauer J, Held R. Emmetropization and the progression of manifest refraction in children followed from infancy to puberty. Clin Vis Sci 1993;8:337-44. 11.. Saunders KJ, Woodhouse JM, Westall CA. Emmetropization in human infancy: rate of change is related to initial refractive error. Vision Res 1995;35:1325-8. 12.. Ehrlich DL, Atkinson J, Braddick O, et al. Reduction of infant myopia: a longitudinal cycloplegic study. Vision Res 1995;35:1313-24. 13.. Irving EL, Sivak JG, Callender MG. Refractive plasticity of the developing chick eye. Ophthal Physiol Opt 1992;12:448-56. 14.. Smith EL, Hung LF. The role of optical defocus in regulating refractive development in infant monkeys. Vision Res 1999;39:1415-35. 15.. Wallman J, Wildsoet C, Xu A, et al. Moving the retina: choroidal modulation of refractive state. Vision Res 1995;35:37-50. 16.. Hung LF, Wallman J, Smith EL III. Vision-dependent changes in the choroidal thickness of macaque monkeys. Invest Ophthalmol Vis Sci 2000;41:1259-69. 17.. Gwiazda J, Thorn F, Bauer J, Held R. Emmetropization and the progression of manifest refraction in children followed from infancy to puberty. Clin Vis Sci 1993;8:337-44. 18.. Gwiazda J, Thorn F, Bauer J, Held R. Myopic children show insufficient accommodative response to blur. Invest Ophthalmol Vis Sci 1993;34(3):690-4. 19.. Wildsoet C, Wallman J. Choroidal and scleral mechanisms of compensation for spectacle lenses in chicks. Vision Res 1995;35:1175-94. 20.. Blum HL, Peters HB, Bettman JW. Vision Screening for Elementary Schools: The Orinda Study. Berkeley, Calif.: University of California Press, 1959. 21.. Goss DA, Winkler RL. Progression of myopia in youth: age of cessation. Am J Optom Physiol Opt 1983;60:651-8. 22.. Bartmann M, Schaeffel F. A simple mechanism for emmetropization without cues from accommodation or colour. Vision Res 1994;34:873-6. 23.. Smith EL, Hung LF. Optical diffusion disrupts emmetropization and produces axial myopia in young monkeys. Invest Ophthalmol Vis Sci 1995;36:S758. 24.. Napper GA, Brennan NA, Barrington M, et al. The duration of normal visual exposure necessary to prevent form deprivation myopia in chicks. Vision Res 1995;35:1337-44. 25.. Zylbermann R, Landau D, Berson D. The influence of study habits on myopia in Jewish teenagers. J Pediatr Ophthalmol Strabismus 1993;30:319-22. 26.. Jeandervin M, Walline JJ, Mitchell GL, et al. Use of the experience sampling method for near work assessment in children. Optom Vis Sci 2000;77:S26. 27.. Gwiazda J, Bauer J, Thorn F, Held R. A dynamic relationship between myopia and blur-driven accommodation in school-aged children. Vision Res 1995;35: 1299-1304. 28.. Gwiazda J, Grice K, Held R, et al. Insufficient accommodation and near esophoria: precursors or concomitants of juvenile-onset myopia? In: Tokoro T, ed. Myopia Updates. Tokyo: Springer-Verlag, 1998:92-7. 29.. Gwiazda J, Grice K, Thorn F. Response AC/A ratios are elevated in myopic children. Ophthal Physiol Opt 1999;19:173-9. 30.. Zadnik K, Mutti DO, Fusaro RE, Adams AJ. Longitudinal evidence of crystalline lens thinning in children. Invest Ophthalmol Vis Sci 1995;36:1581-7. 31.. Mutti DO, Mitchell GL, Moeschberger ML, et al. The association between parental myopia, near work, and children's refractive error. Optom Vis Sci 2000;77:S26. 32.. Zadnik K, Mutti DO, Friedman NE, et al. Ocular predictors of the onset of juvenile myopia. Invest Ophthalmol Vis Sci 1999;40:1936-43. 33.. Hirsch MJ. Predictability of refraction at age 14 on the basis of testing at age 6-interim report from the Ojai Longitudinal Study of Refraction. Am J Optom Arch Am Acad Optom 1964;41:567-73. 34.. Goss DA, Jackson TW. Clinical findings before the onset of myopia in youth. I. Ocular optical components. Optom Vis Sci 1995;72:870-8. 35.. Quinn GE, Shin CH, Maguire MG, Stone RA. Myopia and ambient lighting at night. Nature 1999;399:113-4. 36.. Goss DA, Grosvenor T. Rates of childhood myopia progression with bifocals as a function of nearpoint phoria: consistency of three studies. Optom Vis Sci 1990;67:637-40. 37.. Oakley KH, Young FA. Bifocal control of myopia. Am J Optom Physiol Opt 1975;52:758-64. 38.. Fulk GW. Cyert LA, Parker DE. A randomized trial of the effect of single-vision vs. bifocal lenses on myopia progresion in children with esophoria. Optom Vis Sci 2000;77:395-401. 39.. Leung JT, Brown B. Progression of myopia in Hong Kong Chinese schoolchildren is slowed by wearing progressive lenses. Optom Vis Sci 1999;76:346-54. 40.. Perrigin J, Perrigin D, Quintero S, Grosvenor T. Silicone-acrylate contact lenses for myopia control: 3-year results. Optom Vis Sci 1990;67:764-9. 41.. Khoo CY, Chong J, Rajan U. A 3-year study on the effect of RGP contact lenses on myopic children. Singapore Med J 1999;40:230-7. 42.. Roberts WL, Banford RD. Evaluation of bifocal correction technique in juvenile myopia. Optometric Weekly 1967;58: (38):25-31, (39):21-30, (40):23-8, (41):27-34, (43):19-26. 43.. Grosvenor T, Perrigin DM, Perrigin J, Maslovitz B. Houston Myopia Control Study: A randomized clinical trial. Part II. Final report by the patient care team. Am J Optom Physiol Opt 1987;64:482-98. 44.. Pärssinen O, Hemminki E, Klemetti A. Effect of spectacle use and accommodation on myopic progression: final results of a three-year randomized clinical trial among schoolchildren. Br J Ophthalmol 1989;73:547-51. 45.. Jensen H. Myopia progression in young school children. A prospective study of myopia progression and the effect of a trial with bifocal lenses and beta blocker eye drops. Acta Ophthalmol (Suppl) 1991;200:1-79. 46.. Goss DA. Effect of bifocal lenses on the rate of childhood myopia progression. Am J Optom Physiol Optics 1986;63: 135-41. 47.. Baldwin WR, West D, Jolley J, Reid W. Effects of contact lenses on refractive corneal and axial length changes in young myopes. Am J Optom Arch Am Acad Optom 1969;46:903-11. 48.. Stone J. The possible influence of contact lenses on myopia. Br J of Physiol Opt 1976;31:89-114. 49.. Kennedy RH. Progression of myopia. Trans Am Ophthalmol Soc 1995;93:755-800. 50.. Gimbel HV. The control of myopia with atropine. Can J Ophthalmol 1973;8:527-32. 51.. Stone RA, Lin T, Laties AM. Muscarinic antagonistic effects on experimental chick myopia. Exp Eye Res 1991;52: 755-8. 52.. Bartlett JD, Niemann K, Houde B, et al. Safety and tolerability of pirenzepine ophthalmic gel in pediatric, myopic patients. Invest Ophthalmol Vis Sci 2000;41:S303. 53.. Bedrossian RH. The effect of atropine on myopia. Ann Ophthalmol 1971;3:891-7. 54.. Kelly TS, Chatfield C, Tustin G. Clinical assessment of the arrest of myopia. Br J Ophthalmol 1975;59:529-38. 55.. Brodstein RS, Brodstein DE, Olson RJ, et al. The treatment of myopia with atropine and bifocals. A long-term prospective study. Ophthalmology 1984;91:1373-9. 56.. Kao SC, Lu HY, Liu JH. Atropine effect on school myopia. A preliminary report. Acta Ophthalmol (Suppl) 1988;185:132-3. 57.. Yen MY, Liu JH, Kao SC, Shiao CH. Comparison of the effect of atropine and cyclopentolate on myopia. Ann Ophthalmol 1989;21:180-2, 187. >> Could you point me to a review of such studies? > [quoted text clipped - 25 lines] >have done so, therefore my own humble opinion is they are "proven >ineffective". I think you know me well enough to know that I'm not engaging to troll, but ... serious question: People seeking to prevent/reverse/? myopia with bifocals or plus certainly /have/ occasionally advocated the addition of prisms to offset the 'break' in the near vision triad (accommodation-convergence-mydriasis). Absent that use of prism, though (eg, if somebody merely put dime store plus readers on their myopic kid's eyes), couldn't that disrupt normal fusional amplitudes, potentially harming a developing fusional system? I know that--despite my high hyperopia and ciliary spasm, wearing plus lenses for near work throws my exophoria into a tizzy, driving excess convergence and accommodation.... TIA, Neil  SignatureLive simply so that others may simply live >Hello Everbody! > >First let me say Thank you in advance for your advice. You have no idea >how much I appreciate it. I AM SO CONFUSED and don't know what to do.. <snip description of apparent progressive worsening of the kid's vision> I got my first pair of glasses when I was four. It was an "AHA!" moment in every sense of the word. "AHA! That green blob is a tree, that's what everybody has been telling me makes LEAVES!" And that sort of thing. If you believe your daughter has eye allergies get her some Patanol, which is a prescription eyedrop which will treat eye allergies. It takes a couple of weeks of daily use to kick in. Once the Patanol is working get her in for a complete eye exam - promise what you must (within reason) to get her to cooperate with the exam. Take her to a shop with a good selection of CHILDREN'S frames and help her choose a pair she likes. Once your daughter has glasses on her face and realizes how much nicer it is to be able to see things she will be glad to have them. I know I was. Disclaimer: I'm just a Josephine Public sort of gal with a long history of wearing spectacles. +++++++++++++ Reply to the list as I do not publish an email address to USENET. This practice has cut my spam by more than 95%. Of course, I did have to abandon a perfectly good email account... With regard to the message news:1129467048.688527.8970@g47g2000cwa.googlegroups.com posted by "ally down" <adowning@adelphia.net> My rant, as follows: It continues to be a huge mystery why there is so little interest in understanding the causes of myopia. When I was a kid, developing myopia at a somewhat later age than the mentioned 8-yr. old, I thought I should have some eyeglasses for reading that set my eyes to see my book at infinity, with prisms and positive spherical surfaces. (I did not know about astigmatism then, but probably did not have much of that to start.) That, I thought, would avoid eyestrain when reading. Reading was uncomfortable and I hypothesized that my eyestrain was hurting my eyes. But the OP describes an outdoorsy child, prior to the age of immersing the nose in books. I had one kid who became severely myopic, asymmetrically. My theory for the reading glasses was resisted by all. The kid got into a profession where a lot of reading and close work was required, and had to drop out before it was time for her career to end. (Fortunately, marriage was a possibility.) Looking down the road, it is hard to get the right eyeglasses (if there should be such) for severely myopic persons, particularly if their eyes do not want to do the binocular thing. One does not see nearly as comfortably through thick lenses as thin or none. Or well. And in many cases, the lenses continually need to get thicker and more complicated. The making of complicated lenses is getting to be a lost art, but frames are getting ever fancier. Dentists today can advise us on avoiding tooth decay (but you may die like a rat, of course). It is a shame that our eye doctors can only help sell us eyeglasses, at least when it comes to myopia and progressive myopia. There are some who believe that reading through the kinds of eyeglasses prescribed for myopics to correct their distance vision, encourage the further development of myopia. But you will definitely not hear about that possibility from the eyeglasses (contact lens, etc.) industry. -- Dicky (Recently implanted, and seeing quite well now, thank you, for the first time in many decades.) >With regard to the message news:1129467048.688527.8970@g47g2000cwa.googlegroups.com >posted by "ally down" <adowning@adelphia.net> [quoted text clipped - 3 lines] >It continues to be a huge mystery why there is so little interest >in understanding the causes of myopia. (Yawn) Google around a bit and learn about people like Adrian Glasser, Christine Wildsoet, and academic institutions all over the world who are studying just that. It's not being ignored. It's not outweighed by the vast eye doc conspiracy. It's just a complicated issue that doesn't lend itself to any quick and easy fixes. My $0.02 ... per usual. >My rant, as follows: >It continues to be a huge mystery why there is so little interest >in understanding the causes of myopia. It's a mystery why you aren't aware of the hundred or so research articles written about it each year. > When I was a kid, developing myopia at a somewhat later age than > the mentioned 8-yr. old, I thought I should have some eyeglasses for > reading that set my eyes to see my book at infinity, with prisms and > positive spherical surfaces. Can you promise that it would work? > (I did not know about astigmatism then, > but probably did not have much of that to start.) That, I thought, > would avoid eyestrain when reading. Reading was uncomfortable > and I hypothesized that my eyestrain was hurting my eyes. In order to discuss the lack of evidence for your hypothesis, please tell us how you measure "eyestrain" objectively? > But the OP describes an outdoorsy child, prior to the age of immersing > the nose in books. So let's give her mom something else to worry about? > Dentists today can advise us on avoiding tooth decay (but you may die like > a rat, of course). It is a shame that our eye doctors can only help sell > us > eyeglasses, at least when it comes to myopia and progressive myopia. Yes, it would be a shame if nobody were doing any research on myopia. > There are some who believe that reading through the kinds of eyeglasses > prescribed for myopics to correct their distance vision, encourage the > further development of myopia. There are some who believe that. But none of them have actually measured the rates of change in kids who wear glasses versus those who don't. -MT In article <Rrv4f.147618$qY1.110127@bgtnsc04-news.ops.worldnet.att.net>, > My rant, as follows: > > It continues to be a huge mystery why there is so little interest > in understanding the causes of myopia. f.ck myopia! I was severely myopic. There are glasses, contacts and surgery. Take your pick. My aunt had colon cancer. They removed it. How's that for fun? Then she had heart attacks. She's dead. Too many people die from medical problems. Not as many go blind, but it's a major problem. People with myopia can fix it fairly easily, and myopia by itself is completely and easily correctable. Certainly we want to find out why and find better cures, but it's not time to call out the National Guard. And what about people with hyperopia? Don't they have even worse vision problems? Shouldn't we tackle that first? Some people are too short. Shouldn't we fix that first? Some women have breasts that they think are too small. Shouldn't we fix that? SignatureDan Abel dabel@sonic.net Petaluma, California, USA > Hello Everbody! > failed but at the same level as the year before, she advised I take her > to the eye doctor. I decided against it since her eyes hadn't gotten > worse.. Now we are in present day. Vision screening in the schools is not usually very good. If my child failed an eye screening, I'd have her in to the OD every year. > is okay. She isn't driving yet, so what is the big deal. I mentioned People who have some vision problems can still drive. I think it is very important for people who do some kinds of sports to have good vision. > what was happening with my daughter's eyes to a friend who is an > opthamologist. She immediately said that not having glasses prescribed > is robbing her of corrected vision and the damage will be permanent, If > I don't do something now then her attemtps at correction will be lost > forever and they will never be able to correct to 20/20. The permanent damage is going to be that she won't learn as well at school and she won't be as good at sports. Unless there is something missing here, there won't be any other permanent damage. > I do not know what to do. My child is very active and glasses would be > really difficult. She does gymnastics, dancing, karate, etc. etc. It > would be a real problem for her. Lots of people do sports with glasses. Some sports don't require them, and then maybe you have the hassle of holding her glasses for her. Although she is young, there are kids who wear contacts at that age. This might be a big hassle for all of you, but it is something you should think about. I don't know about kids, but there are contacts that can be left in for long periods of time. Contacts are wonderful for sports. > didn't get her glasses. If this was your child what would you do?? I > want to do everything I can to help her get the best vision possible. I would get her glasses or contacts and deal with it. If they don't work, it's not like you have ruined anything. > My biggest concern that if I don't get her glasses now that her brain > won't grow will never be able to see clearly.. could that happen? Am I > ruining her eyesight forever by not putting her in minus glasses right > away? I'm no doctor, but I don't think that you can ruin her eyes by not getting correction. Hampering her education and her sports, maybe. I don't like bribing kids to do what they ought to do. However, sometimes that's what parents need to do. I think that this is worth a very serious short time bribe. Maybe not a pony, but riding lessons? (Little girls almost always want to ride horses.) Find out what she really wants, and offer a deal. If the glasses or contacts work, she'll soon not need a bribe to use them. If it doesn't work, you haven't lost a lot. Be sure to share all this with the eye doctor. There are many solutions. Some glasses are designed specifically for sports. I predict that suitable glasses will help her sports a whole lot, not hurt her. SignatureDan Abel dabel@sonic.net Petaluma, California, USA It's not at all certain to me from what you wrote that she is myopic, but it is very likely that she is anisometropic, and your "near test" certainly did not rule out astigmatism, or even hyperopia. Please post the suggested spectacle Rx. That will help a lot and will enable us to say with more certainty what danger, if any, there is in not wearing glasses. w.stacy, o.d. She had a very thorough eye exam about 18 months ago and nothing mentioned about her being anisometropic. What was mentioned was that she had a very mild astigmatism and that she couldn't see as well far away as normal. The doctor was the one that said "her world is very close up and she isn't driving,etc.etc, so to come back in 6 months to a year". It is obvious that her vision has gotten a little worse in a year, but more so in her left eye than her right. Her eye appt is tomorrow but I will not be filling her prescription tomorrow because we have vision coverage on our insurance but you need a voucher before the prescription is filled and I have not recieved it in the mail yet. I will post the RX and ask you very kind generous people for more advice.. Thanks, ally Also, I should add. She came home from school today and I retested her on the snellen eye chart I have. She read to thru the 20/40 line with both eyes very easily, she struggled with the 20/30 and got 2 of the letters right. I had her cover her left eye first - she read the 20/40 line, then she covered her right eye - she read to the 20/50 line no problem and then proclaimed - "Jeez - my eyes aren't blurry today - that's weird" and then walked away. How can that be? Are eyes better on some days then next? Could the eye tests at school have been when her eyes were tired? She had been recovering from a cold on that day... hmmm.. I don't get it... > How can that be? Are eyes better on some days then next? Could the > eye tests at school have been when her eyes were tired? She had been > recovering from a cold on that day... hmmm.. I don't get it... We do. Read up on "accommodative spasm." Young females are especially subject to variations of this sort. -MT Quit already with the home VAs. They are way too variable to be of much use. Almost as variable at the eye doc's office as at home. Post the Rx. That will tell us volumes. w.stacy, o.d. > Also, I should add. She came home from school today and I retested her > on the snellen eye chart I have. She read to thru the 20/40 line with [quoted text clipped - 7 lines] > eye tests at school have been when her eyes were tired? She had been > recovering from a cold on that day... hmmm.. I don't get it... Anybody who claims to be desparate to help their child with myopia would do well to get them some glasses and follow the advice of the optometrist. It sounds more like someone who is desperate to do nothing and wants someone to bless it. DrG Also, I should add. She came home from school today and I retested her on the snellen eye chart I have. She read to thru the 20/40 line with both eyes very easily, she struggled with the 20/30 and got 2 of the letters right. I had her cover her left eye first - she read the 20/40 line, then she covered her right eye - she read to the 20/50 line no problem and then proclaimed - "Jeez - my eyes aren't blurry today - that's weird" and then walked away. How can that be? Are eyes better on some days then next? Could the eye tests at school have been when her eyes were tired? She had been recovering from a cold on that day... hmmm.. I don't get it... children's visual acuity can vary dramatically when testing from day to day. they can have very active accommodative systems. if she's 20/40 + in one eye and 20/50 there isn't much anisometropia. > children's visual acuity can vary dramatically when testing from day to > day. they can have very active accommodative systems. > > if she's 20/40 + in one eye and 20/50 there isn't much anisometropia. That's nuts. Consider the following refraction: R + 1.00 sph L - 1.25 sph. This person could easily be R 20/40 + L 20/50 unaided, at ANY AGE. Anyone who tries to figure out anything from unaided VAs alone has gone way out there on a limb... w.stacy, o.d. sorry to be so "nuts". i guess what caused me to believe that she might be a myope is what mom quoted her eyedoc as saying in her earlier post... "What was mentioned was that she had a very mild astigmatism and that she couldn't see as well far away as normal. The doctor was the one that said "her world is very close up and she isn't driving,etc.etc, so to come back in 6 months to a year". " that plus this... "and nothing mentioned about her being anisometropic." Go back and read the entire thread. This could even be a troll, what with all the emphasis on downloading Snellens and home VA testing and all. Whatever, my FIRST RULE is: question everything, especially authority. The mom's in charge here, so I question HER. If she won't tell me what I need to know, then I won't listen to whatever she does tell me... w.stacy, o.d. > sorry to be so "nuts". > [quoted text clipped - 6 lines] > a year". " that plus this... "and nothing > mentioned about her being anisometropic." Funny how we often pander to the concerns of the parents, especially if they make a fuss about their children needing eyeglasses. DrG This thread reminds me of the mother who walks into the pediatrician's office saying "I think my son needs an antibiotic for his infection". He has a fever and doesn't sound too good. Like the pede is supposed to accept the diagnosis, let alone give an opinion as to the efficacy of the proposed treatment... w.stacy, o.d. > Funny how we often pander to the concerns of the parents, especially if > they make a fuss about their children needing eyeglasses. > > DrG > This thread reminds me of the mother who walks into the pediatrician's > office saying "I think my son needs an antibiotic for his infection". He > has a fever and doesn't sound too good. > > Like the pede is supposed to accept the diagnosis, let alone give an > opinion as to the efficacy of the proposed treatment... That sounds fairly stupid, but every once in a while you run into a doc for whom this sort of scenario makes sense. A friend's mom was better at balancing her husband's insulin dose than the doc (actually a GOOD doc) was, and he admitted it. Remember, SOMEBODY was in the bottom 10% of his med school graduating class. > > Funny how we often pander to the concerns of the parents, especially if > > they make a fuss about their children needing eyeglasses. SignatureCheers, Bev ============================================ Buckle Up. It makes it harder for the aliens to suck you out of your car. Thank you for your advice.. I will post the RX tomorrow. I don't have a RX from the initial appt becuase the orders were to come back and he would write the RX then, it wasn't that necessary at the time and he said he would be abe to get a better RX if she was older (she wasn't really behaving and was only 6. Please understand, I want what is best for my daughter. If it's glasses then so be it, if it is not glases, than so be it. What I am trying to do is educate myself, for the sake of my child, so that I can make an informed decision. I don't believe that OD's are infallible and that whatever anybody says goes - One of my college professors once told "It is just as important to evaluate where the information came from as to the information itself" We are not "trolls" or undereducated wacko's (my husband and I both hold advanced degrees". I just believe in doing whatever I can to help my child and I need to educate myself in order to do that. I am not an OD, just a loving a parent who has a difficult decsion to make. I know that my child will need glasses, maybe today, maybe in 6 months, I know that day will come. I know that she will eventually want contacts - that day will come. I just want to make sure that putting minus lenses on a child with binocular 20/40 vision is the appropriate thing to do, knowing that the glasses will effect her lifestyle right now at this point in time - she is too young for contacts. I live in a town where the University is across the street and it is a College of Medicine. Just about everyone I know is affillitated with the medical profession in one way or another. do I take every opinion of their's to heart. No I do not - they are human.. not infallible. I know that my daughter has a reflective disorder. I know that the OD will prescribe her glasses. I know that he will most likely tell me that she needs them all the time (that is his preference). Do I have to agree with him? ally > Thank you for your advice.. I will post the RX tomorrow. I don't have a > RX from the initial appt becuase the orders were to come back and he > would write the RX then, it wasn't that necessary at the time and he > said he would be abe to get a better RX if she was older (she wasn't > really behaving and was only 6. I prescribe glasses for 3 year-olds, some of whom behave as if they were 2. > Please understand, I want what is best for my daughter. If it's glasses > then so be it, if it is not glases, than so be it. What I am trying to [quoted text clipped - 3 lines] > is just as important to evaluate where the information came from as to > the information itself" I'm not sure how to take the phrase "where the information came from.." > We are not "trolls" or undereducated wacko's (my husband and I both > hold advanced degrees". I just believe in doing whatever I can to help [quoted text clipped - 6 lines] > knowing that the glasses will effect her lifestyle right now at this > point in time - she is too young for contacts. Why wouldn't corrective lenses be the "appropriate thing to do"? Which authority on the subject made you think otherwise? Did you ever admit to the possibility that vision correction might have a positive effect on your daughter's so-called "lifestyle"? Did you know that a number of professional athletes are nearsighted? > I live in a town where the University is across the street and it is a > College of Medicine. Just about everyone I know is affillitated with > the medical profession in one way or another. do I take every opinion > of their's to heart. No I do not - they are human.. not infallible. I think that you are confusing human fallibility and scientific knowledge. Humans make errors, and scientific knowledge is never complete, but people have been wearing spectacles for hundreds of years. Some of the greatest and most accomplished of our species were nearsighted and wore spectacles. On the other hand, some nearsighted people have squandered their talents, and need a convenient scapegoat. > I know that my daughter has a reflective disorder. I know that the OD > will prescribe her glasses. I know that he will most likely tell me > that she needs them all the time (that is his preference). Do I have to > agree with him? Of course you don't have to agree with him. There have been other cases where the religious beliefs of the parents caused them to deny necessary medical treatment for even more serious and life-threatening decisions. Thank goodness this isn't one of them. By the way, what is a "reflective disorder?" DrG I am sorry.. I meant refractive - I was typing pretty fast while trying to get the girls ready for school.. Sometimes i think I might have a "reflective disotrder" as in - I don't always like what I see in the mirrior. it is another dark and dreary day here in the northeast and if we don't see the sun here pretty soon I think my eyes are going to glaze over and we might all need glasses.. Speaking of glasse.. Here is my history..long story short Never needed glasses.. never failed vision screenings.. Went to college.. big big classrooms, board very far away.. started getting bad headaches.. went to ENT - thought it was sinuses, ruled that out, headaches persisted.. still headaches.. time went on, went to eye doctor after everything else was ruled out (at one point I thought I had a brain tumor - headaches were pretty bad). I needed eye glasses - very mild myopia with astigmatism. Got glasses, wore them sometimes, mostly for lecture hall and the movies..but.. being in college, vanity won out and after a couple of years I stopped wearing glasses - eventually I lost them and that was 15 years ago. Last year I had an eye exam - 20/20 no problems. Mild astigmatism with no need to treat unless it was causing me problems. Weird.. I do have an important question that I would love a clear anser to. What exactly does eye shape have to do with myopia? In laymans terms please. If eye shape is the cause, will the myopia stop progressing when the eye stops growing (after puberty so to speak). Is it strictly an anatomy thing or is there more at work here. Also does anyone know about the trials for perizipine? Just curious.. Again - just trying to educate myself.. > I am sorry.. I meant refractive - I was typing pretty fast while trying > to get the girls ready for school.. Sometimes i think I might have a [quoted text clipped - 17 lines] > eye exam - 20/20 no problems. Mild astigmatism with no need to treat > unless it was causing me problems. Weird.. But, did the glasses stop the headaches? Wouldn't that be a medically necessary reason for eyeglasses, even though the refractive error was transient (further proof of course that minus lenses do not lead to irreversible or stairstep myopia)? > What exactly does eye shape have to do with myopia? In laymans terms > please. If eye shape is the cause, will the myopia stop progressing [quoted text clipped - 3 lines] > > Again - just trying to educate myself.. Let's distinguish between axial, or true myopia, and accommodative, or pseudomyopia. The accommodative system is like a spring: it's flexible and has a memory. However, it typically cannot account for more than one or two diopters of myopia, max. Some people have ONLY pseudomyopia, some have ONLY axial myopia, and some have a COMBINATION of both. Pseudomyopia will go away, eventually. Axial myopia will not go away because it is caused by elongation of the posterior eye. The mechanism by which this occurs is not completely understood at this time. Authorities used to believe that all myopia was produced by mechanical stress. Some people still believe that axial myopia is always preceded by accommodative stress, but that number is fast dwindling. So, in the simplest sense, the relationship between eye shape and myopia is one of variable length. However, two famous myopia researchers, DI Flitcroft and RA Stone have studied eyeball shape, and have come up with some interesting findings regarding one's eye shape and on-axis image quality, and that this image quality may be linked to the development of myopia via a local neuro-regulatory system. We also know that this local neuro-regulatory system can be blocked by certain drugs know as muscarinic inhibitors, such as atropine and pirenzepine. In summary, myopia research is now looking more at image quality and blur as a function of (1) eyeball shape, or (2) accommodative lag plus some other variable(s). DrG > [ ... ] > Last year I had an eye exam - 20/20 no problems. Mild astigmatism > with no need to treat unless it was causing me problems. Weird.. What is really weird is that "professionals" still use such a crude measure as 20/XX to describe quality of vision. Let me give you an example: Last week I had the final check by my surgeon after IOL implants. I read a few lines on the chart, and he exclaimed "excellent!, you have 20/20", and then walked out. Very busy man! Cheerful, hopeful, optimistic! Gone! Well, I definitely need eyeglasses to read, but +1.25 Walgreens are good, at least for now. I see quite sharply at one meter, and I can guess that I have a quarter or half diopter of unresolved astigmatism in each eye (ears on the full moon). Although I see fine in sunlight, I will definitely need about a minus diopter of combined sphere and cylinder for night driving, if I expect to read the small signs, like street signs and house numbers. Probably I should consider some prismatic correction, too, because my paths of convergence are vertical after horizontal (like rounded "L's" on their sides). The main purpose of eyeglasses is to see things sharply. There are much better measures of visual acuity than 20/XX. It does make some sense to say which line on the chart one can finally read, and call that line a 20/XX line for the purpose of identifying the angle subtended by the characters (or the linear size divided by the distance to the chart). But, as is apparent at this newsgroup, 20/XX-talk lumps a whole bunch of other sources of poor vision as well as refractive errors. Our professionals apparently think that we are all too dumb to know what is going on with our eyes, and those of the ones we should try to help, so that may be why they speak to us in this crude 20/XX gibberish. (When you are so old as me, they assume you are senile as well as dumb.) > What exactly does eye shape have to do with myopia? Eye length is important. Longer eyes tend to be nearsighted, and conversely for short eyes. The shape of the cornea is important, because it behaves as a lens, in addition to the acommodative lens, and because its irregularities are the major causes of astigmatism. A great deal of the mystery lies an a small internal body called the ciliary process, which appears to be both a muscle and a gland, which may be thought of as circular, and some cartilaginous elements against which it works to allow the eye's lens to relax and round up to a quite convex shape, as it does when the eye finds the characters in a book, for instance. > In laymans terms please. If eye shape is the cause, will the myopia > stop progressing when the eye stops growing (after puberty so to > speak). It is quite amazing that eyes can see quite well, in some instances, while their owners grows up and eyeballs change shape and length. By my guess, it is due to a long-term accomodative mechanism affecting the anatomical parts that suspend the accomodative lens. The going wrong of that accomodative mechanism is probably a big factor in bad eyesight. So I think. No, I can't prove it. sh.t, I am not even a professional. > Is it strictly an anatomy thing or is there more at work here. More, perhaps -- one can envisage a conspiracy of folks who would rather sell you eyeglasses than to try to find out why you need them, and need them ever stronger if you are a typical myope. > Also does anyone know about the trials for perizipine? Just curious.. I don't know, but I'd advise to leave it alone. A joint every now and then might be good for relieving ciliary spasms, however. -- Dicky Okay Guys.. here goes.. We are back from the eye doctor with some interesting results. It turns out my daughter does not have myopia. She has an astigmatism. This is what he said in a nutshell: Her eyes are healthy, they are working well together, no lazy eye (I was worried about that and asked him about it). She does not have myopia. She has astigmatism - one mild eye, one moderate eye. He prescipred glasses and said she should use them while she is reading, doing school work, working on the computer, etc. but does not need to wear them 24/7. the RX is as follows: OD: Sphere: +0.50 Cylinder -0.75 Axis 6 OS: Sphere: +1.00 Cylinder -3.25 Axis 158 Let me know what you think.. allyson Hmmm. That's quite a bit of astigmatism in the left eye. I am mildly surprised that she doesn't have a small amount of amblyopia in the left eye as a result. However, given her prescription, I think she will benefit a great deal from wearing them. DrG > OD: Sphere: +0.50 Cylinder -0.75 Axis 6 > OS: Sphere: +1.00 Cylinder -3.25 Axis 158 Kinda makes you think there may have been an injury to the OS. (Which one is that? Why can't they speak English?) Maybe to both. That is probably the prescription so she could see the ball tossed from far off at her head. For reading, those numbers might be modified with the customary add 2.5. Then, assuming hopefully that the prescription is correct, her eyes would be under no stress while reading. Should she have bifocals at her age? Probably she would not want them. As I have mentioned, I believe that the glasses which correct her eyes for distant vision might stress them if used for reading. That is my remembered experience from being a kid at one time. Eyes which see well, or are corrected to see well, at infinity, will, with +2.5 diopters of additional, correctly focus at ~1/(2.5 meter) or ~16 inches, but think they are watching something off in the distance. It would be better if those eyes were corrected to converge at 16 inches, with mild prisms. That is a usual, and very comfortable distance for reading. By not having much stress in her eyes during the next 10 or 15 years when she is growing up to be an intellectual person, which involves a great deal of reading, she might arrive at adulthood with eyeglasses whose weight could be born comfortably on her nose (or hanging from her corneas). Trying to accommodate for reading with uncorrected astigmatism, particularly at the level mentioned, could, I think, be quite deadly for the little anatomic gadgets which make the eye try to focus. If, as I speculate, the -3.25D astigmatism (need for cylinder) is due to an injury, it may resolve somewhat, and might well be watched for that reason. My experience, however, is that the glasses you get this time are going to be very close to the glasses you got last time. That is because the practitioner starts by measuring your present glasses, and starts from there, and tends to timid when it comes to changing anything. It is very unlikely that any eye doctor would prescribe reading glasses for a child, because that is not the mode. I am not an eye doctor. Therefore I recommend that you not follow any advice that may be implied from what is written above. I have had a recent experience which suggests that a practitioner with an autorefractor can do a better job at refraction that one with the standard stuff. But I am old and implanted and my lenses are immobile. Everyone knows that kids can accommodate, and may be difficult candidates for autorefraction that reason. But even then, a second opinion from an autorefractor might be useful. -- Dicky (Progressive myope until very recently) > I am not an eye doctor. Therefore > I recommend that you not follow any advice that may be implied from what > is written above. Amen to that! DrG > My experience, however, is that the glasses you get this time are > going to be very close to the glasses you got last time. That is > because the practitioner starts by measuring your present glasses, and > starts from there, and tends to timid when it comes to changing > anything. Funny, my experience is just the opposite-- I'm refracted before the OD even looks at my glasses. I'm not sure if he avoids looking at my chart, but my experience has been the same if I'm seeing my regular doc or someone in a different practice. SignatureScott Reverse name to reply > Funny, my experience is just the opposite-- I'm refracted before the OD > even looks at my glasses. I'm not sure if he avoids looking at my chart, > but my experience has been the same if I'm seeing my regular doc or someone > in a different practice. That's the way I do it! Start from zero, generate my own objective and subjective data, then look at the previous info for comparison. --LB, O.D. > That is probably the prescription so she could see the > ball tossed from far off at her head. For reading, those numbers > might be modified with the customary add 2.5. Customary according to which newsgroup wackos? > Then, assuming hopefully that the prescription is correct, her > eyes would be under no stress while reading. Should she have > bifocals at her age? Probably she would not want them. She would not want them, she would not wear them and most eye doctors would not recommend them. > Eyes which see well, or are corrected to see well, at infinity, will, > with +2.5 diopters of additional, correctly focus at ~1/(2.5 meter) > or ~16 inches, but think they are watching something off in the distance. > It would be better if those eyes were corrected to converge at 16 > inches, with mild prisms. That is a usual, and very comfortable > distance for reading. Why is one stressful and not the other? If she sees fine up close, shouldn't she be wearing minus lenses so she won't stress her eyes at infinity? > the little anatomic gadgets which make the eye try to focus. ??? > My experience, however, is that the glasses you get this time are going to > be very close to the glasses you got last time. That is because the > practitioner starts by measuring your present glasses, and starts from there, > and tends to timid when it comes to changing anything. What are you saying? She got no glasses last time. > It is very unlikely that any eye doctor would prescribe reading glasses for > a child, because that is not the mode. I am not an eye doctor. Therefore > I recommend that you not follow any advice that may be implied from what > is written above. Maybe because she doesn't need them? SignatureDan Abel dabel@sonic.net Petaluma, California, USA > > OD: Sphere: +0.50 Cylinder -0.75 Axis 6 > > OS: Sphere: +1.00 Cylinder -3.25 Axis 158 > > Kinda makes you think there may have been an injury to the > OS. (Which one is that? Why can't they speak English?) > Maybe to both. Not really. > That is probably the prescription so she could see the > ball tossed from far off at her head. For reading, those numbers > might be modified with the customary add 2.5. Who said anything about anybody needing a reading Rx > As I have mentioned, I believe that the glasses which correct > her eyes for distant vision might stress them if used for reading. > That is my remembered experience from being a kid at one time. that's not my experience as an eye doctor. if you have a lot of astigmatism reading without your glasses can be problematic due to blur and not stress. > Eyes which see well, or are corrected to see well, at infinity, will, > with +2.5 diopters of additional, correctly focus at ~1/(2.5 meter) > or ~16 inches, but think they are watching something off in the distance. > It would be better if those eyes were corrected to converge at 16 > inches, with mild prisms. That is a usual, and very comfortable > distance for reading. this is not appropriate advice at all. > By not having much stress in her eyes during the next 10 or 15 years > when she is growing up to be an intellectual person, which involves [quoted text clipped - 9 lines] > injury, it may resolve somewhat, and might well be watched for that > reason. you are in way over your head > My experience, however, is that the glasses you get this time are going to > be very close to the glasses you got last time. That is because the > practitioner starts by measuring your present glasses, and starts from there, > and tends to timid when it comes to changing anything. you simply do not understand > It is very unlikely that any eye doctor would prescribe reading glasses for > a child, because that is not the mode. I am not an eye doctor. Therefore > I recommend that you not follow any advice that may be implied from what > is written above. THIS IS THE BEST ADVICE YOU HAVE OFFERED IN YOUR LONG MESSAGE. > I have had a recent experience which suggests that a practitioner with an > autorefractor can do a better job at refraction that one with the standard > stuff. wrong. > But I am old and implanted and my lenses are immobile. Everyone > knows that kids can accommodate, and may be difficult candidates for > autorefraction that reason. But even then, a second opinion from an > autorefractor might be useful. most likely her doctor performed an autorefraction as part of her routine exam. most do. however such measurements are of little value in kids for the reason you pointed out. > -- > Dicky > (Progressive myope until very recently) well then my apologies to Dr. Stacy, whom was correct in questioning your assumption that your daughter was truly a myope. the statements that you attributed to your eye doctor at your daughters earlier appointment make no sense at all in reference to her current prescription. key questions are, what is your daughter's best corrected acuity in each eye when she was looking through the corrective lenses in her Rx. also what degree of stereopsis does she have. i am conservative. i would recommend something closer to full-time wear. IMHO the amount of astigmatism in her left eye, which is more than I would term moderate, is significant enough to result in amblyopia if she were to go around uncorrected. i would recommend perhaps full time wear except during recess, gym class, sporting events, etc. where the glasses could be lost or broken. on the otherhand, if her corrected acuities were normal and equivalent in both eyes currently, and her stereopsis is currently normal, then some docs might simply suggest part-time wear and monitoring over time. IT was two different doctors.. He really didn't seem to think she would want to wear them full time, he really said that it might help for reading and seeing the board and some school work but that she wouldn't want to run in them or walk around in them. I asked what the harm was and he said, no harm in not wearing them full time. He wants to see her in the next six months and then every year. He said that her eyes were working together but that one eye was doing most of the work for reading and he wanted the glasses to help the other eye work (I'm paraphrasing..).. he said her eyes were able to correct and that there was no amblyopia.. I hope that helps to clarify.. We are filling the prescription next week when our vision voucher comes and plan on wearing them for all close work and then it will be up to her.. He said he wasn't surprised that she is bothered by it... whatever that means.. Personally, I think it would be optional as to whether she wears them full or part time. If she was wearing them part time I would definetly want to monitor her vision. She could indeed develop refractive amblyopia with this kind of Rx. In your message you stated: > He really didn't seem to think she would want to wear them full time, snip > she wouldn't want to run in them or walk > around in them. snip > and then it will be up to her You must realize that, as her parent, YOU need to be the one to decide if it is appropriate whether or not she wears her glasses full time or part time-- not her. You will hopefully make that decision based upon the advice of your doctor as he/she monitors your daughters vision over time. It can't be up to whether your daugher "wants" to wear them or not! I have seen countless adults who were amblyopic and told me they refused to wear their glasses when they were a child and now they regret it. You need to make the best decision for your daughter and not let what she wants to do get in the way of the development of her visual abilities. Its hard for parents to be the tough enforcer for kids that need to wear their glasses full time but it's your responsibility. > He said he wasn't surprised that she is > bothered by it... whatever that means.. > vision voucher comes and plan on wearing them for all close work and > then it will be up to her. It may be totally academic, but these glasses should help for both near and far (I'm not a doctor, and I'm not familiar with the details, so I could well be wrong). I'm just suggesting that she may not want to give them up for far work. I mentioned contacts a couple of times, but I have some serious doubts now. SignatureDan Abel dabel@sonic.net Petaluma, California, USA > He really didn't seem to think she would want to wear them full time, it shouldn't be up to her. >He said he wasn't surprised that she is > bothered by it... whatever that means i imagine "it" means the blurry vision she has in her left eye would it be possible for her astigmatism to get better in the bad eye? Would wearing the glasses more than not, possibly help? ally Probably not, short of eventual eye surgery. It's pretty much the shape of the cornea that she was born with. When she gets the glasses, and has worn them a week or two, take her in and ask them to check her stereo vision with them on. I'd still like to see some unaided and best corrected acuities. "Normal" just doesn't do it for me. Heck, if you have the charts yourself, check her yourself. Be very careful to completely cover the eye you aren't checking, and try to get different series of letters (or maybe use a tumbling E chart) so memory is not a factor, and make sure she is at the proper viewing distance for the chart (usually, but not always 20 ft.) Measure it. Hopefully your numbers will agree with the docs, when you get them. w.stacy, o.d. >would it be possible for her astigmatism to get better in the bad eye? >Would wearing the glasses more than not, possibly help? > >ally > > > would it be possible for her astigmatism to get better in the bad eye? Not likely, tho it sometimes happens. > Would wearing the glasses more than not, possibly help? It won't re-shape the cornea. Astigmatism like hers usually occurs at the cornea, and there aren't many ways it can change, except by injury, exposure, or slow natural changes. -MT could he have possibly over prescribed her.. from what I read here it sounds like much more of a problem than he made it sound in his office. He really didn't mention anything to me about possibility of amblyopia over time, or anything like that. He basicaly said that wearig the glasses would probably help her see better and for certain things she will need/want it and for certain things she might not. The end. He didn't tell me to rush out and get her glasses.. immediately - ( I called today to have the vision voucher rushed to me so we could have the glasses soon). Could she totally lose vision in the eye with astigmatism? I really don't want that to happen. Is it possible that she will ever be able to wear contacts? (she will most likely want them over glasses in a few years) Can Lasik help her when she is an adult.? Thank you so much.. allyson Okay.. I reread the paperwork he sent me home with.. There is a box labeled: Visual acuity correct to: and it is filled in 20/20.. I don't know if that helps.. allyson > Okay.. I reread the paperwork he sent me home with.. > [quoted text clipped - 4 lines] > > allyson Good. Only I wish it were more specific, as in whas it R 20/20 L 20/20 or just 20/20??? By itself it could mean O.U. (with both eyes). Amblyopia is only an issue if the best corrected acuities are significantly different between the two eyes. And I must disagree with one thing that's been repeated on this thread: If she doesn't wear the glasses, she might develop amblyopia in the futre. I don't buy that. I think there are many reasons she should wear the glasses, but the time for developing amblyopia ex anopsia at age 8 has long since passed, which is why the AOA and others are pushing to get kids' first exams before age 1 year. In infancy, we can prevent a lot of amblyopia. By age 8, she's over the hill so to speak in the amblyopia department, ESPEICIALLY if she is 20/20 R and 20/20 L with correction. Please verify that. I'll sleep better too! w.stacy, o.d. w.stacy, o.d. first, calm down mom > could he have possibly over prescribed her why would you suspect that. likely not. if he got her to see 20/20 the refraction is likely accurate. trust him. >.. from what I read here it > sounds like much more of a problem than he made it sound in his office. if she already has some signs of amblyopia then there is more of a problem than you said. but if she doesn't, and i suspect she doesn't based upon your quotes of what the eyedoc said, then part time wear of her glasses will work fine if you get her checked regularly as your eyedoc recommended. > He really didn't mention anything to me about possibility of amblyopia > over time, or anything like that. He basicaly said that wearig the > glasses would probably help her see better and for certain things she > will need/want it and for certain things she might not. The end. He > didn't tell me to rush out and get her glasses.. immediately it's not necessary to get them tomorrow, but get them soon (a week or two should be fine) > Could she totally lose vision in the eye with astigmatism? no. don't worry about that. > Is it possible that she will ever be able to wear contacts? (she will > most likely want them over glasses in a few years) yes. contacts are definitely an option > Can Lasik help her when she is an adult.? yes Lasik would be an option once she gets to age 18-20. everything is going to be fine. your daughter justs needs to get some glasses and see her eye doc regularly. it's pretty common-- don't worry about it. if your were to stop taking her for regular visits to the eyedoc, or let her never use the glasses, or lose them and not replace them, then you have a chance of her developing reduced acuity in her left eye over time (i.e. amblyopia). just do what you should do and everything will be fine. Thank you so much.. you have really helped to calm me down.. I feel like I left the eye doctor feeling really good and now I have gotten TOO much information that has me all confused. We plan on using the glasses as much as possible (whenever she is on the computer, watching tv, reading, doing homework, etc. etc.) I would like her to be able to go out and ride her bike and play without them (she would most likely damage or lose them). I want to do what's best for her and if forcing her to wear them 24/7 is best, then by golly I'll do it.. I just don't want to have to do that. I don't want to feel guilty every time I see her |
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