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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. 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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 take them off, or decide to go out and play without them. I will be dilligent on her using them for close work. The OD I took her to came very well referred with 22 years in practice, I felt good about him. Thanks so much for taking the time to calm my fears and bring me back down to reality... ally >well then my apologies to Dr. Stacy, whom was correct in questioning >your assumption that your daughter was truly a myope. > I've learned over the years to be skeptical especially of things patients think their eye docs have told them. BTW in your last post you mentioned the doc never mentioned anisometropia. Come to think of it, I can't recall the last time I've used that term to anyone but another doc. It's usually couched as "one eye stronger than the other" or "one lazy eye". >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. > I think they were unsure of their measurments/diagnoses. >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 agree with that and asked about the former, but stereopsis would be great to know as well. Ally hasn't provided the acuities as requested. Please, Ally, give us unaided and best corrected acuities. Thanks. >i am conservative. i would recommend something closer to full-time >wear. IMHO the amount of astigmatism in her left eye, which is more [quoted text clipped - 3 lines] >events, etc. where the glasses could be lost or broken. > I agree totally. This child should be wearing glasses as full time as practical. Anything less borders on the kind of abuse Otis hands out regularly. >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. > > That's true, but I think she will perform many tasks better with them than without. Looking forward to seeing the acuities and stereo (if they didn't do stereo, not to worry, not everyone does, but it would be nice to have... kind of helps with determining how well the two eyes work together. It would be VERY interesting to measure her stereo with and without the Rx in place, after she's worn them for a week or so). w.stacy, o.d. I don't think I have that information that you are requesting.. The whole visit took 1/2 hour, the doctor did NOT stress full time wear, he actually made it a point to say when reading or doing school work and then whenever she wants to wear them. He made it sound like it was more like giving the bad eye a chance to work. He told me that one eye was mild and one was moderate, he said there was no myopia. He didn't say anything about corrected or uncorrected. I asked if she could develop amblyopia and he said it was unlikely. He said that it was likely to stay stable. I didn't even here mention of the word stereopsis. He took a lot of time with her in the chair and took some pictures of her eye before she got into the chair. She was very cooperative today. I am sorry I cannot be more thorough.. I should have taken notes. I do know that when she had the "machine" over her face (with different lenses around each eye), she read the eye chart really well. hope this helps.. ally Hoping you will be able to get us those acuities. I'd like to know if that left eye is actually 20/20 corrected, because it would not be unusual at all for her to have developed a little amblyopia in that eye. I can't imagine why they are waffleing on full time wear. If my child had that, I gently urge full time wear. She will be able to wear a contact eventually (i'd recommend a soft toric at least for the left, maybe R also). But then again, if she really has got 20/20 corrected in the left, then I suppose I'd let her decide indirectly. If, as I suspect may be the case, she's actually a little weak on the left acuity, I might even have her patch the right eye part time, say an hour a day, but only with the glasses on. If either the corrected acuities or stereo measurements came in weak I might get more agressive with the Rx (as in full time, no ifs ands or buts). w.stacy, o.d. >Okay Guys.. here goes.. > [quoted text clipped - 19 lines] > > I am going to call the doctor tomorrow.. what exactly should I ask? I feel like such an idiot that I didn't get a thorough description.. I was trying to be so prepared and then you get in the little dark office and he turns off the light and starts the exam and you just feel like you don't know anything and you turn into a bumbling idiot.. I was so prepared for a myopia diagnosis that I was kind of taken aback.. I do think the eyes corrected very well.. He flipped a little switch on the black machine over her face and her her read the chart - which she did very well. Then he kept saying "better or worse" as he kept flipping switches. I woul d have thought that if he was concerned with full time wear her would have put more stress on it.. He was very casual... He didn't jump up and yell - oh my gosh.. her eye is really bad. He did stress that they were healthy and working together. I will say that he was very nice and gentle and seemed to know what he was talking about. If you want any advice for her on the internet, you have to provide at least 4 numbers: Unaided visual acuity, Right eye Unaided visual acutiy, Left eye Best corrected visual acuity, Right eye Best corrected visual acuity, Left eye He may abbreviate these like UVA, BVA, OD (for right eye), etc., but you should get some numbers that look like 20/20, and they may have little minus or plus signs after them. If he has stereo acuities, great. But I doubt it from your description. If so, they would look something like 30" or 120" which are seconds of arc, and it's just one number, not separately like the 20/ numbers. good luck w.stacy, o.d. >I am going to call the doctor tomorrow.. what exactly should I ask? I >feel like such an idiot that I didn't get a thorough description.. I [quoted text clipped - 12 lines] > > > 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. It's usually the people who don't sell eyeglasses who are doing the research. DrG > > 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. > > It's usually the people who don't sell eyeglasses who are doing the > research. They are actually quite harmless. All they want is more support for further research. "Dick Adams" <bad.addr@nonexist.com> wrote in news:1ic5f.154707$qY1.31648 @bgtnsc04-news.ops.worldnet.att.net: > They are actually quite harmless. All they want is more support for > further research. And all they can do to get it is to produce results and defend their proposal to a system of peer review that is arguably one of the best in the world. SignatureScott Reverse name to reply In article <pD95f.455663$5N3.384471@bgtnsc05-news.ops.worldnet.att.net>, > > 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 believe that's often how it works. I was very severely myopic, but needed less correction as I got older. But then I needed more (cataract). > What is really weird is that "professionals" still use such a crude measure > as 20/XX to describe quality of vision. [quoted text clipped - 3 lines] > exclaimed "excellent!, you have 20/20", and then walked out. Very > busy man! Cheerful, hopeful, optimistic! Gone! You're not an engineer, are you? :-) Very often in life, we severely oversimplify things. That's not a problem, as long as we all understand that. I complained to my OMD about the Snellen test before my first cataract surgery, and he fully admitted that there were serious flaws. However, he said that it was better than anything else, and was a very useful first step. If you read this group for a while, you'll find that the 20/XX is what the patients all talk about, because that's what they were told. The doctors here don't want to hear about it. It isn't very useful information to them. Just read this thread for an example. OP wants to know what to do with her daughter, who has 20/XX vision. The reply from the ODs is that they don't have a clue, what's her prescription? Endless back and forth, lots of discussion of myopia, but the OP doesn't have a prescription. So, now we get a prescription, and she isn't myopic at all! > 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 Try reading this group, over and over again the ODs repeat that 20/XX is a small piece. What's important is, "which is better, one or two?". > 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.) We're not dumb. We just have other things to do. I have a whole lot of other medical issues besides vision. Plus, I have a life! > > In laymans terms please. If eye shape is the cause, will the myopia > > stop progressing when the eye stops growing (after puberty so to [quoted text clipped - 4 lines] > guess, it is due to a long-term accomodative mechanism affecting the > anatomical parts that suspend the accomodative lens. There's nothing more amazing than a baby. A little tiny thing that grows up to be an adult. I don't see why the eye is any more amazing than the heart, lungs, legs, etc. > 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. We see this conspiracy theory far too often here, IMNSHO. I think it's rather offensive, personally. SignatureDan Abel dabel@sonic.net Petaluma, California, USA > You're not an engineer, are you? Nope. I am a myope. Well, X-myope. * > > 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 accommodative mechanism affecting the > > anatomical parts that suspend the accommodative lens. > There's nothing more amazing than a baby. A little tiny thing that > grows up to be an adult. I don't see why the eye is any more amazing > than the heart, lungs, legs, etc. What is amazing to me is how little interest there seems to be to understand how accommodation works, and how it can go wrong, and how eyes in most, or many cases, come out right in spite of vast differences in eye size, and of changes during the growth of individuals. Almost all animals have eyes, and, for the most part, if they do not see well, they do not grow up. > > 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. > We see this conspiracy theory far too often here, IMNSHO. I think it's > rather offensive, personally. Well, you know, conspiracy theories are most part for entertainment, and should not be taken too seriously. "William Stacy" <wstacy@obase.net> wrote in message news:NMk5f.17416$6e1.63@newssvr14.news.prodigy.com... > [ ... ] > Amblyopia is only an issue if the best corrected acuities are > significantly different between the two eyes ... I think that means that, if your child's eyes are corrected with eyeglasses so that each of them sees the 20/20 line on the chart, there is little possibility that one eye may give up and go south. Right? (I think I am getting the hang of this.) -- Dicky ___ * And I'm no dope. (poet and know it) > "William Stacy" <wstacy@obase.net> wrote in message news:NMk5f.17416$6e1.63@newssvr14.news.prodigy.com... > [quoted text clipped - 9 lines] > > Right? Exactly. The definition of amblyopia requires a difference of at least 2 snellen acuity lines between the eyes WITH BEST CORRECTION IN PLACE. This definition ignores the existence of "bilateral amblyopia", which to me is an oxymoron and a misnomer. There is no evidence that I know of that amblyopia ex anopsia can develop after early childhood. w.stacy, o.d. Hello Stacy, I'm replying to this old thread regarding your definition of amblyopia. If a patient has a BCVA, reading at a slow pace, 20/25-2 in the left with no ocular disease accept for higher refractive error and 20/15 in the right in a normal pace, does this still fit this definition? Thanks, Nico >> "William Stacy" <wstacy@obase.net> wrote in message news:NMk5f.17416$6e1.63@newssvr14.news.prodigy.com... >> [quoted text clipped - 9 lines] > >w.stacy, o.d. >What is amazing to me is how little interest there seems to be to understand >how accommodation works, and how it can go wrong, [snip] Heard of presbyopia, Dick? Are you aware that the baby boomers are now all beginning to live/already living with it? If you don't think there's accommodation research going on, you're not paying attention. [Hm. Another anonymous poster stirring the pot. Married to Gertrude? Cousin of Otis's? I wonder.....] SignatureLive simply so that others may simply live Good morning everybody! I just got of the phone with the OD. Here goes: Both eyes corrected to 20/20. There is NO amblyopia. She does not have myopia (these are questions I had asked him). He stated again that he would ilke her to wear them for close up work, reading, school work, and if she wants to wear them all the time, she can - no harm no foul, but he would LIKE her to wear them for reading and computer work altogether. He thought her astigmatism would remain fairly stable - said it was something she was born with, etc.etc. Also, I forgot to ask this one question and I don't want to call him back.. Why does the beginning of her prescription start with a +.. please simplfy for me. If the + is there doesn't that mean that things far away will be blurry... I'm still confused.. the more I learn the more confused I get.. allyson P.S. You guys are great - gotta love the internet >Also, I forgot to ask this one question and I don't want to call him >back.. Why does the beginning of her prescription start with a +.. >please simplfy for me. If the + is there doesn't that mean that things >far away will be blurry.. The + denotes a correction for hyperopia, or farsightedness, which is why the OD wants your kid to wear the glasses for close-up work. She can see the blackboard but probably has some trouble seeing her textbook, her desktop and other things withing about a 5-10 foot range. You really should be asking the OD all these questions since s/he's the person who has examined your kid's eyeballs and evaluated her vision function. +++++++++++++ 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... > >Also, I forgot to ask this one question and I don't want to call him > >back.. Why does the beginning of her prescription start with a +.. [quoted text clipped - 6 lines] > textbook, her desktop and other things withing about a 5-10 foot > range. I almost gave this kind of an answer, but fortunately didn't, because it isn't correct. I'm not happy with eye doctors, because they can't agree on how to write down an eye prescription. I think that this method is particularly confusing. A "plus" means one thing if there is no second number, but something different if there is. So, your daughter is not myopic, and not hyperopic. She is astigmatic. Her vision problems will cause problems at any distance, not just near or far. SignatureDan Abel dabel@sonic.net Petaluma, California, USA >Good morning everybody! > [quoted text clipped - 8 lines] > > All sounds reasonable. I would only add that for functions where she might want the best depth perception possible, she might want to wear them. Example, ping pong and horseshoe pitching, my 2 personal favorites... Maybe not... >Also, I forgot to ask this one question and I don't want to call him >back.. Why does the beginning of her prescription start with a +.. >please simplfy for me. If the + is there doesn't that mean that things >far away will be blurry... No, just means that in the primary meridian she is farsighted (hyperopic). At her age, with numbers that small, it's a non-issue. The second number for each eye is the amount of astigmatism. That's the cause of the blur. If there is myopia in your family, she could yet develop that. But that's another story. Another thread... Glad it all worked out. w.stacy, o.d. I have one cousin on my mother's side that has myopia (from her father's side, not related). Neither my parents or my husband or I or any siblings wear or ever needed glasses - unless you count presbyopia... There is no myopia among my siblings or parents.. >Also, I forgot to ask this one question and I don't want to call him >back.. Why does the beginning of her prescription start with a +.. >please simplfy for me. If the + is there doesn't that mean that things >far away will be blurry... "+" indicates that your daughter is farsighted ... a 'hyperope--' not nearsighted (myope). This means that--aside from her astigmatism which creates blur regardless of proximity--things at distance will be clear; things at near will require her to 'accommodate' (use her ciliary muscles to change the shape of the lens). Hate to thicken the soup, but ... have we already determined whether this was a cycloplegic (dilated with eye drops) refraction or not?? SignatureLive simply so that others may simply live Ok lets dissect it one more time: Her refractive errors are: OD: Sphere: +0.50 Cylinder -0.75 Axis 6 OS: Sphere: +1.00 Cylinder -3.25 Axis 158 The right eye is actually MILDLY hyperopic along the 6 deg meridian (almost horizontal) and is slightly myopic on the opposite (almost vertical) meridian, with the .75 cylinder causing slight blur at all distances. The left eye is slightly more, but still MILDLY hyperopic along the 158 deg. (about 4:00 o'clock to 10:00) and MODERATELY MYOPIC (-2.25) along the opposite meridian. The 3.25 cyl causes substantial blur at all distances. Actually, overall she is very slightly hyperopic in the right eye and mildly myopic in the left, by spherical equivalent (averaging all meridians). So her blur is caused by her astigmatism, not the plus part of the equation. She is NOT more blurred at far than near, and the opposite is likely. Now that I've looked at it again, I think she probably is "going myopic" as we speak. Time will tell. w.stacy, o.d. > > [quoted text clipped - 15 lines] >this was a cycloplegic (dilated with eye drops) refraction or not?? > Now that I've looked at it again, I think she probably is "going myopic" as we speak. Time will tell. w.stacy, o.d. WHAT!! Now something else for me to worry about.. I kind of like what he said about the astigmatism staying the same and to come back in 10 years for lasix (said jokingly).. should I now be worried that she is miopic and I should look at prevention.. > should I now be worried that she is > miopic and I should look at prevention.. Understand that "myopia prevention" is like the Holy Grail. Everyone's been looking for it and nobody's found it, except atropine-like eye drops. If you want to worry over it you're looking too hard for things to worry about. When you find something that works, please tell us, but tell us how you know it works. I prevented myopia in my kids by erecting a totem pole in my front yard to ward off evil spirits. It also does an excellent job of keeping the elephants out of my garden. I know it works because there's no myopia and no elephants. What other proof do you need? Your daughter doesn't have myopia. She has about a 1 in 4 chance of developing it, like every kid in this country, somewhat higher or lower depending on her genetics, her ethnicity, and a tiny contribution from her environment. Whatever you do will make very little difference, so why worry? Many myopes are happy to be that way when they reach 45. About all you can do is keep her from reading with her nose in the book. Or better still, don't let her read? -MT > WHAT!! Now something else for me to worry about.. I kind of like what > he said about the astigmatism staying the same and to come back in 10 > years for lasix (said jokingly).. should I now be worried that she is > miopic and I should look at prevention.. You stress too much. There is no proven prevention for astigmatism, myopia, or any refractive error. Your eye is simply going to do whatever its going to do. Much of it is genetic, and whatever isn't has never been determined sufficiently to plot out a preventative treatment plan. Simply take her to the eye doctor annually and change her prescription to keep up with the natural changes that occur in her refractive error. You cannot influence the changes. And changes are quite commonplace in adolescents. > changes are quite commonplace in adolescents. This has got to be the understatement of the year on this newsgroup! :-) SignatureDan Abel dabel@sonic.net Petaluma, California, USA she was not dilated... >"+" indicates that your daughter is farsighted ... a 'hyperope--' not >nearsighted (myope). > > Not quite. See my last post. The precise diagnosis is complex: antimetropia with mixed astigmatism. She is more myopic than hyperopic. >This means that--aside from her astigmatism which creates blur >regardless of proximity--things at distance will be clear; things at >near will require her to 'accommodate' (use her ciliary muscles to >change the shape of the lens). > Just like every other 8 year old in the world. Is there a point to that observation? >Hate to thicken the soup, but ... have we already determined whether >this was a cycloplegic (dilated with eye drops) refraction or not?? > Good point. If not, she could be more hyperopic or less myopic in one or both eyes than was measured. w.stacy, o.d. >>"+" indicates that your daughter is farsighted ... a 'hyperope--' not >>nearsighted (myope). [quoted text clipped - 3 lines] >Not quite. See my last post. The precise diagnosis is complex: >antimetropia with mixed astigmatism. She is more myopic than hyperopic. Of course you're right. I was trying to explain the spherical plus, but did so out of the context of the rest of her Rx. >>This means that--aside from her astigmatism which creates blur >>regardless of proximity--things at distance will be clear; things at [quoted text clipped - 4 lines] >Just like every other 8 year old in the world. Is there a point to that >observation? At eight years old, though she likely has some 14-16d of accommodative amplitudes, my thought was that she might be taxing their 'facility' with uncorrected refractive error. That's what led me to the question about cycloplegia. >>Hate to thicken the soup, but ... have we already determined whether >>this was a cycloplegic (dilated with eye drops) refraction or not?? [quoted text clipped - 4 lines] > >w.stacy, o.d. SignatureLive simply so that others may simply live antimetropia with mixed astigmatism.. Could someone please tell me what that is?? How can you tell all that from the RX. What does that mean?? should I be really worried No you shouldn't. It's just a concise way to express her condition without resorting to the numbers. Useful for coding insurance claims and talking to other docs. Sounds like gibberish to you, but does impart information. That's all. However, I still think she is headed into myopia and you should keep an eye on her, so to speak. w.stacy, o.d. >antimetropia with mixed astigmatism.. Could someone please tell me what >that is?? How can you tell all that from the RX. What does that >mean?? should I be really worried > > antimetropia with mixed astigmatism.. Could someone please tell me what that is?? How can you tell all that from the RX. What does that mean?? should I be really worried > antimetropia with mixed astigmatism.. Could someone please tell me what > that is?? How can you tell all that from the RX. What does that > mean?? Don't worry about this. This is simply a naming convention. What is important is simply that your daughter has astigmatism, a lot more in her left eye than her right eye. >should I be really worried No. I get the impression you worry too much. Your daughter is fine. She has astigmatism. In general, when a persons vision is blurry its usually due to nearsightedness, farsightedness, or astigmatism (or a combination). In your daughters case its astigmatism. It simply means, most likely, she has an irregular curvature to her corneal. NO BIG DEAL! Just have her wear her glasses and take her to see her eye doctor when scheduled. Relax. You are probably getting eyestrain from looking at your computer too much ;) Dear William, Not quite. See my last post. The precise diagnosis is complex: antimetropia with mixed astigmatism. She is more myopic than hyperopic. Otis> Is this a new term "antimetropia". I have not seen it in any text at this point. Or is this just a slip of the keyboard (that I am prone to do.) Best, Otis It's older than you are. w.stacy, o.d. >Dear William, > [quoted text clipped - 8 lines] > > Otis Brown blathered: >Is this a new term "antimetropia". I have not >seen it in any text at this point. >Or is this just a slip of the keyboard (that I am >prone to do.) >It's older than you are. I'll help out poor old Otis ... again .... Antimetropia is a condition in which one eye is myopic and the fellow eye is hyperopic. [Sigh.] SignatureLive simply so that others may simply live Dear Neil and William, I have the term as: * * Anisometroopia - Difference in refractive status of the eyes. But I guess the alternative spelling is Antimetripia. Thanks for the information. Best, Otis > Dear Neil and William, > [quoted text clipped - 9 lines] > > Otis I wish MY local tavern had WiFi access, too! SignatureScott Reverse name to reply >> Dear Neil and William, >> [quoted text clipped - 11 lines] > >I wish MY local tavern had WiFi access, too! Now THAT's funny! SignatureLive simply so that others may simply live >Dear Neil and William, > [quoted text clipped - 3 lines] > >But I guess the alternative spelling is Antimetripia. No, no, no. Anisometropia is "a condition of unequal refractive state for the two eyes, one eye requiring a different lens correction than the other. In the condition of antimetropia the refractive errors of the eye are of opposite signs and amounts as in: OD +3.00 and OS -4.00. Isoanisometropia is defined as A condition of equal refractive error but with differing dioptric power. Crack a book, Jack.... SignatureLive simply so that others may simply live > Otis Brown blathered: > [quoted text clipped - 9 lines] > Antimetropia is a condition in which one eye is myopic and the fellow > eye is hyperopic. It wasn't a term I was familiar with, although that isn't too unusual. However, neither my dictionary nor Glenn's glossary was able to help me, which is more unusual: http://www.usaeyes.org/glossary/glossary.htm Should somebody let Glenn know to add this? SignatureDan Abel dabel@sonic.net Petaluma, California, USA >> Otis Brown blathered: >> [quoted text clipped - 17 lines] > >Should somebody let Glenn know to add this? Here's an interesting reference on anisometropia that sheds some light on these various concepts: http://www.abo-ncle.org/pdf/helkaa.pdf As to Glenn: sure. He can decide whether or not it merits inclusion (the primary advantage of running the site!). SignatureLive simply so that others may simply live > >> Otis Brown blathered: > >> [quoted text clipped - 25 lines] > As to Glenn: sure. He can decide whether or not it merits inclusion > (the primary advantage of running the site!). Thanks. I've forwarded this to Glenn, in case he's currently taking an Otis break. I find anisometropia of interest because I used to have it Real Bad. Furthermore, it was my choice to have it! I had it for five years, after my first cataract surgery and before the second. I was plano in the right eye, and as bad as -10D in the left. Because of this, I had already switched to contacts, which eliminated the problem. SignatureDan Abel dabel@sonic.net Petaluma, California, USA an update..We got her glasses today!!!! I just didn't want to wait so off to lenscrafters we went. She was excited and then when the optician put them on her I was waiting for her to gasp and exclaim - WOW!!! but no that didn't happen... She said things looked a little bit clearer and then quickly took them off and we left for home. When we got home I had her put them back on walk around the house and watch tv hoping that she would be seeing things really differently.. but no.. she just said "things look a little different but not enough different to keep them on"... does that make sense??? They have been placed in her reading corner and she will be forced to wear them for reading and playing on the computer.. for now that is how we will leave it.. Shouldn't they have made a bigger difference in her vision??? ally > an update..We got her glasses today!!!! I just didn't want to wait so > off to lenscrafters we went. She was excited and then when the [quoted text clipped - 10 lines] > we will leave it.. Shouldn't they have made a bigger difference in her > vision??? I'm just a lay person, but I've had a lot of vision problems, and I know that when one eye isn't working, the eye just ignores the image from that eye. In order to have depth perception using both eyes, the brain needs to learn how to do that. It may be that she just needs time and practice? SignatureDan Abel dabel@sonic.net Petaluma, California, USA >an update..We got her glasses today!!!! I just didn't want to wait so >off to lenscrafters we went. She was excited and then when the [quoted text clipped - 12 lines] > >ally Here's my shooting-from-the-hip-non-medical-cuz-I'm-not-a-doctor two cents. Presuming the glasses were correctly made to the provided Rx, I'd be thinking she needs, and should have had, a cycloplegic (dilated) exam. Anybody with letters after their name [;-)] wanna' chime in on this one? SignatureLive simply so that others may simply live okay.. newsflash.. she has just announced that she has "reading" glasses. She sat down to do her beore bed reading and she said "wow - this looks better" and I will admit that she seems to be reading more fluently. So it looks like they are making a bigger difference for things up close than at far.. go figure...She said it is MUCH clearer when she is reading.. ally > Presuming the glasses were correctly made to the provided Rx, I'd be > thinking she needs, and should have had, a cycloplegic (dilated) exam. > > Anybody with letters after their name [;-)] wanna' chime in on this > one? I sort of agree, but I'm less adamant than I used to be on this. Of course you get a more thorough exam if the eyes are dilated, and it does help nail down the presence/absence of ciliary spasm. But if the doc is really skilled, that final Rx is probably going to be based more on the manifest than the cycloplegic. If the skill/confidence is lower, the cyclo is a must. Also, if the patient is not a great examinee, cyclo can be a life-saver. On ally's posts, this kind of Rx is expected to provide lukewarm reception from an 8 year old. Glad to hear she'll wear them at least part time, but I don't think I'd force too hard. Gentle persuasion is best. w.stacy, o.d. >> Presuming the glasses were correctly made to the provided Rx, I'd be >> thinking she needs, and should have had, a cycloplegic (dilated) exam. [quoted text clipped - 15 lines] > > w.stacy, o.d. I don't think an 8 yr old would be too enthusiastic about having to wear glasses. I recall my experiences when, at 8, I started to wear glasses & at some point, was sent to live with my aunt for a half-year, after having chicken pox. The teacher at the new school made it mandatory that I wear my glasses which I "sometimes forget" to bring it with me; was sent home to get it. I found that I was able to take my time retrieving my glasses without reprimands when it took me 1 or 2 hours to get them even tho it was only a 5 or 10 min walk. I did find that "forgetting" my glasses was a highly "convienent" situation. Kinda miss those "good old days" when I can "officially" miss school time so often...... > I don't think an 8 yr old would be too enthusiastic about having to wear > glasses. You'd be surprised. I fit 8 yos all the time and most of them like to wear them. It's a fashion statement. My own 9 yo granddaughter demands glasses, even though she doesn't really "need" them, mostly because her 11 yo big sis got them. w.stacy, o.d. >> I don't think an 8 yr old would be too enthusiastic about having to wear >> glasses. [quoted text clipped - 5 lines] > > w.stacy, o.d. Ahhh, forgot about the current Harry Potter fad........ > They have been placed in her reading corner and she will be forced to > wear them for reading and playing on the computer.. for now that is how > we will leave it.. Shouldn't they have made a bigger difference in her > vision??? Children, particularly girls, usually find eyeglasses cosmetically unacceptable. This one has one sharp eye, according to what has been written. Probably she can see what is written on the blackboard, and recognize her friends across the street. So, beyond a doubt she will seldom wear her glasses while out and about. ally down" <adowning@adelphia.net> wrote in message news:1129853779.755657.3510@g49g2000cwa.googlegroups.com... > okay.. newsflash.. she has just announced that she has "reading" > glasses. She sat down to do her before bed reading and she said "wow - > this looks better" and I will admit that she seems to be reading more > fluently. So it looks like they are making a bigger difference for > things up close than at far.. go figure...She said it is MUCH clearer > when she is reading.. It's a damned shame she is not identical twins. Then we could give the same eyeglasses to both, with the except that one twin gets a pair of actual reading glasses (say "add 2.25D" or whatever is found to be appropriate) plus base-out prisms, all to make her eyes think they are seeing her books at virtual infinity. Then we would, for the next several decades, have a good little experiment. With regard to the oft-heralded failure of the efficacy of "plus" lenses to be established, please consider that "plus" lenses can be used in a number of ways. For instance, they are good for nuking ants with concentrated sunshine in the sidewalk. The bottom of a broken classic coke bottle was good for that. Competently prescribed and made eyeglasses are better, well, for ophthalmic problems anyway. You eye guys need to tighten up your lexicon. -- Dicky Professional Myope Parent to Myope "one-eyed", etc. Dear Dicky, Subject: Why test on human-primates. The results are more certain on monky-primates. It's a damned shame she is not identical twins. Then we could give the same eyeglasses to both, with the except that one twin gets a pair of actual reading glasses (say "add 2.25D" or whatever is found to be appropriate) plus base-out prisms, all to make her eyes think they are seeing her books at virtual infinity. Then we would, for the next several decades, have a good little experiment. Otis> Actually, when you place a mild plus on the primate eye the refractive state (measured) follows the applied plus. With regard to the oft-heralded failure of the efficacy of "plus" lenses to be established, please consider that "plus" lenses can be used in a number of ways. Otis> This depends on who is making the measurement. When Dr. Colgate made the measurements he confirmed his vision cleared. Opinions differ on this subject. For instance, they are good for nuking ants with concentrated sunshine in the sidewalk. Otis> This first thing a kid learns about the plus. The bottom of a broken classic coke bottle was good for that. Otis> Naw -- the optics of a coke-bottom diffuse the light. It takes a good 5 inch plus to get a "focused" point of the sun. It would be interesting to calculate the watts per square meter for that case. (Poor ant!) Competently prescribed and made eyeglasses are better, well, for ophthalmic problems anyway. Otis> They are 1,000 times easier -- that is for certain. You eye guys need to tighten up your lexicon. -- Dicky Professional Myope Parent to Myope "one-eyed", etc. Otis> I always enjoy these analytic discussions about the natural eye as a dynamic system. > Why test on human-primates. The results are more certain on > monkey-primates. Yer kiddin', right!!? Can the monkeys learn how to read the Snellen charts? > Actually, when you place a mild plus on the > primate eye the refractive state (measured) follows > the applied plus. Not understood! Do you mean that the monkeys become more nearsighted or more farsighted? How are the lenses applied? (Will the monkeys wear eyeglasses?) What structure of the eye changes to compensate the refractive change? Where can I read about it? > This depends on who is making the measurement. > When Dr. Colgate made the measurements he confirmed > his vision cleared. Opinions differ on this subject. What does "cleared" mean in this context. Do you mean that he could read lower lines on the charts. At what distance? Was he reading through eyeglasses? > optics of a coke-bottom diffuse the > light. It takes a good 5 inch plus to get > a "focused" point of the sun. It would be > interesting to calculate the watts per > square meter for that case. Coke bottle optics are kinder. They give the ants a fighting chance. > > Competently prescribed and made eyeglasses are better, > > well, for ophthalmic problems anyway. > They are 1,000 times easier -- that is > for certain. It is hard to find eyeglasses good for zapping ants. > I always enjoy these analytic discussions > about the natural eye as a dynamic system. We are going to get blasted by Dr. Leukoma. -- Dicky Dear Dicky, Subject: Strong opinions -- strong resolve. Re: Prevention (i.e., clearing from 20/60 to 20/30) is indeed very difficult -- I believe that we all agree on that point. Re: The only issue is that many say it is totally impossible, while others suggest that it is possible. To reply: Otis> This depends on who is making the measurement. When Dr. Colgate made the measurements he confirmed his vision cleared. Opinions differ on this subject. Dicky> What does "cleared" mean in this context. Otis> "Cleared" in this context means that he read his eye-chart at 20/70, and by INTENSIVE use of a +2.5 diopter lens, slowly cleared his distant vision to 20/20. (This result is consistent to primate-eye studies -- as the "second-opinion".) Dicky> Do you mean that he could read lower lines on the charts. Otis> Exactly -- how else could you tell? Dicky> At what distance? Otis> Stirling Colgate has a Ph.D. in physics. He knew the standard distance is 20 feet, and the size of the letters. Dicky> Was he reading through eyeglasses? Otis> He "caught" his vision as stated, and realized that he personally had to take care of it himself. i.e., he realized the nature of nearsighedness was the NATURAL eye adapting its refractive state to its average visual environment. By ending the "near" environment with a plus lens -- his distant vision slowly cleared. This would only be possible because the natural eye CONTROLS its refractive state to its AVERAGE visual enviroment. You might enjoy reading his commentary on this preventive process on my site: www.myopiafree.com Best, Otis > [ ... ] news:pM96f.474588$5N3.471330@bgtnsc05-news.ops.worldnet.att.net mostly deleted to preserve web space. > You might enjoy reading (Dr. Colgate's) commentary > on this preventive process on my site: > > www.myopiafree.com OK, Otis, I'll do that. You must be doing something right, or these eye guys would not hate you with such vigor. Perhaps you might be interested in my latest theory: Now that the pocket movie viewer is available, the next thing will be the eyeglass viewer. The eye guys will be so busy fitting these little viewers into eyeglasses that refractive corrections will take a total back seat. Nobody will care because the real world will totally disappear behind movies. Maybe drivers watching movies as well as gassing on cell phones. Probably a good thing for the eye guys, because I am guessing that they are all about to be obsoleted by the next generation of autorefractors. Thank you for your response. -- Dicky P.S. My guess has been that myopia is due in part (probably mostly) to stretching of anatomical elements which succeed in the well-functioning eye to keep its relaxed focus at infinity. That stretching, once beyond the elastic limit of said elements, would not likely be reversible. Thus, my proposal for positive lenses would be preventative, not therapeutic. It is for reading glasses, positive with respect to the distance correction, based on a competent prescription to correct refractive errors, and prisms to point the eyes straight ahead when focused on the work (converge at infinity). I do not imagine I am the first to propose that. -d. > P.S. My guess has been that myopia is due in part (probably > mostly) to stretching of anatomical elements which succeed in > the well-functioning eye to keep its relaxed focus at infinity. > That stretching, once beyond the elastic limit of said elements, > would not likely be reversible. If myopes "stretch" to read, then hyperopes "stretch" three or four or ten times harder. Shouldn't they get nearsighted? -MT > > P.S. My guess has been that myopia is due in part (probably > > mostly) to stretching of anatomical elements which succeed in [quoted text clipped - 6 lines] > > Shouldn't they get nearsighted? Well, I am a myope, and can't really speak for the hyperopes. But I could hope, for them, that they would inelastically stretch far enough, so that their eyes would come to rest at infinity. Then their eyes would function normally, and they would not have to work so hard to focus close. But they can't do it. Or, if they did, you would not notice them as hyperopes. -- Dicky so the point is that excessive accommodative stress does not induce myopia, or hyperopes would all become less hyperopic. they don't, and in fact at middle age they usually reveal increased hyperopia. another point-- why do uncorrected myopes, such as children who are -1.50 and refuse to wear their glasses, become more myopic. if your myopic then you don't stress your accommodative system so you wouldn't expect them to get worse. yet they do, at the same rate as those who do wear their glasses. same is true for kids who are given bifocal. hell, kids who are given excessive minus lenses so they have to overstress their accommodative mechanism also don't change any more that those with their exact prescription. are you getting the feeling that it's pretty clear that accommodative stress doesn't play a role in myopia progression in humans? if so, then you are already leagues ahead of our good buddy Otis. Dear Dicky, I have friends in optometry and ophthalmolgy. I set "professional limitations. I define this as follows. I DO NOT deal with the great mass of humanity walking in off the street. The public wants that "instantly sharp" vision, and so it is provided. That is "optometry" and that is how it has been for at least the last 150 years. I do not propose to "chage" it. In fact Dr. Raphaelson spelled this out with stark clarity in "The Printer's Son", there the plus was indeed successful, and the parents -- not understanding the necessity of it -- totally rejected this intelligent use of the plus -- for prevention. That DEFINES but the problem -- and the fact that these ODs can never achieve a "solution". But I simply report the fact that the nautural eye is a dynamic device, and is a "control system". When you respect the natural eye is this manner, then you get accurate scientific results. But that becomes a matter of judgment of the scientists who are conducting this type of review. This respect for scientific facts, however can never be "reduced" to a matter of dealing with the general public -- and I don't propose to do it. My proposal was for my immediate relatives who had the insight to "work" the preventive measure -- and personally verify their vision as passing all legal VA requirements. This they did. It certainly was not easy, and reflected on their motivation in this issue. The REAL SKILL and ability was in them. To further respond: Dick> P.S. My guess has been that myopia is due in part (probably mostly) to stretching of anatomical elements which succeed in the well-functioning eye to keep its relaxed focus at infinity. Otis> It is just easier to say that when you take a population of primate eyes -- and place them in a more-confined environment, the refraction of the "confined" primates moves in the direction and approximate magnitude of the "confined" environment -- in diopters. This is a NATURAL process -- and can be verified by any scientists who wishes to make this meaurement effort of the NATURAL eye's behavior. That is just the way it is. This is an expected result -- there is no surprise to is. It would be very surprising if this result DID NOT OCCUR. Dick> That stretching, once beyond the elastic limit of said elements, would not likely be reversible. Otis> That is true. The only possiblity is prevention -- as suggested by the scientific work of the Oakley-Young study. Dick> Thus, my proposal for positive lenses would be preventative, not therapeutic. Otis> That is my position also. It puts "responsibility" on the person himself to make THAT kind of choice. Not easy at all. But the consequences of NOT doing it are as you state. Dick> It is for reading glasses, positive with respect to the distance correction, based on a competent prescription to correct refractive errors, and prisms to point the eyes straight ahead when focused on the work (converge at infinity). Otis> It is my belief that a person educated as to the true-facts concerning the natural eye's behavior -- can teach himself how to use the plus. I believe that the "prisms" are not necessary -- and very cumberson. It is hard enough to help the person understand this type of choice -- indeed. Most people will not respond to this -- at all. So the ODs have NOTHING TO WORRY ABOUT. Dick> I do not imagine I am the first to propose that. Otis> It is not difficult to propose a preventive solution -- under the person's control. The "reality" is that most people have NO INTEREST in "protecting" their distant vision, and so eventually, there is no choice but to wear a minus lens -- when the eye-chart goes below 20/50 or so. As always, the issue is more a preception that the natural eye is a "dynamic" system, rather than a "medical" preception. Please enjoy our pleasant analytic reviews of the natural eye's proven behavior. (In terms of measured refractive-state -- not in terms of "error".) Best, Otis > >What is amazing to me is how little interest there seems to be to understand > >how accommodation works, and how it can go wrong, > > [snip] > > Heard of presbyopia, Dick? (Guess he is pulling my chain!) Ooh, yes! I am intimately familiar with that, and with progressive myopia, and with cataracts. > Are you aware that the baby boomers are now all beginning to > live/already living with it? I guess they will have to get used to presbyopia and, at least, get some reading glasses. (Maybe some day in the future, attention will be given to keeping the eyes' lenses young and clear and elastic forever.) But I do not think that they should stand by idly while their kids' eye doctors, when it comes to eyeglasses, play the same games with them as their eye-doctor daddies and granddaddies did in their day. > If you don't think there's accommodation > research going on, you're not paying attention. Could you kindly send me more references to cogent research publications, preferably review articles to start? ( http://www.optometrists.asn.au/gui/files/ceo865276.pdf did not work. ) > [Hm. Another anonymous poster stirring the pot. Married to Gertrude? > Cousin of Otis's? I wonder.....] [ Hmmm. Another self-entitled poster attempting to play the ad hominum game! ] No, I am not aquatinted with that gentleman nor that lady. I have looked on here long enough to see Otis get idiotically blasted a few times, though. "Neil Brooks" <Neil0502@yahoo.com> wrote in message news:dahal1h5pe0mj6ldkev9bj1eotnma596s4@4ax.com... > [ ... ] > People seeking to prevent/reverse/? myopia with bifocals or plus > certainly /have/ occasionally advocated the addition of prisms to [quoted text clipped - 9 lines] > lenses for near work throws my exophoria into a tizzy, driving excess > convergence and accommodation.... I could imagine that focusing (accommodation) and convergence (triangulation) are related, in properly-functioning eyes, as they are in an automatic rangefinder camera. I would suspect that reading glasses placed on the noses of kids should have base out prisms as well as whatever other necessary corrections. I do continue to feel that reading glasses might be useful where progressive myopia is a possibility. The OP's girl has one eye good enough for distance and probably will not wish to wear glasses in public. If given eyeglasses for reading, should they be the same as those that would be given her for distance seeing? > Live simply so that others may simply live How about "Speak simply so that others may understand what you are talkin' about."? -- Dicky (Dick Adams) firstname dot lastname at bigfoot dot com > > >What is amazing to me is how little interest there seems to be to understand > > >how accommodation works, and how it can go wrong, [quoted text clipped - 76 lines] > (Dick Adams) > firstname dot lastname at bigfoot dot com Dick, are you providing a service here or just amusing yourself? Other being a smart aleck, I don't see that you've really contributed anything useful. Perhaps clinging to ideas that are out of fashion are a sign of old age. DrG > Dick, are you providing a service here or just amusing yourself? Well, I was asking some questions! > Other being a smart aleck, I don't see that you've really contributed > anything useful. I feel that I have been more of a victim than a contributor, when it comes to visual health. But that is a lifetime thing, is not intended to obliquely implicate any present company, nor the implant surgeon who restored me to what he calls 20/20 very recently. > Perhaps clinging to ideas that are out of fashion are a sign of old age. Fashion? -- is that the name of your game? I am sorry that I mentioned that I am old. By that, and by the fact that I mentioned cataracts, you might conclude that I am senile. You may disregard my posts. -- Dicky > But I do not think that they should stand by idly while their kids' > eye doctors, when it comes to eyeglasses, play the same games > with them as their eye-doctor daddies and granddaddies did in > their day. Check your history. Our daddies and granddaddies used plus lenses, bifocals, contact lenses, incantations, and all sorts of apparati. We don't, because none of it has worked so far. ( http://www.optometrists.asn.au/gui/files/ceo865276.pdf did not work. ) Many such publications are only available as Adobe PDF files. If your computer doesn't have a PDF reader, you might try one that does. There are free readers that aren't tied to the Adobe product, but Adobe Reader 7.0 installs quite cleanly. > I do continue to feel that reading glasses might be useful where > progressive > myopia is a possibility. And what have you (besides a feeling) that tells you that reading glasses prevent myopia? -MT > And what have you (besides a feeling) that tells you that reading glasses > prevent myopia? Because I had said: > > I do continue to feel that reading glasses might be useful where > > progressive myopia is a possibility. I think my utterance was a bit more tentative than your comment suggests. The theory would be that long-term accomodation (changes in the focusing range as the eye grows) is related to the ciliary process, and involves a irreversible stretching of collagenous elements, which, for us myopes, for one reason or another, goes too far. Usually, I suspect, myopia is due at least in part to reading or to other close work. Undoubtedly the theory is not new or unique, but I did come by it independently. It is based on the history of my own eyes and some education in science. And, to some extent, on reading, and on observations among my colleagues. I did get finally succeed to download the article you suggested I read, http://www.optometrists.asn.au/gui/files/ceo865276.pdf and am reading it carefully. It seems to say that eyeballs may adapt to changes during early years to adolescence, by growing longer in response to certain signals, so as to keep seeing well. It seems to suggest that a way to prevent the development of myopia might be to prevent the eyeballs from growing too long, which they might do if the get their signals mixed. Studies on chickens are described. Well, I might mention that most of the myopia I suffered occurred during adulthood, not counting the 2nd sight phenomenon in later years. In any case, I do not think the eyeballs grow longer to any appreciable extent during adulthood. The conviction that myopia is caused by too-long eyeballs won't seem to go away, and must be convenient for persons dedicated to the eyeglasses solution. Maybe there is a study somewhere which will show me that everybody with long eyeballs is myopic? -- Dicky > > And what have you (besides a feeling) that tells you that reading glasses > > prevent myopia? [quoted text clipped - 38 lines] > -- > Dicky Dick, I don't think you read so well. The discussions in this group have included axial and accommodative myopia. Either one, or both, can exist in a given individual. The evidence that "axial" myopia is caused by elongation of the posterior chamber is so well-established that it is beyond discussion. Whether you choose to believe it or not makes no difference. And, furthermore, it goes almost without saying that there are and have been various "solutions" for the problem ranging from vision therapy, biofeedback, and "Bates" to drugs, eyeglasses, contact lenses, and surgery. The latter three are optical solutions, and only the optical solutions have been found to be reliably and universally effective. And that's just the way it is, Dick. Nature really doesn't care what you think. DrG > The theory would be that long-term accomodation (changes in the focusing > range as the eye grows) is related to the ciliary process, "Accommodation" means something very specific when you're talking about the ciliary. By "long-term accommodation" I suspect you mean "long-term adaptation" or "developing myopia.". > and involves a > irreversible stretching of collagenous elements, which, for us myopes, > for one reason or another, goes too far. It's important to note that hyperopes work this structure _much_ harder than myopes, yet as a rule they don't get nearsighted. > Usually, I suspect, myopia is > due at least in part to reading or to other close work. Undoubtedly the > theory is not new or unique, but I did come by it independently. There is a statistical association between reading and myopia. That's more than a theory, it's observed fact. The problem is that fooling the eye with lenses, so that reading is done at virtual infinity, doesn't reliably interrupt the process. >Well, I might mention that most of the myopia I suffered occurred >during adulthood, not counting the 2nd sight phenomenon in later >years. In any case, I do not think the eyeballs grow longer to >any appreciable extent during adulthood. No. They reach about 90% of adult size by puberty. >The conviction that myopia is caused by too-long eyeballs won't >seem to go away, and must be convenient for persons dedicated >to the eyeglasses solution. Maybe there is a study somewhere >which will show me that everybody with long eyeballs is myopic? Usually they take the other approach. I don't know the citations but ultrasound measurements show that axial growth outpaces corneal flattening as myopia develops. -MT Dear Dicky, There was a Dr. C. Prentice (a long time ago) who deduced what you stated. He recommended the use of a strong plus for all close work -- for myopes on the order of -1.25 diopters or so (about 20/70). He produced successful results, but what he said was that the process is "tedious" for the person, and their intelligence is clear on the subject, it is almost impossible to get them to use the plus "correctly". That seems to be the "sticking" point more than anything else. PLEASE do not take this as a medical statement. This is just and observation of the dynamic behavior of the natural eye. Best, Otis www.myopiafree.com > (Maybe some day in the future, attention >will be given to keeping the eyes' lenses young and clear and >elastic forever.) > Ok Dicky, contact Ponce De Leon for help on this, but meanwhile make arrangement to have your head frozen... w.stacy, o.d. >What is amazing to me is how little interest there seems to be to understand >how accommodation works, and how it can go wrong, and how eyes in >most, or many cases, come out right in spite of vast differences in eye >size, and of changes during the growth of individuals. Almost all animals >have eyes, and, for the most part, if they do not see well, they do not >grow up. There is plenty of interest, and has been for hundreds of years. But "vast differences in eye size"???? Surely you know that the range of eye sizes among humans is very narrow. Most non pathologic eyes are about 22 mm in diameter. Maybe you're thinking of the amount of eye that is visible between the lids? Lid aperture varies, for sure, but behind those lids sits a 22 mm ping pong ball, in most cases... w.stacy, o.d. > What is amazing to me is how little interest there seems to be to understand > how accommodation works, and how it can go wrong, and You should try reading this group. A large percentage of the posts here are about just this. > > Amblyopia is only an issue if the best corrected acuities are > > significantly different between the two eyes ... [quoted text clipped - 5 lines] > > Right? Right. My wife has amblyopia. There's nothing wrong with her right eye, she just never learned how to use it and now she's too old to learn. Seems a little odd to me, but that's how it is. A similar thing happened to my son. He had hearing problems when very young, and so never learned how to say certain sounds. He's now 22 and still has speech problems. We knew that kids with hearing problems develop speech problems, so we put him in speech therapy starting at age 3. SignatureDan Abel dabel@sonic.net Petaluma, California, USA > <>My wife has amblyopia. There's nothing wrong with her right eye, she > just never learned how to use it and now she's too old to learn. Seems > a little odd to me, but that's how it is. It's always the simplifications that get people wondering. What's really up with amblyopia is that we have 2 eyes and in order for the brain to "fuse" the separate images from each into one useful image, it develops a very fine alignment ability. This get messed up when one eye can't line up (strabismus) or when one eye is out of focus (anisometropia). Not being chameleons, we cannot focus our eyes independtly, only in a "yoked" fashion. So what does the young, developing brain do when faced with strab or aniso? It has a choice. Ignore one image (the blurred or misaligned one), or see double. Double vision is not a happy thing for the brain, so it goes so far as to actually supress the central input from the amblyopic eye. Doing this in the first 5 years of life basically causes the brain to never learn how to aim the amblyopic eye accurately: amblyopia ex anopsia. Sometimes agressive therapy on such an eye can actually cause the diplopia (double vision) that the brain was trying to avoid in the first place. w.stacy, o.d. > > <>My wife has amblyopia. There's nothing wrong with her right eye, she > > just never learned how to use it and now she's too old to learn. Seems > > a little odd to me, but that's how it is. > in the first 5 years of life basically causes the brain to never learn > how to aim the amblyopic eye accurately: amblyopia ex anopsia. Sometimes > agressive therapy on such an eye can actually cause the diplopia (double > vision) that the brain was trying to avoid in the first place. I want to thank everyone who has posted about my wife's amblyopia. However, she is very clear that contacts aren't an option, and I don't see that anything else would help. As she told me, she's been one-eyed her whole life and she's used to it. SignatureDan Abel dabel@sonic.net Petaluma, California, USA > As she told me, she's been one-eyed >her whole life and she's used to it. > Now there's another patient reported diagnosis that I'd be skeptical of until I saw if for myself... w.stacy, o.d. > > As she told me, she's been one-eyed > >her whole life and she's used to it. > > > > > Now there's another patient reported diagnosis that I'd be skeptical of > until I saw if for myself... Why would that be? Are you quibbling about "whole life"? Another oversimplification. She was diagnosed with amblyopia at the age of 10. She was treated, but frankly, wasn't compliant. She is now 55. I saw the DMV form that the OD filled out. It was pretty clear. SignatureDan Abel dabel@sonic.net Petaluma, California, USA Not at all. About the "one-eyed" bit. Just trying to point out (with a little failed humor) how patients and doctors sometimes speak different languages, and it's easy to get misunderstood (both ways). > > [quoted text clipped - 16 lines] > > > Not at all. About the "one-eyed" bit. Just trying to point out (with a > little failed humor) how patients and doctors sometimes speak different > languages, and it's easy to get misunderstood (both ways). > >>> As she told me, she's been one-eyed > >>>her whole life and she's used to it. Sorry. I was trying to be nice about this, but the truth of the matter is that my wife doesn't like visiting doctors, and she's gotten pretty hostile about this. I just lost my sense of humor about this, and didn't recognize what you were trying to do. SignatureDan Abel dabel@sonic.net Petaluma, California, USA > Thank you for your advice.. I will post the RX tomorrow. Looking forward to it. > 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'm glad to hear that. > 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? You don't *have* to do anything. But I will recommend one of three things when I see the Rx. I might suggest anything less than full time wear would be abusive to the child. I might suggest part time wear is fine. I might suggest no Rx is needed at this time. The numbers will tell me which. Also, see if you can get her unaided acuities plus her best corrected acuities with the new Rx. thanks w.stacy, o.d. > 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? No. I'm not aware of significant benefits from full-time wear, except they might not get lost as often. -MT > knowing that the glasses will effect her lifestyle right now at this > point in time - she is too young for contacts. As someone else posted, glasses will indeed affect her lifestyle. For one thing, she'll be able to see better. I firmly believe that the reason that my wife and I were so bad at sports is because we just couldn't see. As for contacts, I don't believe that there is any age limit. Certainly it would be more difficult at her age, but somebody at work said her granddaughter, who was just a little baby, was getting contacts. I don't know how well they work, but there are tools to help insert and remove contacts. > 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? There are scientific facts, and there are opinions based on those facts. You know your daughter better than the OD, but the OD knows how things work for most people better than you do. My suggestion is that you find out *why* the OD recommends certain things, and then you can decide if your family situation fits. As someone posted, a good reason to wear glasses all the time for a kid is that otherwise they lose them. SignatureDan Abel dabel@sonic.net Petaluma, California, USA > She had a very thorough eye exam about 18 months ago and nothing > mentioned about her being anisometropic. Why don't you post the recommended or measured Rx from that exam? 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". Not good enough. Give us the Rx 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.. Thank you. I can't wait. You should have an Rx in your hand tomorrow at the end of the exam. Post it. w.stacy, o.d. |
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