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Medical Forum / General / Vision / March 2007

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Three Year Old Child Vision

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Navy_Wife - 24 Mar 2007 06:25 GMT
My three year old went to the doc yesterday with my husband. He did not
understand the dx, nor did the doc take the time to explain what her issues
were. The only real information he really received was a rx for glasses.
That rx reads -0.25 -0.50 x 180 and below that the same is written again.
What does this mean, is she near sighted, far sighted, does she have
astigmatism? He told my husband his hope was to retrain her eyes to
communicate with her brain and he wanted to see her again in 6 months. I am
in the dark as to what her problem is!  Any helps?
Tammy
Mike Tyner - 24 Mar 2007 12:00 GMT
She's a tiny bit nearsighted, with slight astigmatism.

Most doctors would not recommend glasses, or any other treatment.

You haven't described anything that needs "retraining."

-MT

> My three year old went to the doc yesterday with my husband. He did not
> understand the dx, nor did the doc take the time to explain what her
[quoted text clipped - 7 lines]
> in the dark as to what her problem is!  Any helps?
> Tammy
Dr Judy - 24 Mar 2007 18:05 GMT
> My three year old went to the doc yesterday with my husband. He did not
> understand the dx, nor did the doc take the time to explain what her issues
[quoted text clipped - 5 lines]
> in the dark as to what her problem is!  Any helps?
> Tammy

You will get more accurate information by calling the eye doc instead
of posting here.

Possibly the rx was miswritten or you have misread it as it is a
minimal Rx and gives no evidence of any brain retraining being
needed.  That comment makes me think of amblyopia but if she was
amblyopic than the prescription for one eye would be much different
than the one for the other.  Did he mention patching an eye?

Call the eye doc before filling the prescription.

Dr Judy
William Stacy - 24 Mar 2007 19:46 GMT
I would get a 2nd opinion, as by far most eye docs would not correct a 3
yo with that small a refractive error.  If there is a separate
binocularity issue (heterophoria, strabismus, etc), that may require
some training or even surgery.  Glasses are not indicated unless they
also contain some significant prism for a major binocular imbalance.

w.stacy, o.d.

>  
>
[quoted text clipped - 23 lines]
>
>  
Navy_Wife - 24 Mar 2007 23:46 GMT
Dr Judy,
I would get a  second opinion, but unfortunatly that is going to be a
difficult task. We live in Japan in an isolated area and the optomotrist only
comes down once every 6 months. He left to go back up North this weekend. A
friend of mine is a doc here on base and she has agreed to read over her
chart and find out what the issue is. I will be traveling back stateside for
a brief visit in June. Will it harm her eyes more to just leave them as is
until I don't have to attempt the language barrier if we go out in town here?
He did not mention patching either eye, though he did say one was weaker than
the other ~ but it did not reflect that on the Rx that I could see.  

Tammy

>> My three year old went to the doc yesterday with my husband. He did not
>> understand the dx, nor did the doc take the time to explain what her issues
[quoted text clipped - 14 lines]
>
>Dr Judy
Mike Tyner - 25 Mar 2007 03:50 GMT
> a brief visit in June. Will it harm her eyes more to just leave them as is

No. If the prescription is as you say, waiting 1 or 4 weeks for a second
opinion is NOT likely to cause any problem

Again, nothing in your description calls for treatment at that age.

-MT, OD
Mike Ruskai - 25 Mar 2007 05:14 GMT
>Dr Judy,
>I would get a  second opinion, but unfortunatly that is going to be a
[quoted text clipped - 6 lines]
>He did not mention patching either eye, though he did say one was weaker than
>the other ~ but it did not reflect that on the Rx that I could see.  

Neither getting the glasses nor skipping the glasses will do any harm
to her vision, period.  If you see someone named Otis posting, ignore
him.  He's a kook who thinks wearing glasses will make your vision
worse (it won't).

I'm no optometrist, so take this as only the interpretation of someone
who's worn glasses/contacts for over 20 years.

-0.25 -0.50 x 180 written twice seems to suggest this:

For each eye, -0.25 diopters spherical correction (meaning she's very
slightly near-sighted - contact lenses are only manufactured in 0.25
diopter steps, to give you an idea how slight that is).  Also for each
eye, -0.50 diopters of correction for astigmatism (making the lens
somewhat more like a cylinder than a sphere), at an angle of 180
degrees.

The only way this can fit with a comment about one eye being weaker
than the other is if she also shows a difference in accomodation
ability.  That is, she can focus properly on an object at a shorter
distance with one eye than the other, with the one that requires the
object to be further away being the "weak" one.  There's nothing in
that prescription to correct for this.

I can't even think of an activity for a 3-year-old where the clearest
vision possible is critical.  In your position, I would not fill the
prescription.  I'd wait until she was at least in school and had to
read a blackboard before deciding if she needs any correction or not.
With those numbers, she's not suffering any great loss of visual
acuity.
Signature

- Mike

Ignore the Python in me to send e-mail.

Ms.Brainy - 25 Mar 2007 04:15 GMT
What was the reason you took the child to the doc in the first place?
Apparently you detected some problem, but what was your (or your
child's) complaint?

> My three year old went to the doc yesterday with my husband. He did not
> understand the dx, nor did the doc take the time to explain what her issues
[quoted text clipped - 5 lines]
> in the dark as to what her problem is!  Any helps?
> Tammy
Navy_Wife - 25 Mar 2007 05:27 GMT
I noticed a habitual blinking going on with both eyes and some minor
squinting with the left. No lazy eye noticed or crossed issues present either.
She is an identical twin, adopted, and birth mom had a history of drug abuse
and no prental care during pregnacy. Knowing the history, I talked with her
ped. during a routine visit. He gave her a referral to the opt. And here we
are....
Tammy

>What was the reason you took the child to the doc in the first place?
>Apparently you detected some problem, but what was your (or your
[quoted text clipped - 5 lines]
>> in the dark as to what her problem is!  Any helps?
>> Tammy
 
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