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Medical Forum / General / Vision / March 2007another follow up for 20/60 but -10.00
My daughter, who just turned 4, went in for another follow up. I am happy to say that she was seeing a whole line better on the vision chart. She saw 20/40 with the left eye(and a little on the 20/30 line) and 20/50 consistantly with the right. Her perscription has not changed. She has been a -10.50 in both eyes for over a year now. The year before her lenticular myopia doubled. I am hoping the doctor is correct that there is a chance that because her perscription is so high it might not get worse. I don't know if anyone is reading this anymore but everyone was so helpful before I just want to keep everyone informed on the progress. Just for the record she still sees alot better without her glasses than her perscription suggests but definately likes wearing them. Glad to hear your daughter is doing better. I am curious though, how can someone see 20/30 or 20/40 and yet be -10.5 nearsighted ? Dear Concerned Parent, Subject: Some questons about your 4 year-old visual acuity. Thanks for your post on your daughter's progress. On Mar 26, 3:26 pm, "concerned parent via MedKB.com" <u18668@uwe> wrote: > My daughter, who just turned 4, went in for another follow up. I am happy to > say that she was seeing a whole line better on the vision chart. Otis> Is this naked eye -- or is it with the -10.5 diopter lens on her face? She saw > 20/40 with the left eye(and a little on the 20/30 line) and 20/50 > consistantly with the right. Her perscription has not changed. She has been a > -10.50 in both eyes for over a year now. Otis> Has she been wearing the -10.5 diopter lens all the time? The year before her lenticular > myopia doubled. Otis> What do you mean by "doubled". Is her lenticular myopia -10 diopters, or -5 diopters? I am hoping the doctor is correct that there is a chance that > because her perscription is so high it might not get worse. Otis> I assume you mean that her refractive STATE will move to -15 diopters in a few years. I don't know if > anyone is reading this anymore but everyone was so helpful before I just want > to keep everyone informed on the progress. Otis> We are all interested in her vision improving. Just for the record she still sees > alot better without her glasses than her perscription suggests but definately > likes wearing them. Otis> In other words her Snellen is better with no -10.5 diopter lens on, than it is with that minus lens on? Otis> Thanks in advance for your reply. Otis > -- > Message posted via MedKB.comhttp://www.medkb.com/Uwe/Forums.aspx/vision/200703/1 On Mar 26, 6:16 pm, "otisbr...@pa.net" <otisbr...@pa.net> wrote: > Dear Concerned Parent, > [quoted text clipped - 59 lines] > > - Show quoted text - Is this dialogue between 2 blind people or deaf? Or perhaps they are blind and deaf? The vision test was done with her glasses on. She wears them full time. When she wakes up in the morning she doesn't even ask for them unless she starts watching television. My daughter definately perfers wearing them. What I meant about how she still sees better than her perscription suggests is that when she does not have the glasses on she sees better than I think she should. An example is that on saturday we had a bithday party for her. I took off her glasses because her face was getting painted. When her friends came in the front door (about 15 feet away) she would say their names before anyone else did. I was a -4.50, I know I would not be able to tell who was walking through the door at 15 feet especially the face of a 4 year old(because they are smaller). When I said she doubled she was about a -5.00 the year before. We did not believe it so we waited a year unfortunately so she could tell us what she sees. During that year she became -10.50. I still don't understand how she saw originally 20/60 at one doctor's office and 20/80 at another with no glasses and still be a -10.50. For this reason we thought the doctor's were crazy for telling us she needs such a strong pair of glasses. But I believe they were right and everything is goin well. >Dear Concerned Parent, > [quoted text clipped - 50 lines] >> -- >> Message posted via MedKB.comhttp://www.medkb.com/Uwe/Forums.aspx/vision/200703/1 On Mar 27, 5:48 am, "concerned parent via MedKB.com" <u18668@uwe> wrote: > The vision test was done with her glasses on. She wears them full time. When > she wakes up in the morning she doesn't even ask for them unless she starts [quoted text clipped - 75 lines] > > - Show quoted text - The human optical system is capable of much more complexity than can be described by the comparatively simplistic system of refraction that is commonly used. The entire system is based upon everything being a simple concave or convex lens with or without a cylindrical (astigmatic) component. In other words, we are REDUCING this complexity to a very simplistic paradigm and discarding the rest of the information. Wavefront aberrometry breaks the system down into much greater detail, and one can readily see the differences in optics from one person to another. Some people have optical systems that may be very nearsighted within the central 2 millimeters, becoming less nearsighted out in the periphery. Therefore, the refraction can change as the pupil becomes larger or smaller. Since mainstreaming this technology into my practice, I don't know how I did without. Has anybody suggested having a wavefront refraction done on your child? I suggest contacting a university teaching hospital or school of optometry and have this done. I'm certain that once you describe the situation, they would jump at the opportunity. DrG We took her last year to Bascom Palmer Institute in Miami. I am not sure what tests they did. I know the one doctor did an ultrasound on her eyes. The other doctor took pictures of her eyes that were of the inside of her eyes. I remember the photograph being red and I believe it was from behind the eyes. After the picture was taken I remember the doctor saying the reflex was good (I don't know if that helps tell you or not the type of test).I know she also looked into a machine that gave them measurements. She looked into another machine that had a picture that gave them her perscription. Back then I asked him if something like that was occuring because we noticed that the darker it was the better she seemed to see. He said with the retinoscope he did see that she was very nearsighted in the middle and not as much on the outer part. Her other doctor (who is a very well respected pediatric opthalmologist and friend of the Basolm Palmer doctor) seemed to think that it was a bunch of bull. I believe it was you who brought up the posssability of being lenticonus last year. Both doctors did not see it when they looked into her eyes. The Bascolm Palmer doctor thought he possibly saw the start of a cataract in her eyes where the other doctor thought that was a bunch of bull saying that it would be easily seen. I know Bascolm Palmer is world respected but I feel most comfortable with the other doctor. I will definately look into your suggestion and appreciate your time. >On Mar 27, 5:48 am, "concerned parent via MedKB.com" <u18668@uwe> >wrote: [quoted text clipped - 24 lines] > >DrG > him if something like that was occuring because we noticed that the darker > it > was the better she seemed to see. He said with the retinoscope he did see > that she was very nearsighted in the middle and not as much on the outer > part. That's the only explanation that makes sense to me. This can be detected with retinoscopy, but most surgeons don't do retinoscopy very often. -MT On Mar 27, 12:50 pm, "concerned parent via MedKB.com" <u18668@uwe> wrote: > We took her last year to Bascom Palmer Institute in Miami. I am not sure what > tests they did. I know the one doctor did an ultrasound on her eyes. The [quoted text clipped - 50 lines] > > - Show quoted text - Certainly, one who is very skilled in retinoscopy could detect it. As was said to me by a well-known surgeon: "A retinoscope is an analogue wavefront aberrometer." However, it is nice to have it documented in nice colored printouts as opposed to a doctor's impression. In the not to distant future, it will be possible to design a contact lens that will neutralize the myopic prescription in the center, but only in the center. In the meantime, we do the best we can with what is available. DrG |
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