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Lazy eye, squints, glasses etc.....

(907 Posts)
cheekyginger Thu 01-Sep-11 22:38:05

Im an orthoptist (binocular vision specialist) and a mummy.

I thought i would start this thread in case anyone was wanting any advice, re-assurance, opinions about any eye problems that you wee ones are having.

cheekyginger Sat 12-Nov-11 22:04:55

deanery Our guidelines for stopping the patch are based on the child's vision. If the vision is static over 2 visits then the optimum level has been achieved. If your eye clinic stopped the patching after 9 months then they must have achieved the best level of vision and that's why it was stopped. Therefore there would be no benefit in doing any more patching.
Longterm, her vision should remain around the level that was achieved with the patching. Her prescription will fluctuate but it would be unlikely to reduce enough for her to manage without them. Contact lenses would be an option in the future if she wanted them. Whatever effect the glasses have on her eyes she can expect the same from contact lenses.

cupoftea Thats a tricky question! confused Most kids have their treatment to maximise their vision and their binocular vision(BV), and once this is achieved they are discharged to the care of a "high street" optician. So i would imagine your son has reached his potential for his BV. Most opticians do a 3D test of some kind which detects binocular vision. Hope that makes sense!

SolidGoldVampireBat Sat 12-Nov-11 22:11:32

Just another sharing of experience here: I first suspected DS was a bit squinty when he was a baby, though the HV said that most babies squint a bit and it would probably settle down. When he was 3 it was rather more noticeable so we went to the GP and asked for a referral; he had glasses and patching for a couple of years, then glasses for another year and this summer they said he had pretty much grown out of it and could be discharged. He does still roll one or the other or both eyes in when tired and concentrating, but not very much; they said it was 'cosmetic' now and he could have surgery for it, but i am disinclined to subject him to surgery for the sake of appearances.

cupofteainpeace Mon 14-Nov-11 21:46:01

Thanks. Will ask optician next time for 3D test. Amazing how eyes adapt and adjust. Have learnt a lot these last 7 years!!
And thank you to all eye specialist people. You are amazing!

sparklejawsy Tue 15-Nov-11 13:11:29

Hi, this is my first post on here and I happened to log on and see your post straight away, must be fate!

Anyway, yesterday my 5 yo DS had his school eye test and came home with a referral sheet which said he has Reduced Vision in his right eye (RV 1.6 (2/60) LV 0.1 (6/7.5)).
Underneath the problem is circled as severe rather than slight or moderate.

There is no other info, just says I will get an appt sent through the post for a specialised local clinic.

He's never shown any sign of struggling with his eye sight, catches balls, writes, draws and reads etc really well so this has come out of the blue for us.

I've tried to phone the clinic but the Orthopist isn't there today and I have to admit I'm panicing a bit about what this all means!

I would be really grateful if you could shed some light on this for me.

Thank you

detoxdiva Tue 15-Nov-11 13:40:22

Hi..this is a great thread - I certainly could have done with it a year ago!

For the parents seeking advice from cheekyginger, I thought I'd share another positive experience.

Dd was seen at the local hospital at 3 years old after we noticed a squint in one of her eyes. We were told she was extremely long sighted, with an astigmatism in 1 eye and virtually no 3d vision sad

She was prescribed glasses but at her first 3month check we started patching the 'better' eye as the vision was not improving as would have been expected. After a further 3 months of patching for 6 hours a day the improvement in her vision was astounding, and after another 3 months of patching for 3 hours a day her eyesight improved even more to be pretty much equal in each eye and she has 3d vision. She is now only being patched for 2 hours a day and we're hoping that this will be the last 3 months she has to be patched.

I'll admit I did have a 'secret' cry when we discovered the need for patching - I was so worried about her being picked on having just started school, and was really nervous about her not wanting to keep the patch on and having to face a daily battle with her grin. However she was fantastic at wearing it and I can honestly say that she has not encountered a single negative comment about wearing her patch. Of course children are curious and ask about it, but once she'd explained why she had it, they lost interest and it was never mentioned again!

Good luck to all the little ones going through the same smile

Great thread cheekyginger, what a fab idea! I first noticed my daughter squinting shortly before she turned two. she wore glasses from age 2 no problem. She had a squint and was long sighted. She had her last check up 6 months ago and they didn't mention the squint at all, but have given her +3.5 & +4.5 glasses this time. I can't even remember the last time I saw her squint. They said she has an astigmatism too. They never give me a straight answer & was wondering if you could advise me on a possible prognosis

cheekyginger Fri 18-Nov-11 17:29:40

sparklejawsy Normal vision in the UK is 6/6 which is the equivalent of 20/20 in the US. Your sons vision is reduced in his right eye by a significant amount. BUT DONT PANIC your LO is likely to have a lazy eye (which means the vision is lazy but this does not always mean a squint) this could have been caused for a need for glassed just in this eye (if the image going into the eye is blurry the vision doesnt develop properly).
It is likely that the vision has been reduced in this eye from a very young age and that's why you have not noticed anything about your sons day to day abilities as his left eye works normally. That's why the screening happens to pick these things up. I would imagine you would get seen quickly so that treatment can get started asap. The younger a child is the better for treatment. The orthoptist and eye dr will assess your son for glasses and find out what is the cause of the reduced vision. He will likely need patching treatment to improve the vision in his RE. But as detoxdiva describes this isnt as awful as people think. Kids are amazingly adaptable smile

kellibabylove Thats a bit of a tricky one confused, as it depends on her type of squint!! If her squint is fully corrected with the glasses then it will stay this way longterm. Contact lenses will also have the same effect when she is older. Generally if a child has a squint and has over +3 of longsightedness (think i made that word up but it works!) they will need there glasses all day and longterm. Think that almost answers your question!

sparklejawsy Sat 19-Nov-11 11:23:23

Thank you so much cheekyginger, and all the other posters who've experienced something similar.

The Orthopist called me back on Wednesday and has book us in to see her on this coming Wednesday so I will let you know how we get on.
It was really useful for you to explain what this possibly means.

I am feeling shocked/upset/worried about it as I just never noticed and therefore feel bad that my lovely boy has been struggling with his eye sight for so long and I didn't know. Because he is one of the oldest in his class (birthday in September) he is also older for his screening test. Really wish they did yearly screenings now so this could have been picked up earlier.

DS is a pretty adaptable child and I sometimes wear my glasses when not wearing contacts and he asks to put them on and likes looking at his reflection so I think he'll be OK about wearing glasses. Plus his best friend (of this week anyway!) wears glasses so he won't be alone.

Eglu Sat 19-Nov-11 11:40:55

Great thread. DS2 is 4.2 and in the summer he got glasses he is +2 in the right eye and +4 in the left. No squint yet as we caught it before that.

He has worn the glasses almost 3 mths now and has improved 2 lines on the chart with his left eye, so is starting to use it.

My question is will he always need to wear glasses?

Eglu Sat 19-Nov-11 13:16:22

Great thread. DS2 is 4.2 and in the summer he got glasses he is +2 in the right eye and +4 in the left. No squint yet as we caught it before that.

He has worn the glasses almost 3 mths now and has improved 2 lines on the chart with his left eye, so is starting to use it.

My question is will he always need to wear glasses?

Eglu Sat 19-Nov-11 13:17:22

Oops.managed.to double post. stupid phone

cheekyginger Mon 21-Nov-11 10:52:43

Sparklyjawsy Good luck at your appointment. Unfortunately its a bit of a postcode lottery for screening. Im in scotland and the vast majority of kids get pre-school screening and some of the kids are not 4 yet. This isnt the case throughout the uk and the screening is really patchy throughout england. (Not sure about wales and ireland).

EgluSince his right eye is +2 he technically will manage for short spells without his glasses. BUT this is only once he is a teenager and all his eye are full developed. He will always need them to comfortable for reading, but for sports or a night out he might mange without them. It will really be up to him if he wants to do spells without them. Most people (that are longsighted) find they get headaches if they go without there glasses for a few hours.

Glad people are liking this thread smile

Eglu Mon 21-Nov-11 20:21:16

Thanks cheeky. Great help.

Snuppeline Mon 21-Nov-11 20:51:30

Dear Cheeky, thank you so much for starting this thread. My dd was born with a unilateral cateract in her right eye which was discovered when she was 8 weeks old, she had surgery when she was 10 weeks old. Patching started at 11 weeks. She has been unfortunate in that the cateract keeps growing back and we have just had the fifth round of surgery last Tuesday. She's now 3 years old and we are doing a marathon two weeks of patching (24/7) to see if we can kick start her brain to make best use of her bad eye.

My dd received amazing care, for which we are eternally grateful, but I find that the staff are all (understandably) really busy and can't answer all random questions or explain everything. For instance, I'm finding it really difficult to understand what sort of sight my daughter has, when she uses just her bad eye and when she uses both eyes. Obviously not easy for you to just say but perhaps if I provide you with more information you can give it a go?

Again, thank you so much for starting this thread I will be watching it with great interest!

I bet you are wishing you never started this thread! grin

My DS is 13months and I noticed a slight turning in of his left eye months ago, left it for a while as figuured it might just be one of those things that disappears with age, no change so mentioned it to the HV who has referred him to the orthoptist in a couple of weeks. I was just wondering what to expect? How do they detect a vision problem with a baby so young? And is there anything they can do to treat it if a problem IS found?

Any advice on what to expect or if there is anything I should specifically be asking would be much appreciated.

Thanks for all your useful advice.

cheekyginger Tue 22-Nov-11 21:54:11

Snuppeline I cant tell you what she can see with her bad eye as i would need to know her level of vision as in 6/6 or 6/60. (The higher the bottom number the poorer the vision), but when she has both eyes open her good eye will allow her to see normally. She will be able to see everything any other child her age can see. Her 3D (depth perception) vision might be affected depending on the level of vision in her bad eye. The poorer it is the harder it is for the brain to put the images together and give 3D vision (hope that makes senseconfused). BUT bear in mind whatever vision she has that is what she is used to and she will adapt.

Tittybojangles Im quite enjoying getting to use my brains. And its really interesting to see my work from a mums perspective!!
As for your question......When did you first notice it? Is it happening more frequently? Is there any family history of squints/glasses/lazy eyes? How is your DS's general health? Was he a full term pregnancy? Thats some of the questions that you will likely be asked.
The orthoptist will get a rough estimate of your sons vision using specially designed vision tests for this age group. (You can google "cardiff acuity cards" for an example). You'll be surprised at what they will manage. They'll show him lots of wee pictures on sticks and carry out a "cover test", which tests for a squint. The tests will seem very basic but an orthoptist can tell quite a lot just from basic tests and observing a child. They will do some basic tests for 3D vision.
If they find that he has a tendency to squint, your son may need to be seen by an optometrist (optician) or a ophthalmologist (eye Dr) to have the actual glasses test carried out. But i'll stop here just incase he gets seen and he's fine!!! No point me rambling on for ages!!! grin

EttiKetti Tue 22-Nov-11 22:04:38

I've a houseful of eye problems grin
DS is 6 and had bilateral divergent squinting, noticed at 12 mth, specs constantly for 3 years then squinting surgery on one eye. Two more years in specs then they took them away, said he didn't need them.....only he did, he walked around for a year with one eye closed! Finally a few months sho he was offered a tiny prescription with a 25% tint and the difference was instant! smile

DD1 was told lazy eye at 8(now 18) but warned not fixable. Wore +8.5 glasses for right eye until age 14 when suddenly pronounced normal vision! Recently told lazy right eye again but nothing glasses can fix, so leaving her be. I don't really understand and she went to last eye test alone so....

DD2 is a recent glasses wearer, only +0.75 but she loves them, which aged 9, helps smile

Ineedacleaneriamalazyslattern Tue 22-Nov-11 22:19:42

What a fab idea this thread is.
Right my story grin my whole family wear glasses we have a strong family history of astigmatism the only people who don't are my dad and DS1.
DD has an astigmatism and was found to have a lazy eye at 2 and has had glasses since.

She is no longer seen by the hospital but way back when ds2 was just over a year old the hospital she was attending asked to get ds1 referred to check him out and catch any problems early. He was fine.

Now I have ds2 who is 17 months. I have noticed (not all the time but enough to have a pattern forming) in pictures since he was about 6 or 9 months old that he looks like he has a squint. My sister and my mum had squints. I spoke to the gp when I first started noticing it and he basically said nothing to worry about was a latent squint. Which may be true but he was not keen to be referring me to get ds2 checked at any point unless I actually noticed him having problems.

Fast forward a bit and I had dd at her regular optician appointment and he mentioned getting ds2 referred soon because of our strong family history and dd getting her glasses so young.

So getting to the point haha what is a latent squint and should I go back and be more forceful about getting ds2 referred? I think I should go back because dd was only 2 and by that point already had a lazy eye but felt fobbed off and neurotic by the gp.

cheekyginger Tue 22-Nov-11 22:52:50

Ineed You are in no way neurotic!!! I totaly agree with your optician. One of the main things we tell HV and GP's in our are that the family history is so important!!!!
Ask to see a different GP if you can....or can you book son in with your optician get a test with them and get them to refer? Opticians in scotland can directly refer, this may not be the case elsewhere??
A latent squint is really hard to explain confused!!! But here goes......it is the natural underlying drift of the eyes if you cover one up. So if this natural drift is quite large it can eventually break down a become a manifest squint, a visible squint. So definitely worth getting it checked out!

ZuluWorrier Tue 22-Nov-11 23:09:59

Fab thread cheekyginger, thank you!

I have another hopeful story to add if that helps? My DD had an intermittent squint at 6mths old-I mentioned to GP and we got
referred to Moorfields eye hospital there and then as my mum and sister both have/had amblyopia (is that the same as lazy eye?).

She was 9mths old when we went to the first appt. We saw a collection of amazing people (Orthoptist, optometrist and ophthalmologist) and after about 4hrs of tests she was diagnosed with severe longsight (+4.5 and +5) and an astigmatism. The tests were as cheeky said, but my dd was given eye drops to dilate her pupils. The Optometrist then shone a light into each eye to work out where the light 'hit' (before or after the retina) and then held various lenses up between DD's eye and the light to work out the degree to which she was longsighted.

DD had her glasses within a week and I had been really worried about her pulling them off, but its never been an issue. From the minute we put them on her, she beamed! smile She started focussing on us more when we were holding her (previously I guess too much work for her eyes to accommodate) and showed much more interest in stuff at close range.

DD is now 2.4 and so used to them. The prognosis is that she'll have to use glasses (or later, contacts) for the rest of her life, unless/ until a surgical technique is developed to sort out her condition. But we're not worried and i don't think she will be either. They're so much a part of her and who she is that we can't really imagine her NOT wearing them. Today for the first time she proudly talked about a character on TV "wearing glasses, just like me, Mummy!" which was great. grin

Hope that helps-all the best to everyone out there just starting out with glasses/patching. It is worth it, I think. My sister's was caught much later so despite some patching and glasses through her her teens she now has one v longsighted eye and one slightly short-sighted eye. She only uses one contact lens though (no point with the v bad eye apparently) so monthlies last twice as long wink

Ineedacleaneriamalazyslattern Tue 22-Nov-11 23:17:58

Thanks that was really helpful grin I am in Scotland it was the optician that originally referred dd. Our current optician did say that he was limited in what he could check as he is so young but if the go was still not forthcoming then to take him back to him and he would be able to tell me if there was anything.
I just felt the go was treating me like I wanted ds to have glasses like I was wishing it on him but really I just don't want him to end up with a lazy eye and all the fights over patching I had with dd if it can be at all avoided.
Thank you so much it's good to hear I should be checking and will go back to the go and be a bit more forceful.
Take it you're in Scotland too? Shame we can't see you grin

Ineedacleaneriamalazyslattern Tue 22-Nov-11 23:24:05

Sorry another post smile just to add dd had absolutely fab care as well. I also worried about her pulling them off but she was delighted when she got them I think she realised straight away how much more she could see with them. She is 8 now and her glasses are so much a part of her she loves choosing new ones and it helps I love my glasses too and we both enjoy choosing nice fashionable frames and she is treated so well at the optician we use now and treated like a grown up there.
We had great people at the hospital who acted quickly with both her and ds1 and the optician said because of catching it early she sees so well with her glasses now.

Seona1973 Wed 23-Nov-11 08:11:56

I referred dd through the hv so if the gp doesnt help try your hv instead (in Scotland too!)

BirdyBedtime Wed 23-Nov-11 09:29:05

Hi cheeky - thanks for this thread. My DD was diagnosed with seriously lazy eye in Feb (we are in Scotland too but in our area visual screening not done until P1 so 4.5 -5.5). By the time we saw the orthoptist she was just turned 6. We've been patching since June and she can now see the 4th line on a standard chart with her glasses (+6) - she could only see the 1st to begin with. She didn't improve at the last visit so is now patching 6 hours and another appointment in 2 weeks. My concern is that they are only checking her bad eye and don't seem to be looking at BV - if she remains the same with one (good) eye able to see the second bottom line and the other static at the 4th is there a chance that she will develop BV or will her brain only use the better image as there is such a big difference between the 2 eyes? Also in future how will an optician test her eyes when the best she is ever going to achieve is the 4th line - will her prescription just remain static or will it reduce with changes in the shape of her eye.

cheekyginger Thu 24-Nov-11 15:00:30

Good luck Ineedacleaner.....keep me posted.

Hi birdybedtime As long as she doesnt have a squint. There is a chance the eyes will work together to some degree. Once the patching is tailed off the brain may or may not develop some BV. Their is no way to exercise this it just happens naturally as the eyes are used together. The orthoptist will continue the patching until the vision stops improving.
Once you are attending the optician they test each eye separately to find the required strength of lens so that actual level of vision doesnt matter. Her prescription will vary as she grows, but this can fluctuate either way up or down.

Great to hear lots of successful stories, thanks everyone grin

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