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Children's health

Orthoptist and squint query

40 replies

HoneySocks · 01/04/2009 21:39

Hi all
my dd who is 3 has a slight squint just for the last few weeks - the gp couldnt see it but referred her to the orthoptist about a week ago. i also took her to the optician who said that she may prob need glasses and is doing the eye drops test on monday with her and will give her glasses then.
all this is new to me - no glasses in my family at all so have couple of queries if you please!

  1. have been told may be a few months to wait to see orthoptist - what will the orthoptist do that the optician cannot? we can pay for her to be seen privately if that is a benefit?privatly she will be seen next week

2.what is eye drops test like - any hints or tips?
3.she has such a mild sqint - will she have glasses for long?
any other hints/ tips/info very gratefully receieved - feel bit worried for her, thank you
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CMOTdibbler · 01/04/2009 21:46

DS has been to the orthoptist a few times, and I have a severe squint, so we've done this !

DS has seen orthoptists within a few weeks each time. Much better to be in the NHS system as it all works together if she needs anything doing.

Eye drops - fairly easy, just confusing to them as it makes everything blurry. You have to wait around for 30 minutes or so for them to work.

If she needs glasses becuase she is long or short sighted, then it's impossible to know how long she'd need them. Some children grow out of short/long sight and some don't.

She might have a squint that is unrelated to short/long sight and the orthoptist would use patching and eye exercises to correct it.

Or she may not actually be squinting, and just look like she is - my DS looks like he does a bit, and hence has been referred twice (and been seen 4 times by orthoptists), but it's just how he looks

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Sidge · 01/04/2009 21:53

We see an orthoptist for DD2, as well as an optician - she has a squint as well as being severely short sighted. Orthoptists treat eye problems eg squints, whereas opticians treat visual problems I think. Certainly we have to see both as they do different things.

We didn't have to wait long for an appointment but I guess it depends on where you are.

The eye drops dilate the pupil so they can get a good look at the back of the eye to determine the extent of long or short sight. It doesn't hurt but can make the eyes more sensitive to light until the pupil goes back to normal (a few hours later). I took DD2 some sunglasses to put on afterwards.

Apparently squints often go hand in hand with long sight (ie having trouble seeing things close up) so the glasses correct the visual problem, and reduce or remove the squint.

My DD2 (5) has had glasses for a couple of years now and they don't bother her at all, and she got used to wearing them within days - I think she liked being able to see clearly for the first time! Unfortunately she is odd as she has short sight so her glasses don't help her squint so we are awaiting a referral for possible surgery.

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MadBadandDangerousToKnow · 01/04/2009 22:03


We've also been down the orthoptist/patching route. My child has a squint and wears glasses to correct it. The glasses keep the squint under control but we have also had phases of patching, which is designed to strengthen the eye muscles by making the eye work harder (there is a risk with a squint that the squinting eye will in effect switch off). We have been told that our child will need glasses indefinitely - but some children grow out of squints.

I am surprised that you're having to wait so long to see the orthoptist but I agree with Cmot that it's better to be within the NHS (unless, of course, you can have a private first consultation and then rejoin the NHS queue). Two children we know first went to the optician to get glasses for their squints but both now have been referred to orthoptists, as they offer a broader range of treatment options.

It is a bit daunting, but we've always found the professionals very helpful and very attuned to children's concerns. They have always, for example, kept the patching to a minimum so that our child doesn't have to wear the patch outside the house. The eyedrop test isn't very pleasant as it makes everything blurry and dazzling for a few hours afterwards, but even that is bearable (we only have one every 12-18 months or so).

Good luck!
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HoneySocks · 01/04/2009 22:05

thank you both very much for your replies.

cant recall what optician said she had - long or short sight but he said to let her go right up to the tv to watch it so it is clear to her? is that long sight then do you know?

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Battycat · 01/04/2009 22:09
  1. Orthoptist is specialist in eye muscles so more trained in this particular area than the optician.The only concern I would have with seeing the orthoptist privately is NHS spectacle provision,ophthalmologist check which is usually done on the NHS and follow up care such as patching and exercises - I would stick within the NHS personally.The optician can give her spectacles in the meantime and will check for the squint.Ask the optician about the squint and whether there would be any benefit in being seen privately quicker.


2.The drops take about 30 mins to work and do sting!Take a treat for her but leave it up to the optician to prepare her and tell her about the drops.Don't let your worry make your dd nervous - perhaps borrow a book from the library about getting your eyes tested or wearing spectacles to prepare her.She will be blurred close up and have big pupils(so light sensitive) for most of the rest of the day.Choose her glasses while the drops work or beforehand as she might be a little blurred after.Let her choose the spectacle frames she really likes (within reason)and make her happy to wear them.

3.Depends on her spectacle prescription as to how long she will need spectacles for.The optician should be able to give you an idea.
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mrsruffallo · 01/04/2009 22:10

I too am surprised that you will wait so long to see an orthoptist. Are you sure that's right?

The eye drop test- this makes the pupil bigger therefore letting more light in so straight home after appt esp if sunny
A squint is usually a sign of short/long sightedness as far as I know, so glasses will probably be a long term thing.

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Piffle · 01/04/2009 22:11

my dd has several visual issues incl. Squint, long sightedness, astigmatism and bilateral latent nystagmus.
They failed to patch her squint or diagnose her prior to age 4 due to us moving and getting "lost" in the system
I'd wait for the NHS tbh
You'll be referred then to opthalmological consult clinic, this is an excellent service.
They provide full support and guidance
Don't worry about glasses they get used to them and dd loves hers
She is 6 and we are told to let her read things very close.

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Seona1973 · 01/04/2009 22:18
  1. dd saw an orthoptist within a few weeks of referral


  1. the drops do sting and your lo's pupils will be dilated for several hours afterwards. DD was fine with them the first few times (has had glasses since she was about 18 months) but the last time was quite traumatic and she had to be held down to get them in.


  1. DD had a squint but is also long sighted. She has quite a high prescription so will have to wear glasses forever probably (a shock to us as neither me or dh or our brothers/sisters have glasses). Her squint was still noticeable even after patching and while wearing her glasses so she had an operation on her eye to improve it which worked very well (she was about 4 1/2 when it was done)
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mrsruffallo · 01/04/2009 22:22

Seona, did the operation make much of a difference

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MadBadandDangerousToKnow · 01/04/2009 22:23

Seona - Can you tell me more about the operation? It hasn't been ruled out for us but I'm very squeamish about it (although I hide this from my child). How quickly was your dd back in circulation?

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Seona1973 · 01/04/2009 22:24

yes, the squint is definitely not so noticeable when she is wearing her glasses although she does squint a bit when they are off (which is normal)

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CMOTdibbler · 01/04/2009 22:27

I've had the operation twice - at 13 and 18, for each eye. I was in hospital for a day, and out and about the next day each time. It's sore, and very red at first, but OK.

Made a huge difference - I get double vision with my squint, and they couldn't resolve my vision even with stick on fresnel prisms before the last lot. I still have prisms now (9' in my reading glasses, only 1 in my distance), but can maintain single vision fine, and no one knows I squint

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Seona1973 · 01/04/2009 22:28

she was back to nursery within a week. She had a sore eye for a few days but had medicine (ibubrofen type stuff and calpol) that was sent home with her plus some eye drops that were a bit of a nightmare to get in as she wasnt very co-operative!! She didnt have to wear a patch afterwards and her eye looked a bit red for a couple of weeks but she was fine after that.

The op itself took about 40 minutes and I was with her when she was put under and was able to go to recovery to see her just as she was waking up. She was aperated on at 1pm (ish) and was home around 6pm after she managed to eat/drink and keep it down.

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francagoestohollywood · 01/04/2009 22:28

I had a very severe squint as a child, back in the 70s.
I wore glasses (as was astigmatic, couldn't see close objects). I wore a patch (to strengthen the eye muscles).
I also used to see the orthoptist every week to do exercises to strengthen the eye muscles. That was needed in preparation to the operation, which I had when I was 5.

I don't remember much about the operation, but I do remember I got a type writer as a present!

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francagoestohollywood · 01/04/2009 22:30

Oh CMOT I have double vision as well and used to have prisms in my glasses!

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francagoestohollywood · 01/04/2009 22:31

I must say that after the operation my vision was perfect, and the squint gone.

But it came back when I was 12 and started to get short sighted only in one eye

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mrsruffallo · 01/04/2009 22:33

Did you have binocular vision afterwards?

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CMOTdibbler · 01/04/2009 22:33

Nice to meet someone else - there aren't many with double vision out there. I have a fantastic optician now who really understands double vision, and it's made a real difference.

I remember well all the visits to the orthoptist and the exercises - but as I didn't start squinting till late I was an oddity

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CMOTdibbler · 01/04/2009 22:35

Yes, I have binocular vision although it is slightly odd - but have complicating factors that probably account for that. I drive, ride a motorbike etc without any problems, but find tennis/babminton difficult

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francagoestohollywood · 01/04/2009 22:37

Squinters of the world unite!!!

That's pretty unusual CMOT. I have funny pics of me with an impressive squint at 8 months already. I started to wear glasses when I was one

Yes, I had binocular vision after the op. But when I became short sighted I started to use my stronger eye more than the weak one. My orthoptist (yes, she still works after 37 yrs) suggests to have an operation again to correct it for good, but I'm

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francagoestohollywood · 01/04/2009 22:38

Same here cmot. I can't play any sport that involves catching a ball. Or drive at night.

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mrsruffallo · 01/04/2009 22:40

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CMOTdibbler · 01/04/2009 22:43

I know - but I have an unstable squint (ie, I can pull it in if I concentrate, but it's hard to do and I can't sustain it) so it's harder to diagnose. Mum spent a lot of time telling people I squinted (heaven only knows that she spent her life at the opticians/opthamologist as the whole family have had eye surgery with the same consultant for different things), but it went unnoticed. And then the day came when the school nurse did eye tests and found I couldnt read anything on the chart with my left eye...

When I took DS to the opthamologist, the consultant got very excited and wanted me to have more surgery. Since prisms sort it out well, and I'm short sighted (plus astigmatism), I don't really see any benefit

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HoneySocks · 02/04/2009 21:15

hi all thank you for your kind replies - am not sure of the exact time to wait for the orthoptist, just working on rough estimate from the optician. hopefully it will be sooner as would like to get on with it all i guess.
think i will stay in the nhs system, thanks t your replies, seems an excellent service.
will prob post again on monday after eye drops test with yet more worries!

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amazonianwoman · 02/04/2009 21:51

Can I just ask - is a squint where the eye turns inward? Or is that a lazy eye?

I noticed just on Tuesday that DS's left eye is turning noticeably inward when the other is looking straight. It was only obvious a couple of times on Tuesday, but already by today it seems to be almost permanent. He looks really strange

We have an optician's appointment on Saturday, and I'm desperately trying not to google any symptoms/diagnoses, but I'm quite worried

He was 2 in March, and his eyes appeared completely fine until Tuesday. I'm surprised how rapidly the left one has changed! Lots of people have noticed, so it's not just my paranoia. He is very tired this week (4 missed naps, 2 late nights cos we've been away) which I know can make things more pronounced.

I'm very short-sighted (but no squint/lazy eye) and DH is very long-sighted. I kind of hoped we'd cancel each other out and have kids with 20:20 vision

All I can think of (well, I'm worrying about all sorts of things..) is how on earth I'll get him to keep glasses on...

Honeysocks sorry to hijack, I hope the eye drop test on Monday isn't too stressful xx

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