January 25, 2011

Helping Her Vision

Today we had a follow-up visit with A's opthomologist. I was eager to see her, as we had two things to discuss. First, there was the reason we had the visit scheduled in the first place: to do a vision test on A's left eye. Our last visit in December showed that A's eye may not be as in bad shape as we had thought it was, and the doctor wanted to do an undilated vision test. Second, I wanted to discuss A's recent falls and how I thought they were directly related to A's new prescription glasses for astigmatism.

The first thing the doctor did was test A's left eye. With her right eye covered, she was able to see letters on a chart at 20/300, possibly at 20/250. Our last visit she tested at 20/200. However, as the letters got smaller A got bored and was done...so it's hard to tell if that is where her vision really is, or if she could see better. Regardless, even a 20/300 is more than we'd previously thought. It's still technically "legally blind", but that's just a term. What that means for my daughter is that her left eye is providing a lot more peripheral vision, and possibly central vision, than we'd thought, and helping her depth perception. Great news!

Next, we discussed the glasses. The doctor agreed that perhaps A wasn't ready for the prescription, and is sending her new glasses back to be have clear, non-prescription lenses put in. She had never heard of a child falling on her forehead due to this prescription before, but she agreed that it seemed the glasses were the culprit. (Of course, I'm sure not many of her patients are also missing their semi-circular canals and have impaired balance to begin with). Easy, peasy.

We then got in to discussing A's options. As A is only 4 1/2, and still technically "plastic" (the doctor's words) with her vision, she would like to try to improve A's eyesight as much as possible. To that end, she is suggesting two things:

1) She wants us to start patching A's "good" eye (her right eye) daily. This will cause A to only use her left eye, thereby strengthening it. Even patching for a few minutes a day will help, although up to a few hours would be optimal. In reality, I think we might be lucky to get an hour in a day. The doctor recommends that A not be walking around while patched (as her depth perception will be severely impacted and she might fall again) and so we have to do it while sitting down. But any time with the patch on will help, the doctor says.

2) The doctor is recommending surgery for A's ambyopia (lazy eye). Her left eye tends to wander at times, although it wanders far less now than it did when she was younger. She thinks that having her left eye always looking central will also help to strengthen the vision in that eye. Also, although it's a much lesser, secondary reason to do surgery, it's cosmetic. The good news is that if we decide to go ahead with the surgery, she can schedule it for the same time that A is having surgery to get her stoma from her tracheostomy closed (she says she schedules with our ENT all the time) so A would only have to be put under anesthesia once.

I'm at a loss as to what to decide about the surgery. I'm sure J and I will have lots of discussions about it. I know it's a common surgery, but it scares me. My own mother had the surgery; our doctor has done hundreds, if not thousands of them. But I just need to make sure it's the right choice for A.

All in all, it was a good visit. We already had our patching session for today; she was reticent at first, but it helped that both D and I put our own patches on. Hopefully we can get this resolved, as I would love to help A maintain and even improve whatever vision she has.


  1. That's great news about A's vision being better than you thought. I know how you are feeling about the eye surgery because Gracie has had three of them now.

    The first one was after she was two and it made her able to walk. Even the day of surgery she was balancing much better and then the next day she set a new walking record and took off after that. It was amazing to watch, especially since we didn't know that it was possible to see such a thing happen. We were told it was mostly cosmetic but it was much more than that for Gracie.

    We didn't see much differenc after her second surgery, but since her third we have seen some problems. One of my biggest fears of doing surgery after her first one was that we would take away whatever they did that made her able to walk. This didn't happen, but she has had more problems with double vision and depth perception than before surgery. The doctor thinks she just needs more time for her brain to adjust. It's been almost a year now and we have seen some progress.

    Good luck making this choice. I know it is a hard one. I didn't mean to make this so long and if you have any questions feel free to email me!

    P.S. I gave you an award on my blog today!!

  2. Quite a good report! Of course, I vote for the surgery, but I know you will make the best choice for A.

  3. I'm sure you and J will weigh all the options and come to the best decision for A. I also am sure it's not an easy thing to think about. It's hard to see our babies go through surgery for any reason but in the long run it could be a good thing.


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