Strabismus (Crossed Eyes)
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Strabismus (Crossed Eyes)
August 2006
Can anyone recommend a Pediatric Ophthalmologist in the East Bay
to evaluate my 7-month old who may have a slight strabismus
(crossed eye)? I want someone who is experienced and gentle
with babies and communicates well with parents. I am a Kaiser
member but would consider going outside of Kaiser for the right
doctor.
suzdriver
While Susan Day (In SF) has received rave reviews, we chose to
stick with our Ped Ophthalmologist in the East Bay to save the
trouble of crossing the bridge. Our son began seeing Otis Paul
at Children's Hospital Eye Clinic when he was 1 yr. Dr. Paul
isn't exactly warm and fuzzy, but he put my mind at ease and
was willing (when pressed) to answer all of my questions. He
diagnosed the problem and treated my son effectively (he has
severe far-sightedness that presents like strabismus but
isn't).
Good luck - and if your child ends up with glasses, I highly
recommend the solo bambini line!
anon
March 2006
Hi
My son has exotropia/ambylopia and was under vision therapy for
3 yrs. His doctor now suggest a surgery. I visited couple of
doctors for second opinion, and the advice was split. (some
said go for a surgery, some said no!)
(Already saw Dr. Day, Dr.Good.)
Any advice on that? Can any one suggest a good doc in bayarea
for surgery?
Thx
sally
Have you gotten an opinion from an optometrist? You say that your child has been
in vision training for a while--normally it's optometrists that do the VT--what do
they have to say? Also, you don't say how old your child is--that will make a big
difference. I suggest getting an optometrist's opinion because as since they are
non-surgeons, if they recommend surgery, you would probably feel better about
going forward. And, if they recommend waiting, they may have other VT ideas for
you to consider.
anon
Hi there,
My 2.5-year-old daughter has esotropia/ambylopia and will be
undergoing strabismus surgery with Dr. Good next month.
We've seen three pediatric opthalmologists (Dr. Day and Dr.
Good being two of them) and we've seen a professor at the UC
Berkeley optometry school for a consult about vision therapy.
For us, there's consensus that surgery is the best option for
our daughter. I feel for you... it would be SO hard if the
doctors were split.
Are Dr. Good and Dr. Day of the same opinion? If so, I'd go
with their advice. I've heard again and again from optometrists
and various people at the UC Berkeley optometry school that Day
and Good are the best pediatric opthalmologists around. In the
case of the UC Berkeley optometry school, I believe they're the
only opthalmologists they refer pediatric patients to.
If you haven't been to the optometry school at UC Berkeley, I
highly recommend seeing Dr. Sarah Fisher. She runs the
binocular vision clinic there and has a wonderful manner with
children. She seemed more reluctant to turn to surgery than the
opthalmologists, though she eventually did tell us that surgery
was the best option.
If you have any other questions, feel free to email me.
kht
I recommend Dr. Koseoglu as a highly skilled pediatric eye surgeon. He operated on
my daughter to fix her strabismus when she was nine months old. She recovered
quickly from the surgery and has had straight eyes ever since. Dr. Koseoglu has a
somewhat stiff and formal manner, which might be offputting at first, but he's really
good at what he does.
We waffled about the surgery, too (it's never fun to watch your kid go through that, and
I'm sure it's even harder with an older child than with a baby) but we're very glad we
did it.
Parent of a now-straight-eyed toddler
I suggest you see Dr. Douglas Fredrick at UCSF. He's head of
the pediatric ophthamology department, and is absolutely
fabulous, and highly recommended by those that work with him
(ie. nurses in the operating room). He is a surgeon as well.
Good luck!
anon
Hi Sally, I can't give advice on your specific situation, I can
only relate our experience for your consideration. Our son had
surgery at 7 mos., performed by Dr. Day, for strabismus- he is
now almost 4 y.o. and has no signs that he ever had any eye
problems-- for weeks and months after the surgery I sometimes
saw hiw eye turn inward and then correct itself, but now it's
surely been more than a year since I've seen that happen. So
of course, we are extremely happy and grateful that Dr. Day
recommended early intervention (we patched for several months
but saw no improvement) and that the surgery was a success.
Good luck with your decision.
Luisa
Aug 2005
My 21-month-old daughter has lazy eye and strabismus (one eye
crosses in frequently). The lazy eye has almost been resolved with 6
months of eyeglasses and patching, but we just saw her opthalmologist
and found out that the strabismus is actually worse. Her dr. is
prescribing less patching and new lenses, one with a bit stronger
prescription than the other. We're going for a second opinion in a month
to see how another highly regarded pediatric opthalmologist would
approach the problem.
I'm interested in hearing about other parents' experiences with resolving
strabismus. Anyone had success with non-surgical methods?
Thanks!
Keri
Hi Keri, I don't have much to suggest in the non-surgical arena
since our son had surgery at 9 mos. to address his strabismus,
but I would recommend our pediatric opthamologist, Susan Day
(415-202-1500), if you are looking for a second opinion and
haven't seen her yet. She's well worth the drive to SF to see
her and while she performed the surgery, she also has many
clients who don't receive surgical options, and I'm sure she
could offer good advice. Good luck.
Luisa
Here is our experience with strabismus for what it is worth. My
daughter was diagnosed with strabismus (accomodative esotropia)
at age 3. In other words, she crossed her eyes because she was
very farsighted.
It was difficult for me to deal with because the diagnosis seemed
so vague and the treatment protocol seemed so nebulous. Because
I had some conflicting information and recommendations from a
very highly respected pediatric opthalmologist I ended up getting
a second opinion from a second pediatric opthalmologist and then
also from the UC Meredith Eyecenter. This did not help the
situation as none of the doctors recommended the same
prescription!! Suffice it to say that I was confused and lost. I
finally settled with the doctor that I felt most comfortable with
which was actually a third pediatric opthalmologist. We are
lucky in the Bay Area to have so many of them!!
He prescribed glasses for my daughter with 3-month and then
6-month interval follow-ups. We also patched her stronger eye to
encourage the weaker eye to respond to the glasses. It was very
expensive early on because we had to change the prescription
every 3-6 months. Her eyes were changing very rapidly. The
prognosis for her was that the glasses would help with the
crossing and that there was the possibility that she would
outgrow the glasses at around age 8 or 9.
She is now 7-1/2. She wears her glasses religiously except while
swimming and during gymnastics. She has gone from a two diopter
difference between her two lenses to no difference. It used to
be that her eyes would cross pretty quickly when she didn't wear
glasses. Now she gets through an hour and half of gymnastics
without crossing. She complains of double vision when she
doesn't wear her glasses for a long time and when she is
fatigued. Her lenses are still a 3+ which indicates that she's
still pretty farsighted, but I think since the lenses are the
same in both eyes they are more 'equal' then when she was younger.
Will she ever grow out of glasses? Don't know and I'm not sure
that my daughter would be comfortable without them. She's had
the same pair in the past 4 years and upgrading her to a new pair
this week was a little traumatic.
I'm happy to say that she's had very little difficulties with the
glasses vis a vis other children. Early on I taught her to
explain to others that she wore the glasses to 'strengthen her
weak eye'. The worst people were the older women who would take
on a pitying tone about 'the poor child that needed glasses' - I
could have slapped them, but generally I would just explain to
them and say that all was fine.
Good luck to you and your child. I guess the need for surgery
rest upon the root cause of the strabismus. For us it was never
really an option.
bergahoo
Feb 2005
My six-month-old baby has crossed eyes (strabismus) and will
probably need surgery. The pediatric opthalmologist she's
been seeing (who would do the surgery), Dr. Koseoglu, is not
mentioned in the archives. Does anyone have any positive or
negative feedback on him?
When we asked our pediatrician if we could get a second
opinion, she also referred us to Dr. Gordon Smith, whom we
have not seen yet but who has positive recommendations in
the archives. However, Dr. Smith is booked until April. If
our baby is going to need surgery, we'd rather do it sooner
(especially since the earlier it's done, the more chance
there is of preserving some stereo vision). Would we be
better off switching from Dr. Koseoglu to Dr. Smith, even
though Dr. Koseoglu is the one who's been monitoring our
baby's progress and we'd have to wait an extra few months?
Parent of cross-eyed cutie
I am a resident in pediatrics at Children's Hospital Oakland. Dr.
Koseoglu is an outstanding surgeon who is very perfectionistic &
has a huge heart. His bedside manner is a little difficult to
interpret because he speaks heavily accented English very
quickly... however, I think you will be pleased with his care and
surgery results.
Best of luck.
Katherine
Hello,
Have no specific feedback on Dr. Koseoglu. But, what I wanted to talk to you
about was the timing of the surgery. It's true that earlier rather than later
is more likely to result in better stereopsis. But, children born with
crossed eyes are unlikely to develop normal stereo anyway--in fact, are most
likely to have none, regardless of outcome of surgery or timing of surgery.
You need to balance wanting stereo vision for your child with risk of
anesthesia and risk of needing a second surgery. Both risks are higher with
earlier surgery. If you decide to delay, and I would advise delaying until
about 1 year of age, you should be on a patching regimen to make sure that
normal vision is developing in both eyes. For example, if it is always the
left eye that turns in, that vision will not develop normally. So,
occasionally patching the right eye to force your baby to use their left eye
would be in order. Your doc can instruct you how to do this. And finally, this
happens to about 1% of children, so you have lots of company! Good luck!
Been there, done that
If possible, see if you can get a referral for a second opinion
with either Creig Hoyt at UCSF or Susan Day in San Francisco.
Both are excellent pediatric opthamologists/surgeons and are
experts when it comes to strabismus. My son was diagnosed with
strabismus (in one eye) at 2 months of age, was prescribed
glasses by Dr. Hoyt, and after 2 years of wearing the glasses,
the strabismus was corrected from wearing the glasses.
Although we do not have personal experience with Dr. Day, we
have friends who have been very satisfied with her and have
highly recommended her. She is also recommended by our
Berkeley pediatrician. Additionally, it is my understanding
that surgery for strabismus does not correct vision, but only
has cosmetic benefits as far as straightening out the eyes.
Since your child is so young, please make sure that before she
undergoes surgery that other options (glasses, patching) aren't
a better first option for correcting the problem.
Charlotte
April 2003
It looks like my six year old will need surgery for her strabismus.
We are looking for a surgeon in the Alta Bates Medical Group who
does this well. Her opthamologist said the only person in our group
who does this is Otis Paul, but I can't find any information about
him in the archives or even on the California Medical Board site.
We know about Dr. Susan Day, but she is not covered.
Thanks for any info.
I don't know anything about Dr. Paul, and don't want to suggest
anything bad about him but I do know about Dr. Day and that she
is held in very high regard amongst ophthalmologists (I work for
one in SF). For such an important surgery, it might be worth
changing your daughter's medical group for a period of time in
order to see the surgeon of your choice. Usually this just
involves finding a primary care physician in the medical group
the surgeon is in (likely BTMG) who will accept her as a new
patient. You can likely change back to ABMG once the surgery and
postop is completed. Find out how long the postop period is - I'm
guessing about a year. Good luck!
Cara
In my opinion, the best ped. oph. surgeons for strabismus in the Bay area are,
in order of preference:
William Goode, M.D.
Craig Hoyt, M.D.
Susan Day, M.D.
I would not be comfortable with any of the other area ped.
ophthalmologists performing such surgery on my child. It may be
that you have to consider paying out-of-pocket for such a
procedure if your insurance limits your choices.
While strasbismus surgery is a fairly straight-forward one, there
are other, not unknown, complications involved with the
procedure--splitting the rectus muscle, over/undercorrecting such
that your child might need a re-op.
1998
My daughter had Strabismus when she was a baby and we took her to see
Dr. Susan Day, who is located in SF. Dr. Day is really wonderful,
caring, and it's clear that she really knows her stuff.
Toby
My son saw Dr. Susan Day at Pacific Medical Center in SF, 415/202-1500.
(We were dealing with an injured nerve to his eye which eventually
recovered). At one point we wanted a second opinion on proposed surgery
(which we ended up postponing and avoiding). For that, we went to Dr.
Creig Hoyt at UCSF, 415/476-1289. We were pleased with the treatment of
Cynthia
We recently brought our son to see a woman named Dr Susan Day at CPMC. She
was very highly recommended and spent a lot of time explaining things. It
turns out that our son won't need surgery, but she is supposed to be very
good.
Jennifer
My optometrist husband said that a recommendation for an ophthalmologist
will depend on the nature of the eye problems and the age of the child. He
suggested your friend might start at the UC Opt School (642-2020), (the
infant and toddler clinic, if the child is younger), and have them suggest
an appropriate referral. The best docs in the Bay Area are associated with
UCSF/Stanford Medical Center, and if the problems are very serious, the
child may end up seeing someone there.
Karin
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