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Strabismus (Crossed Eyes)
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Strabismus (Crossed Eyes)
My toddler was just diagnosed with intermittent exotropia - a form of
strabismus where one eye sometimes wanders out while the other is looking
Has anyone else in the community dealt with this with their child or
I am keen to hear stories regarding treatment and long term outlook. What was
your experience with treatment and how does the condition affect your life
Is it merely a nuisance? Can you offer any tips on how to discuss the
with your child, teachers, friends, etc.?
Worried about little eyes
I had surgery for this problem when I was 8 years old.Prior
to that I could easily make myself see double. The surgery
was successful and it is only on rare occasions and if I am
very tired that I have to focus so I do not see double.I
remember being in the hospital and having big white bandages
over my eyes.When the bandages were removed every thing was
way to bright for maybe a day or so. This was in 1960 so the
treatment may be different now.My parents stressed a lot but
it all turned out fine.
My 4 year old daughter and 6 year old son have both been
seen at UC Berkeley's infant/toddler eye clinic for
wandering eye/esotropia and vision correction for several
years. Our O.D. has tried to treat my daughter's the eye
turn with corrective bifocals but she's reached a point
where her prescription is not controlling the eye turn and
we've been referred to consult a pediatric surgeon for
Stabismus surgery. My understanding is that she's not a
candidate for eye patch therapy because her visual
acuities are equal.
We have Kaiser insurance and have been referred to Dr.
Eddy Tamura in Oakland for a consult next week. Has
anyone else had a similar experience or feedback on the
effectiveness of Strabismus surgery in toddlers?
I wanted to respond to your post as we chose surgery for our
son diagnosed with strabismus as a 4 mo old. We patched for
several months, and were frustrated at seeing no progress.
We saw Dr. Susan Day at California Pacific in SF because our
insurance would cover it, though I am familiar with the name
of your prospective surgeon as well. At 9 mos, we agreed to
do surgery, and Dr. Day performed it. I highly recommend
consulting with her if you can with your insurance. The
surgery was completely successful and he has not shown signs
of strabismus since. We continue to do annual checkups with
Dr. Day to ensure that his vision is as she expected. I am
so glad we did it when we did, young as he was. He is now 9.
Hope you get the answers you need for your children's
vision. my best wishes. If you want to contact me directly
for more details, feel free to email me.
I had strabismus surgery when I was 3 in 1972 and it was
very successful and --- in retrospect --- a good time to
do it as I have minimal memories of the experience. I'm
sure it's handled much differently these days but I do
know they put splints on my arms for a couple days so I
wouldn't touch my eyes. My mom tells me that was the
hardest part but maybe they don't do that anymore. My
wandering eye was very severe and the one surgery
corrected it perfectly. I've been told by subsequent
doctors that my surgeon did exactly the right thing in
undercorrecting it, as in adolescence eyes turn outward
and will make a final correction on their own. Absolutely
no one can tell that back in the day you could only see
the whites of my eyes. I'm very grateful and as an adult
have only minimal near-sightedness corrected with
lenses. I would say do it. Kids I knew later in
elementary school who had uncorrected wandering eyes were
teased severely and I never had to experience that.
Fan of the surgery
My daughter, now 25, had surgery for strabismus at age 2
1/2. Altho her eyes are straight, she has weak vision in her
corrected eye and has trouble seeing the world
stereoscopically. It leads me to believe that another
therapy, The Anat Baniel Method (ABM), might have helped her
more. This method is beneficial for children with special
needs and vision problems, like strabismus. Often, after
several ABM lessons, the child's vision improves without
surgery. Check it out at:
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
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
Good luck - and if your child ends up with glasses, I highly
recommend the solo bambini line!
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
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.
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.
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
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.
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.
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?
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.
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
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.
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
Best of luck.
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.
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!
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.
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.
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
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
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.
My three-year old daughter has just recently developed strabismus (aka
crossed-eyes). Does anyone have recommendations for how to help her
keep her glasses on, encourage her to use them, etc.? Has anyone had
experience with toddler strabismus and can share their experience with
treatments with me? Thanks in advance!
Regarding strabismus in a toddler. I have two children with strabismus,
one diagnosed at 18mos and the other at 9 mos. Both have worn glasses
since diagnosis. We saw Gordon Smith M.D. in Walnut Creek and he was
great. Both kids started with plastic frames that either had a strap
across the back or wrapped around their ears. We weaned them onto the
glasses, wearing them for short periods of time in the beginning and then
for longer periods. By the end of 2 weeks each child was wearing her
glasses regularly. At some point they realize the benefit and usually ask
for the glasses. My kids are now 6 1/2 and 2 and they wear their glasses
I want to reassure you that since my daughter got glasses at 3 1/2 (she is
now 6 1/2) we have never had trouble convincing her to keep her glasses on. I too
thought it would be a struggle but she has never complained. Maybe because it helps?
She has the accomodative esotropia variety of strabismus and sees Dr. Susan Day in
SF, who is extremely positive and tells her she has these glasses to help her eyes grow
in the right way. Dr. Day told her from the beginning that if she wants a break from
her glasses she should just tell mom or dad and we'll keep them safe for her. When she
does ask for a break (not very often at all--and usually because the little nose pieces are
out of alignment and rubbing her the wrong way) I tell her after 5 or 10 minutes that
it's time to put them back on and she always agrees. I assure you she is not this
compliant on everything, so it's not like we just have a very placid child, I just think
glasses at this age are not as big a deal to them as they are to us. Recently while
sledding in the snow I let her have them off for a couple of hours at a time because they
were a pain (and could have been a danger) in this instance, but I have never found
them to get in the way of any other activity-swinging, monkey bars, running, tumbling,
dancing, horse-play, etc. Good luck!
Our son is 1 1/2 now and has been in glasses since he was 1, to help correct strabismus. They
wrap around his little ears (I think these are called "comfort cables"), but we also attached a
colorful cord to each side, which we got at the eyeglasses shop, so that if he tries to hurl the
glasses to the ground, they just dangle around his neck instead. The cord can be tightened in
back to help keep the glasses from slipping down his nose. He is good about keeping them
on--we just insist he wear them, like clothes, and he got used to them remarkably fast.
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