Berkeley Parents Network: Amblyopia (Lazy Eye)

Berkeley Parents Network

Amblyopia (Lazy Eye)

Berkeley Parents Network > Reviews > Health & Medical > Amblyopia (Lazy Eye)

Questions:

Optometrist for child's lazy eye

4-year-old diagnosed with severe amblyopia

Ophthamologists for Amblyopia
Related pages:

Ophthamologists

Eye Conditions in Kids

Optometrist for child's lazy eye

September 2003

Can anyone recommend a good optometrist for my son? He has been diagnosed with one eye that is weaker and is not being corrected completely by glasses. We've been going to the UC Optometry but are thinking of switching over to a private doctor with more experience and consistency than the students. Someone in Oakland or Berkeley would work for us. Also any other thoughts on dealing with patching are welcome!! Leah

We go to Richmond Kaiser, so I don't have any private doctor recommendations (we see Dr. Tamura, who also works at Kaiser Oakland). However, I wish to stress the importance of patching. Our family knows a woman who is blind in one eye because of insufficient patching.

This may not be helpful since it's not exactly what you're asking since Optometrists and Ophthalmologist deal with 'lazy eyes' differently and he isn't in Oakland/Berkeley. But we LOVE Dr. William Good of Walnut Creek. [see Opthamologist for Amblyopia (Lazy Eye)]

For your son's ''lazy eye,'' you should consider an ophthalmologist - not an optometrist - who is experienced in treating amblyopia. This is an opportunity to save your child's sight. The pediatric ophthalmology staff at UCSF is at the forefront of research and care in amblyopia. Try Drs. Doug Fredrick or Dr. Jonathan Horton (415) 353-2289. Merry

As someone who comes from a long line of ''amblyopics'' and I would urge you to seek a consultation with William Goode ... [see Opthamologist for Amblyopia (Lazy Eye)]

Dear Leah. The best, and I mean it pediatric opthamologist is Dr. Creig Hoyt at UCSF. ... I do not have a lot of faith in optometrists, other than for prescribing glasses and contacts. Your son has a muscle problem and should see an opthamologist. [see Opthamologist for Amblyopia (Lazy Eye)]

I think you really want to see an opthamologist, not an optometrist (despite what the folks at the school of optometry tell you). We've seen, with our 7 year old, a number of people.

One doctor in Walnut Creek saw the amblyopia when our daughter was three, four and five and did not patch. I recently read studies that indicated patching is much more effective before age 5. ( I can send you references if you e-mail the moderator)

We tried patching with David Bui in Alameda when she was six and despite patching reliably there was no change after six months. We were then referred to Susan Day for surgery, who is the person you really want to talk to, I have found.

She is having my daughter wear glasses with -125 and a slight prism for six months to see if it will work, and if it doesn't she will schedule surgery.

I am still a little mad at myself for not reading the studies earlier, so I would know to make sure she got patched early enough.

In any case, you may want to get two opinions before you go any further.

Optometrist recommendations received: Benjamin Gaynor, Paul Odes, Larry Sarver

4-year-old diagnosed with severe amblyopia

March 2003

we learned recently that our four-year-old has severe amblyopia without strabismus. her vision's 20/400 and 20/40 uncorrected. we had no idea! we'd like to hear from other parents with similarly affected kids. please let us know if you have stories, experience, recommendations, or warnings to share. thanks. david and andrea

I have a lazy eye, so does my mother & my nephew...all in the right eye. Mind you, a lazy eye is not a wandering eye; a lazy eye moves in tandem with the other eye, it just doesn't see as well.

-My mother was not diagnosed until adulthood, she wears glasses with one lens MUCH thicker than the other.

-I was diagnosed at about 10 years old and was told I was too old to wear a patch so was told to wear glasses full time to correct/alleviate problem. (Which I must admit I did not do that often). I now wear contact lenses and there is still a pretty significant difference in vision for each eye. (Heaven forbid I mix up my lenses!)

-My nephew was diagnosed very early, like your daugher. His doctor had him wear a patch on his stronger eye during most of the day, then switch to the weaker eye for the rest, all while wearing glasses. His vision has greatly improved/evened out using this old fashioned method. He doesn't even wear glasses anymore.

If you end up using a patch like my nephew, don't worry too much about what other kids say. They have some pretty cool looking patches these days! My nephew had quite a variety to choose from in fabrics/patterns/graphics. Almost like playing dress up!

Hope this is somewhat helpful. Best wishes! Anon

you didn't say whether or not you are taking any steps to treat the amblyopia. at age 4, there is still a chance that the amblyopia could be lessened. definitely pursue this with your optometrist.

there are plenty of people out there who do fine with untreated amblyopia. your child has already learned how to compensate for it and will continue to. the warning is that you must take extra care to protect the ''good'' eye. wear polycarbonate lenses, wear protective eyewear for sports, etc. there maybe some career choices that will not be possible for a person with significant amblyopia.

an optometrist

My now 5 year old daughter had this exact same diagnosis when she was 2. Our pediatrician referred her to Dr. Susan Day, at California Pacific Medical Center in SF. Dr. Day is a pediatric opthamologist who is really the best in the biz. She has excellent diagnosis skills, and had my daughter wear glasses to correct the problem for about 6 months, and sure enough, she grew out of the problem, which many kids do, and doesn't even have to wear glasses any more. Try Dr. Day - she's worth the trip to the city... Lisa

My 5-year old has accomodative esotropia so our situation is a little different from yours. She was diagnosed at age 2 and has been wearing corrective lenses to deal with the issue. For us that is helping but not making the problem go away. Now that she is 5 I may look into Vision Therapy at the UC Eye Center.

There is an active yahoogroup which deals with this issue. They were very helpful when I first started exploring the issues around 'lazy-eyes'.

To enroll send an email to: LazyEye-subscribe at yahoogroups.com

They also have an archive of messages that you can check out. Evaa

I had ''lazy eye'' as a young child and had to wear an eye patch on my ''strong'' eye through all of first grade. Since I know children nowadays with eye patches, I know that's still a prevalent way of dealing with the syndrome (and exercises). I ended up with 20/20-25 vision on both eyes and never wore glasses (well, until I became middle aged....) The hardest thing was being teased by other children about wearing a patch (and being ''different'') and the fact that the patch itched. I always talk to kids that I know who have patches about that I used to wear one too to help them have some perspective(I also used to have to wear corrective shoes, but that's another story). Karen H.

I wanted to address this as a person who was diagnosed with amblyopia as a child and how things went as I grew up. When I was a child I was made to wear a patch over my good eye. My eyes improved really well. Unfortunately, as I got older, I got vain. My optometrist gave me a pirate's patch to make it more interesting and I wore that for a while, but eventually I stopped using a patch at all. Unfortunately, I was not forced to wear it. My eyes gradually deteriorated again and when I decided I wanted to try again, I was told the damage had been done and it was too late to do that. I spent a great part of my adult life having daily headaches. I was supposed to wear glasses (I had 20/20 vision in my good eye and something much worse in my bad one), but again, was too vain and never really liked the frames I ended up with. Long story longer, I finally found a pair of frames that I liked, started wearing them daily, and I didn't have headaches any longer. What is my point? Make your kids wear their glasses and patch! I noticed a colleague's daughter with a really cool patch under her glasses recently. She has amblyopia. I told her the same thing - make her wear the patch!

Hindsight is 20/20 (pun intended)

Important to know about amblyopia:

--has to be addressed before age 5, otherwise the weaker (''lazy'') eye will not accept any more visual messages and ''go to sleep'' (become blind, partially blind, or mostly blind)

--you should be seeing a ped. ophthalmologist (not an optometrist)

--best area ped. ophthalmologist (and considered one of the top in the country) is William Goode, M.D.--various locations: San Ramon, Walnut Creek, SF, Marin County, Stanford.; he has a lovely bedside manner, clnically and surgically brilliant, and, somehow, manages to run on time

--in treating amblyopia (patching, glasses, etc.) you are not only preserving the vision of the eye but you are also preserving stereopsis (the ability to see 3-D), and lessening the issue of not only a functional issue but also a cosmetic issue (often the untreated eye will turn out/in from lack of seeing/use. Often there is a ptosis (drooping of upper eyelid) associated with amblyopia.

--finally, amblyopia has a strong familial presentation; I had it (was treated successfully at an early age), my father and maternal grandmother had amblyopia as well. Consequently my children were (are) screened for it by Goode.

This requires as early intervention as possible.

G Advocate of Early Intervention

I thought you might find this article useful, as a drop in the eye once a day is a lot easier to keep up with than an eye patch.

http://healthlink.mcw.edu/article/1030635385.html

selection from article: Amblyopia: Eye Drops Could Be as Effective as Patching

Amblyopia, or “lazy eye,” is the most common cause of visual impairment in children. For years the standard treatment for this disorder has been to patch the unaffected eye in order to stimulate use of the “lazy” eye. In a recent study, researchers found that atropine eye drops, given once a day, worked as well as patching. This research finding may lead to better compliance with treatment and improved quality of life in children with amblyopia. The results appeared in the Archives of Ophthalmology.

After six months of treatment, researchers found that the drug atropine, when placed in the unaffected eye once a day, works as well as eye patching and may encourage better compliance. Compliance is an important factor in the success of amblyopia therapy.

''These results are important because they provide an effective alternative treatment that helps prevent permanent vision impairment for children with amblyopia,'' said Paul A. Sieving, MD, PhD, director of the National Eye Institute, one of the Federal government's National Institutes of Health and the agency that sponsored the study. ''Amblyopia is currently treated by wearing an eye patch over one eye for weeks to months. Children us -ually do not like this treatment approach because of quality of life issues, such as irritation of the skin and teasing by other children. This new study found that atropine eye drops had a higher acceptance rate and better compliance by children and their parents than did patching. This may well become a new standard treatment for some forms of amblyopia.'' susan

I just really also want to encourage people to deal with a ''lazy eye'' as early as possible, not only by going to the doctor but also by communicating to your child the reasons behind an eye patch (or whatever corrective option you decide). I also had a lazy eye when i was younger, but instead of wearing the eye patch all day, I would take it off when I got to school and then put it back on before I went home. Since nobody had explained to me why I was wearing it, it was only an irritating thing that kept me from running around and having as much fun as I wanted. It wasn't vanity, it was just harder to see while wearing it and I didn't understand why I had to wear it everyday. I regret now that nobody took the time to explain to me the importance of fixing my eye. Today I wear a contact on my other eye, and I don't use the ''lazy eye'' at all- my other eye compensated and sort of took over.

Good luck, and please take care of lazy eyes early and talk to your child about it! anon

I was diagnosed with a lazy eye when I was in preschool. I don't remember much about the diagnosis since I was so young, but I do remember wearing a patch on my good eye for several months (maybe more). The patches I had were similar to fabric bandages with adhesive around the edge and my mom used to draw pictures on the patches (for example, a birthday cake when I went to a birthday party). I then wore glasses from about kindergarten to 8th grade and now do not need glasses or contacts. Hopefully, your child will not be adverse to wearing the patch and glasses because diagnosing and treating a lazy eye early can mean a full recovery. I don't have any recommendations for doctors because I did not live in the area at the time. Good luck. Anon

patching is one of the therapies for amblyopia. you can consider the atropine eye drops but sometimes people need to consider all that goes with instilling medications to your child.

early intervention is the key. i would recommend going to see dr. deborah orel-bixler at the UC Berkeley School of Optometry Clinic. she is kind, great with kids and makes things go as painlessly as possible. she is also a kid specialist. When you make an appointment (642-2020 or make an appointment via online http://www.caleyecare.com/), make sure you request dr. orel-bixler in the infant/toddler clinic.

hope that helps. judy

As someone who comes from a long line of ''amblyopics'' and who is medically trained, I would urge you to seek a consultation with William Goode, M.D. (925-277-1135, San Ramon and a host of other local locales), someone I (and a lot of my ophthalmologist colleagues) consider to be the finest pediatric ophthalmologist in No. California. Lazy eye (Amblyopia) is really considered the purview of an ophthalmologist (M.D.) not an optometrist (O.D.)

Most importantly, the earlier lazy eye is addressed, before 5 years of age, the greater the chance of reclaimed vision. After age 5, the eye, essentially, goes to ''sleep'' because the brain will not recognize visual input. As well, because there are different types of amblyopia, there are different protocols for dealing with the problem--patching as well as other things. Good luck

Physi Patched successfully at a wee age

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