Amblyopia (Lazy Eye)
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Amblyopia (Lazy Eye)
May 2008
My son had a bad cold late March and a result was one of his eyes looked
lazy/inward. FYI: He is almost 2. I went to see Eugune Stern early April in
Oakland and he said it was from this cold and that his nervous system just has
to work harder. He asked that I come back once my son was all better since he
still had a little of the cold at that time. I just went to see him on Monday,
since my sons eye has not improved, he confirms again it is not lazy eye, that
his eyes are healthy. The options were: glasses(which would be removed in a
minute by my son), daily drops which would act like glasses(which would be a
chore and stressful on my son and me), or to wait it out. He encouraged me to
wait it out. Of course, not an option I can appreciate. I am afraid we will
lose this window of correction I have read about. Any thoughts or refernces on
docs?? Again he does not have lazy eye or ambro....but the treatments may be
the same. Thanks
concerned mom
Take your son to the UC Berkeley Optometry Center for a complte exam. They are great
there and have a separate childrens eye center. It's not scarey for the kids...very
kid oriented but they'll be so thorough and you can believe what they tell you.
My son had lazy eye, diagnosed when he was 5. He was patched for about a year on and
off and had eye exercises. He improved a lot. I don't know if your son has this or not
but you definately need a 2nd opinion and UC Bkly is the place to go.
anon mom
Oh dear. The ''wait til he outgrows it'' advice is simply awful. Vision develops
during the first two years of life primarily, and continues to develop until age 6. If
your child does not have amblyopia now, they will unless you intervene--they are young
enough that they will start to lose vision. Since they have good vision from their
straight eye, they will act like a normal kid, but they will be slowly losing vision.
The eyedrop suggestion is meant to force them to use the unused eye. The easiest and
best thing to do is to have your child wear glasses. IF their eyes are straight with
glasses, rejoice! They won't lose vision, they will retain their fine depth
perception--everything will be great. You can get a 2 year old to wear glasses. Yes,
you can.
I suggest you go to UC Berkeley infant toddler clinic to have your child examined
properly, and get some good advice. 642-2020 is their number. Call fast, their
appointments are hard to get, and the longer you allow this to continue, the more your
child's vision will be affected.
Eye Doctor
I am not a medical professional, but I have never heard of a cold causing a person's
eyes to turn inward. You did not mention if this person you visited was an actual
doctor, but if he is not, please consider consulting an opthamologist. My husband has
this condition (strabismus) and it is nothing that can be cured with drops or
''waiting it out''.
concerned
If my child had any kind of eye issue, I would take him to the Infant-Toddler Clinic
at UC Eye Center in Berkeley for a comprehensive assessment. 642-2020.
Barbara
Get a second opinion! I highly recommend Dr. William Good. He specializes in kids, but
I also see him. I had amblyopia as a child, which was thankfully caught early and
treated by another doctor (long since retired). Dr. Good is watching my 1.5 year old
daughter's eyes for the same disease. He is very thorough and cautious. He's seen her
twice already, and wants to see her again in a year to make triply sure she doesn't
have it.
- former lazy eyed mom
hi,
did your son's doctor look in your son's eyes - dilate them, etc.? i ask because my
son had a similar inward eye (though he was only three months old) and, thanks to our
amazing eye specialist, my son was diagnosed with coats disease - a rare condition
that usually affects boys and is unilateral (in one eye). i won't go into the tx. but
it might be something to ask your doctor.
good luck!
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
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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