Re: vision check in 5 year old (long)On 4/18/08 7:34 AM, in article
8e40cd18-accd-43b9-b10d-60a9abc6d456@a23g2000hsc.googlegroups . com ,
"janesire@gmail . com " <janesire@gmail . com > wrote:
> On Apr 17, 4:07 pm, Neil Brooks <neil0...@yahoo . com > wrote:
>> On Apr 17, 1:25 pm, janes...@gmail . com wrote:
>>
>>
>>
>>> I took my 5 yo DD to a pediatric ophthalmologist. He dilated her eyes
>>> and checked and came up with a prescription, let's say "x" which was
>>> rather high (worse) reading. Since we don't have anyone in family that
>>> had glasses DH wanted a second opinion so I took her to an optometrist
>>> today. She was very thorough and fully engaged DD and tested for a
>>> while without dilating and came up with a prescription that pretty
>>> much identical to "x". Then she said this reading is a bit on the
>>> higher side and also since I never noted any problems with DD's vision
>>> at home, she wanted to dilate and check again. She used a stronger
>>> solution to dilate her pupils and checked again after 45 minutes. This
>>> new reading "y" turned out to be negligible enough that she doesn't
>>> need glasses.
>>
>>> But, DD also has astigmatism. So she gave me 3 choices:
>>
>>> 1. The biggest problem with DD is that she's unable to relax her eye
>>> muscles and she's over focusing. So she said we can use a solution to
>>> dilate her pupils that lets her relax her eye muscles. We can use it a
>>> few times a week after school. During that time she has to have
>>> bifocals with reading glasses in the bottom half in case she wants to
>>> read etc.
>>
>>> 2. Get prescription glasses that address astigmatism and try to get
>>> her to relax her eye without dilating or anything.
>>
>>> 3. Get a 3rd opinion if that makes me more comfortable.
>>
>>> I felt that the optometrist did a more thorough job than the Ped
>>> Ophthalmologist but I don't know who knows better. Also, does anyone
>>> know if there any eye-muscle-relaxation-exercises that I can have my 5
>>> yo do every day?
>>
>>> Any comments are appreciated. Thanks.
>>
>> 1) Can you post all the various prescriptions -- with and without
>> cycloplegia (dilation)?
>
> First (x) from the Opthalmologist with dilation and optometrist
> without dilation:
>
> Right: sphere -3.00 Cyl: +1.25 Axis 123
> Left: sphere -3.25 Cyl: +1.25 Axis 080
>
> Second (y) at optometrist with dilation:
>
> Right: sphere -0.25 Cyl: -0.75 Axis 021
> Left: sphere 0 Cyl: -1.50 Axis 175
>
>
>>
>> 2) It might help to know if DD has had any history of binocular
>> function disorders (strabismus) or surgeries, and the specifics on
>> that, too -- perhaps including her alignment pre- and post-
>> operatively, if applicable.
>
> None of the above.
>
>>
>> 3) Also, there's nothing to be gained ... and much to be lost ... in
>> paying any attention to Otis Brown.
>>
>> I'm not an eye doctor, but a very interested patient.
>
I notice you wrote the prescription "x" from the ophthalmologist was the
same as the optometrist, yet this is a plus-cylinder prescription.
You note the optometrist's dilated prescription, written in minus-cylinder.
Therefore, I wonder if the undilated numbers you got from the optometrist
may LOOK like the numbers from the ophthalmologist, but really are
different.
I suspect that the undilated numbers really are more minus than the dilated
from the ophthalmologist. However, I still cannot explain the difference
between the dilated numbers from the two exams, which should be more equal.
The strenght of the drops , as you said, may have had something to do with
it, and it is not clear which is correct.
A cylinder 1.00 or higher is a relative reason to prescribe glasses at age
6, per the Ophthalmology Academy guidelines. However, some kids see fine
anyway, and do not need glasses, and others see not so fine, and need the
glasses.
This is a quandry here. You have to put your faith I who you believe more,
or get a third opinion to help settle it.
David Robins, MD
Board certified Ophthalmologist
Pediatric ophthalmology and adult strabismus subspecialty