Strabismus/exotropia or other eye conditions diagnosis process

[Imogen's_Mum]

Hi mamas,

I have a 3.5 yr old DD with possible strabismus/exotropia, but no diagnosis yet. We have an appointment with a specialist in a few months but I am going crazy waiting. The local clinic that specializes in pediatric eye conditions books out further than I anticipated! We think she has exotropia because her right eye (and DH thinks left as well) tends to flutter sometimes and/or wander before it comes back into alignment.

Any mamas out there who have LOs with this condition who can help me out with some idea of what the diagnostic process looks like? DD isn't very good with strangers getting in her personal space and I am worried about how she will react to having her eyes dilated and strange objects in her face.

I have not been able to find many resources online but maybe I am looking in the wrong place.

[craigwick]

Hi! My DD2 has intermittent exotropia, but it was diagnosed when she was one...at 6 months she looked crossed eyed (was just an optical illusion as her nose bridge was wide and she has small eyes). We actually saw our optometrist first, but at the 2nd appt she lost it (autism, and it was just not a good day!) and was referred on to a pediatric opthamologist.

DH and my MIL actually took her to the first appt where they dilated her eyes, she was not impressed but little enough to forget it! It took quite a few appts to get comfortable with the process, we go every 2 months or so depending on how full they are with bookings and they dilate her eyes every year at whatever appt she happens to be co-operative at.

Since the place you are going specializes in kids, I imagine it will be similar to ours with all sorts of toys, fun glasses to wear and a tv they use to catch the kids attention so they can look at their eyes. It does weird DD2 out a bit, but they can usually get her to co-operate (especially with the princess and dora themed stuff!!)

Oh, and I sit in the chair with her on my lap so I can assist the tech doing the exams and help talk her through it.

[Imogen's_Mum]

Thanks! That is very reassuring

In all my worrying I didn't take into account the fact that we are taking her to a pediatric specialist and they would.....duh...be used to working with preschool age and younger kids

[craigwick]

lol! I know, I'm like that, the obvious totally escapes me sometimes! Our Dr. is great, she has slowly but surely won DD2 over, she even sings to her during exams (and this is major, because until recently she couldn't stand the sound of anyone singing but herself!)

[blane,j,&morgansmom]

HI!!! My 3.5yo ds just had the surgery to fix the strabismus/esotropia 3 weeks ago. I made an appointment to see a pediatric opthomologist not optomotrist (both probably spelled wrong) The optho noticed right away that his right eye floated inwards. His surgery was scheduled for the next monday following the appointment. I think first they have to figure out if glasses will help. With my lo it was a muscle issue and not a vision thing. My lo is finally looking almost normal after the surgery, the redness is decreasing daily. I do think it is SUPER important to take your lo to a pediatric opthomologist for sure. They just handle little ones better!

[Mama2judeNcamdyn]

Hello! My DD was diagnosed with accommodative esotropia at age 5. We noticed her right (primarily, but sometimes her left as well) was starting to drift inward, especially when she was sleepy, or focusing on a book, small object, etc. Around Thanksgiving we saw a local optometrist who brushed us off.

The crossing of her eyes continued to worsen, so I went with my mommy instincts and made her an appointment with a pediatric opthamologist. We saw her right before Christmas, and she was very happy that we came in as quickly as we did. The doc explained that the strain on DD's eyes when focusing caused them to cross (when her eyes were dilated~which she HATED~and her vision was blurry, they BOTH crossed horribly!) Her prescription was not too bad, 20/25 and 20/30, but the doc said if we'd waited even a year, it would have likely been 20/100 in her right eye, and that eventually her brain would have shut of all signals from the "bad" eye, rendering her blind in it. :-/

The doc prescribed glasses, and they have worked like a charm! We were told that she may be in them until she's a preteen (maybe not so long, maybe longer) and that she may require a patch or surgery one day, but at her last two checkups, the doc was thrilled with how straight her eyes were with the glasses!

Good luck with your LO!

[Imogen's_Mum]

[QUOTE=craigwick;15231266]Hi! My DD2 has intermittent exotropia/QUOTE]

I believe this is what my DD has, it is intermittent but from what I have read it could become more and more frequent if left untreated. If you don't mind me asking, how frequent was your DD's when it first started, as compared to now?

[Imogen's_Mum]

Originally Posted by Mama2judeNcamdyn Hello! My DD was diagnosed with accommodative esotropia at age 5. We noticed her right (primarily, but sometimes her left as well) was starting to drift inward, especially when she was sleepy, or focusing on a book, small object, etc. Around Thanksgiving we saw a local optometrist who brushed us off. The crossing of her eyes continued to worsen, so I went with my mommy instincts and made her an appointment with a pediatric opthamologist. We saw her right before Christmas, and she was very happy that we came in as quickly as we did. The doc explained that the strain on DD's eyes when focusing caused them to cross (when her eyes were dilated~which she HATED~and her vision was blurry, they BOTH crossed horribly!) Her prescription was not too bad, 20/25 and 20/30, but the doc said if we'd waited even a year, it would have likely been 20/100 in her right eye, and that eventually her brain would have shut of all signals from the "bad" eye, rendering her blind in it. :-/ The doc prescribed glasses, and they have worked like a charm! We were told that she may be in them until she's a preteen (maybe not so long, maybe longer) and that she may require a patch or surgery one day, but at her last two checkups, the doc was thrilled with how straight her eyes were with the glasses! Good luck with your LO!

Thanks, this helps a lot. We have been noticing the eye wandering more frequently in DD in the last few months. We have also been looking for it which may contribute to seeing it more.

What you mentioned about your doctor telling you she could have lost some sight in the one eye if left untreated for even a year....that is exactly why I am not taking a "wait and see" approach, even though DD's eye wandering is still intermittent. She was screened at day care and the nurse saw it wander the first time, but when she re-tested it was gone...so she actually crossed it off DD's screening form. I am now wishing she had not!

I worry about her needing glasses so young but I guess we will have to see what the Dr says. When her vision was screened at day care she had normal vision in both eyes and I want it to stay that way.

[Imogen's_Mum]

Originally Posted by blane,j,&morgansmom HI!!! My 3.5yo ds just had the surgery to fix the strabismus/esotropia 3 weeks ago. I made an appointment to see a pediatric opthomologist not optomotrist (both probably spelled wrong) The optho noticed right away that his right eye floated inwards. His surgery was scheduled for the next monday following the appointment. I think first they have to figure out if glasses will help. With my lo it was a muscle issue and not a vision thing. My lo is finally looking almost normal after the surgery, the redness is decreasing daily. I do think it is SUPER important to take your lo to a pediatric opthomologist for sure. They just handle little ones better!

Glad to hear your LO is doing well after surgery! I have a feeling DD's issue would be muscle related as well since her vision was tested at normal in both eyes.

I hope your lil' guy keeps getting better!

[craigwick]

[QUOTE=Imogen's_Mum;15232916]

Originally Posted by craigwick Hi! My DD2 has intermittent exotropia/QUOTE] I believe this is what my DD has, it is intermittent but from what I have read it could become more and more frequent if left untreated. If you don't mind me asking, how frequent was your DD's when it first started, as compared to now?

I would say when we first noticed it, it was happening at least 10 times a day that we would see it flit out and back (usually when she was tired, or looked up quickly) and now I mainly see it at the end of the day once or twice. That, and I sometimes suspect she moves it on purpose...I called her once while she was watching TV and she rolled that one eye to look at me while the other watched the show. Creepy!

We are patching now, have been for 3 months (2 hours a day, whoops forgot today!) and seeing improvement. She can draw stick people now, which she couldn't before and has real interest in fine motor skills. Also the vision in her "good" eye is worse than the lazy one so it acts as a natural patch (normally the lazy eye has worse vison). She will need glasses for that and astigmatism, but they don't want to try it yet until she needs them for school. Surgery was mentioned, but they want to exhaust all other options first.

She inherited this from DH, and as pp mentioned wanting to avoid that eye becoming a dud, that is what happened to him. So every time he huffs and gets embarrassed by our 3 year old wearing a cute patch in public I remind him of that!

Oh, and for anyone reading, this is where we get her nifty patches:
http://www.myipatches.com/home.php