Vision therapy for lazy eye? 8 year old son has amblyopia and esotropia

[mommy22pumpkins]

Hello. I know this is way OT but I have found such good advice from the wonderful people on this board I figured it's worth a shot. My son is 8 years old and has a lazy eye. He was treated with patching on and off from age 3 till now. We did not realize there was a window of time where patching would be effective as his doctor did not explain anything to us and we are currently looking for a new doctor.

He has 20/40 vision in the *lazy* eye. I believe that is with his glasses on. He started off with 20/80 so the patching did help somewhat. I am worried now though as he cannot see well at all without his glasses on. We lost them a couple weeks ago and his gym teacher said he is having trouble seeing the ball etc. And my son tells me he has been tripping alot. He has always been prone to falling down and I asked his eye doctor if his depth perception could be off or if it is related to his vision and he said no. Told me Babe Ruth had a lazy eye on and on but not sure I believe him. Why else would he be so prone to falling down- he has even fallen down the stairs several times We took him to a neurologist for the falling down as even his teacher was concerned about it- he was falling out of his chair at school- and he didn't find anything wrong on exam that would indicate a neurological problelm.

I am wondering if anyone has ever tried vision therapy for esotropia- his one eye turns inward. Or amblyopia (aka lazy eye). I am trying to look it up online and there are websites with doctors who specialize in it but I am leary of people advertising online. And playing off people whose children have this problem.

Any advice or info about where to find a legit doctor who provides vision therapy would be much appreciated. We are located in South Jersey so anyone within driving distance would be great. Sorry so long! Thanks for reading and I am very grateful for any advice.

 

[andrews_dad]

This is a board on this site called DISabilities. Check there. Those folks know alot via personal experineces.

 

[Jynohn]

We did vision therapy with our daughter last year for tracking issues. Unfortunately I'm not aware of any doctors in your area, but perhaps our daughter's doctor could recommend a colleague? His name is Dr. Abbondanza in Southborough, MA if you'd like to ask him for a recommendation. PM me if you'd like his number.
Good luck!

 

[lziol]

My daughter is 5 years old and has amblyopia and strabismus. She wears bifocals and was wearing an eye patch until recently. We live in NJ also. My daughter sees Dr. Judith Lavrich. She has a reputation for being the best pediatric opthamologist in our area. I think the closest office to you would be in Lawrenceville. She also has offices in PA. The name of the office is Total Eye Care Center. I hope this helps!

 

[taximomfor4]

My dd7 went through patching (made the original lazy eye better, but then the other one now turns in). Then glasses. A little weak, I think, to make the eyes work a little. Now she is turning inward WITH the glasses too often, so her pediatric opthalmologist is starting her in bifocals. Waiting for them to come in now, so she can start getting used to them.

My middle dd (11yo) has a vision field issue, a blind spot. And strabismus. Recently, her eye has also started drifting UPWARD a little, too. She's just always had glasses (nearly got surgery, but I got a second opinion and trust the second guy better!) He has, just 2 weeks ago, decided to reduce her prescription to make her eyes work a little. He hopes this alleviates the drifting eye.

I say, find a pediatric opthalmologist you trust. When I found our current one (while seeking that second opinion), he called me, talked to me for almost 45 minutes!!!! about the doubts I was having, then got us on the cancellation list (to get an appointment sooner, rather than later). He is very thorough, thoughtful, and talks TO me, not down at me. You need to really, really trust the dr. you end up with. After all, it will impact your child's eyes FOREVER!!

 

[Befferk]

I apologize upfront because have no firsthand knowledge of this type of thing except seeing a friend go through it, and maybe there are different types that require different treatments? But is surgery an option? I know that sounds horrifying, but a friend of mine's daughter had a lazy eye, and they told her that since it hadn't gone away by age 4 or so, they could do surgery. They did it, and it was a super quick outpatient surgery with fast recovery time and it was all better after that. I don't know how serious your son's is, but it sure was a quick fix for their daughter. She doesn't need any type of glasses now. I believe they had a choice between the quick fix of surgery or waiting out other types of therapy

 

[Tinkmom75]

My DS has the exact issues your child has. Are you going to a optometrist or opthamologist? Get second or third opinions. My DS ended up having surgery at 5 yo because his muscles on both eyes were too tight and caused the turning inward. No amount of therapy could have helped. I went to 1 optomestrist and 3 opthamologists before deciding on the surgery. We decided on an opthamologist 1 1/2 hours away from where we live.

The tripping and crashing into things is because there is a depth perception issue. Depth perception is learned early in childhood. My DS still does not have full depth perception, but it is better than if he hadn't had the surgery. There was patching required after surgery for the amblyopia. He wears glasses with bi-focals now. Good luck!

 

[carj]

Hello. I know this is way OT but I have found such good advice from the wonderful people on this board I figured it's worth a shot. My son is 8 years old and has a lazy eye. He was treated with patching on and off from age 3 till now. We did not realize there was a window of time where patching would be effective as his doctor did not explain anything to us and we are currently looking for a new doctor.

He has 20/40 vision in the *lazy* eye. I believe that is with his glasses on. He started off with 20/80 so the patching did help somewhat. I am worried now though as he cannot see well at all without his glasses on. We lost them a couple weeks ago and his gym teacher said he is having trouble seeing the ball etc. And my son tells me he has been tripping alot. He has always been prone to falling down and I asked his eye doctor if his depth perception could be off or if it is related to his vision and he said no. Told me Babe Ruth had a lazy eye on and on but not sure I believe him. Why else would he be so prone to falling down- he has even fallen down the stairs several times We took him to a neurologist for the falling down as even his teacher was concerned about it- he was falling out of his chair at school- and he didn't find anything wrong on exam that would indicate a neurological problelm.

I am wondering if anyone has ever tried vision therapy for esotropia- his one eye turns inward. Or amblyopia (aka lazy eye). I am trying to look it up online and there are websites with doctors who specialize in it but I am leary of people advertising online. And playing off people whose children have this problem.

Any advice or info about where to find a legit doctor who provides vision therapy would be much appreciated. We are located in South Jersey so anyone within driving distance would be great. Sorry so long! Thanks for reading and I am very grateful for any advice.

There are a couple of things going on, correct? He has lost his glasses. So whatever his vision is, is his uncorrected vision. So if he is 20/40 with glasses, he is worse without them. If he is used to wearing glassses and he has a discrepancy between his eyes, which may very likely be worse without them, I would expect to have some depth perception issues.

If you don't feel comfortable with your doctor, then I would certainly get a new one.

Have you bought new glasses yet, or does he need a new prescription? This is the very first thing that I would do. It is the thing that is most likely to have the biggest impact in the short term.

I would think that the goal would be to get him to see 20/20 in both eyes with correction (glasses). 20/20 in both eyes without correction doesn't seem like a realistic expectation. He may always need glasses or contacts, but that is okay.

There is a critical window of time where patching does the job of making the weaker eye do all the seeing. It actually sounds like you have had reasonably good results if he has improved in the weaker eye from 20/80 to 20/40.

If that were his vision with both eyes together, that would be the difference in being able to drive without restrictions, and having many restrictions placed on his driving, ,or perhaps not driving at all. I know that is a long way off!

I think that you are wise to be careful of vision therapy and the promises that they make. I believe that it is most effective before age 6. Though I think it can still be effective through about age 10. I would want to have a realistic picture of what I can expect as far as results, not the best case scenario. I would investigate that as much as you can.

Best wishes!

 

[Tinkmom75]

I have another question. Is the crossing corrected with the glasses? I agree that the goal should be acceptable eyesight with glasses on. My DS's prescriptions have also been getting lesser as he grows. I guess there is a correlation between the eye and getting taller. So he may get out of bi-focals, but probably not completely out of glasses.

 

[uncutk]

My daughter has been doing this also. Her Dr. suggested her playing a game such as a DS or a similar one instead of vision therapy while wearing her patch. We patched from the time she was 3 (she got bifocals at 4) until about 6 months ago. She is now 8.

 

[JustineMarie]

My daughter goes to Dr. Preito in Woodbury. She is a pediatric Opthamologist. She is GREAT! I love her. She explains everything in detail, she makes sure you understand, and she is great with my daughter. She does book up months in advance, but she is well worth the wait. My daughter has been going to her since she was 3 and her eye has definitely improved. She did tell me she may always need glasses, and we are ok with this. But there is a possiblity that by the age of 12 it may have been corrected and she won't need them.

 

[tlens]

Patching at 3 is definately the right window and it did help it appears. The first order of business is the new glasses. The 20/40 is with glasses on and if his vision decreases corrected beyond that, he'll have issues with driving and getting certain jobs later in life. However, the good news is, that by age 8, he's out of the danger zone of the brain completely shutting off the signals to that eye. He most likely will never become legally blind in that eye which is a concern when they are younger.

That's what was happening with my son. WE were tracking him closely enough from very young that he got glasses at age 3 ( his problem was difficult to diagnose because his eyes worked in tandem which often isn't the case). He's 5 now and at his last appointment he's seeing 20/20 with his glasses. The Optometrist even said that by the time he's 8 he may not need his glasses full time anymore.

So, get the new glasses. It sounds like he's having a depth perception issue (the falling down and the problems in gym class). I'm not too familiar with vision therapy but I know it appaers to have helped a friend of mine's daughter.

 

[Hannathy]

You are a short drive from one of the best eye centers in the country Wills Eye in Philadelphia, I certainly would start there.

And If you haven't replaced his glasses WHAT are you waiting for? If I lost my glasses I'd be tripping and falling that's for sure.

Get the poor kid his glasses if you haven't (when I taught that used to drive me nuts when kids would lose their glasses and then the folks would drag their feet replacing them and wonder why the kid's performance and behavior was slipping, duh!) If you have I apologize in advance.

 

[mjkacmom]

I think this is what dd8 had - we tried patching for 2 years, and decided to go with the surgery when she was 3. It was so easy, and we fixed it before any damage was done to her vision. She went to an excellent pediatric optomologist in NJ, Dr. Mickey (I think he's in Wayne now). What kind of doctor is he seeing?

 

[MyDizneyBoyz]

Ditto going to Wills Eye Hospital in Philadelphia, even if you're not that close.

I have Duane's Syndrome and have had several surgeries at Wills to correct the positioning of my right eye.

It is VERY important that you find a doctor and therapy or surgery that will work for you and your son. The longer his eyes see different images due to drifting or not tracking properly, the worse the problem will become as his brain will start to ignore the image from the eye that doesn't match up with his "primary" or stronger eye. This will lead to a lack of depth perception and will make it hard to get his weak eye up to a decent level of vision. I know this from personal experience as my parents were not proactive with my vision problems when I was little (and it was 40 years ago so I don't blame them - they did their best) and I now have problems with binocular vision and definite depth perception issues.

Find a new pediatric opthamologist ASAP or give a call to Wills to get some recommendations in your area. They are a fantastic resource!

 

[i'mfluffy]

I had a lazy eye until I was 21. I had surgery at 3 that wasn't completely successful and it tramatized my mom so bad she refused to have it done again. I have very bad vision in that eye because it was turned in for so long. The vision is so bad because my brain wasn't used to using that eye. The eye doctor said there is nothing that can be done to improve the vision in that eye so I don't wear glasses. I also have a lot of trouble with depth perception. Again it is due to having a lazy eye for so long. Please consider surgically correcting the eye. If mine had been taken care of earlier in life it would have preserved the vision in my eye. Also I have self esteem issues that stemmed from the way I looked.

 

[Avonlady1001]

My DD5 has intermittent exotropia (sp?). I took her in for her lazy eye at 18mths, was told she was fine (of course, the eye didn't turn out at the appt!!) and back again at 2 where the doc finally saw it. We patched for 2 years (3hrs a day), and I didn't think it was helping. I took her to another doc for 2nd opinion & was told it was intermittent exotropia & she should have the surgery. I was told the best window for this was between 4-5 yrs. I've held off for almost a year, doing the "wait & see" approach, since the surgery is not 100%! I'm going to take her back in the next month or so & see if the doc still recommends the surgery, if there's no change. If she does, we're going ahead w/ it.

She has 20/20, so no glasses.

OP, get your son new glasses. LOL If I had lost mine as a child, I don't think I'd have been able to function well, either.

 

[mjkacmom]

My DD5 has intermittent exotropia (sp?). I took her in for her lazy eye at 18mths, was told she was fine (of course, the eye didn't turn out at the appt!!) and back again at 2 where the doc finally saw it. We patched for 2 years (3hrs a day), and I didn't think it was helping. I took her to another doc for 2nd opinion & was told it was intermittent exotropia & she should have the surgery. I was told the best window for this was between 4-5 yrs. I've held off for almost a year, doing the "wait & see" approach, since the surgery is not 100%! I'm going to take her back in the next month or so & see if the doc still recommends the surgery, if there's no change. If she does, we're going ahead w/ it.

She has 20/20, so no glasses.

OP, get your son new glasses. LOL If I had lost mine as a child, I don't think I'd have been able to function well, either.

I am so glad we went the surgery route! I was a nervous wreck, but it was fast, and my dd had no pain with recovery. She hated being patched, and was so glad not to have to do it. She might need another down the line, but now I'm not worried about it, because it was no big deal.

 

[BabyFu18]

When I was younger I had vision therapy for my lazy eye, I did the therapy a couple days a week at a specialists office for several years. There were also lots of activities that I had to do at home with my parents. There was certainly a window when my doctor felt like the therapy would be effective so my parents moved on that pretty quickly as I was fairly young.

What I can tell you is that the therapy was always made fun for me as a child, it was different types of games and activities so it was never a problem to get me to do it. That being sad, the therapy did not correct my lazy eye completely, it's still noticeable at times and I do still wear glasses to help correct it.

I'm glad my parents went forth with the therapy though, because my lazy eye could be a lot worse. On any normal day you probably wouldn't even notice I have a lazy eye, it's only bad when I'm stressed/tired/sick or without my glasses (though I am normally not without them). When I was younger my lazy eye was very bad, I had no strength in the eye to correct the "floating" so the therapy they had me doing helped a lot in strengthening.

Doctors suggested surgery for me in the beginning but my mother was very scared of that so she wanted to try everything else before she went that route with me. From my perspective my lazy eye isn't completely "healed" but it's certainly better than it could be and surgery is also not always 100% effective. So if it comes down to surgery I suggest trying everything possible to avoid that if you can, so if therapy is an option I'd certainly try it before moving on to more invasive options.

 

[Avonlady1001]

I am so glad we went the surgery route! I was a nervous wreck, but it was fast, and my dd had no pain with recovery. She hated being patched, and was so glad not to have to do it. She might need another down the line, but now I'm not worried about it, because it was no big deal.

Thanks! Makes me feel better!! My next door neighbor's DD had it too, and the mom said it was no biggie.