I wrote previously about my oldest who was diagnosed around the age of three with accomodative esotropia. After a horrid experience at a “pediatric ophthalmologist” in the big city, our local eye doctor has successfully treated her by changing her prescription to cosmetically make her eyes look aligned while the lenses do the work of focusing, allowing her eyes to relax. At a meeting about the progressive lenses, I brought up the question of whether vision therapy would help her. After listening to my concerns, he suggested we go to an expert who deals with pediatric patients and vision therapy and get evaluated.
We had to wait almost a month for the first of four possible evaluation appointments. The first appointment was an intense eye exam. All the usual tests were done – with and without Child #1 wearing glasses. Her eyes were dilated and more testing and looking was done with all sorts of interesting devices. Child #1 was quite the trooper. The only tough part was when the doctor put on a kind of “miner’s helmet” complete with bright light. It was too bright for her dilated eyes and she couldn’t get herself to keep her eyes open. (I’ll admit that we ended up all (Child #1, doctor, & me) praying that she would have the strength to look past the bright light for three solid seconds so the doctor could get what she needed and move on.) It was tough, but she did manage two seconds of not rolling her eye up her head and we were able to move on.
The doctor (specialist) indicated that the prescription is exactly right, but that she does not believe in progressive lenses for children. She would rather have seen Child #1 in a bifocal. She also admitted that it might be a moot point for what we are doing. She pointed out that Child #1 sees JUST FINE close up (which is what I thought), but that her eye turn is HUGE when doing so. Our local eye doctor is trying to lower the eye turn by using the lens to take some of the focusing/strain off the eyes. The specialist said the eye turn is so large that it really doesn’t matter either way.
Another thing I learned is that Child #1’s esotropia is “constant” – in that it is always there and . . . here I didn’t take notes, so you’ll have to forgive me if I get this wrong, “intermittent” (or was it “alternating”?). Basically, Child #1 uses one eye at a time – but alternates between which one she uses. Her eyes don’t work as a “team.” There’s a term for it, but I can’t remember what it is (monocular?). (My spouse’s eyes don’t work together, either. He doesn’t remember them ever doing so. He compensates just fine.) The specialist said that if we wanted to have her eyes learn to work together, now is not the time to try it because of the emotional maturity needed for the treatment.
However, she wanted us to continue with testing at two future appointments. We are, in effect, skipping a visual evaluation appointment (#2 of 4) and continuing with Visual Perception testing (#3 & #4 of 4). After those, we will have an hour or more consultation with the specialist on what she recommends going forward. The next two appointments are in the upcoming weeks. Our consultation won’t be until near the end of October due to my spouse’s work schedule and the specialist’s schedule. I’ll let you know how it goes.