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Eye Care Archive (Expert Forum)
High Myopia
Our Ask A Doctor Ophthalmology Forum is where you can post your question and receive a personal answer from physicians affiliated with the American Academy of Ophthalmology.
High Myopia
by wendy12367ri, Apr 04, 2006 12:00AM
My 2 1/2 year old son has been diagnosed with high myopia (-6.75) in his right eye and brown syndrome. His left eye is normal. He has been wearing glasses since September. Recently his eye Doctor has suggested using atropine drops in his good eye or patching. We have decided on the drops. I wanted to know if either choice would be a better one and what is the chance of improvement? I also feel guilty for basically making him blind by patching or not letting him use his good eye is the improvement it will make worth it??
Doctor's Answer
by Forum-OD-MP, Apr 04, 2006 12:00AM
there are a lot of opinions on this. i will give you mine:
YES he needs to be patched or atropinized or SOMETHING a few hours/day or that right eye will never see well no matter what Rx you put in front of it later. its a developmental problem...if you dont FORCE his brain to pay attention to the image from that right eye, its going to ignore it and the retina on that right side will never develop. its called "refractive amblyopia".
patching vs atropine: patching is harder, especially in a 2 year old. you'll never be able to keep the patch on (you'd be putting the patch on the LEFT eye...the good eye...to force him to look out of the right eye). atropine works by blurring the other eye so much that the right eye will have the clearer image.
IMO atropine may be the better route for now... *IF* his left eye has an Rx that atropine will work on. if he's slightly nearsighted IMO atropine will not work. he will have to be farsighted in the LEFT (good) eye for it to work like its supposed to IMO.
also ideally he'd have a contact lens fit. if the left eye really is a good eye, there will be too much difference in image size if he's wearing NOTHING on the left eye and -6.75 on the right.
if he were my son he'd have a contact lens fit and patching 2-4 hrs/day and/or atropine.
dont feel guilty about patching. think of it this way: if you dont patch or use atropine, it is HIGHLY LIKELY the right eye will later be a very, very blurry eye no matter what Rx he wears over it.
YES he needs to be patched or atropinized or SOMETHING a few hours/day or that right eye will never see well no matter what Rx you put in front of it later. its a developmental problem...if you dont FORCE his brain to pay attention to the image from that right eye, its going to ignore it and the retina on that right side will never develop. its called "refractive amblyopia".
patching vs atropine: patching is harder, especially in a 2 year old. you'll never be able to keep the patch on (you'd be putting the patch on the LEFT eye...the good eye...to force him to look out of the right eye). atropine works by blurring the other eye so much that the right eye will have the clearer image.
IMO atropine may be the better route for now... *IF* his left eye has an Rx that atropine will work on. if he's slightly nearsighted IMO atropine will not work. he will have to be farsighted in the LEFT (good) eye for it to work like its supposed to IMO.
also ideally he'd have a contact lens fit. if the left eye really is a good eye, there will be too much difference in image size if he's wearing NOTHING on the left eye and -6.75 on the right.
if he were my son he'd have a contact lens fit and patching 2-4 hrs/day and/or atropine.
dont feel guilty about patching. think of it this way: if you dont patch or use atropine, it is HIGHLY LIKELY the right eye will later be a very, very blurry eye no matter what Rx he wears over it.
Member Comments
by Michelle1973, Apr 12, 2006 12:00AM
Just a suggestion....we struggled with my 6 year old wearing a patch. They didn't want to use the drops because since he is nearsighted he would just hold things close to make it more clear. Our doctor suggested putting clear fingernail polish on his lens to make it blurry. The lens will be ruined but we did what he said and it made a HUGE difference in his vision. The eye that was worse is now seeing better then the other. We have to get a new lens now but we don't care - we are just so happy it worked.
by bluesky7211, May 04, 2008 05:54AM
A related discussion, high myopia was started.
