Toddler diagnosed with sever farsightedness

My 2 1/2 year old daughter was diagnosed yesterday with severe farsightedness (+6.50 and -.5 Cylinder and 180 Axis in OD ; +7.00 OS).  The ped. opth. said that she can hardly see.  She was born early at 33 weeks.  My husband's family seems to have severe farsighted problems with the females in his family.  WE had no idea that she had any eye problem and we are shocked.  She seemed completly normal and can spot a tiny pebble on the ground.  She likes to read and draw etc.    The ped. opth. said that she has 2 lazy eyes and that is why we didnt see it.  He wants to see her back in 3 months with the new glasses and possibly do some patching.    The pediatric opth. said that I should have brought her earlier, but my pediatrician didnt think it was necessary.  I am feeling terribly guilty that she has been overlooked.  What is the outlook for a child like this?    Is there a possibility of misdiagnosis?  Would you get a second opinion?  Is this the correct treatment?

[Forum-OD-MP]

as a rule, pediatricians/nurses dont know squat about eyes or vision.  you can tell them i said that haha!  i fight them all the time over this exact scenario.

but the prognosis is EXCELLENT for your daughter.  as long as you do what the ped ophth says, have your daughter wear her glasses all the time, do the patching if the doc rx's a patching regimen, etc...the chances of your daughter seeing normally are EXTREMELY high.  yes, it would have been a little better if she had been caught a little earlier, but 2 1/2 is still fairly early and there's plenty of time to "catch her up" in retinal/eye development.

it is for this EXACT reason/scenario that the American Optometric Association (NOT THE AMERICAN MEDICAL ASSOCIATION!) recently instituted a program called "infantsee", in which every child in the U.S. can get 1 comprehensive eye examination by a volunteering optometrist for absolutely no charge.  no paperwork to fill out, no "qualifying", etc.  any parent anywhere can just go to www.infantsee.org and find a volunteering provider near them and make an appointment.  there is absolutely no obligation to buy anything.  we're trying to catch this exact problem in infants just like your daughter.

incidentally (and i'll probably ruffle some feathers here) but the AMA opposes this new program.  not publically, of course, but they have ongoing litigation and lobbying in certain states where the states are trying to force mandatory eye exams for children before entering school.  you would think the AMA would PROMOTE required eye exams for children, but they somehow inexpliably oppose it.  its a big political battle that the AOA (optometrists) chose to circumvent by having VOLUNTEER optometrists do FREE exams.

in my state (Texas) it is required that children see a DENTIST before they start school...but it is NOT required that they have an eye exam.  i think that is hilarious and absolutely tragic at the same time, especially since i know that over 80% of learning is VISUAL (not dental!)

okay, off the soapbox...apologies!

[nowherechild]

Do you have any idea why the AMA opposes this?  What could their reasoning possibly be, when hearing screening of newborns on the day of birth is almost universal in this country?  Just curious as to what their motives could be.

[JenSch]

When you say that my daughter's chances of seeing normally are extremly high, do you mean that she will always have to wear these thick glasses?  Or is this a problem that will resolve and she will not need glasses anymore?

Thank you so much for your info...I will pass this on to others...maybe it will spare someone else the pain and guilt that I feel.

[Ag-i-doc]

nowhere:

its purely political.  the AMA *loathes* optometrists.  my pediatrician (who doesnt know i'm an optometrist) told my wife to make sure and "take your children to get an eye exam by an OPHTHALMOLOGIST, not an optometrist".  they push the completely incorrect idea that all optometrisys are idiots b/c they're not surgeons and all ophthalmologists are gods/geniuses b/c they are surgeons.  its a complete crock.  most of the ophthalmologists in my town are complete pediatric IDIOTS.  they dont realte well to them and they dont know what to do for them unless they're strabismic (and even then their methods are questionable).  thats just here.  i am not saying that all ophthalmologists are idiots.

anyway its a political deal.  they heard/saw that optometrists came up with a plan, and they dont even care what the plan is.  as a general rule they oppose whatever we do.

[Ag-i-doc]

jensch:

it is highly unlikely that your daughter will ever grow out of the need for glasses.  when i say her prognosis is good, i'm saying that with the right treatment and close monitoring the prognosis is good that she will have good retinal development and be able to see well WITH GLASSES.  if she really has 5 diopters of astigmatism in one eye and is +7 in the other eye then yes, she will always need glasses or contacts or SOMETHING in order to see.  she can have surgical options after she's 18, but until then she'll be in glasses or contacts.

[prescott22]

I feel the need to clarify something here.  All school-age students get mandatory eye screening exams.  These have been proven (over and over again) to be an adequate and cost effective way to detect children with vision problems.  Requiring a full examination before entering school would be equivalent to asking every student to visit their ear, nose throat specialist (or perhaps even an audiologist) before entering school (regardless of whether or not they passed or failed the school screening test).  

Of course, in an ideal world, every student would get a full body CT scan, echocardiogram, visit to every medical specialist imaginable, etc.  Obviously more diseases would be picked up this way, but there would be no money left to pay for kidney dialysis, prescriptions or anything else.

Passing the mandatory eye exam would only create more business for ophthalmologists (members of the AMA) so they have ABSOLUTELY nothing to gain personally by opposing it.  

Yes, this is another issue polarizing optometrists (non-medical eye doctors) and ophthalmologists (medical eye doctors) but please do not mistake the ophthalmologists intentions here.  If anything, I have to question the optometrists desire to pass this law despite excellent evidence that it is not necessary.