4 year old extremely farsighted

[lynnfox1975]

This past June my son was seen by  an Optometrist who declared that he was "a little farsighted" but said they would just follow up in a year and issued a paper for the school indicating normal vision. Since then (over the last couple of months) we've noticed he would intermittently turn his left eye inward. He appeared to have normal vision otherwise. We took him to see an Opthomologist who said he needs +5.25 lenses for both eyes. This is extremely strong!  How was this missed before? Also does he need to these all the time? I would think if he is farsighted then wearing them for distance would be problematic??? Can he outgrow this degree of farsightedness?

[John C Hagan III, MD, FACS, FAAO]

The visual system for correction of reduced vision (amblyopia) due to misalignment of the eyes or one eye being badly out of focus (aneisometrophia) completes development about age 5 to 6. If treatment is started after that time neither the vision or the position of the eye respond to treatment with glasses, often bifocals, patching as when the child is much younger. That's why a screening or visual exam is recommended about age 3 to 3.5 yrs of age. In families with eye problems age 2.5 is recommended or sooner if problems are noted.

Moreover because of school and socialization treatment with glasses and patching are much more difficult for child and parents when older (as you are finding out).

JCH MD

[lynnfox1975]

Thank you for your thoughtful reply.
Just a further question in response to your remark that late detection (5 or older) complicates treatment.

My son is nearly 5 - will be 5 in February. Since we are just detecting this now and treating him what complications are you referring to exactly? What should I be watchful for if anything?

[John C Hagan III, MD, FACS, FAAO]

As I have said many time before there is a huge difference in the training and experience and capabilities of an eye MD ophthalmologist and a non-ME optometrist. Your case illustrates the point I've made over and over.

Yes he needs the glasses all the time. taking them on and off will make them much more difficult to adjust to and jeprodize vision and keeping the eyes straight.

It's NOT likely he will outgrow this degree of farsightness.

If you have other children have the pediatric ophthalmologist check them also.  Tell your brothers and sisters to have their children checked as this often runs in families. Late detection (5 or older) greatly complicates treatment.

JCH MD