Astigmatism - My 3year old just diagnosed

[jpedone72]

Hi, just looking for some feedback...my son ~ 3years of age has just been diagnosed with Astigmatism in both eyes 20/50 and needs to wear glasses!  Im a little disappointed, but I will do whatever it is to help my child.  Is this something they can outgrow?  Any kind of advice regarding this.

Thanks so much! - JP

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

It is very difficult to get an accurate "cycloplegic refraction" on a child. Pediatric ophthalmologists are experts at this; there is a significant chance the Ped Eye MD will get a different result than the less trained optometrist.  In that case you will need to change the glasses from the optom with attendent expense. If you must see the optom and glasses are prescribed I would suggest you get the glasses at a commercial optician such as Lenscrafters or EyeMasters. Tell them what the situaation is. Generally the commercial optician will make a free change within 2-3 months. Often the otpm's office will refuse to honor the Eye MD glasses RX.  Bifocals are often used for accommodative esotrophia.

Discuss the problem with your pediatrician. The Ped may feel waiting 2 months is acceptable. In socialized medicine countries (UK, Canada for example) posters often say its 3-6 months to see an ophthalmologist.

JCH MD

[Jme1611]

Dr. Hagan,

So what do you mean that the pediatric opthomologist will likely not get the same results? Does this mean she may end up with an incorrect prescription for her glasses? Also, you said that 6-8 weeks would be an acceptable wait time to see the ped. opthomologist but the first available appointment is over 2 months away and I am just getting more concnerned by the day...

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

It is extremely important to see the pediatric ophthalmologist. If the child seems otherwise well waiting 6-8 weeks will not hurt. I'm told by posters from UK they might wait 6 months, that's too long.

See the optometrist first is likely a waste of time and money. You undoubtedly will be prescribed glasses and its highly likely the pediatric ophthalmologist will NOT get the same results.

The most likely cause of this is "accommodative esotrophia" a specific type of eye muscle problem (strabismus). You will be able to research it on the internet and also use the search feature and archives.

JCH MD

[Jme1611]

My daughter just shy of 3 yrs old and I have an eye exam scheduled in the next week, but I am trying to do research before going in order to know which questions to ask, etc. She had an eye exam done at her preschool a few months ago and it showed "significant astigmatism" and they suggested she see an eye doctor. We had some insurance issues and decided to wait for the appointment since she did not show any visible symptoms of eyesight troubles. Within the last month, however, we started noticing her right eye turning in (not all the time, just randomly does it). It seems like this occurs more around dinner time when she is getting tired. She will blink and rub her eyes like it is irritating her, then the eye will go back into focus. I have been reading that significant astigmatism may lead to amblyopia or even blindness in one eye, and it obviously has me concerned. Additionally, though... last night, it seemed like the LEFT eye was turning in as well which really confuses and worries me further. The appointment we originally scheduled is with an optometrist. I also have recently got a reference to a pediatric opthomologist (about an hour away from our town) and made an appointment with his office in case we are referred there after this appointment (he generally has a 2-month waiting time for appointments). Is there anything I should be doing in the meantime to help or are there specific questions I need to address at the appointment? Also, it seems inevitable that she will be given glasses. Is there a recommendation you have for a good durable brand to endure the life of a energetic toddler? And finally, I have a younger daughter (15 mos) who sometimes seems to have a droopy eye when she is sleepy... at what age would it be advised to schedule an eye exam for her?
Thanks for your time and I apologize for the lengthy post!

Jamie

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

Astigmatism is not a disease but a aspherical corne is the usual cause. In a young child it can cause the vision not to develop normally (amblyopia).  Often the problem is NOT outgrown but when he's older contact lens or refractive surgery may correct the problem as an alternative to glasses.

JCH MD