Question

My 15 month old boy went to the doctor today for a check up. After the pediatrician tested his eyes, an appointment was made by the office for him to see a Pediatric Ophthalmologist. The nurse said that one of his eyes were not normal. I am sorry about my terminology, my wife went to the appointment, so I am hearing this third person. My 8 year old sister has esotropia, and is showing no signs of improvement. I guess my question is, "Is this what my son might have?" His eyes show no sign of "laziness". His depth perception seems to be fine. If goes to pick up a penny off the floor, he has no problem picking it up. Can there be any other diagnosis? Now my wife said the nurse tried to explain it to her by drawing two lines on a piece of paper and a dot being in the wrong place. Maybe this can help. Thank you for your time!!

[John C Hagan]

Eye muscles problems are called "strabismus". Esotrophia is another name for crossed eyes. The amount however varies tremendously from eyes that have huge crossing that everyone can see to very small amounts that must be specially measured to detect. Some crossings don't create cosmetic problmes but can cause functional problems like an eye that doesn't see normal even with glasses (amblyopia) or reduce depth perception.   Strabismus affects about 2% of USA children but if its in the family (like your sister) the chances of anyone related by blood having the problem or their children, grandchildre having strabismus is closer to 20%.

There's an old saying among pediatric ophthalmologists that may account for why children with strabismus are not picked up young and that's "the parents are the last to notice". None of the things you mention are an accurate guide to your child's health.

If your wife is not sure what the ophthalmologist said call back and speak with his/her nurse. If she understands and you don't you make the call. Alternatively both of you go in for the next eye examination.

Be sure all members of your familh having children watch for eye problems and even if things seem perfect see an ophthalmologist or a pediatric ophthalmologist between age 2 and a half and 3 to screen for these problems. The older children get the more difficult strabismus is to treat and if amblyopia is not detected before age 5 it often does not respond to treatment.

Remember to have ALL your children checked by the pediatric ophthalmologist.

JCH MD Eye Physician & Surgeon.  Eye MD = Ophthalmologist