lazy eye - different drs opinions

My daughter is 5 yrs old and has one lazy eye.the other eye is 20/20,  Her optometrist advised a patch and glasses with -4 strength.  We then saw an ophthalmologist who said this was the wrong prescription and that the optometrist did not use drops which were needed to make the diagnosis.  He suggested a patch and glasses with -3 strength.  Now I am not sure who to listen to.  It is correct that you need to use  eye drops to properly tell the prescription strength.  The ophthalmologist did not have her look at letters and say better or worse he just looked into her eyes after the drops.
Thanks

[Houman Vosoghi, MD]

Sounds like the ophthalmologist is correct.  You need a cycloplegic (dilated) refraction in a child to be able to tell what the full strenght of the perscription should be.  ALL cases of strabismus and amblyopia in children need to be treated by a pediatric ophthalmologist who is fully trained in dealing with all diseases of the eye in children.  Optometrists, unfortunately, frequently treat disorders that are beyond their expertise.  You can not simply check the perscription of a child as you do in an adult, especially if they have a lazy eye.  If you are having doubts, get a third opinion from another pediatric ophthalmologist and compare the perscriptions.

HV