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Astigmatism or Not ??

by Jaya2367, Nov 12, 2007 10:31PM
Since last several months occassionally my daughter (3 yr 3mon old ) right eye seems to move outward when she is watching TV. Sometimes after she wakes up. I was told that kids learn to focus so as she grows it will go away.

6 weeks ago we went to the Optometrist. She checked her and said, there is no doubt my daughter uses both her eyes because she passed the stereo tests and said she has perfect vision. No eye prescription, comeback in six months to check again.

Recently she was not having a good sleep because we just had a baby. And my daughter is a light sleeper. We noticed her both of her eyes seems to be moving out occassionally. Althought not at the same time when one is focussed, the other moves.

We went to another optometrist this week. He did the tests and declared she has severe astigmatism. 300 and 275 in the two eyes. And the right eye has a +1.00 D. He also checked with corneal tomography.
He could not say anything about the moving out eyes. Asked us to check with a pediatric specialist.
May be it is due to the astigmatism.

We are totally confused, within 6 weeks span we are getting completely different opinion.
The first optemetrist may have 25 yrs of experience, the latter one 13 yrs.
Should we go with the glasses, or seek for another opinion. I heard about patches. I am not sure what that is.

Any advice is appreciated.
Member Comments

by John C Hagan III, MD, FACS, Nov 12, 2007 11:08PM
Do not go get the glasses. Having normal stereo tests does not mean than she does not have strabismus. Your description is highly suggestive of intermittent exotropia. That means that at times one of the eyes moves outward toward the ears (sometimes called 'wall eyed').  When the eyes are straight the stereo tests are normal.

We have discussed before the vast difference in training and experience between non-physician, limited scope optometrists and an Eye MD physician-ophthalmologist.  

You need to make an appointment to see a pediatric ophthalmologist. Hopefully your pediatrician can arrange it for you. If not you can go to www.aao.org and use the Find An Eye MD feature to locate a strabismus specialist near you.

JCH III MD

by Jaya2367, Mar 10, 2008 01:43AM
To: Followup
Dear Dr. Hagan

My opthalmologist gave a similar prescription for glasses. My daughter tried the glasses for almost two months. We see a good response, while she is on glasses eyes hardly drift,  but when she take them off, one of them drift sometimes.

In the followup, the doctor suggested to do a EXOTROPIA SURGERY. I have no idea about the surgery. What is the effectiveness of this surgery. Is it a simple one? Dr. said 10% cases, he needs to operate again. Can things go bad? Should we take a second opinion. The Opthalmologist is the most senior and reputed doctor, though.


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