AMBLYOPIA and ASTIGMATISM

[JS3]

I have a 5 years old son who was diagnosed with a 20/40 vision at his pediatrician annual exam, but otherwise does not show any vision problems and is attending Kindergarten and starting to read normally. He was then referred to a pediatric ophthalmologist. He just had an exam with the pediatric ophthalmologist, who diagnosed him with astigmatism in both eyes and 20/40 on the R eye and 20/30 on the L eye. The
pediatric ophthalmologist said that my son has amblyopia and prescribed glasses to be worn all day long for 6 weeks and return for re-evaluation and then she will decide if a patch is needed. She requested transitions lenses. The prescription is below:
      sphere     cylinder      axis
R=     PL          +0.75       090
L=      PL          +0.75      100

The doctor told me that with glasses my son's vision will be 20/30 on the R eye and 20/25 on the L eye.

I have several questions:

1-Is my son really at risk for Amblyopia if he does not use glasses? Is this astigmatism (+0.75) considered severe? Could it potentially cause Amblyopia?
2-Why is the prescription for both eyes the same (+0.75) since the L eye sees better than the R one?
3- Considering that both eyes have astigmatism, wouldn't it exclude the chance of having amblyopia?
4-Should we have a consultation with another ophthalmologist?
5-Will the astigmatism improve if he wears glasses? What about orthoptics - is it recommended in my son's case?
6-What are the chances of success for reversing Amblyopia and Astigmatism in a 5 years old?
7-What could happen if we choose not to do any treatment now and re-evaluate periodically?

Many thanks in advance!
Very worried mom

[JS3]

Thank you Dr.O. !

[Ray T Oyakawa, MD]

The doctor does not see an changes in the eye.  It depends on the response of the child.
You can get a false positive if the child does not know letters, numbers, or pictures.

Dr. O.

[JS3]

Dear Dr. O.

Thank you so much for your answer!

How can the Dr. tell if the child has amblyopia?
Is there a test for that? Does the Dr. actually see any changes in the eye?

Many thanks!

[Ray T Oyakawa, MD]

Get a second opinion.  I do not see children.  I would not expect ambylopia from this mild degree of astigmatism.

Dr. O.