Daughter eye concern

[nagamanimn]

Dear Doctor

My daughter   had  an eye  examinationon ( March 12th 2009) f .She  was  diagonised  for  Astigmatism ,Farsightedness   and  amblyopia.
Her  prescription was  
OD   +4.00, -3.75,7
OS   +3.50, -4.00,172

After  we  got her the prescrybed glasses  she  could  not  READ  what she would otherwise with bear eyes( she  says everything looks wiggly) .So Today (1st april) we had one more appointment with her optometrist .After reexamining her the  doctor  gave  significantly different precription for glasses(below)
oD : +0.75 ,-4.75, 9
OS : +0.25 ,-4.25, 166
Due to this  me & my hubby are quite confused with the entire diagnosis.  what  should we do now .Please advice

Please advise
-Nagamani

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

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[kalpana44]

How is your daughter doing now?

Today my 5 yr old was  diagonised  for  Astigmatism ,Farsightedness   and  amblyopia.
got same readings as your daughter.
OD   +4.00, -3.75,7
OS   +3.50, -4.00,172

Any Improvement in her vision.How old is she?

Thanks inadvance

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

In my opinion she should be under the care of a pediatric ophthalmologist.

JCH MD

[nagamanimn]

Dear  John C Hagan .

The optometrist  gave  this  explanation(below)  on the   on my daughters situation . Please  advise  me based on your experience whether  i should   go  with the new  prescription  or take   her to a pediopthamologist

-Nagamani
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Spoorthy has a fair amount of farsightedness and astigmatism in both eyes. The computer and I pick up +5.00-4.00x7 in the right eye and +4.50-4.25x175 in the left eye when her eyes are dilated. These are the true amount of the refractive errors in her eyes. So her eyes have been working/focusing very hard trying to clear the image for years. Therefore, the eyes are not readily relaxed to give up some of the focusing muscle tone. Although I reduced the first prescription; however, Spoorthy still cannot adapt to it. So I backed down the prescription some more today to ease her into her first pair of glasses.

Even with the correction, Spoorthy can only 20/50 in each eye. That means she has amblyopia (lazy eye). In order to improve vision, patching therapy was prescribed so that each eye can work independently. Hopefully, we will see some improvement in vision when I check her in about 2 months.

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

There is a very big difference in those prescriptions. Ideally you should see a pediatric ophthalmologist. In the USA find one at www.aao.org or ask your pediatrician to refer you.

The first RX might take some time to get use to, if she's very young she might need some drops to help her get use to them. The bottom RX might contribute to her eyes crossing amblyopia developing and she will have too work too hard to read.

JCH MD