toddler with astigmatism

[ian_dario]

I was told my 2 1/2 year old has astigmatism by a school nurse. The exam was done by the Welch Allyn SureSight. I was wondering what these numbers mean and how bad is it?  Thank you. The results that were given me to are as follows:

R 8 *S-2.7 *C+9.9
L 7 *S-2.8 *C+9.9

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

This is what a glasses RE looks like  I am using # to signify a number, oftet it is a whole number and a quarter of a number that is  .25 or .50 or .75 or 0.00


OD (right eye)  # Sphere then either plus or minus +/-  # Cylinder  at or @ Axis
OS means left eye       Add is a reading bifocal   PD is pupil distance (how far the eyes are apart.   some times is will also say Prism  and Base  This is an example of a complete RX

OD +1.25 + 2.75 axis 175 degree 2 prism base up
OS +2.00 + 4.75 axis  95 degree  0 prism
Add + 2.25 OU (both eyes)
PD 70 mm

Both of you your child's glasses RX should look something like this  almost 10 diopters of astigmatism is HUGE amount and requires visiting a pediatric ophthalmologist to be sure the child does not have a corneal disease such as keratoconus.

JCH MD

[ssvs]

in my daughter's 3 year annual check up, Ped informed that she might have astigmatism ,she was not sure, as she said both numbers are equal (i dint understand )and asked me consult an ophthalmologist.
her numbers is as follows:
OD SE -0.25, DS +1.5,DC -3.25, Axis @171
OD SE 0.00, DS _1.5, DC -3.00, Axis @22

I have taken an appointment, but its after a month as i could not find the dates. Now am totally worried, i tried testing her eyes by making her read with one eye, and she was good. Hopefully the results is wrong. :( L(

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

I'm not sure how the pediatrician checked for glasses, most don't. Also the glasses RX you wrote out is not in standard formula which looks like this  RE or LE for right or left eye   Sphere        Cylinder    Axis  ( It has 3 parts). So I can't interpret your numbers. You do need to see a pediatric ophthalmologist.  if she does have 3 diopters of astigmatism she likely will need glasses to help the eyes develop normally.

[ssvs]

Than you for your prompt reply. We did seek a pediatric ophthalmologist and the doctor gave the following info: OD: sph -1.5, CYL +3.25, Axis 75; OS: Sph:-1.00, CYL+2.75 and Aixs 110. am terrified with the numbers and unable to bare the fact that my lo will have to go through this life long. Is there any solution for this? like any surgery or permanent lens. i have done some study and found that this might go away gradually is this true?. Please help me with any possible advise....
Worried parents....

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

Without glasses your child's eyes and vision will not develop normally so you are extremely fortunate to discover this and begin treatment at a young age.  If this was not detected till say first grade her vision might be poor or subnormal all her life.  If you have other children have them checked also as this problem runs in families often.   Sometimes patching is required if one eye is not seeing as well as the other with glasses  (amblyopia)   Surgery is not an option to get out of glasses.  There are very few pediatric refractive surgery units in the world.   The first in the United States was opened here in Kansas City at Children's Mercy Hospital and is under the direction of Erin Stahl, MD     However this is expensive, involves general anesthesia, may still require glasses or patching.   This problem does not lens itself to contact lens. When she is older (13-18 )  refractive surgery might be an option if she does not like glasses.

[ssvs]

Thank you for your valuable information.
1. I need more understanding of what is patching here with my daughter's case considering her numbers. Also, we are planning for second opinion to get correct numbers.
2. Also based on the results does it mean she has myopia with astigmatism too? and are they chances of getting it worse or growing gradually?
3. What is the success rate of pediatric refractive surgery for 3 year old, in layman knowledge are there chances of triggering again.

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

Patching has to do with amblyopia or whether WITH glasses one eye is not seeing as well as the other.   The glasses correct for myopia (sphere #) and astigmatism (cylinder is how much and axis is direction the cornea is lopsided)  The astimatism is the biggest problem.    This is generally way too much astigmatism to go away and she will likely have significant astigmatism all her life.     Pediatric refractive surgery is a very new, very specialized, not very available treatment and i have no expertise to quote you any success rates.

[ssvs]

So would you suggest me to go for a second opinion to check if she has amblyopia as well?. Please suggest us any contact who can guide us to gain knowledge on the surgery. my repetitive word "surgery" might sound little crazy. but am just helpless mother ;(.

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

Don't go to pieces. There are a lot worse things that could happen both to her eyes and the rest of the body. If she had an orthopedic problem or a dental problem you would understand the need for braces on one or teeth. The real tragedy is most kids don't have this discovered until the are too old to help.   You don't need to get a second opinion as checking for amblyopia is something that is done every visit and will not be able to be determined until she is wearing her glasses.

[ssvs]

Thank you

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

Sure and best of luck. Remember check other kids.

[ssvs]

Sorry to bother you again sir, we did seek a second opinion. but this time the numbers given were opposite to the first. the doctor tested and he gave the following
OD: sph +1, CYL -3.00, Axis 125; OS: Sph:+1.00, CYL-3.25 and Aixs 25

now we are in dilemma. Please advice

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

The first set of glasses RX are in "PLUS" cylinder   your second set is in "MINUS" cylinder. They are not that much different.  Think of it like your weight. It will look totally different if it is recorded in pounds or kilograms but the weight is the same.  there are internet calculators where you can change them both into PLUS or into MINUS cylinder formation. When you do that there is a difference but not much and often hard to get exact numbers on children. I would go with whichever ophthalmologist you feel most comfortable with and/or that specializes in pediatric ophthalmology.

[spavee2001]

Hi!
My 3 yr old daughter was also found to have astigmatism recently. Her eye test showed results similar to your kid. She got +9.9 CYL in both eyes. How is your kid doing now?  What do these values mean and are they correct? Is he/she wearing glasses? I hope you can understand how I am terrified by these big numbers. Please reply at the earliest.
Thanks.

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

That notation is not in a form I can understand.

My suggestion is to see a pediatric ophthalmologist

JCH MD