We first met Ann & Zoe at our Cribsheet get together this summer. I am one person who asked the above question “How did you know she needed glasses?” Ann answers that question and educates us below.

My daughter Zoe wears glasses - she has for nearly a year now, since she was 14 months old, which means we hear this question a lot. And here’s the answer: I didn’t. I noticed Zoe’s eyes crossing around 9 months. When we took her in for her 9 month appointment, I asked the pediatrician about it. Now I’m a first-time mom, so by 9 months, I was very used to the following happening at Zoe’s well child visits: I would ask about some random thing that seemed worrisome to me, and Zoe’s pediatrician would very kindly tell me that it was absolutely normal and nothing to worry about. I fully expected that to happen when I brought up her crossed eyes. Instead, she told us that she didn’t see anything, but referred us to an ophthalmologist. It turns out that Zoe has partial accommodative esotropia. Accommodative esotropia means her eyes cross to compensate for being farsighted, which is why she needs glasses. Partial means that the glasses don’t fully resolve her cross, so she had surgery in August to correct the eye turning that the glasses didn’t correct. The surgery went fine, but I’d be happy to never go through that again.

I think that, often, when people ask us about Zoe’s glasses, they’re not so much interested in Zoe’s story per se, as much as they’re worried that they may have missed some signs that their own child has vision problems. How do you know if your child can see clearly when she is hardly saying more than “mama” and “no!” and certainly isn’t reading? While pediatricians do look at babies’ eyes at well child visits, they’re looking for abnormalities such as cataracts and glaucoma, not for focusing issues, and the truth is, they’re not trained as eye doctors. So it is up to the parents to notice and take their children to an eye specialist if they’re worried. There is a program for assessing vision in infants, called InfantSEE, developed by the American Optometric Association. It provides no-cost exams to babies between 6 and 12 months of age. You can learn more and find participating doctors at infantsee.org. But as great as InfantSEE may be (we didn’t know about this program when Zoe got her eyes checked, so I don’t have any personal experience with it), many vision problems present themselves after the age of 12 months, but before the recommended 3 year old vision assessment. That led me to pull together a list of the signs that caused parents to take their children to an optometrist or ophthalmologist. Many thanks to the readers of Little Four Eyes and Dr. Bonilla-Warford, O.D., F.A.A.O., who contributed their experiences to this list.

The most common thread from the parents and doctor was to trust your instincts. If you think there is something not right with your child’s eyes or vision, take them to an ophthalmologist or optometrist who specializes in pediatrics. That said here are some specifics things to watch for.
· One or both eyes are crossed or wander in or out, even if only occasionally. Often this is first noticed in pictures taken straight on where the reflection from the flash is on different parts of the each eye (story and pictures).
· Eyes were “jiggly like a sunny side up egg” and “wobbly like jello” (full story, but the short version is that if you’re using food analogies to describe your child’s eye movements, get it checked out)
· One eye is bigger than the other (story and pictures)
· Squinting at TV, computer, books, and anything else they try to see details on (story)
· Family history of needing glasses at an early age
· An unusually large pupil or white reflection in one of the pupils
· Both eyes appear to be growing larger and bulging
· Extreme aversion to sunlight (“photophobia”)
· Excessive tearing
· Eyes that are red, watery or irritated
· Closing one eye during tasks such as reading or watching TV
· Avoidance of detailed near-work such as reading, writing or drawing
· Complaints of seeing double

Ann Zawistoski runs the blog Little Four Eyes for parents of young kids in glasses, and keeps her own blog at Tragic Optimist.

For more resources for parents Ann provides this helpful page on Little Four Eyes - Resources

This entry was posted on Monday, October 27th, 2008 at 12:40 pm and is filed under Health. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.