How did you even know she needed glasses?
Posted on October 27th, 2008 – 12:40 PMBy Kay Krhin
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
19 Responses to "How did you even know she needed glasses?"
Thanks, Ann! Our daughter, who is three, squints with one eye shut when looking out the car window or sometimes when looking across the room. It varies which eye it is. It didn’t seem to consistently be one or the other. We told our doctor, who referred us to a specialist. The specialist did not find any problems. He thought maybe it was a developmental phase. That was a year ago, and our daughter is still squinting. Your post is prompting me to get this checked out again.
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Aw, she’s beautiful. What a sweet picture. And probably the second most common question that you get:
How did you get her to keep the glasses on at first? I’m assuming she is used to them now.
Ann, glad to hear surgery went fine. I’d wondered…
Becky, that does seem like something to check out, even if it’s just to put your mind at ease.
Kandace, I think that’s the question we get the most. She’s very used to them now and asks for them in the mornings. It took a couple of weeks before she left them on, and even then she was taking them off and throwing them whenever she was bored or angry. Basically we just kept repeating the following: put them on her face (with a smile), she pulls them off, put them back on her face (with a bit of a forced smile), she pulls them off and starts to cry, set them aside for a few minutes and try again once she’s distracted. Eventually we wore her down. I think it helped that Chris and I both wear glasses. Sometimes we’d let her put our glasses on us, and then she’d let us put her glasses on.
May, surgery was rough, but man kids bounce back fast. I would have been on the couch for a couple of days, but Zoe was off and playing that afternoon.
Ann - Thanks for sharing your very personal story with us. We need open folks like you to make us all better parents!!
Ann, thank you for sharing this story and for your openness and honesty.
I have a three year-old who may have a slightly wandering eye. It seems to only happen occasionally and when it does happen, it is almost imperceptable (it took my husband two weeks to notice it after I mentioned the possibility.) I’ve tried to take a picture of it to show our pediatrician in case it doesn’t appear during our well-child check, but so far, I can’t catch it. My son has his well-child check in a few weeks and I will ask about it then.
Do you have a pediatric eye doctor you’d recommend? Either from your experience or in your work through your blog? Thanks in advance!
Our daughter got her glasses at about 14 months, too. (In fact, I think she has the pink and blue version of the ones Zoe is wearing in this photo.)
Our story is a little different, so I thought I’d share it. Since we adopted our daughter at just under 3 months, I would periodically wonder whether she could see. She just didn’t seem to be tracking things the way other babies do (she’s our second), and she rarely reached for things. But my husband and her pediatrician thought I was way off, because she did show some signs of seeing things. They just thought she chose not to (!).
Her eyes began to cross at about 9 months, around the time she had some other health issues arise. A pediatric ophthalmologist said that she needed corrective lenses (but not strong) and some patching (but not all the time).
Long story short, her vision is definitely impaired, but, as we have since learned, more from neurological issues than from visual acuity issues (in other words — the problem is not so much with the eyes themselves, more with how her brain perceives what her eyes are seeing).
So she wears her glasses (but only at preschool — refuses to wear them at home!). They have helped with the crossing and seem to help focus her attention on small objects. But her primary visual condition, called Cortical Visual Impairment (CVI, sometimes called Cortical Blindness), is something that the glasses don’t address.
The reason I am writing this is that often kids who have CVI are mistaken for being autistic or cognitively impaired, due to their unusual visual interactions with the world (for example, our daughter has certain repetitive behaviors that are directly linked to her CVI). So if your schools or doctors are going down an autism or mental retardation diagnosis — and if your child’s ophthalmologist says that his or her acuity issues don’t account for your impression of what your child sees or doesn’t see — make sure that you have your child evaluated for Cortical Visual Impairment.
There is a wonderful CVI specialist (in Pittsburgh, unfortunately), who has been very helpful with our daughter’s diagnosis and adaptation plan. Her name is Christine Roman-Lantzy (I couldn’t find her website, but you’ll find her if you google her). There are people in MN who work on CVI issues, but those are likely to be the vision specialists in the schools — not the eye doctors or neurologists.
Very interesting post, thanks so much for sharing this info with us.
Alison, do you notice your son’s eye wandering more when he’s tired or when he’s focusing on something close in? Those might be times to try to get a picture - we took pictures to the ophthalmologist’s office and she thought it was really helpful. Email me at ann @ shinypebble . com and we can talk eye docs.
T, thanks for your story about your daughter, too. I didn’t know that about CVI. Would you be interested in writing something for the little four eyes blog? I’m trying to collect stories of children’s vision problems. I figure it can help other parents who are dealing with the same thing. How old is your daughter now?
I also started wearing glasses as a small child (about 13 months), but the frames that were available back then were not nearly as cute as the ones Zoe is wearing!
Also, I wanted to reiterate the importance of bringing pictures to show your doctor if you suspect something is not right with your child’s eyes. The reflection in my eyes in baby photos are what convinced my family’s doctor to do more tests. My mom insisted something was “not right” about the way my eyes looked in direct light.
Ann - my daughter is now 3, and I’d be happy to blog about it. Will send you an email.
Michelle - I second your comment about pictures. We found that my daughter’s strabismus was kind of like when you have car trouble, but when you take it to the shop it won’t repeat the problem for the mechanics. Our daughter’s eyes were sometimes REALLY bad, but they’d look great when we brought her to the eye doc! So we took in some pictures that really showed the problem.
I’ll third the pictures suggestion. We took them with us to our first appointment and the ophthalmologist found them really helpful. She ended up not recommending glasses at the first appt because it wasn’t severe. But when we noticed the turning getting worse a few months later, we just emailed the new pictures to her office and based on them, she had us bring Zoe in for another vision test.
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I thought I’d post what the infantSEE exam was like. I took my DD when she was 8 months old and the eye doctor did a bunch of little tests. Just seeing if she followed a toy with her eyes, if she looked in the direction of noise (bell ringing), there were some grayscale cards with pictures outlined in white to see if the eyes moved to the pictures, and some other eye checks with the corrective lenses (you know, is 1 better or 2). They also dilated her eyes. I’ve been in glasses since the age of 3 and have horrible eye sight, so I really wanted to get DD checked as soon as possible. Thankfully she seems to have gotten her daddy’s vision and is right where she should be.
I am guessing she had bilateral strabismus surgery…my daughter had this procedure done when she was 23 months old. She has had a crossed eye as well as that same eye is lazy…she wears a patch 5 hours a day and glasses. when she does not wear the glasses she squints the bad eye closed and only looks out the good eye. when she is tired her eye still sometimes slightly crosses…only enough that we notice it 
it’s tough stuff dealing with eye troubles on a 2 1/2 year old. It took her until she had her surgery to be willing to wear her glasses without a fight…and she has had them since she was 11 months old
Thanks for posting this story, it is nice to know that others out there have these same things happen and great results in the end too!
Jenny
Allison***
I hope this link works…
my daughter has been seeing a pediatric opthalmologist since she was 3 months old…she is now 2 1/2.
His name is Dr. Erick Bothun and he is amazing. Did an amazing job with her surgery(bilateral strabismus surgery) and has also done a fantastic job with her glasses prescriptions as well as we lazy eye and patching…
He is very personable which makes him easy to understand and great with kids too!
Jen, yep bilateral strabismus surgery it was - and almost the exact same age as your daughter - Zoe was 22 months. So far, Zoe doesn’t have a lazy eye, just the strabismus, and I’m really hoping that we can avoid it, though I know having strabismus puts her at a much higher risk for developing a lazy eye.
It’s been nice reading other people’s stories, too.
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