The eyes have it

Jamie has a squint.  While the treatment and prognosis of this are interesting to me, and something I want to record to look back on in later years, I do realise that it’s not going to make for thrilling narrative for anyone else.  So by all means talk amongst yourself during this post.

Following various eye checks and monitoring, it was determined that Jamie is long-sighted.  So, a few months ago, he was prescribed glasses in the hope that if he could actually see properly out of both eyes, he’d be more likely to get them working together.  I wistfully anticipated that the glasses would diminish his cuteness, but in fact they’ve added a whole new and hitherto unknown cuteness dimension.  With those and the shorts he’s wearing for summer, he looks like the world’s smallest 50’s schoolboy.  Well, apart from the dummy.

On a more practical level, I wondered how the hell we’d ever get an active toddler to keep his glasses on.  This proved to be far less of a problem than I’d expected, although we found out the hard way that it’s a good idea to take them away from him when he’s hungry or tired.  (Fortunately, the NHS pays for not only the initial pair of glasses but also for repairs – up to a point, anyway, although Barry says the opticians did ask him some very searching questions last time he turned up with a toddler-mangled pair of frames.)  Jamie has, on the whole, cheerfully accepted his glasses and enjoyed the improvement in vision that they provide him.  On the day he first got them, he came to meet me at the top of the stairs when I got home from work and pointed very carefully and deliberately to his glasses, then to mine.  Look, Mummy – Jamie’s got glasses now too!

The glasses improved things somewhat, but he’s still squinting.  So, at the end of June, we moved on to patching – Jamie now has to wear a patch on his good eye for two hours every day, to force him to use the other one.  (For the benefit of anyone who, unlike me, didn’t spend a misbegotten childhood reading obscure child development books, I’d better explain that the idea of this is to preserve the vision in the squinting eye.  Because the brain can’t make sense out of the double message it gets from two eyes pointing in different directions, it learns to ignore one of them.  This then means that the visual pathways don’t develop properly, which means that the child eventually becomes blind in that eye.) 

The plan is that we’ll keep on with the patching until he’s old enough to demonstrate to the optometrist that the vision in his squinting eye is what it should be, which will require him to identify a standard set of line drawings.  Given the rate at which his talking has been progressing, I resigned myself to being stuck with the patches for a heck of a long time.  Fortunately, it seems that it’s permissible for him to identify the drawings by matching them to identical ones rather than by actually having to name them out loud, which is something I do anticipate he’ll be able to do before too many more months.

Jamie, having got used to this new part of his routine, has decided he likes having the patches put on, to the point where he’s got quite proactive about it.  If no eyepatch is forthcoming in the morning – sometimes in the afternoon as well for good measure, regardless of whether he’s had that day’s eyepatch already – he toddles over to the chest of drawers where the boxes of patches are kept, pointing emphatically at the side of his face, gets a box, fishes out a handful of patches, and tears open one of the packets, all ready to have the patch applied.  While this attitude is obviously all to the good, it unfortunately isn’t matched by a similar enthusiasm for keeping the patches on.  On the whole, he’s pretty good about this, but often he’ll rip the patch off before I can stop him.  While I stick another patch on when this happens, there are days when he rips off one after another, every few minutes, until I decide we’ve wasted enough patches and give up for the day. Jamie is less inclined to admit defeat, and has been known to keep going and getting eyepatches and opening them up even when I’ve decided we should leave it for now.  This has led to some of the stranger disciplinary conversations in the history of parenting: "No, Jamie, you can’t have another patch.  You’ve already had five – no, leave them, Jamie.  You can have another one tomorrow – oh, well, all right, just one more.  But it’s the last one, you hear me?"

However, between the three of us, we’re apparently managing to keep his eye patched long enough for it to have the desired effect – his squint is visibly improving, and the optometrist (I think I mean optometrist – I’ve yet to figure out the difference between an optometrist and an orthoptist) was pleased with how things were going when she saw him again on Tuesday.  This was, incidentally, the first time both Barry and I had managed to make it to an appointment – all the previous ones had been held on days other than Tuesdays (my day off each week), until the one before this one, when Barry took advantage of my presence to sleep in.  On that occasion I managed totally to miss the fact that there was a children’s waiting room off the main waiting room, replete with toys, and thus Jamie had to entertain himself by climbing on the (fortunately already broken) coffee machine.  He didn’t mind this in the slightest, but it did mean I was stuck with hovering behind him instead of being able to sit down and relax.  This time, Barry pointed the children’s waiting room out to me and so Jamie was able to occupy himself more conventionally with toys that made noises when he pressed buttons (until he decided that climbing up on the windowsill was more interesting, and I was back to hovering behind him again).

The optometrist called us through, ran through the checks (which consist of flicking between a pair of line drawings in different positions on their cards, which apparently allows her to check how well he can move his eye from one to the other), and told us that he clearly could see all right out of that eye, and that what we had to do now was keep things that way by continuing the patching.  Hopefully this will be sufficient – it’s possible that he may eventually need an operation to straighten his eye, but no decision needs to be made about that until next year at the earliest.  She was at great pains to reassure me that I shouldn’t worry about it, but in fact I was far less worried about the prospect of an operation than she was about the prospect of me being worried – I was more concerned with practical details such as how long he’d have to have a bandage on for post-op if he did have to have surgery.  (No time at all, apparently, which was a relief – I didn’t fancy the idea of fighting a post-op toddler to keep his eye covered.)

He doesn’t currently have binocular vision, and may or may not ever develop it, but this isn’t likely to present him with any problems unless he wants to become an RAF fighter pilot or a professional tennis player.  (Professional football player is, apparently, still open to him as a career – in deference to my mother’s hopes for her first grandson, I asked specifically.)  It certainly doesn’t seem to be giving him any problems at the moment – I wouldn’t have thought a child without depth vision could do the amount of climbing that Jamie does, but it seems people learn to adapt.  The optometrist asked me whether I’d noticed him having trouble stepping up or down a step.  Um, yes – he’s a toddler.  Doesn’t that come with the territory?  (Having said that… yesterday at the park I did notice a couple of points at which it was clear that he didn’t have depth vision and was trying to compensate.  And doing so so well that if I hadn’t already been aware of the issue, I’d never even have noticed.)

So, for the time being, we continue with the patching, keep seeing the optometrist every couple of months, and go back to the ophthalmologist (eye consultant) for a further eye check at some stage in the foreseeable future (appointment to be sent out).  At some point, I may even get round to figuring out just what the hell the difference is between an optometrist and an orthoptist.

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1 Comment

Filed under Adventures in Squint Correction, Here Be Offspring

One response to “The eyes have it

  1. We’re doing exactly the same thing for Frances’s lazy eye–first the glasses, then the patch. The patch worked really well, and very quickly. She’s only had it for a few months but the lazy eye has almost completely gone away. I hope it works as well for your little one.

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