Adam wrote:
I have a student who is not able to read the board from the centre of the room.  I asked if he had been prescribed glasses, and he said yes, but that his parents told him he couldn’t wear them on a regular basis and so he had to sit in the front.  His parents told me that they didn’t want their son wearing the glasses regularly in class because their natualpathic optometrist told them that his vision would get worse if he wore them and better if he didn’t wear them.

My understanding is that this is a myth based on a change in perception, but I’ve also heard of other people being told this by their optometrists.  Is there any credible evidence for this stance?

Thank you.

ANSWER

Adam,

Thank you for your question.  First, it is difficult to answer since we don’t know all the real facts, but perhaps you could share some of this information with the family in question.  I also must say I have never heard of a natualpathic optometrist.

You are correct about the myth. Not wearing his glasses will not slow progression of myopia (near sightedness). There is no natural way to alleviate the development of myopia.

If choices have to be made, since school is important to a child’s development, I would suggest that this child choose the classroom to wear his glasses. He could easily take them off to walk to and from school, while playing outside, while doing sports, and while at home. Squinting and struggling to see often results in headaches and may hinder his education.

Children grow until they are in their mid 20s and during this growth phase, the eyeball will grow and cause myopia to increase. We have not found a way to stop this growth as yet. Many studies have been done on ways to reduce myopia, and you can read about them on this website: www.allaboutvision.com/parents/myopia.htm

Keeley  wrote:
Hello, My daughter is one month old and I am beginning to worry that there is something wrong with her eyesight. Everywhere I read says that at one month of age she should be turning her head towards me, following objects with her eyes and smiling when we talk to her. She does not seem to do any of these things. She rolls her eyes back and moves her eyes in really weird ways. I have also noticed that she will cross her eyes for over a couple of minutes and make them shake. Is she okay? Is this normal??
Thank you in advance.

ANSWER

Keeley,
At one month it is very normal that children would not be able to control their eye muscles well.  If you are concerned you could take her to visit your Optometrist or discuss your concerns with your Physician.  Generally it is recommended that children have their first eye exam at 6 months of age.

Dr. Doman

Renatta wrote:
My 7 yr old son has just had an eye exam where the Dr. said he has convergence excess and needs eye therapy. The treatment is very costly and they also recommended readers as well. The therapy could be as long as 1 yr and I just want to make sure that this is serious enough to make this investment. I will do anything to help my son but I don’t have money to spend on something that doesn’t need to be done or isn’t as big of a concern as they have presented it to be.  Any light you can shed on this would be appreciated.
Thanks

ANSWER

Dear Renetta

You are lucky ! Your optometrist did a very good job considering that convergence excess is rarely diagnosed on time and represents the  no. 1 reason for school drop-out. Convervence excess means that your son’s eyes cross too shortly before the text he has to read. This leads to a reduced distance for reading (25 cm vs 40-50 cm). A shorter distance is very disturbing and demanding to the visual system. Imagine  seeing a computer screen at 25 cm as opposed to 60 cm where it is supposed to be. At 60 cm, a patient that suffers form convergence excess will see 2 screens (double vision). Ocular fatigue, migraine, headaches, nausea, loss of binocular vision could develop over time. It is not rare to see this condition, left untreated to lead to school failure. Most often, the student quits before graduation because their visual system cannot handle the demand.

This is why it is crucial to treat convergence excess. This treatment includes not onlyt the prescription of reading glasses (convex lenses help to reduce convergence excess) but also on orthoptics training. The visual system has to learn how to function properly even with the presence of glasses. Namely, with exercises the eyes will “learn” to converge less and to diverge more, making reading, computer work and any near visual tasks not only more comfortable but also for prolonged hours. The future at school of your son depends on the accuracy of this treatment.  Ask yourself how much money you would spend to assure a future to your chilldren and you will be able to balance  the value of the treatment that is proposed to you.

Thanks for your interest.

Dr. Langis Michaud, OD, MSc, FAAO
Associate Professor
Université de Montréal, School of Optometry

Heather wrote:
My son was recently diagnosed with convergence insufficiency.  He is currently wearing prism glasses for this.  I have heard that vision therapy can also be of great help to children with this diagnosis.  Is there anyone in the Belleville area that offers this type of service that your organization knows of?

Thank you

ANSWER

Heather,

To find an Optometrist in your area, contact the Ontario Optometry Association..    http://www.eyecareoao.com/    They should be able to direct you to an Optometrist who specializes in Vision therapy.

Dr. Joan Hansen - Optometrist, for CAO

Valeva wrote:
My daughter started crossing her eyes about 2 months ago when she was 29 months old. We took her to see an optometrist who diagnosed far sightedness and put her in glasses (+3.00 bilaterally). These seemed to help her align her eyes initially, however, after about 3 weeks, she started to again cross her eyes. We returned to the optometrist, who reported that now that her eyes were able to relax, he was getting a reading of 5.25 bilat, but that she could be in fact worse still. He mentioned drops to get a true reading of her eye, however didn’t feel like this was needed at this time, and prescribed a new set of lenses at +5.00 bilat.

My questions are this: Will we be repeating this process again, and needing new lenses again in a month? Is this common? How soon should I be seeing a result from her new lenses? And finally, her optometrist noted that she is already having to work harder to use her left eye, and was inconsistent in recognizing pictures with it (she was right on with all images shown to her right eye) when should I start to worry about a lazy eye?

ANSWER

Valeva,

Congratulations to you for getting your daughter’s eyes looked at immediately. I personally would feel better measuring your daughter’s eyes with drops to relax her focusing.  It is the only way we can be sure that we know just how far sighted she is.  Even with the drops though, it is often necessary to adjust the strength of the glasses in a  month or so.  The stronger lenses should straighten her eyes almost immediately.  The glasses are the first step (often the only step needed) in preventing a lazy eye from developing.  Your Optometrist will follow your daughter closely to assure that both eyes see well, and if not will advise about further intervention.  Often eye exercises are required, alone or, along with patching.  Your daughter is young enough to overcome a lazy eye fairly easily.  Expect to see your Optometrist every 6 months at least for the next few years.

Dr. Joan Hansen - Optometrist, for CAO

Kary wrote:
I’m wondering if an optometrist could diagnose a blocked tear duct?  My daughter has had a lot of problems with recurrent eye infections in one eye.  This eye also waters a great deal on a regular basis.  I’ve spoken to my Dr. about seeing an ophthalmologist, but no ophthalmologists in my area see children under 8 years old.  The closest one to us has a waiting list of 10 months long.  I’m wondering if an optometrist could take a look at her (I’ve heard that there’s a dye test that could be performed).  He/she may also give us some tips on how to live with it until we can see an ophthalmologist… or maybe determine if something else is causing all the infections.

Thanks for your help.

ANSWER

Kary,

Yes, your Optometrist should be able to examine your child and offer advice on how you may possibly open the tear drainage without needing to see a surgeon.  You did not say how old your daughter is, but if she is under 2, this is a common condition that we see in kids.  It rarely needs surgical repair, but if this is the case, then your Optometrist can refer you to a surgeon as needed.

Dr. Joan Hansen - Optometrist, for CAO

Stacy  wrote:
My baby will be six months old at the end of the month.  It looks like he is developing normally.  My only concern is that roughly 6-8 times a day, particularly when we put him down to change him, his eyes will flutter for about thirty seconds.  During this time, you cannot make it stop by holding an object for him to focus on, but he does respond to your voice and will show appropriate emotion.  He doesn’t seem bothered by it, and he did it since he was born.  Our podiatrist didn’t seem bothered by it at our 4 month check-up, but it makes me wonder if other babies do this.  What is causing this?  Should I be concerned if he’s still doing it a couple months later?

ANSWER

Dear Stacy,
Visual coordination begins at age of 6 months and the process will be completed at 6 years old. It takes time for the visual system to mature and to develop all the connections that are needed to get an efficient vision from both eyes, what is called binocular vision. It is quite normal for a young baby to do not have eye coordination and the movement you describe could be considered “normal” at his age. However, if this does not stop by the next months and/or if this increased over time, you should consult an optometrist to make sure that there is no “nystagmus”, which describes constant, non voluntary movement of the eyes, that can be linked to a neurological problem. Based on what you are describing I have no concern of such an issue namely because it is not constant.
On the other hand, this could be a good thing,  even without any symptoms, to bring your baby to your family optometrist for a check-up. The Canadian Association of Optometrist recommends that every child should have his first exam at 6 months and, if everything is OK, the follow-up should be made at age 3.  Consequently, to see your optometrist could be the best thing to do at this moment.

Good luck and thank you for your interest in the visual health of your baby.
Langis Michaud, OD, MSc, FAAO (Dipl) – Associate Professor, École d’optométrie de l’Université de Montréal

Nicole wrote:
My daughter was born with congenital cataracts, just like my husband was. I would like to know if there is anything that can be done prior to pregnancy or during pregnancy to help reduce the risk any future children being born with cataracts?

ANSWER

Hello Nicole,
I’m sorry to hear that your daughter has to suffer this condition.  Congenital cataracts are almost always genetic in nature (meaning you are born with them).  Because it is a mutation in the genes themselves, there is nothing that you did during pregnancy to cause them, and nothing you could have done to prevent them.  It is certainly possible that children from future pregnancies would be affected as well, and there is unfortunately nothing you can do to prevent cataracts.  The risk of the genetic mutation being passed on will depend on the inheritance pattern.  You can certainly ask your family doctor for a referral to a genetic counsellor to give you an idea of what the chances are of children from future pregnancies developing cataracts.
That being said, cataract surgery is remarkably successful with low risk of complication.  Once they are removed, your daughter will have to be followed regularly, but her visual prognosis is good.  I hope this helps.
Dr. Donati

Lianne wrote:
Hi there,

My 3.5 yr old just had drops put in his eyes in order for the optometrist to check his vision without him accommodating.  She has informed us that he has farsightedness… approx 5.5?  She is saying he needs glasses.  I’m very confused though.  My son knows all his letters, and is a master at Nintendo DS (requiring close vision).  I know he must be able to see clearly enough to do these things.  He is a very challenging child and I know he will never leave glasses on.  He was uncooperative for most of the appt.  I’m afraid she didn’t get an accurate exam.  I’m thinking of waiting another 6 months or so, and having him checked again for a second opinion.  I don’t want him to have to wear glasses.  I’ve read that many children diagnosed at a young age, will outgrow farsightedness.  If I wait, do I risk making his vision worse?  If we get glasses and he won’t keep them on, is that going to mess up his vision even more (switching between glasses and no glasses)?  Could he outgrow this on his own with strengthening exercises instead (e.g. patching the eyes)?  Could the testing be wrong at all? She had him look through 2 lenses to ask if it helped, but he didn’t really answer.  So I do not understand how she is determining that he’s farsighted?
Thank you,

ANSWER

Dear Lianne

The optometrist put drops into your child’s eyes in order to measure his full prescription.  Children are able to pull things into focus which is how your child has managed until now.  He is straining his eyes but children usually do not complain.  If you feel unsure about the eye examination then it might be a good idea to have another one - the child might cooperate this time as the test will be familiar.  As the child grows he might have an improvement in the prescription.  Wearing spectacles will not improve or make his eyes worse but he will be able to see fine detail.  A bit of encouragement from family and friends help children wear their spectacles.  Exercises and patching are used to treat specific eye conditions –often referred to as a “lazy eye” or a “weak eye”.  Your child may not require this treatment.

MJ wrote:
Hi there, I have a question about eyeglasses to correct hyperopia. My 5 year old has a strong prescription and her glasses magnify her eyes significantly. Is there anything I can do to minimize this? Thanks!

ANSWER

Dear MJ

Spectacles to correct hyperopia (plus prescription), does have a tendency to magnify.  The quality of lenses has improved a great deal over the years. Lens laboratories are able to improve the cosmetic and the optics of the lenses because of new materials, surfacing, base curve, coatings and small blank sizes.  It is best to speak to an Optometrist or a dispensing optician about these options.  The options do cost a little bit more than standard lenses, but it is worth the price as your child will wear her spectacles every day.