So my nephew has vision problems-any advice?

Miscellaneous and Personal Stuff I Must Share
1

My brother-n-law has pretty bad vision, and has had it since he was a really young kid. Because of this, my sister and BiL had some concerns about my 18 month old nephew, even though he hasn’t seemed to have any seeing or getting around. The other day, she took my nephew to the doctor for testing, and while I’m not really sure how you give an eye test to an 18 month old, they did, and he has a vision score of -16 diopters, which is pretty severe, and he’s going to need corrective lenses, and pretty thick ones.

My sister is pretty upset for a few reasons. She’s afraid he’s going to get teased when he gets older, because my BiL did when he was in school, and she’s also worried that his vision is going to get worse.

The thing is, I really don’t know what to say to her, but, other than reassuring her that everything will be ok, I’d also like to let her know about some resources that she can go to. Does anyone here have kids with bad vision, and if so, how did you deal with it?

2

She’s afraid he’s going to be teased for wearing glasses? Maybe things used to be different but when I was in middle and high school I was never once mocked because of my glasses. Not a single time. I think he’ll be fine on that end of things.

Edit: Also, I’m curious how they test a baby’s eyesight.

3

We’re about the same age, yeah? Mid 20s? Because I’m with you on this- nobody ever got made fun of for glasses. In fact, everybody in elementary school wanted glasses-- and braces! It was considered something ALL kids do-- so why can’t I do it, too, mom?! :slight_smile:

4

My 9yo son, coincidentally, is also -16 diopters. He was in the -13 range when we first had his vision tested, when he turned 3 - he could only watch TV from 5 inches away, and books we’d read to him he pressed up close to his face. Well… he’s got Progressive Myopia, or Degenerative Myopia (both Googlable), so there are obviously no expectations that his vision will correct itself somehow. We were told that, because of the severe curvature of his glasses, he’s basically got very little peripheral vision. Doesn’t seem to bother him too much, but do make sure once he gets to school that he sits at a desk facing the front of the room, in the front of the room. (You’d think this would be common sense, but school personnel don’t take these kinds of things into account sometimes.)

Yes it can be heartbreaking to see your child in “Coke bottle glasses,” but my son never reports that anyone teases him for it. Many of the children in his school wear glasses too. An opththalmologist we saw suggested he try gas permeable hard lens contact lenses when little Mr Glot was about 5 years old. It was hell on wheels to get those suckers in his eyes, and once we managed it, one of the lenses wouldn’t stay put over his cornea. We plan to try again in a year or two with soft lenses, once he seems responsible enough to treat them gently and clean them thoroughly. Again, it’s not so much about his vanity - yet! - but just to help with his peripheral lack of vision.

As for how they test the vision of very little children, the eye doctors my son has seen have to dilate his eyes with those stinging drops. Little Glot hates them, but I promise him ice cream after his appointments. :slight_smile: Oh, and they only ask to see him once a year at this point, and it’s an optometrist, not an oph, that he sees, but it’s at the local Children’s Hospital. My husband is always fond of reminding our DS that with the amazing advances in technology these days, they’ll be growing perfect little eyeballs in a petri dish for transplantation one of these days!

Anyway I don’t know how much help any of this is, Captain, but if you have any questions I’ll be happy to try to help. Good luck to your little nephew!

5

I never remember any serious teasing over wearing glasses; yeah, getting them meant you’d joined the four-eyed crowd but so what. Some people are blond, some dark-haired, some are tall, some short, some wear glasses, some do not. For college labs, we could get graduated goggles or small graduated glasses under goggles (contacts were Not Acceptable, being a safety risk); most of us opted out of the six-eyed model simply because it was uncomfortable as hell.

One of my nephew’s classmates (4 or 5, I don’t know when this kid’s birthday is) wears glasses, with a cord tying them to his clothes; when they’re running around and the glasses fall off, the other kids stop the game for an instant to let him get his eyes back on. Most kids will need glasses at some point, based on family histories (or at least will need to wear sunglasses, safety goggles, etc), so when the kids were curious about this child with the glasses, the majority of parents took it as an Educational Moment to avoid, not teasing, but this kid being left aside for physical games. My brother wears glasses; my sister in law normally wears contacts, but she wore her glasses for a few days; they explained that the two uncles and myself have had surgery but we used to wear glasses, and one grandma has worn glasses since she was a child and the other one needs them now, and one grandpa wore glasses too. So glasses are something normal, although yes, they can be bothersome.

6

I suspect they measure the eye proper, specifically the shape of the eyeball compared to what it’s supposed to be. Heavily myopic people have eyeballs that are elongated front-to-back, so that the focal point through the lens is in front of the retina rather than on it. There is at least one relatively simple in-office test with a machine that ophthalmologists can do to measure the eye this way. (Sorry, I do work in ophthalmology, but I’ve only ever had one patient need this test so I’m completely blanking on it. We do have a couple pediatric ophthalmologists in the office as well.)

Also, -16 diopters isn’t just “glasses.” It’s coke-bottle lenses, and I’m fairly certain (though this isn’t my specialty area either) that even the new lens technologies might not be able to get rid of all of that thickness.

As a comparison, I’m at -5ish and I’m one of those “is that an E?” types without my glasses on when I’m getting my vision checked.

I’ll try to remember to ask the pediatric ophthalmology specialist that I work with if there are any resources he’d recommend. Also, whether his vision will get worse really depends on what his diagnosis is.

7

One test you’re thinking of is an axial length ultrasound, FYI. Softwear used prior to cataract surgery, like the IOL Master, also can take axial length measurements (which is to say, front-to-back measurements.)

Oh, and there are a few ways to measure a baby’s eyesight. You can get a good idea about their refractive error simply by shining a light into their eyes and watching the pattern it makes as lenses are placed in front of the eye called retinoscopy. That’s a very simplified explanation of a procedure that takes quite a bit of practice to do well, particularly on kids. In order to see the effect this has on the child’s eyesight, even young babies can have their acuity measured by using gratings and a technique called “forced preferential looking,” in which the examiner determines if the child is preferentially examining a board with gratings on one side vs. a blank board. Slightly older children are given shapes, and as it’s natural to look at the grating or shape longer than a blank board, a good estimate of their acuity can often be derived through this technique.

8

“BIL turned out just fine and managed to find a wonderful woman like you, didn’t he?”

My son was really bad in one eye, but his eyes have gotten better since they were first corrected at four and each set of glasses is thinner - he’s twelve now. He’ll always need glasses, but it isn’t the “he won’t be able to see from one eye” that was the original fear (one eye was really bad, and was lazy because it was so bad). Plays baseball, hits fastballs for homeruns and pitches really well.

You deal by dealing. Don’t borrow trouble.

On the “your nephew doesn’t have it so bad” front, my friends’ daughter has CP and has been wearing cokebottle glasses since she was six months old - she’s also wheelchair bound and cannot speak.

9

Get it taken care of right away. My sister had undiagnosed cataracts when she was in 3rd grade. The school kept sending note after note and there was even talk of putting her in special ed about her school work. By the time she got the glasses she needed, she was so far behind that she never caught up and she had a deep hatred of academics for the rest of her life. She had to put in extra hours after school to graduate high school, and she couldn’t go to a regular college. She also had to put up with the teasing about her glasses when she got them.

Imho, there’s a choice: the child can fall behind in school and get scarred for life, or get teased for wearing glasses and get scarred for life. If it was up to me, I can teach the child how to deal with bullies and there are more laws now to protect children from being victimized. However, if a child never learns how to love learning, it’s not something you can give them later in life.

10

Thanks for all the support, by the way. My sister is going to be taking my nephew in for glasses either today or tomorrow. The reason my sister is so worried about the teasing, by the way, is that my brother in law got teased really badly about his coke bottles when he was a kid up until he got contacts around 16.

11

I’m going to chime in with the teasing thing–it doesn’t seem to happen any more. I was teased a lot, but my kids not at all. It may have to do with the much cuter frames we have these days, I dunno, but all they ever get is compliments.

12

So get him glasses and teach him karate. Problem solved.

13

Yeah kids with glasses never get teased. Even in my day, the 70s, there wasn’t much teasing, outside of an occasional “hey four eyes,” no one cared.

14

Ohhhh I thougt your nephew was a religious zealot. My bad. Carry on.

15

I like this. Really, it made me smile :slight_smile:

16

The smaller the lenses, the less thick they are along the outer edge, and the lightest plastic technology is a must. If his peripheral vision isn’t so great anyway, and he won’t miss it, frames that are wide and solid along the temples will also effectively disguise thick lenses. Also - make sure to pay extra to have the lenses polished where they “spill” outside the frame.

I’ve had thick lenses since age 12 or so - they’ve gotten thinner over the years between newer lens technology and the style of frames becoming smaller - the bigger the lens, the thicker it is.

I also have no recollection of teasing when I started wearing glasses. People have always noticed when I got new frames. Gradeschool - that would have been 1982 when I started wearing glasses, and no one teased me.

17

There’s lots of anti-bullying laws now. Check with a nearby school if they have been passed in your state.

18

I think babies in glasses are absolutely ADORABLE. I mean, of course it’s not my kid and I don’t have to feel bad about it…but…squee!

When I was on vacation last week there was a kid on a kiddie ride with my friend’s kid who had neato thick blue frames. I had my friend take a picture of the cutie for me.

19

When you get a prescription for these lenses, and it’s time to get the lenses made:

Ask the opthalmologist / optometrist that writes the prescription if they will put this phrase on the prescription - “No tolerance for axis”. Without these words, it’s perfectly OK for lenses to be delivered up to 7 degrees wrong without them needing to remake the lenses. 7 degrees wrong on a -16 would be criminal bad optometry, and a 2 year old would be unlikely to be able to vocalize just why exactly he doesn’t like his new glasses. “No tolerance for axis” will cut this behavior off at the knees - the lab tech will know not to mess around.

Ask to speak directly with the optician in charge of the lab. You want the most experienced technician they have (Not a salesperson, just to be clear - you want the guy who actually gets his hands dirty grinding the lenses.) No offense to the salespeople, but they’re more likely to be interested in making a sale - and a commission - then making sure your nephew’s lenses are as flat and thin as possible, and these things can be lost in translation sometimes since the lab techs rarely deal with customers face-to-face.

Tell him that these lenses will be worn by a child, and ask him to recommend the frame that will best accommodate the lenses. They’ll be able to look at the prescription and visualize what the uncut lens will look like, taking into account the cylinder/astigmatism and such, and believe me, a lab tech that’s worth his salt will immediately know what frame will be best.

Ask him, challenge him, even… to get those lenses as thin as possible, and the edges as smooth and polished as possible.

Don’t buy into the idea that the more expensive an optical shop is, the better quality the eyewear will be - the opposite is usually true. Places that charge $1000 a pair don’t make nearly as many orders (and often don’t even HAVE their own lab) and their techs don’t get as much practice with the unusual prescriptions. Steer clear of the dirt-cheap Medicaid-focused type places as well, and zero in on a mid to large chain. Eyemasters, Lenscrafters, PearlVision, etc. - look for a place that has a lab on premises - although they still may need to send your nephew’s order to a special-order lab, they’ll likely still be the ones doing the finishing/polishing.

Make sure that the staff takes plenty of time doing the final fit when the glasses are delivered. Have your nephew shake his head vigorously a few times to see if they slide down. Don’t quit until they’re comfortable and snug. Because if they slip down, the optical center of the lenses won’t be centered on his eye anymore, and a 2-year old will most likely not understand why his vision just went all blurry and know to push them back up his nose.

There, I’ll get off my soapbox now - best of luck with your nephew and I hope he does great with his glasses. There’s something almost magical about when the really young kids get their first good look at the world. It’s awesome to see. Kudos to your sister and BIL for getting on top of the situation BEFORE he’s 8 and can’t read the blackboard!

20

Adding kudos for getting the situation addressed promptly. I needed glasses for years and years before anyone noticed. I think that’s a major reason why I was never able to play any sports and did not develop good hand/eye coordination.