Friday, March 9, 2012

I'm Seeing More Strabismus These Days!

As I travel from school to school to check on my students with visual impairments, I have noticed a rise in the number of students who are not on my caseload who have misaligned eyes or strabismus. I've had to send notes home via the school counselors to get the parents to take those children to their ophthalmologist.

Three children had significant vision loss in the inward or outward turned eye. I had  write one mom a couple of times. The counselor said it had been an issue before and she was hoping that my being a vision specialist teacher would light a fire under her. The school had even gone as far as procuring transportation to the doctor for her and the child. Finally, near Christmas break he came to school with the cutest pair of flimsy wire framed glasses. I don't think they helped much. I checked on him later in his next teacher's class and we talked about making some accommodations for him even without an IEP. Gosh, I wonder about that kid. He should be in second grade by now. Even though that school is no longer on my caseload, I should contact the school counselor and see how he's doing.

The second child was in pre-k in the class of another student who was on my caseload. He had so much involvement from being born preemie that his eye was easy for his folks to overlook. He had a shunt and had orthopedic issues, using a wheelchair for most of the school day. He'd had so many surgeries that, of course mom and dad were happy he was sitting up and talking. In fact, in that class he was the only one who could string together a complete sentence! I was taking pictures of the class during a birthday party as they tackled chocolate cupcakes. He was the only child in the class to understand that he should be able to see a preview of the photo from the back of the camera, asked if he could see the photo of himself. While letting him see it I suggested we play a game where I cover one eye at a time and see what his picture looked like. When I covered the good eye, his picture disappeared! "Um..Where did I go?" he said. Then when I removed my hand he said, "There I go!" Fortunately, the school nurse was across the hall and I sent a note home through her as suggested by the teacher. The parents were on it right away and had him seen by an ophthalmologist.  

The next time I saw him, the para was pushing his chair down the hall and he was laughing with his friends. "Look! Show Ms. Kathy your new glasses!" she said. "His folks took him right to the doctor and they discovered he needed surgery. He had one on the same eye as an infant and was supposed to have it checked again but with all the other things they had to have checked--like his shunt, his wheelchair, they didn't think of it after a year."

Those were the cutest little glasses--and the eyes behind them were straight on!

If it's my child or yours and their little eyes are not lined up, get it checked out. It could mean that the vision is slightly different in one eye from the other. It could mean that as an infant, the eye muscles need to mature a bit more and they'll align as they approach five or six months old. But it could be something a bit more serious if by pre-k or kindergarten one eye seems to wander for near and far vision. Wouldn't you rather err on the side of caution when it comes to your child's vision?

I met a parent at a festival whose cute-as-a-button four-year-old had a pronounced inwardly turned eye. [Yes, I'm one of those people who talk to strangers concerning the health of their children.]  She said his pre-K teacher and his doctor mentioned it but she was content that his eyes were just a part of him that was different--even though other children teased him about his cartoon eyes. The doctor had suggested surgery, which I would have suspected from the severity of the inward turning of that eye--called esotopia. An outward turned eye is called exotropia. From what I've read, esotropia is more difficult to repair--especially  if it is not corrected a soon as possible. This mother said that she didn't want her child to suffer through a surgery. I reasoned with her: Would you rather he have a temporary discomfort from a surgery or a preventable blinded eye? Because what is happening is that in order to avoid the confusion of double vision, the brain will gradually ignore the visual input from the misaligned eye and that eye will be unable to send sight messages from non-use.

There are different causes for strabismus and different approaches to ameliorating the condition or not, depending on it's cause. But, please, get your child's eyes checked to uncover the cause. 

Here's a link to an easy-to-understand-even-for-me explanation of strabismus:

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