My 5-year-old kid has 40% less vision in her right eye and 10% in the left eye. How to treat it?

Hello,

Welcome to icliniq.com.

Seeing the reports (attachment removed to protect patient identity), your child has high astigmatism in the right eye leading to poor vision in that eye. The good thing is she has been diagnosed at the right age, so treatment is possible. Start here with glasses at first. After a month, we will see how much she improves. Depending upon that, we will decide to patch her eye or not. Her condition is curable until the age of 8 years. So we have time. Please avoid mobiles and gadgets for her. That will only worsen her eyesight.

Hope it helps.

Thanks and regards.

Hello,

Welcome back to icliniq.com.

I understand your concerns.

Your daughter has with the rule astigmatism that is regular astigmatism. And it has been detected at the right age, so treatment is very much possible. The glasses are prescribed four days after giving Homide drops. It is because the pupil remains dilated for 72 hours. We call it a post mydriatic test (PMT), which gives the exact number your child is accepting. About the watery image, she sees. I will try to explain in an easy way. What happens in astigmatism is that she cannot see straight. Instead, she will see a way image of that line, which even leads to headaches at times. So she feels as if she sees water or ripples. I hope this makes sense to you. About future concerns. You have to get yearly check-ups done. Once she is 9 to 10 years, you will need to get a corneal mapping and topography done to rule out keratoconus. It is a condition resulting in high cylindrical power, which usually develops in the growing child. Also, no TV, laptops, mobile phones for her. Lessen the screen time as much as possible. She should not rub her eyes also. You can start eye drop Bepos twice a day so that she does not rub her eyes. Drops can be given for six months without any side effects. She will never lose her vision. So dont worry about that. Yes, she will need glasses, and she has to wear them regularly. And once she is 18 years glasses can also be removed by lasik treatment.

Hello,

Welcome back to icliniq.com.

The numbers given are fine. Along with cylindrical power, she also has a spherical number in her right eye. It takes approximately 10 to 15 days for a child to adjust to such high powers. You understand it like this. Until now, she only saw from the left eye. For the first time, an image is being formed from her right eye as well, and now she will see binocularly. This adjustment process will take time. That is why the doctor has called you after a month. We give that much time for the patient to adjust to new glasses and then start occlusion therapy. Make sure she wears glasses at all times. She will have discomfort, slight headache, and giddiness, but that is just a part of the adjustment process. As far as the left eye power is concerned, that is negligible and will go away with developing age. So nothing to worry.

Hope it helps.

Thanks and regards.

Hello,

Welcome back to icliniq.com.

As far as patching is concerned, it is not required because she is able to see 6/6 with glasses only. It is a very good thing. Previously her vision was not improving beyond 6/18. That made her amblyopic. That means she was having a lazy eye. But that is being corrected with glasses itself which is very good for her. It is happening as she is less than 6 years of age and that is the developing age for the eyes. The number is very flexible. But she will require permanent glasses. That should be worn at all times. Regarding the watery image, I would suggest checking the axis of the glass in the left eye. It can be done in any optical shop. If it has not been made at that degree, she will have blurring and distorted images. And also try a lower power. She is wearing 0.75. Try a 0.5 or 0.25. Wearing an overcorrection can be one of the reasons. This can be tried at any optical shop dear.

Hope this was helpful.

Thanks and regards.

Hello,

Welcome back to icliniq.com.

In my experience, I think the axis of the cylindrical power given might be wrong hence she is still having a distorted vision. I would like to know if her retina has been examined post-dilatation. If not, I would advise to get it done this time to rule out any retinal pathology for the same. It is alright to be concerned at this time. For checking her vision at home, you can ask her to read the score of a cricket match on tv from a certain distance. That is the normal vision. I would also recommend getting a corneal topography done to see for any corneal pathology for the same.

Hope this helps.

Thanks and regards.

Hello

Welcome back to icliniq.com.

I saw all the reports.

I would advise you to go ahead with the current glass prescription. With the previous glasses, she was seeing blurring and wavy lines still. and giving a plus correction might not be suiting her. Did they conduct the scans I asked you? Was topography and pachymetry done? They are required for cylindrical powers so please get them done. Also patching for four to six hours five days a week is more than enough. Doing eight hours daily is not required. Also while patching keep checking the vision of the better eye. The vision in that eye should not decrease. That is known as reverse amblyopia. To avoid that, I am advising 5 days of patching only. Numbers will change frequently once you start patching. Every two to three months her power will reduce. I would advise going for monthly checkups and not straight after three months.

Hope it helps.

Thanks and regards.

Hello,

Welcome back to icliniq.com.

They should have called you for the number actually. They have prescribed the cylinder power as it came after dilatation. In children below 12 years, the child should be called for post mydriatic test. I think you should talk to the doctor regarding this.

Hope it helps.

Thanks and regards.