Eyes, Noses, Throats

[elfs]

Friday, my adventure started with a quick jaunt over to Omaha's pharmacist so I could pick up her medication before hurtling down to Tukwila to visit Pearl (sic-- why didn't Pearle Vision sue them into the next dimension?) Vision and see what's what with Yamaarashi-chan's vision. Her mother and she were a few minutes late showing up, but we were soon seen by the optometrist. After a few basic tests, we determined that what she has is something called intermittent extropia, or basically "eye-turn." She had been diagnosed with it early on in her life, but you can't do anything about it until the child is at least four without disrupting the normal development of vision anyway. They also did the color-blind test, which I loathe because people can actually see things in all those dots that I cannot, and it drives me nuts.

The optometrist on-site kept pushing surgery, especially this one particular surgeon, and for some reason the way she kept repeating this one referral over and over made my hackles rise. Surgeons, naturally, like to do surgery, but there's a lot to indicate that intense therapy can sometimes assist with eye-turn. Yamaarashi-chan's eye-turn has gotten worse; the doctor didn't want to do any intervention after her last check-up because she was seeing depth with both eyes quite well at her last test. The left eye would help in determining depth and then wander away; it's not doing that nearly as strongly now.

I'm reading up on a variety of options and tests, and I'd like Yamaarashi-chan to get everything possible done, but the doctor emphasized that perfect vision is unlikely for Yamaarashi-chan. We're in the window now where it's possible, but the expected outcome is primarily cosmetic; she won't look odd when looking straight at you.

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Omaha and I spent most of the weekend at home. Kouryou-chan and I are both down with colds, so we spent most of the weekend trying to stay warm and hydrated and not do nothin' if we could help it. The vacuum cleaner broke again, this time there's no power going to the agitator head.

Sunday, Kouryou-chan's cold got even worse, to the extent that she wasn't hungry, was listless all the time, and when she went to bed she coughed so hard it made her throw up. That was no fun cleaning up-- we had to change the sheets, and rinse her off with her pyjamas still on in the bathtub, then strip her and wash her hair. She was miserable. We didn't get to bed until eleven, and I couldn't fall asleep for a long time after that. Kouryou-chan climed into bed with us sometime around 2:30.

Omaha and I also had a spat. It was pretty serious, the first "real" one we've had since Kouryou-chan was born, and it really freaked me out. I thought we'd put that kind of arguing behind us, but... I suppose it's better that it happened than not. Still, it's not an experience I want to repeat any time soon.

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I went to work today, tired after the all-night with Kouryou-chan, but determined to kill as many bugs as I could since I finally had the hardware I needed to test the code I'd written. No such luck. Right before lunch, Omaha calls and asks me if I can come home; she'd hada seziure and seriously hurt her back, and needed me. I came hope, fed everyone, let her nap, made her a bath when she woke up, drew and painted with Kouryou-chan, then took Omaha to work. I hope she's doing okay. Kouryou-chan and I had our Monday tradition of ravioli, and now she's playing with her stuffed animals.

I really need to get some sleep.

Comments

[secanth.livejournal.com]

Speaking as someone whose depth perception is screwy because of the same problem...I wish Mom had had the surgery done. I wouldn't mind not having perfect vision (right now I don't have reading sight in my left eye, I just see colors and blurry things)...but it would be nice to be able to draw or sculpt, which is nearly impossible when you can't judge depth and perspective well. I did have all the *other* therapy avaliable at the time, and my eye doesn't wander, but I don't have the ability to do some things I'd like to be able to do.

My ex also had the problem...and no surgery. His eye *does* wander, which is very disconcerting for people at times. And yes, it is disconcerting for people when they first meet him. (And sometimes even after they know him.) I've been told mine will get worse as I get older...so far, it hasn't, but given that the vision in it is still declining (just a little bit a year, but still) it will probably happen.

[mathochist.livejournal.com]

Her mother and she were a few minutes late

Uh, no, you were the one who was late. When you finally walked in I was about to call you to make sure you hadn't gone to the Pearle around the corner. We'd already been there for some time.

The optometrist on-site kept pushing surgery

That wasn't the impression I had at all. What she did say was that *if* we were going to do surgery, we needed to do it *soon* for best results, given Stormy's age. Otherwise she kept emphasizing that surgery wasn't something we *had* to do.

I've been researching, too, and talking to people. I've talked to several people who have had the surgery, or whose children have -- for some it worked wonders, for others it didn't do as much, but I haven't talked to anyone who was sorry they had it done.

And it seems very clear that vision therapy is extremely important. But surgery would not have *only* cosmetic effects -- it would make it more likely that the vision therapy would be as successful as possible.

If we try therapy without surgery, and that turns out to not work, we won't have as much chance of success if we decide later that we want to try the surgery after all. With younger children, they recommend trying the therapy for a while first, but at her age, and given the fact that she *is* losing depth perception, the surgery seems to be highly recommended. (Followed, of course, by therapy.)

There are risks with any surgery, but this one seems pretty low-risk as surgeries go. So (assuming the insurance will cover it), I don't see a lot of reason to *not* try it.

Of course we need to meet with the surgeon, and probably with a therapist, as well, first. But my feeling at this point is that we should go ahead with the surgery and then therapy, to give her the best vision possible. What do you think?

[elfs.livejournal.com]

The impression I had, from her pushing her one referral, was that she had some kind of working relationship with the referral. Like I said, it was just an impression. For all we know, the referral really is competent.

Whether the insurance covers it or not, I'd like to go through with it. Like you, I've been doing research. I found one anti-surgery site, but I'm not inclined to let single examples guide my opinion.

My only question now is, are there other surgeons in the area who do this work, and should we "shop around" for the best one before proceeding?

[mathochist.livejournal.com]

Oh good, I'm glad we're in agreement.

I called Pearl back just now because they hadn't called me earlier this week with the information on the surgeon; they'll call me back in a bit, hopefully.

should we "shop around" for the best one before proceeding?

That's a good question. How do you want to approach that?

strabismus, surgery, etc

[sarabande7.livejournal.com]

"Yamaarashi-chan's eye-turn has gotten worse; the doctor didn't want to do any intervention after her last check-up because she was seeing depth with both eyes quite well at her last test. The left eye would help in determining depth and then wander away; it's not doing that nearly as strongly now."

She's probably going over increasingly to her dominant eye (which sounds like her right eye). I believe this is a learned, compensatory action, though I know much much less about eyes than i do about the back and upper extremities.

I had pronounced esotropia (inward turning eye) from the time i was 8 or so, until i had surgery at age 18.

I was told for years that surgery would only be cosmetic, and that improved depth perception would probably NOT result -- and i wasn't interested in having someone cut on my eyeballs for purely cosmetic reasons.

Unlike most patients who develop this condition early in life, I developed esotropia as my vision deteriorated and my dependence on my dominant eye (the left) caused the weaker one to become lazy. (This despite glasses, as I didn't always wear them, or took them off to read, etc.) As my eyes stopped working together, I started to see double, Then to suppress input from the weaker, lazy eye. Eventually, my right eye would stay crossed until the left was covered -- at which point it would straighten out and look ahead. Without both eyes working together, it became impossible to correct my vision to 20/20.

At some point my depth perception deteriorated -- I couldn't tell you when. I know that by 7th grade I was no longer any good in athletics; the lost depth perception really screwed with the kind of coordination you need to play tennis, basketball, or really basically anything. Furthermore, my strabismus was so pronounced that there really wasn't a prism thick enough to put into my glasses that could make me see straight.

Skip to the end: when i graduated high school, an unlikely series of events led to the discovery that when both eyes focused properly together (at a distance of about 5 inches from my nose) i DID in fact have normal depth perception. We did surgery, and after several years, i can now chuck a wad of paper at the bin and expect it to land inside. I can catch things that people throw at me. I'm less afraid to get in front of a soccer ball or a volleyball, and my clean driving record is testimony that I'm no longer in danger of misjudging my stopping distance in traffic.

If your daughter has depth perception, but is tending to look with only one eye, i think she will very likely lose most of it over time. If you think you can successfully treat this condition with eye-training, good luck and let us know how it goes (I've wondered about that myself, since surgery). If a prismatic lens can draw the eye straight, that could solve the problem (I have no idea if this is possible for exotropia strabismus). If you opt for surgical intervention, you may be surprised by the improvement in 3D perception over time, and even what can be regained in adulthood.

But eye-muscle surgery is not small potatoes. It's general anaesthesia. It hurts for several days, and you have to do nasty things like put ointment on your eyes afterward. (this was very traumatic for me, and i was not a child when i had mine done.) Furthermore, if they don't get it exactly right, you end up needing revisions and post-op 'eye-training' to get the results you should have gotten from a single, correctly-executed procedure.

Get a good cutter. Get a pediatric neuro-opthalmologist. (A few years ago I could have recommended an excellent one, but she moved back to Greece.)

Finally -- and i have very mixed feelings about this as a consideration for surgery, but can't bring myself to ignore it -- having a crossed or lazy eye can do terrible things to a girl's self-image in adolescence. I'm sure this isn't news to you. But I do know that even as a terminally geeky, semi-butch chick, i used to wear my hair in front of my right eye all through high school. It's not even long enough to do that any more. And I don't avoid cameras as much, either.

Best of luck with this and everything else -- sarabande