Incase you don't know her story, when Olivia was first born we joked about her crossing her eyes. In a "man she's trying so hard to see....haha" kind of way you do with newborns. Given her prematurity, she had a scheduled eye exam at 6 months of age, at which point it was becoming a concern she wasn't growing out of this eye crossing. That eye doctor refereed us off to a pediatric ophthalmologist. I found a second, and we had 2 visits back around August 2010.
Livi was diagnosed with strabismus. Specifically, intermittent alternating esotropia. Meaning her eyes take turns intermittently turning in.
Shortly there after, she started wearing glasses.
For a while, it seemed to fix things.
Then that ended. And we noticed mostly her left eye turning.
So she started wearing a patch.
The doctor felt she was at the best place she could be with her actual vision, both her actual vision & the frequency of eye turn was equal in both eyes. Yet her eyes still turned, both with & without glasses.
So we scheduled surgery. Which was a terrible experience. It was a hard week after.
That was August 2011. Here we are 3.5 years later...
We started noticing somewhere around a year ago some turning again. We saw it as turning in. But our eye doctor corrected us, her eyes this time were alternating turning out! We were just expecting an inward turn, so we completely misinterpreted the direction she was looking! They also deviate vertically with the outward turn.
We've now seen 2 very different specialists this month- on 2 very different ends of the spectrum.
We were referred from our eye doctor back to the surgeon. He diagnosed her with dissociated vertical deviation (DVD). I read somewhere that "DVD is to strabismus as fever is to infection." That a DVD is somewhere around 50% likely to occur after strabismus surgery. And some research I did tonight said that without surgery prior to age 2, the incidence of DVD is as high as 80%. So I guess this shouldn't be a surprising place for her to be. He recommended a prescription change, and a follow up in a year. He said the severity of her DVD was mild & not surgery worthy. And that her vision in both eyes is great! If anyone out there would have pushed for surgery it would have been him. So since he saw no need, I feel confident that surgery isn't the route to go.
I also got recommended the name of a vision therapist, and have done a bit of research regarding it. Vision Therapy (VT) seems to still be a pretty newly accepted thing, and in fact many people in the medical community don't believe in it at all. They told me that only one insurance carrier in NE will even accept claims for VT. Luckily that's the insurance we have... unfortunately its still extremely expensive!!
The doctor at this focuses more on the neurological side of strabismus, rather than just the muscular side as a surgeon would. The Dr. at this office feels that Olivia is very rarely using both of her eyes together to see anything. She has great vision in each eye, but she is almost always suppressing one or the other. Try walking around your house, or reading, or doing simple tasks alternating closing one eye or the other. They believe that is how she sees. I am shocked!!
We've done one practice run to see if Olivia is old enough to be capable of doing VT. Vision Therapy is essentially training your brain on how to correctly use your eyes. Through watching her do some of these exercises, I do agree, she is very often suppressing one eye. BUT it appears she CAN actually fuse them both together & see the whole picture. Which is what VT would ideally teach her how to do & control.
The problem is at age 5, lots of kids aren't capable. Not that they aren't smart, or physically able. But that A) 5 year olds lack the communication skills & vocabulary to communicate to you what they are seeing. and B) 5 year olds try to hard to please you. For example, they did one test with Olivia with some glasses & had her point out what she saw. They then TOLD her they turned the glasses upside down, (however in truth the glasses stayed the same) & again asked her what she saw. She had 2 pictures to choose from to point at. Given that they told her the glasses were upside down, she though she should see something different, so she pointed to the other picture even though that's not what she really saw. She just wanted to be right. If you can't be 100% honest & communicate effectively what you see, it won't work. We also did some test runs with a therapist who also has an early childhood education degree & Liv seemed to do better with those. So she's kind of on the fence. We're going to go ahead & TRY... see how it goes. And if we get a few weeks in & see its not going well, we'll stop & try again in 6-8 months.
Liv & I discussed honesty & not being shy if we do this. And she came to the conclusion she would be able to be less shy if I waited for her in the other room. So I think when we go back next week we'll give that a try. If in fact she can handle going-it-alone it would make the whole process easier. I could tote the boys along then. If I have to sit with her the whole time (no idea how long a session truly lasts) I'm stuck trying to find help with the boys every week!!
How the brain & eyes work is simply amazing. And even these few diagnostic appointments with the vision therapists have been so eye opening into her world. Its amazing actually that her motor skills are fine, that she's reading, etc. I wonder sometimes if her shyness is somewhat a side effect of her vision? I know that's not completely the cause, but it could play a part?
So here we are.... hopefully we can have success with this!!