Eli's Glasses - Frequently Asked Questions

Thanks so much for all of your support about Eli's glasses! My Instagram post announcing them got almost as many likes as the fact that he's getting a new sibling in December - now that's saying something! Since the blog post, we actually saw an additional pediatric ophthalmologist to get a second opinion. Thankfully he had a similar diagnosis, although he also added one hour of patching a day and  told us that he wouldn't count on Eli's vision ever "fixing" itself, like the first one told us. That said,  I've received quite a few questions about our experience and navigating the world of eyeglasses with a child that can't speak. So here are answers to a few of the most frequently asked questions I've received. 

How Do You Tell If Your Child Needs Glasses?
Hands down, the number one question I get asked when people find out my child needed glasses  at 14 months is, "How did you know?" It's a valid question, I mean Eli only had a few words in his vocabulary, and they definitely didn't include, "That picture looks blurry." For us, we noticed that one of Eli's eyes wandered a bit and a pediatrician noticed as well, referring us to a pediatric opthalmologist. But did you know that the American Association of Opthalmology and the American Academy of Pediatrics recommends that all children have their vision checked at three months, between six months to a year and at the three and five year well visits?

I had absolutely no idea this was the recommendation and while my pediatrician checked Eli's eyes at each visit for major signs, often some of the signs are not apparent or don't reveal themselves during the short window of time a well-visit allows. Eli's eyes had been turning for about five months, but the pediatrician never saw it until 14 months since it only happened at certain times of the day. And because neither Mike nor I wear glasses, we just assumed our child wouldn't need them, especially not as a baby, so we actually never signed up for his work's vision insurance - which means a preventative-care assessment to have Eli's eyes checked wasn't even on our radar.

While it was no question as to whether or not we'd take Eli to the eye doctor and pay for anything and everything he needed, my cousin and fellow blogger Nicole tipped me off to a wonderful public health program, InfantSEE that offers comprehensive infant eye assessments between 6 and 12 months at no cost. All you need to do is type in your zip code to find a participating provider. Oh how I wish we would have known about that program - and the fact that you should have your child's eyes checked starting at three months!

*Please note! It is normal for a child's eyes to cross from newborn to three months. It's after three months that this becomes unusual and reason for concern.

How Does The Ophthalmologist Check A Child's Eyes?
The second question we receive is, "How did they know what prescription Eli needed?" We actually went to two different ophthalmologists to check Eli's eyes. We heard from a lot of people it was a good idea to get a second opinion, not only to be sure you're comfortable with the actual doctor, but because it can be difficult to check children's vision, so it's nice to have a confirmation. I'm so glad we did get a second opinion, even though the diagnosis was fairly similar from both ophthalmologists, the experience was night and day at each one. Part of it was likely just Eli's mood, but I also think one doctor seemed to be a bit gentler with Eli and checked for more things.
While I'm no expert, I'm a big question asker, so here's what I know about how the ophthalmologist actually checks a child's - that can't follow instructions - vision. (Also, please note, it's likely much more complex than this!) When you arrive, a nurse will dilate the child's eyes with eye drops and then you hang out and entertain your child in the waiting room for anywhere from 20 -30 minutes while you wait for the eyes to dilate. Back in the exam room, the ophthalmologist uses a toy to check the child's eye movement, watching both eyes together, then covering one at a time to watch them individually. To check for a prescription, the ophthalmolgoist uses a retinoscope on the eyes, which is a small handheld instrument that shines light into the eye, watching for movement in the retina. They then take lenses and put them in front of the eye, testing different ones until the movement stops - which provides the prescription (pictured above).

The full appointment takes about an hour, the actually exam taking only about 10 minutes. From there it's talking with your doctor about the diagnosis, entertaining your child, and depending on the diagnosis, heading over to a children's eyewear shop to pick up glasses.

What is Eli's diagnosis?
Both our ophthalmologist were wonderful doctors, and thankfully, we received similar information from both of them. Eli has congenital (born with) and accommodative (developed after birth) esotropia, which means his eyes were crossing (we thought it was just his left eye, but it's actually both) because of the effort he was putting in to focus his eyes and see clearly. The more farsighted a child is, the more the eyes cross. If it's not caught early enough, often the vision can be permanently reduced in one eye. For now, Eli is wearing glasses to allow his eyes to relax when focusing, which reduces the crossing. While the ophthalmologists were in agreement for the glasses prescription, one of the ophthalmologist also suggested we patch Eli's stronger eye for one hour a day, which we're now doing. If glasses don't fix the crossing, surgery is an option. Children can outgrow accommodative esotropia, although one doctor predicted Eli would in about 10 years, the other doctor said he wouldn't count on it ever happening.

How Do You Get The Glasses & Patch To Stay On? 
Eli actually took to his glasses really well. This was one of the things I was most concerned about going into the diagnosis, but it only took about three days for him to begin to wear them consistently. When we had him trying on glasses at the eyeglasses shop and when we had his actual glasses fitted, Eli would have none of it. It was a battle and he cried a lot (below).

But when we brought him home and it was just Mike and I around, Eli was much more calm. There were moments with lots of tears of course, but we distracted him a lot in those first few days, going to the mall, the park and other places with lots to look at, and we intentionally distracted him at home as much as we could - interacting with him pretty much the entire time he was awake. We also tried to reduce how often we "messed" with them. If they were dirty, we just let them be until there was a natural time to clean them, such as taking them off for a nap. We found that if we touched them, he'd remember they were there and want to pull them off.

When he did tug at them, we always tried to remain positive, wanting his glasses to be a good experience. So we'd just reposition them with a smile. Eventually this switched to him playing with them, and thinking it was funny when he pulled them off or had them on crooked. So we soon had to use a more firm, yet gentle voice to remind him that glasses are not toys and while he still messes with them once or twice a day, I'm not concerned, he's just a kid.

We also tried to be very consistent with having him wear them the entire time he was awake. As soon as he woke up, even before I picked him up from the crib, I put on his glasses and they were the last thing I took off before naps and bed. The only time he doesn't wear them is in his carseat, which the eyeglasses provider warned me not to do. I did try it a few times and every time they came off and became a toy.

After just a few days, Eli seemed to start to want to wear his glasses, and would point to them when he woke up. We truly believe he realizes that they help him to see. He's much more interested in books and TV then he ever has been before, and instead of flipping quickly through a book, we find he's studying each page, looking at everything much more slowly and intently. I even once caught him starting at his hands and turning them over and over in front of his eyes - you know, like a 2 or 3 month old does? I really think he was finally seeing them clearly for the first time! Before glasses, Eli also wasn't walking, something that was beginning to become a concern, but after a few days with glasses he began to take steps more confidently and initiate walking short distances on his own, rather than always needing to be prodded to try. And as of this past weekend spent with four very mobile cousins, I'm so proud to say that he's walking fairly consistently!

The patch was a little more difficult to keep on. Eli doesn't seem to like how it feels and seems to notice the reduced vision. When he pulls at it, we just gently pull his hand away, saying, "Let's leave your patch on!" with a happy voice and a smile, then distract him. Since he only wears it an hour a day, it's not too hard to watch him like a hawk during this time and keep him happy. I try to plan it for when we're home, yet still busy with something, or on a walk. I'll be honest, he gets a lot more stares when he's out and about with it on then with just his glasses, so I just try to avoid that to protect him.

pssst. Looking for more tips on how to introduce glasses to your toddler? You're in luck, they're right over here.  

What brand of glasses and patches do you have?
Glasses: Eli's glasses are Miraflex's rectangular frames in grey. They're great for kids because there are no metal pieces or hinges and are pretty much unbreakable. So far, we've been very happy with them.

Patch: Because Eli only wears a patch an hour a day, and doesn't care what it looks like, we use these plain ones from Nexcare. But if he needs to wear it when he's older and has more of an opinion, I've heard good things about Ortopad, which has gender-specific patches with cool designs.

If you have any other questions, I'd be happy to answer as best I can!

Oh! And if you're just starting down the road of having a child in glasses, I'd recommend taking time to check out the website, Little Four Eyes. It's a great community of parents who have children in glasses, patches and more, and is a wealth of information. In addition, they have a very active Facebook group, Little Four Eyes, that is super supportive and helpful with any questions you might have. I found both these resources to be comforting and encouraging, particularly when Eli was first diagnosed and I had no idea what we were doing.

*Sorry for the poor iPhone pics, I took these more for personal use (sharing with family) not realizing how interested everyone would be in his glasses - and of course, I was more concerned about being there for Eli than snapping a good pic. 

Other Posts In This Series on Oakland Avenue:
Seven Things Moms With Toddlers In Glasses Want You To Know
Eli Four Eyes (Our experience getting Eli diagnosed and introducing glasses for the firs time)
Tips and Tricks for Introducing Glasses To Your Toddler For The First Time (And Get Them To Keep Them On.)

My writing on other websites about glasses:
Little Four Eyes Blog: The Benefits of a Second Opinion
Twin Cities Moms Blog: How To Tell If Your Child Needs Glasses

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