On March 5th , 2010, the President declared that the first week of March each year would be Save Your Vision Week, during which time people are encouraged to raise awareness regarding eye and vision care. So, I feel that this is a good week to share my personal experience on the subject.
My son is 3 years old and he started wearing glasses one year ago this month. The question that everyone asked me when they saw his new glasses or when meeting him for the first time was, “How did you know he needed glasses”? He was so young, even people who were not parents yet were curious. What were the signs? How did we know? This is what I tell them about how we discovered he needed glasses and how lucky we were to catch it so early.
Within the first week of my son’s life I noticed that he was waking in the mornings with green “crusties” in his left eye and when he was awake, tears pooled in his eye and ran down his cheek. Having had conjunctivitis (pink eye) a couple of times in my life I immediately thought that’s what he might have. We took him to the doctor and I was relieved to find out that my week-old baby had not contracted pink eye. Instead, he had what the doctor called a clogged tear duct. He told us that sometimes when babies are born their ducts have not opened, but that it may open on its own in time. He said that we would give it a year and if it did not open up on its own he would refer us to an ophthalmologist.
That first year came and went in a flash and at his one year check-up that left eye was still leaking. Our doctor scheduled an appointment with a pediatric ophthalmologist and told me that the duct would likely have to be opened surgically.
About a week later I packed him (my son, not the doctor) into the car and drove an hour to see this specialist. After another hour in a hot, crowded waiting area with a restless one-year-old, who’d missed nap time, we were finally called into see the doctor. Then we had another 15 minutes of waiting in a room full of things requiring repetitive use of the phrase, “No, no, don’t touch!”
When the doctor finally came in, there was barely an introduction before she squeezed some drops in his eyes and left us for another 10 minutes to allow the tears to drain (or something like that). When she returned she looked at his eyes with a special light. The pooling tears glowed yellow in the left eye confirming that they were not draining from his eye. (Did I mention how the eye was always dripping with tears?) Anyway, she took a minute to show me a pamphlet and explain how tear ducts function, which was actually pretty neat:
Tears drain from your eye through a tiny hole in the inside corner of each eye, these ducts run through your nasal passages and drain into your throat. When you blink, excess tears drain from your eyes through these ducts. When you cry, more tears are produced faster then they can flow through the ducts which causes tears to spill from your eyes and run down your face, and also causes your nose to run because they overflow into there too!
She told me that I needed to schedule a surgery where they would stick a tube into the duct to open it up and leave it there for a number of weeks. She said time was of the essence because the older he got the less likely it was that the surgery would take (the duct could build scar tissue and close again). She warned that he would be super upset and cranky when he first woke up from the anesthesia, and she gave me directions to the hospital for the surgery. Then she sent us out to the receptionist to schedule the surgery and get a quote for the cost of the surgery – $800.
I left the office feeling frustrated, scared, and unsure. I just did not have a great feeling about this doctor or her office. Although I learned in detail how tear ducts work, I felt like she told me very little about the surgery and what exactly she was going to do to my baby. Her bedside manner was cold in the way that some doctors get when they do the same thing day in and day out, as if they forget that some of us have never done this before. I was way too nervous and unsettled about the whole thing. Now if this had been about me, I would have just shrugged off my bad feeling and went ahead with the planned surgery, but this was my baby and if I wasn’t going to make sure that he was getting the best treatment, who would? I could not send him into a surgery with someone I didn’t feel comfortable with. So after talking about it with my husband and my best friend, I called my family physician and asked them to find me another pediatric specialist because I wanted a second opinion.
The new doctor, Dr. Brown, was also an hour away, but the experience was like night and day. For starters, the office was not crowded and they had a play room for kids! The doctor was friendly, she talked to my son as well as to me, but most importantly she did a complete eye exam on him. It had not occurred to me at the other office, but the other doctor never checked his eyes past the tears!
Dr. Brown asked if we had been massaging the tear duct to encourage it to open. Umm, what? We had not been doing that, no one had even mentioned that. I am a massage therapist, I’m all about trying massage to help anything! She showed me how to do it and suggested that we massage the eye three times a day. Then, because he was over a year old (I think 15 months at that time) and his duct had not opened on it’s own she also recommended surgery. She explained the entire procedure, showed me photos of children who’d had the surgery and what exactly it looked like to have a tube in his tear duct, how long it would be in there, how to take care of it, and even how to deal with other people who might try to help me “get something off the baby’s face”. The earliest she could to the surgery was about a month away and in the meantime we should be doing the massage three times a day. Even better the cost of the surgery was going to be $80 versus the $800 the first doctor quoted!
During the vision exam, she asked me (because I wear glasses) if I had ever been told that an astigmatism was my main issue. I explained that I have one but had never been told that it was the main problem with my vision. She explained that she’d noticed a significant astigmatism in my son’s eye and that we should watch him because it could lead to a condition called amblyopia which is unequal focus in the eyes and can lead to a “lazy eye” or “wandering eye”. She asked if anyone in the family had this issue because it can be genetic. Turns out that this condition is on both my and my husband’s side of the family.
I left Dr. Brown’s office quite glad I got another opinion. I was still a little nervous about the idea of my baby having surgery, but I was glad that this woman was going to be the one doing it. Later that day I told my husband the doctor’s recommendation to massage the duct three times a day and we started doing the massage at least once a day – do you have any idea how difficult it is to get a baby to let you stick your finger in the corner of his eye and rub around in there for 30 seconds?!
About 3 weeks later, almost exactly 1 week before the scheduled surgery, I realized at breakfast one day that his eye was dry. When I thought about it I had not cleaned any “crusties” from his eyes that morning either. How long had it been dry? I couldn’t say. We watched the eye closely for a few more days and discovered that the massage had worked! His eye was no longer crusty or drippy! When I called the office to share the news, the doctor got on the phone with me personally and confirmed that we should cancel the surgery. She also scheduled an appointment for one year to check on that astigmatism she had noticed.
The following year we took him back to the doctor. His condition had not improved so she hooked him up with some sweet glasses – red like Mommy’s. Which reminds me of the second question everyone asked, “How do you get him to keep them on?”
We found three things that worked for us. First, I tried to get him really excited about having glasses. He helped pick out his frames, decided what color, and for the week it took to have his glasses made we talked endlessly about people who wear glasses, friends and family, people on TV, cartoon characters, anyone we saw, etc. Second, I wear glasses. As soon as I told him he needed glasses he asked if they would be red like mine. So, we got him red glasses and I made a big deal about how cool our glasses were and I made sure to wear my glasses. Third, I just have a really good kid. The doctor had told us that we should try to get him to wear the glasses 50% of the time that he spent indoors (he didn’t have to wear them to run around outside). He wore them 90-100% of the time that he was awake.
Since then we have been going back every six weeks (sometimes a little longer) to check the progress, see if his vision is improving, make sure the prescription is correct, and do what we can to prevent his dominant eye from taking over and the weak one from shutting down and weakening the muscles in the eye causing a “lazy eye”. Right now he wears his glasses all the time and we patch his good eye for two hours a day to strengthen the weaker eye.
If he had not had that clogged duct that lead us through this process we might not have known that he had any issue with his vision until the eye began to wander. I don’t think I would have thought to take him to the eye doctor at such a young age and I had no idea that this was a genetic condition.
Children should be given general vision checks by their pediatrician or physician within the first year and if the doctor suspects an issue they will recommend a more in-depth exam. According to WebMD.com, your child’s eyes should be checked around 6 months, 3 years, 5 years and at least every two years after that. However, you can always have your child’s eyes checked sooner or more often if you suspect a problem or if there are genetic conditions that run in your family.