Did your ROP baby need glasses? UPDATE

My son had successful ROP surgery when he was around 35 weeks gestation. His first follow up was normal but at his next appt only a month later he had some nearsightedness (-4.00) in both eyes. I was told we would wait because everything in his world is so close to him and could see fine close up. He is now 18 months old and his rx has been stable at a -4.00 for about a year now and recently his right eye has started crossing I just knew when we went to the eye Dr we would be getting glasses but he still wants to wait. I used to work as an optometrist assistant so I know more than I would like at times so knowing how my son sees with a -4.00 rx really bothers me. I tried to express my concern to his Dr but he kind of brushed me off and said we would recheck in April I feel like it bothers my son especially in the evening thats when his eyes just seem tired they cross a lot and he is constantly rubbing at them.
Has anyone else been told to wait if so why? For those moms of babies with glasses what were their rx when they got theres? I cant decide if a second opnion is in order or not.

Edited June 25, 2009 at 10:51 am

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Our 26 weeker daughter had ROP which resolved itself by 40 wks gestation. We went to the Opthamologist about every 4-6 months and were told to wait until our daughter turned 2 before making a decision about glasses. At her 18 mo. check up, one of her eyes had just started crossing she had nearsightedness in both eyes of -4.00 as well. We got her some glasses (very expensive for baby glasses) and she wore them for only about a year and when we followed up her vision had already improved to the point that the doc didn't think it would be worth it to get a new RX and have her glasses adjusted. She is now 3 yrs old and only needs to follow up every 6-9 months with the pediatric opthamologist now. Good luck with your son and if you end up having to get glasses my advice would be to get a couple of pairs of inexpensive frames while he's so young and see if his vision improves as he gets older. i wish I hadn't spent so much on glasses that we only needed for a year!

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My son had rop in both eyes , he was a 25 weeker. His surgery was done right before we left the nicu, we were there about 4 and 1/2 mhts. We where going every six mths to get his eyes check but now we are going every 4. He has a slight lazy eye mostly when he is tried. He is 2 actual age and I don't it bothers him and most of the time you don't see it. I would say if you see it a lot or get worse get a second opinion. Our doc is from childrens and he is a littile wired but I feel good in dealing with him and thats important.

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Hi,

My son (24 weeker, now 2) had successful ROP laser treatment at about 35 weeks gestation as well. We went a little more often for follow-ups at home becacuse of a delayed hemmorage at the laser site so his first few follow-ups were either normal or the difference between his eyes were within a normal limit. It was at about 8 months actual/4 months adjusted that he started wearing glasses. At that point his one eye was still "normal" and the other was quite nearsighted. We also started patching a few months later. I never really understood the timing of the glasses or patching but I feel very comfortable with the decisions my son's doctor has made. Things became a little clearer for me about 2 appointments ago...he had a couple of med students come in & my mom was with me for the first time. DS had a change in prescription and he explained things a little more thoroughly for the students & my mom. What he explained was that they're more concerned with the development of their binocular vision at this age instead of correcting their vision itself. He said it really walking a very fine line over the first few years of their lives between glasses, patching, etc to get them through this development period. As I thought about that, everything started to make a little more sense.

My son has now been wearing glasses full-time for a year & a half; we're on our second round of patching. He's gone from plano in one eye & nearsighted in the other to farsighted in one, nearsighted in the other to now nearsighted in both. His vision has changed very quickly at times and we see the opthalmologist as often as every month but typically don't go longer than 3 months without a visit. Right now, DS is -4.something in both eyes (they're slightly different) w/ a pretty wicked astigmatism in one. We also patch one eye 3 hours a day.

Based on what you wrote in your post, if his script is the same in both eyes, despite being -4.00, his binocularity is developing appropriately. Since your LO is getting a little older now & his world is expanding and you've indicated that you're seeing some crossing, you may want to push a little harder or seek a second opinion. Feel free to email me with any questions. Best of luck!
cj

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Hi-
Our son had 3 rounds of laser surgery to treat advanced ROP- then a vitrectomy in the left eye to remove the scar tissue from all the laser- the scarring had caused the retina to start to "tent" as it healed. At about 3 months corrected- his eyes started crossing. Our opthlamologist thought it might be correctable with glasses. His nearsightedness was really quite bad- he behaved like a blind child unless looking at lights or objects were right in his face. He over-compensated magically though with his reach and grab- and responding to facial expressions (with no noise.)
So he got glasses at 5 mo. corrected. When they placed them on his face- he looked my husband and I right in the eye and smiled- I swear that's the first time he'd really seen us. But that did not straighten his eyes. Next -we addressed the crossing of the weaker eye by patching.
This actually made things worse- as it caused his eye to "bounce" which wasn't solving our issue of getting the brain to use the left eye.
So at the beginning of Dec 08- he said stop patching all together- and wanted to schedule surgery to fix the lazy eye. Because of Evin's history- we can only have surgery at a fully equiped children's hospital- instead of the outpatient it would normally be. We are not comfortable going back to the hospital during RSV season- and we have a repair to do in his muscle from a drain is his side from his first week. We'd like to double up since he has to be under.

Since you have a greater understanding- I have not really ellaborated on why we want the eye to be used now- and what it means to wait. I'm hoping 5 months won't be that big of a deal. In the meantime- our dr. wants us to blur the vision in his good eye. He was hesitant to offer dialating drops, because he knows we hate any unnecessary drugs. Evin coded due to a combination with proparicane drops- after an eye exam. I asked if we could just put scotch tape over the lens of his good eye to blur the vision- but not cause the left eye to bounce. This worked for a couple of weeks.
However, in the past 3 weeks- I have noticed that if I don't put the glasses on at all- he shares vision equally between the eyes. If I am on the left side of him- the left eye focuses and the right turns in- and if on the right- he uses that eye and the left turns in.
I go back to the opthamologist late this month- I'll be interested to see what he says.

As for getting glasses- since you work as an optometrist assistant- I am sure you know about this brand- but I LOVE our "Solo Bambini's." They were very inexpensive- and comfortable for him because they are a soft plastic.

My son's eyes cross worse as he is tired too. Evin has 2 issues that don't seem to be treatable at the same time without surgery. But our doctor was very clear in letting us know- studies have shown- the quicker you get on these issues with their eyes - the quicker the results.
Maybe if you are thinking it's not best to wait- see someone else. I would think with as much understanding- and being the mom- you know best.

I hope you'll post an update to this- I don't hear many parents talking about lingering sight issues.
Thank you- Amy

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My daughter had laser surgery for ROP while in the NICU as well. She was a 25 weeker (weighed 15.5 oz). We saw (and still see every 6 montsh) the ophthalmologist every 4-6 months and she put glasses on Katelyn starting at 9 months of age. She is very far sighted in the right eye and slightly near sighted with astigmatism in the left eye. She has worn glasses ever since. She also had horizontal strabismus (eyes weren't crossing, but were turning in) and had surgery for that around 2 1/2 years old. It seemed to work, although one eye is slightly off center, but not bad enough to do anything about right now. We also patch her better eye once a day to make her use her other eye since it tends to be lazy. She is now 5 and we still patch her. Our doctor started the glasses very early. It was hard to tell how well it worked because she couldn't communicate with us. Now that she can, she doesn't really say much about it, but it hasn't been a struggle to get her to wear them for years (it was tough in the early years).

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My daughter had laser surgery for ROP in the NICU. She got glasses when she was 2, and her vision was roughly -2 in both eyes at that time. I asked the ophthalmologist to show me what she sees, and once I saw how limited it was I made the decision to get her glasses. While it's true that their world is mostly very close up for fine motor skills, your child still needs to develop gross motor skills as well. My daughter had a VERY hard time judging small steps, not tripping, etc. because she was nearsighted and couldn't see the ground properly! Once we got her glasses, she began to develop much better gross motor skills.

Her vision has continued to worsen over time. She's 5.5 years old and has -7 in one eye, -6.5 in the other. She had exotropia that started in the evenings when she was tired, but that kept getting worse, so just last month she had surgery to correct it. We're hoping the surgery was successful, but with an 80% failure rate (meaning it has to be redone), we know the odds are against her.

As you are a former assistant, you may realize that most child prescriptions are LESS than fully corrected in order not to make the eye muscles too weak. I had a hard time understanding this, but it may be part of why your doctor wants to wait. As one of the above replies stated, they are more concerned with developing binocularity. That's why my daughter had to have the surgery: they didn't want her to lose that ability.

If I were you, I'd get another opinion, but I'd also ask your current doctor to fully explain his reasons for NOT prescribing to you. I'm sure you can find someone who will be perfectly happy to prescribe glasses for your child, but you want to make sure he really needs them first. I went through 3 opthalmologists before I found someone I had a lot of confidence in and who took the time to explain everything to me.

Good luck!

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Thank you all so much for your responses. Even though I have experience in the optometric field opthamology can be a different story and especially since the Drs I worked for didnt do Peds. I very rarely worked with infants and definitely no ROP babies. Before my son I had only read about it in books. I definitely understand what some of you have said about the binocular vision it had never been explained to me that way before and makes me feel more comfortable. We go back in April mostly for him to recheck the the alignment of his eyes so if I dont get a better answers then or it gets worse I will most likely be seeking out another opinion. There are opthamologist at the office I worked for ( just at another location) that I have a lot of confidence in and they see children but arent Peds. I really like his Dr for the most part he is the one who did his ROP surgery and I hate to switch but I will definitely do what I feel like is best for him.
and Evinsmom I will definitely post an update as I learn more.
Thanks Again everyone

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Hi

Thank you so much for replying to me, we have 26 hours to wait until we find out if the surgery managed to control the disease, it is so cruel to hit children with something like this just as they are about to walk out the door!

We have been told if everything goes well tomorrow, my daughter will be home Tuesday!

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My twins were born at 25 wks+2 days in December 2003. both had laser surgery int he NICU. Lucas had Stage 3 Zone 2 and Austin had Stage 3 (with PLUS) Zone 1. Lucas doesnt wear glasses and Austin does. Austin started wearing them about 1 year actual. His Rx was around -1.75 and -1.25. In 2006 his myopia worsened to my horror to -10.5 and -9. But have held at that until this past December and it only worsened to 9.5 in that one eye (so in 3 years only worsened by .5) We had a hard time keeping his glasses on in the beginning since his world was so close to him, but by age 2 or so his glasses were the first things he looked for in the morning and the last thing he took off before going to sleep. He loves his glasses and even swims with them on! I will watch for your updates :)

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I am wondering...you said your child's eyes got better with glasses? you mean, his refractive error reversed? How is that possible?

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Tyler was born at 23 weeks and had laser surgery for ROP with plus disease. He is now 15 months 11 months adjusted and is supposed to wear glasses. I have a really hard time getting him to wear them. Tyler had a grade 4 bilateral IVH so even though he has all the mechanics to "see" I don't think the light bulb has gone off yet. He is very near sighted and we have a vision therapist that works with him during the school year. I am praying that eventually he will learn to look through his glasses and see. He has overcome so many obsticles I am sure he will overcome this one as well. I pray

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