I have been suspicious since Talia was about 8 weeks old that something was up with her eyes. For one she has had clogged tear ducts since birth but the thing that stuck out to me was how often she was cross-eyed in the awake photos I took of her. I probably pay attention to this because I am a photographer and I am always scrutinizing the catch light’s in eyes. It is normal for newborns to be cross-eyed and I see it all the time. Most newborns that I photograph are cross-eyed for at least some of their newborn photos but the eye crossing is supposed to stop at around 8 weeks. Continuous eye crossing after 8 weeks can be a sign of vision and brain problems, I know this because I looked it up on WebMD, which I don’t recommend doing as every symptom on WebMD points directly to cancer . It scared me bad enough that I made an appointment with a pediatric optometrist and had Talia’s eyes examined at 3 months of age. 3 months is young for a first eye exam but the receptionist told me it couldn’t hurt to look especially since I had concerns.
All my friends and family wanted to know how an optometrist measures a non verbal child’s eyesight – and the answer is retinoscopy, it’s a technique that uses a tool called a retinoscope to examine the reflection of light on the back of the retina. It’s pretty complicated but this youtube video explains it very nicely. http://www.youtube.com/watch?v=kAreDffuVCQ In short the optometrist dilated Talia’s eyes and then wore a set of really funny looking goggles (the retinoscope) that shown a light into T’s eyes. In the video they show a hand held retinoscope but T’s optometrist had a hands free one that strapped to her head (probably because she works with kids all day and you need both hands free for that).
The optometrist eased my fears that T had some sort of brain tumor but she did note that Talia was farsighted. Actually all babies are farsighted but Talia was “out of the range of normal”. The optometrist wanted to wait two months and then exam T’s eyes again. An Infant’s vision is constantly improving so in just 2 months time she might have been back in the “range of normal”. So we waited 2 months and in the mean time I was instructed to take photos of Talia crossing her eyes /miss alignment. so I did.
I think Myles was even skeptical because when she does this eye misalignment thing it’s not like her eyes are “stuck” looking at her nose. She moves in and out of it as she looks around at different things but whenever she looks at something up close she turns one eye in, sometimes it’s subtle, sometimes it’s dramatic. So two weeks ago I took her back to the optometrist and repeated the exam – no change. Meaning Talia’s vision did not improve at all in the two-month time frame. Not really good news when you’re an infant and your vision is supposed to be constantly improving.
Talia was diagnosed with accommodative esotropia. You can google that but it is the most common form of strabismus (miss-alignment of the eyes) and it means that she crosses her eyes inward because she is over compensating by tightening the muscle in her eye for not being able to bring a close object into focus. Talia seems to be alternating the eye that she crosses (see above photos) so she is not suffering from amblopia, which is decreased vision in just one eye (which is often treated with an eye patch) The problem with having misaligned eyesight is that the human brain hates double vision. So instead of trying to make sense of the double image the brain just turns off one eye. Eventually if not corrected the child will completely loose their binocular vision.
So to help with this problem T gets little baby glasses to correct her farsightedness. Yes, they are cute for the fist day or so after that you realize what a nightmare it is to keep glasses on a baby and to keep them clean. We have also gotten the strangest questions about them “are they real?”, “does she really need those?” (trust me it’s a lot of work to keep the glasses on the baby – no one is using them as a fun accessory!). But we have also heard a lot of encouraging words from adults that suffered from this condition but now have great vision. It is possible that Talia will outgrow farsightedness in late childhood/ early teen years but she may need glasses for the rest of her life. I don’t really see this as a big deal as According to the Vision Council of America; approximately 75% of adults use some sort of vision correction (glasses or contacts). Also people with accommodative esotropia are great candidates for LASIK.
I am just beginning to research and understand this condition but it is quite common. According to the College of Optometrist – esotropia is the most common type of strabismus, occurring in approximately 1-2% of the population. Talia is just on the young side for being diagnosed. This experience has made me an advocate for having all babies eye’s examined. Getting treatment for vision problems young can make all the difference and you can get a FREE eye exam through a program called Infant see (http://infantsee.org/) and they recommend having an eye exam between ages 6 and 12 months, which I now recommend for all children. I think if we waited until Talia was 2 or 3 to work on correcting her vision she might have totally lost her binocular vision which can make tracking a line of text and reading very difficult this cold also limit her future career choices. Right now we are just seeing the optometrist but it has been suggested to me that Talia see a pediatric ophthalmologist and start vision therapy. I am going to consult with her pediatrician at her 6 month well child check coming up in a few weeks and she what she recommends. Talia still has one clogged tear duct (her right eye) but the left eye cleared about a month ago. If her right eye doesn’t clear by 12 months of age she will likely have to have surgery on it. Clogged tear ducts are a result of the membrane in the duct not opening. It’s very common but there is really not much you can do for it since it’s a physical barrier to the tears draining from the eye out through the nose.
If you have a child with accommodative esotropia or another vision difficulty or if you yourself have been diagnosed with accommodative esotropia I would love to hear about your experience – please leave me a comment.Portfolio | Contact Me | Book a Session
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