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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7821
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Eye doc Re glasses Rx Sph Cyl Axis Add Right -0.75 -1.25 180 +5.50 Left -0.25 -2.2

Customer Question

Eye doc
Re: glasses Rx
Sph Cyl Axis Add
Right -0.75 -1.25 180 +5.50
Left -0.25 -2.25 180 +5.50

9 year old who has both nystagmus (with left gaze null point), intermittent exotropia, and ONH recently received these glasses from OD at local discount vision clinic. He is very resistive to wearing them. What might the impact of these glasses be on his vision?
Submitted: 2 years ago.
Category: Eye
Expert:  Dr. Rick replied 2 years ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

in addition to the optometrist is your son being treated/seen by an ophthalmologist?

Dr. Rick :

 


I see that you are offline. We can use the Q&A system to 'text message' each other. An email will be sent to each of us every time something is posted to this thread.


 

Customer:

I am a teacher of students with visual impairments. Student has not seen opthalmolgist in two years, but that is the source of the diagnostic info I provided. Optometrist's report did not address these issuses. Also, might add that noted a reference in that ophthalmolgy report to V-pattern strabismus (distance)

Expert:  Dr. Rick replied 2 years ago.
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Expert:  Dr. Rick replied 2 years ago.
I am still here and looking forward to your response so we can continue to work on your question.
Expert:  Dr. Rick replied 2 years ago.
I see you are online and have read my posts. Are you available to "chat"?
Customer: replied 2 years ago.
I responded to your question but then apparently mistakenly disconnected you. Can you still help me?
Expert:  Dr. Rick replied 2 years ago.
Yup. I'm still here....and now I see your post.
Customer: replied 2 years ago.
I'm sorry. Am I doing something wrong?
Expert:  Dr. Rick replied 2 years ago.
I cannot figure out any reason that an optometrist would give specific, restrictive instructions on wearing the glasses Rx you described.

Also, the extensive ocular history for this 9 year old boy, including V pattern strabismus, I have do not know what the optometrist is thinking with the +5.50 bifocal add.

Bifocals are used in children's glasses for specific reasons such as accommodative esotropia, discomfort with some near tasks (asthenopia)or other eye alignment issues.

None of the problems you listed are treated with bifocal glasses like you listed.

I really think, given all of this child's ocular conditions that he would be much better served being treated by a pediatric ophthalmologist on a routine basis instead of every 2 years with an optometrist "filling in" the middle.

Does this make sense to you?

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Nope you aren't doing something wrong -- I'm just not the worlds fastest typist :o)
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7821
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Expert:  Dr. Rick replied 2 years ago.
Oops! I misread some of your post.....you said that child doesn't like to wear the glasses not that the optometrist gave restrictive use instructions...sorry about that.

If the glasses don't give him better vision, and they might not given his left gaze null point, he might have worse vision with them then without them. He is old enough to figure this out and not want to wear them.

As I said, I think he would do best with a visit to his pediatric ophthalmologist. His ocular issues are way beyond the training and expertise of an optometrist at WalMart.
Customer: replied 2 years ago.
Thank you for confirming my faith in this young man's judgement.
Expert:  Dr. Rick replied 2 years ago.
You are welcome. Also, I forgot to mention that not wearing the glasses, given his ocular history and age, shouldn't hurt him in the least.

Thanks for helping these sight-limited kids out. :o)
Customer: replied 2 years ago.
Thank you and please know I understand the need for this young man to see an ophthalmologist. I will be speaking with his parents this week. It is not an uncommon problem where I work among families with limited incomes and limited insurance. I will have our school nurse assist in finding some $ assistance. Thanks once again for your concern.
Expert:  Dr. Rick replied 2 years ago.
My pleasure. Keep up the good work.

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