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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7962
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Hi My six yr old son, who has type 1 diabeties has been seen

Resolved Question:

Hi
My six yr old son, who has type 1 diabeties has been seen by three eye drs since july.
The first one put the eye drops and 45min later, told us that he has amblyopia and hypermetropie; that he needs to patch one eye over 6months and that he will need permanant glasses of 3 on one eye and 7,5 on the other eye.
Second one said, he only needed a 3,5 on one eye
Third one confirmed today the 1st dr's opinion but asked us to put the eye drops during 5 consecutive days then come back and see him to confirm glass perscription.
My quetion:
DOes having a high glycemic reading on the day of the visit blur the diagnostics?
(today and the first dr visit day he had over 300 in his glycemic reading)

Thanks
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Rick replied 1 year ago.

Dr. Rick :

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

Dr. Rick :

What type of eye doctors examined your son?

Dr. Rick :

Was any of them a pediatric ophthalmologist?

Dr. Rick :

Was your son prescribed glasses? If so, do you know the Rx?

Customer:

We live in Paris France and the one we saw today was yes opthalmologist

Customer:

yes he was

Dr. Rick :

Do you ever notice your son's eye crossing?

Dr. Rick :

Does the eye drop have a red top? Is it called Atropine 1%

Customer:

left 7,5. right 3,5 on the first dr then 1,25 and 2,5 in the second dr and today he said we should reput the eye drops during five days and then come back and see him

Customer:

yes

Customer:

atropine

Customer:

eyes not crossing at all

Dr. Rick :

Ok. An Rx of +7.5 in one eye and +3.5 in the other could cause amblyopia.

Customer:

he is able to focus and make little legos for 14 yr olds during 3hrs with no help

Customer:

i see

Dr. Rick :

I complete agree with the use of the atropine drops for 5 days prior to a refraction.

Customer:

but i am wondering if these high results might be due to high glycemic reading

Dr. Rick :

No. High blood sugar would cause his readings to be more negative, not more positive.

Customer:

when you say negative, do you mean he would read better

Customer:

what is positive and neg mean

Customer:

when i say 7,5 that is the perscription, it is not the success of his reading

Dr. Rick :

High blood sugar readings will, over time, cause sorbitol (a type of sugar) to be forced into the lens and lead to a myopic shift (negative) in the eye glass prescription, never a positive one.

Dr. Rick :

I Understand. He is a +7.50 sphere hyperope. This is the power of his glasses

Customer:

exactly so it is i believe a very thick lens

Dr. Rick :

He probably can read 6/6 in his good eye and much worse in his "lazy" (amblyopic) eye

Dr. Rick :

yes it is

Customer:

and as there is a big difference bet the two eye sights, what do you recommend

Customer:

he does not want to put the drops, is there any way we can get him to agree, any painless methods

Dr. Rick :

But, in order to get the glasses prescription correct the doctor needs your son to use the atropine drops before the refraction. This will "uncover" his complete power needed for glasses

Customer:

any other drops?

Dr. Rick :

As a father of 5 children, I wish that there was!

Customer:

what happens after 5 days. how does this atropine work?

Dr. Rick :

You can sneak up on him when he is asleep and put it in.

Customer:

they told us to put it twice a day

Customer:

am and pm before bed

Dr. Rick :

Do not get it in your eyes. One drop will make your pupil dilated (huge) for up to 3 weeks.

Dr. Rick :

Does he want the drops 2x/day for 5 days?

Customer:

which means he will have blurry vision during 5 full days

Customer:

which means no school

Customer:

yes

Dr. Rick :

Actually, his vision will not be all that blurry although he might want sunglasses if the sun is out.

Customer:

how about tv, ipad etc

Dr. Rick :

OK. Just put the drops in after he is sound asleep and do the same thing before he wakes up.

Dr. Rick :

If you can only get it in once a day for 5 days that will probably work.

Customer:

ok

Customer:

so you agree

Dr. Rick :

If you try to force it on him he will cry and the tears will flush out the drops before they soak in

Customer:

what will these drops do after 5 days

Dr. Rick :

Yes. I agree with this plan. It sounds like your son is in the hands of a very good ophthalmologist.

Dr. Rick :

And he will probably need glasses and the patching of his stronger eye.

Customer:

ok then he will confirm the perscription and the amblyopia

Customer:

?

Dr. Rick :

If this is not done in the next two years he runs the risk of having poor vision in his weak (ambylopic eye) forever

Customer:

any ideas for patch brands, they are very stick and harsh around the eye in france

Customer:

no i would like to take care of this situation this month

Dr. Rick :

Yes. He will confirm the prescription and the depth of the amblyopia. The doctor will be rechecking your son frequently for the next few years.

Dr. Rick :

Do NOT delay treatment. There is only a short window for treatment

Customer:

and i believe he will need to put a patch for a long time?6 months or so?

Dr. Rick :

Your doctor can give you some samples of patches available in France.

Dr. Rick :

I'm in The USA

Customer:

i know but i can buy it and have it sent to me from the us that's why

Dr. Rick :

The time per day of patching will change and he may have to wear it at least part time for a couple of years.

Customer:

the ones here are not good, i already check when they diagnosed him in last july

Customer:

i see

Dr. Rick :

Oh.....

Dr. Rick :

You can probably buy the patches online.

Customer:

i will chech

Customer:

anything else

Dr. Rick :

I like nexcare since they stay on well and don't leave a sticky gunk behind

Customer:

i will check nexcare

Dr. Rick :

Is there anything else I can do for you today?

Dr. Rick :

I'm glad that you caught this issue.....it can be tricky

Customer:

so you confirm that the high glycemic rate has no affect on the bad vision during todays testing

Dr. Rick :

That is correct. It did not significantly affect today's results.

Dr. Rick :

It has to be high for months......

Dr. Rick :

to affect the lens/eye

Customer:

this issue with the diabetics is really annoying and hard, poor guy has too much stress due to all the dr visits already and now he has to patch and eye!

Dr. Rick :

I can understand :(

Dr. Rick :

But the patch can be a game....Be a Pirate and all....

Customer:

one last thing, does the higha dn low sugar levels in one day like 49, 120, 350, back to 55 bac to 200 effect vision

Customer:

or can it have long term damage on vision

Dr. Rick :

It will affect his retina later in life. But I know how hard it can be to control blood sugars in young diabetics.

Customer:

unfortunately every single day is differnet and he only has had it sine 2011. so we are just at the first chapter of a long story.

Dr. Rick :

I deal with diabetic retinopathy every day.....must have had at least 10 patients this morning with diabetic retina problems.......just do the best you can do to keep his blood sugar as normal as possible over the upcoming decades.

Dr. Rick :

This is not a sudden thing but rather builds up over decades

Customer:

thanks for today, are you in nyc? that is amazing, it seeems so rare here or they just never make it so visible .

Dr. Rick :

He should be examined by an ophthalmologist at least every year. Not an optician or optometrist but an MD

Dr. Rick :

I trained in NYC many years ago but now I live in Wisconsin.

Customer:

MD in france is ophthalmologist?

Customer:

so if we need to find you again?

Dr. Rick :

Yes. They are still called ophthalmologist but I don't think doctors in France are called MD....don't they use some other title?

Customer:

yes just DR

Dr. Rick :

Just ask for me, Dr Rick, here on JA. You can specifically request me if you want.

Dr. Rick :

OK.....

Customer:

thanks

Customer:

have a good day

Dr. Rick :

You too.

Dr. Rick :

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. And please let me know if the rating system gives you any troubles.


Thanks in advance,


Dr. Rick

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7962
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Expert:  Dr. Rick replied 1 year ago.
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