Hand to Hold's Official Blog: Written by Parents for Parents

Amblyopia: The Hidden Eye Problem

Glasses 3Before J left the NICU, a pediatric ophthalmologist cleared him of any vision problems caused by being on oxygen for 10 weeks or from being so premature. His vision developed normally, and by the time he was a toddler, my husband and I were pleasantly surprised by how good his vision was. He would point to a dot in the sky and call it a bird, while we just about needed binoculars to see it.

As it turned out, his vision was excellent…in his left eye.

We moved just before J’s 4th birthday, but we traveled back to his pediatrician one last time for his annual check-up. That decision probably saved his vision for the rest of his life. Our pediatrician was partnering with a large research hospital in the testing of a hand-held vision machine that was able to check a child’s vision within seconds. It didn’t work at all on our baby, but our pediatrician said that they were finding it to be very effective for toddlers and older children.

When the nurse checked J’s vision, the machine said that he had a large difference in the vision between his eyes and that he likely had amblyopia, or a lazy eye.

We were shocked.

We took J to a pediatric ophthalmologist, who told us that most children with J’s type of amblyopia have it for years before it is caught. Structural problems with the eye can cause it to cross, which is the more obvious form of amblyopia. But, J’s condition was caused by uneven eye development. Babies have very limited vision, and over the course of their first years, their eyes develop, expanding their vision. J’s eyes developed at very different rates. Both eyes are structurally healthy, and both eyes are capable of seeing objects at a great distance. However, J’s right eye was so weak in its ability to focus on close objects that his brain began to ignore the signal from the weaker eye. Over time, the brain continues to ignore the weak eye to the point that the condition is irreversible, usually at about age 9. The older the child, the harder the condition is to treat.

What is amazing to me is that we caught J’s condition at all! I had no reason to question his vision, we had absolutely no history of amblyopia in our family, and J had been cleared from vision issues caused by his prematurity. Even the pediatric ophthalmologist said we were very lucky to have found the problem before J struggled with reading, which is a red flag for most children with his specific condition.

I believe J’s eye condition was related to his unusual brain development. He was born at 26 weeks, and I’ve noticed a number of quirks that I believe have to do with a baby being born so early. J is very left-side dominant, another anomaly in our family, and I don’t think that it is a coincidence that his right eye developed so far behind his left one because it mirrors exactly how he learned to hold objects, to crawl, and to walk. The right side of his body was always behind his left.

Glasses 4Amblyopia is very common, affecting as many as 20% of children. I want to encourage my fellow preemie parents to have your toddler’s eyes checked. I had a false sense of security because J’s eyes were healthy when we left the NICU, but the truth is that as our kids grow, it is especially important for us to monitor all aspects of their development. They can’t express vision problems to us, and it is so much better to be safe than sorry.

Within days of his wearing glasses, we noticed an improvement in J’s vision, and we hope that because his condition was caught early, he may eventually have normal vision in both eyes. That is just another blessing to add to our many, many blessings!

 

 

Summer Hill-Vinson About Summer Hill-Vinson

Summer (MS) delivered her son 14 weeks early in July 2010 as a result of preterm labor, and he was in the NICU for 3 months. She unexpectedly developed severe preeclampsia with her daughter, almost had her in another state while on vacation, and delivered her 11 weeks premature in January 2013. Both babies weighed 2.5 pounds, and they were in the same NICU for a combined 150 days. Summer, a journalism instructor, is writing a book about her family's NICU years.

Comments

  1. Hi Summer!
    Thank you for this, I have an appointment tomorrow and will surely ask the doctor to check this. My son had ROP and I think he has this, as a result. One eye is definitely weaker. Thank you!!!!!

  2. We had this same thing happen! Our daughter was born at 29 weeks and none of the follow ups ever indicated any problems and we didn’t notice any problems either. We switched ophthalmologists after a recommendation by our pediatrician (for easier scheduling and more available appointment times). After our first visit, Rox was wearing patches an hour a day and at the next visit, she got her first pair of glasses. Its crazy to be thankful for an overbooked office, but that motivated our switch to the doctor who was able to diagnose a problem we didn’t know was there.

    • Samantha, isn’t it amazing how little things like an overbooked office–or one last doctor’s visit, in my case–can make such a huge difference! I hope your daughter’s vision is improving.

  3. shannon radka says:

    Thank you for sharing. My son was born at 31wks and is now 3. We started noticing his right eye would wander when he was tired or stare off at something. Last year the opthamologist told us to patch his right eye for 2hrs a day, he went back in 3 months and he still noticed it but maybe a slight improvement. At this point we just have to continue the patches until our next visit. His vision is great! I know you had said your son had great vision as well, yet he is wearing the glasses. We were told there was no need for glasses to help correct it. Since his vision was fine.

    • Hi, Shannon. Actually, my son’s treatment has been the opposite. They prescribed glasses because what was causing the amblyopia was that one of his eyes was much more farsighted than the other. So, he could see things at a distance just fine with both eyes, but he was almost unable to see things up close at all with his right eye. For some reason, one of his eyes just developed much, much slower than the other one (I suspect because of his prematurity and brain development, but I understand it could have happened anyway.) So, they corrected the farsightedness in his right eye (his left eye is perfectly fine), and they expected to also need to patch him. But, he responded so well to the glasses that they didn’t need the patch. I think how doctors prescribe the patch versus glasses depends on what is causing the amblyopia and how severe it is. I actually was really worried about my son wearing glasses at such a young age, but now I can’t imagine him without his blue glasses!

  4. It is interesting that amblyopia can be there for years before it is noticed. It is good that you were able to catch it so early on. This is something that makes me want to ensure my children’s vision is tested early on. Thanks for sharing.

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