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Evie the Wolverine and Glasses

How many optometrists does it take to find Evie's glasses prescription?  Today I found out the answer is 3.

Over the last several months, I thought I noticed Evie squinting.  I at first brushed it off because her last retinoscopy (the process of determining one's glasses prescription by watching the direction of the light reflex on the retina) had shown a mild myopic/near-sighted prescription.  But I got to thinking that it had been a couple years since this anesthetized exam (aka Exam Under Anesthesia (EUA)), and decided to take her to a pediatric ophthalmologist known for her touch with kids with special needs.

It was a battle zone.  We tried it the nice way, but Evie kept saying Bye Bye and trying to open the exam room door.  I held Evie down while my husband kept her legs from flailing, and the ophthalmologist pried her tight lids open while trying to take 1-second swipes with her retinoscope to see the retinal reflex.  After we were all a sweaty mess, she declared that Evie was a -6.75 prescription and definitely needed glasses.  As a mom and an optometrist, this number shocked me.

I talked it over with colleagues, I went back and forth about whether to question the findings.  In dealing with my own child, I couldn't make the decision because I was too emotional about it.

I decided to try myself, and dilated her eyes before bedtime.   I tried while she watched her iPad, and confirmed more myopia. However, she would not cooperate enough for me to get a great reading.  So I waited for her to fall asleep, and crept into her bedroom.  Friends, doing retinoscopy through crib slats is not recommended.  I had to contort my hands in positions that just weren't natural.  I again saw more myopia than I wanted, but could not get her eyelids pried open enough to hold both my scope and the trial lens at the same time, while contorting my body.

Finally, I made an appointment with an optometrist known for her work with kids with special needs, and who I wanted to meet anyway.  Just one more person giving it a shot would at least help me feel better about what I was going to prescribe.   This time, I dilated her eyes before the appointment (don't try this if you're not a licensed professional or without the permission of your doctor), which turned out to be key. There were way less tears, so that the drops could actually work and give us an accurate reading.  My dear daughter is ever so suspicious of instruments held near her face, so I used the flashlight on my iPhone to check if her pupils were dilated. Phone near my face, Mommy?  Sure, no problem! I love phones!

Enter in the pediatric optometrist.  She gave it a shot with just me holding Evie down, and quickly realized that my warnings were merited, and asked an assistant to help hold her lids open.  This assistant quickly found that Evie's lids like to flip very easily.  So the optometrist then went to get the other pediatric optometrist, who happens to be a friend of mine, and she pried open Evie's lids while the other optometrist did the retinoscopy, and I had one leg thrown over Evie's legs, while holding her arms against her chest, and holding her head down with my chin. The assistant helped me to sing Twinkle Twinkle Little Star over Evie's screaming.  It was glorious.

Of course, Evie got loose every so often, because we were sweaty and became more slippery.  We hadn't gotten around to cutting her nails, so my little Wolverine got loose and would swipe at my arms, chest, neck, and hands in her desperate attempts.  I am the walking wounded.

But we got a prescription, and it's the best yet!   It makes the most sense, and it's the most precise (she had some astigmatism).  For the eye nerds reading, it was a -3.00 -1.50 x180 and -4.00 sph.  Evie yelled Bye Bye very loudly when we left.

You may be wondering about what frames Evie will be getting.  Out of Miraflex, Nanovista, Dilli Dalli, and Tomato Glasses, I like the look and weight of the Tomato Glasses the most.  They are in my opinion the cutest, and very flexible with an adjustable nose bridge and replaceable parts in each kit.  If she destroys them, then I'll probably try Nanovista.  I managed to try on some frames with 5 seconds of success in having her keep them on.  Pray for me.  :)
You want me to wear these things all the time??
The moral of the story is:
1) Always trust your gut about your child's vision, and get another opinion if needed.
2) Sometimes it takes some creativity to get better results for our kids.  You can ask your eye care professional if you can bring the child to the visit dilated already, if you have similar levels of uncooperation as we do!  Asking them to observe the child in the waiting room first before bringing them into the exam room can take advantage of a lower level of anxiety if the child is scared of doctors.
3) It never hurts to get your eyes checked at any age!  Kids with DS are checked around 6 months old to look for an eye turn or high glasses prescription that could hinder their development.
4) Listen to Laurie Berkner's "These Are My Glasses" song over and over again to help your child think that glasses are fun.  It's SORT OF working for Evie!


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