Adventures in Ophthalmology 

Yesterday O had a check up with her Ophthalmologist to assess how she is progressing with her newest prescription (updated in September to R+4.50 and L +7.00 and a new diagnosis of slight astigmatism).

O is usually well behaved at appointments. She was particularly cooperative yesterday and it makes it so much easier on me, as my emotions are always running high at the Ophthalmologist’s office. Since she’s older and so communicative (I wonder where she gets that?) they now have her identify shapes and letters projected onto a mirror from a screen on the back wall (as shown below). O is seeing much better with her new prescription and is closer to 20/20 vision than ever! The doc says her muscles are responding appropriately and that she can see even further down the chart to smaller lines she’s never seen before! He looked at me and told me it was “the absolute best case scenario for her.”

O does need to patch 4 hours each day again. Her left eye is crossing minimally and we need to keep things balanced for her. The good news is that her brain is using both eyes almost evenly! Hubby and I are thrilled and very proud of our girl!

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New Sights: An Update on O’s Eyes

O just had a check up at the Ophthalmologist this week. As you may recall from my original vision post, O is seen by the same doctor who treated my husband 30+ years ago. The doctor just moved to a new office not far from the old one… but we felt like we were in a whole new world. The new office was a stark contrast from the old school office we were used too. But I was pleasantly surprised to see that our doc kept his old equipment along with adding all kinds of new technology. Below is his classic set of equipment, followed by the new stuff.     O did a little better at identifying the shapes this time…. because they were actual shapes. His old tests were of a classic desktop telephone, a duck and a stick figure on a bike. Most kids didn’t even know what the phone was! But I also think the thinner lines in these illustrations simplified it for O. O brought along her doctor kit. She often pretends to be looking in our eyes. I’m glad she’s so interested! And she continues to be very cooperative and well behaved for the doc and nurse staff.

Her exam showed that her lense prescription is doing its job and her muscles are responding well to patching. We were told to continue patching the right eye 3 hours each day and an appointment was scheduled for later in the summer. Over all, all is well!

What’s new with O – Fall 2014

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It’s been a while since I’ve done an update on our sweet little O. It’s true what they say about time flying. We’ve been having a blast with O and all of her toddler adventures. And I’ve just realized she’s not so little anymore.

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We headed to the pumpkin patch as a family last week and she could have cared less about the pumpkins. I practically had to make her sit for a pumpkin picture. She was all about the hayride and pony rides. And she also attended a birthday party with pony rides. Those cowgirl boots are getting worn in. Get this: she wants a pony for Christmas. Too bad that doesn’t fit in Santa’s sleigh (or his budget).

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She’s looking less and less like a toddler and more like a kid. O also now has quite the fashion sense… this season she’s big on side ponytails, vests, jeggings, Toms, cowboy boots, rain boots, and bracelets galore! You know, if you take your fashion cues from almost-3-year-olds.

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She always puts her shoes right next to mine. And on rain days she begs to go “puddle jumping” on the way to the bus stop. Being two and a half is so much fun!

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O has also taken up painting. She’s always liked coloring and drawing. Up until now we used Magnadoodles, chalk boards, computer paper and notebooks for art. On a recent trip to Ikea we found a little set of watercolors complete with brushes and water cups. I also grabbed a roll of paper. She’s been a painter ever since. Great for patching time too!

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This was the first year O was really into Halloween. For the past two years we had chosen her costume (bumble bee and Elmo). This year she knew she wanted to be Elsa (from the movie Frozen … in case you live in a hole) for months. I found a costume in early September at Target for a cool $20 and I jumped all over it… because as I suspected all the other Elsa dresses I saw later were double that price a few weeks later. Due to the weather, we incorporated a fur vest into Elsa’s wardrobe. I think it worked out. You can’t tell in the pictures, but she insisted on wearing her cowboy boots under that dress. Of course, I was Batman… er, um… Batmom?

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She made it to a dozen or so houses… that’s a lot of walking for those little legs. O had more fun handing out our candy and treats. You may recall that she has moderate food allergies (milk and eggs) so we participated in the Teal Pumpkin Project that I blogged about earlier this month. We handed out spider rings, vampire teeth and (practically every allergy free) Dum Dum suckers.

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In addition to choosing her own costume, O is old enough to tell us what kind of face she’d like on her pumpkin. She chose Hello Kitty. It was a bit of a challenge to carve, but I forgot how much I love to carve pumpkins until we started!

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As a special surprise we treated O to a trip to Disney on Ice. We didn’t tell her until we arrived at the show and she was so excited. Below is her “excited” face.

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Hubby and I had fun too. I was impressed with the show! Worth every penny. Even this $12 foam crown. It came with cotton candy… which she hated and Mommy and Daddy devoured.

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O also went to the Ophthalmologist last month. We learned that her prescription increased to +5.00 in the right eye and +5.50 in the left eye. We weren’t really surprised by the increase because she’s growing and changing. She was so small (18 months) at her last major exam that it can be hard to get completely accurate measurements. We’ve ordered he new frames and lenses and are awaiting their arrival. She will still be patching 3 hours a day (over the right eye) for the Accomadative Esotropia and Ambloyopia. She was being silly in the mirror when we were ordering her new glasses.

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xo, Hilda

 

Painting While Patching

We finally have more updates on O’s Ophthalmology appointments to share! You may recall that she is farsighted (Rx: L +4.5 & R +4.00) with accommodative esotropia and amblyopia in her left eye. If you’re new to my blog you can read more about O’s condition and how we figured it out here, here and here.

We hadn’t had an appointment since March so we couldn’t wait to see how things were shaping up for her. We went last week to see what kind of progress she was making with her patching. We had been patching “as needed” an hour or two on each eye, depending which one seemed to have “weaker” muscles demonstrated by intermittent crossing of the weak eye. There is no real formula on how to determine how long a kid needs to patch… so even the doctors use educated guesses and trial and error to see what is working for her. The doc seemed to think she was responding very well to patching and is showing progress (verses regression or no change) in her strength. So good news! We continue daily patching for 3 hours on her right eye (strengthening her left).

Also, the exams are getting easier as time goes on. She is more cooperative, knows what to expect and is super excited to go to our appointments. But that last one may be based on the fact that we promise donuts. Hey, you do what works! Her appointments are easier for us too. Since she is less resistant and there is less crying, squirming and holding her down, then we don’t feel stressed or guilty about the situation. I personally am less anxious about the entire vision situation for her. In part because I’ve educated myself on her individual condition, possible outcomes and treatments and such. It’s much less unknown and so I’ve really had an easier time with it lately. I also credit a facebook group called “Little Four Eyes” for helping me through. It’s an online support group of sorts for parents of children in glasses. It has been a great place to compare notes, swap stories and pictures and find deals on patches. I also have found great gratitude for our situation. O has a considerably minor and easy to treat condition. Some of these kids are dealing with much more difficult or unusual diagnoses. Cataracts, glaucoma, strabismus, and so many things I’d never even heard of. Some have been through multiple surgeries already in their short little lives. I’ve realized how simple her condition is to treat and am so thankful we have the means to help her overcome it. We are blessed with great insurance and the added bonus of vision insurance, access to amazing professionals as well as consistent paychecks to help us pay for it all.

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We’ve been embracing patch time with O. She’s moved on from her recent playdoh obsession to now loving paint. She’s been watching me paint forever and I recently gave her brushes that she pretends to paint with all the time. My sister came over the other day and brought along paint and canvas. O was in heaven! We stripped her down (since this is acrylic), spotted several coordinating colors on each one and let her go to town. This way there wouldn’t be a muddy mix of colors since we kept them in the same family (pink, blue, purple and white) and we did it again with blue, green, yellow and white.

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We loved watching her paint. She was concentrated and intent with each stroke. I could tell she was taking pride in her work.

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She made two masterpieces. Once for our house. I think it may even end up on the gallery wall! And another for her grandparents.

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O had so much fun that she even stopped caring about being messy! Usually she has a paper towel by her side during every meal and craft. But today she let loose and jumped right in. Below is her forearm, complete with gold bangle bracelet and paint. We call her “Baby GotRocks,” you know!

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Anything For A Donut

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O just had her first appointment at the Ophthalmologist in a while (since November I think). This was actually only her third visit. If you recall, her first trip was quite an ordeal as far as cooperation goes. But we learned lots, got her script and ordered the glasses. I wrote a post on all that we had learned about O’s prescription, condition and what exactly happens during the vision examination of a toddler here. Her second trip was to evaluate the effectiveness of her prescription and explore the possibility of patching (which we were instructed to do 4 hours per day on the right eye). After a few weeks of patching, we found that her other eye crossed and were told to scale down our patching hours and alternate eyes. That happened nearly in tandem with the free replacement of O’s Miraflex frames due to significant fading.  I wrote about both here.

At this appointment we were there to see how well her left eye had been responding to the patching of the right eye. O had been patching since November and we had been told over the phone (not an actual visit with the doctor) to scale down and alternate patching. By the time we visited the Ophthalmologist this week, we had taken patching to one hour per day on the right eye (to exercise the left) and patched the left eye only on an as-needed basis. The doctor was thrilled with the results! O’s left eye had responded extremely well to patching and we will continue to patch the right eye 1 hour daily with occasional patching on the left. He did say to increase the occasional patching on the left eye to 2-3 hours when we do decide its needed so that it’s just a little more effective. This is all good news! Basically, the brain is choosing to use the left eye almost as often as the right and has been learning not to favor one eye over another. This way, both eyes are being used fairly evenly and are therefore working together with each other as well as the brain. Because the brain is choosing to use both eyes so often, then the muscles that keep O’s eyes straight are working hard and staying strong. Since those muscles are being used then they aren’t getting weak! So it is unlikely that O will have a “lazy eye” or Amblyopia. See, this is not just a vision issue… It’s a vision, muscular and neurological thing. And we need to get that trifecta working together in perfect harmony. Um, kind of like juggling… or a symphony.

By the way, my kid was completely cooperative and happy during every moment of the appointment. The nurses were shocked at her impeccable behavior and I was proud. I kind of felt like a magician. Wanna know how we got O to be a perfect angel for all of this? Well, since our past appointments were tough on her as well as us, we started prepping her a few days ahead. We talked about going to the doctor and all the things we will do there. She showed me how she would put her glasses on/off to let him see her eyes and I talked about how she might get to see a flashlight so he can look in her eyes. She was especially excited when we reminded her of “the puppy”… our doc has a stuffed animal in the corner that barks and moves when he flips a switch. It is used to get kids to look in a particular direction and focus on things at a distance while he examines. But we were worried that practicing just wasn’t enough. Considering that each time we had been there before, not only had O cried but so had I; we needed motivation. Let me tell you something about our little O: she’s quite determined. Tell her she can’t do something? She will. Remind her that she can have dessert after those green beans are gone and she’ll shove all of them in her mouth at once. What does O love more than ANYTHING in the whole wide world? More than m&m’s, more than puppies, more than shoes, more than going to school to get Z? Donuts. We may or may not have bribed our kid with donuts. With the simple mention of donuts she actually couldn’t wait to get to her appointment. And as soon as we walked in, she told the nursing staff, “I go to the donut store”… and each time the doctor was finished with one portion of the exam she would say, “All done! Go to donut store now please?” and she didn’t forget. She didn’t let us forget either. We talked about donuts non-stop, on repeat for the whole exam, all through check out, into the car and while buckling. We had a 10-15 minute drive to our old neighborhood in town where we get coffee and see our friends. All the way there, “I so excited! Go to donut store!” All. The. Way. There. There is only one place this family buys donuts. Busken Bakery is our jam. The headquarters/commissary is just a block from our old coffee shop. O knew where we were as soon as we pulled in. She clapped with excitement and fought to get out of her carseat faster than I could unbuckle her. The absolute best thing in the whole world is witnessing the look of shear joy on your own child’s face. In fact, it makes me forget the 9 months of morning sickness and 3 days of labor… for like a minute. When we walked into Busken, O radiated sheer happiness and politely ordered “My donut, please,” as if the woman behind the counter knew how long she had been waiting for it and how well behaved and brave she had been this morning. Like that lady had been waiting all day long for her to walk in a reward her with that heavenly donut. She even got her own bag for her very own donut. Pssst- We only let her eat half today after telling her it was gone. So there is more in the bag to surprise her with tomorrow.

At any rate, we are proud of our little O for being so good about keeping her glasses on and even asking for them every morning when she wakes up. She is a trooper when she has the patch on and a tough cookie when we take it off (like a band-aid… ouch!). And boy, oh boy does she rock those little pink rectangular frames… everyone thinks she’s a little fashionista with her skinny jeans, hipster frames and ponytail!

I’ll leave you with this picture of O napping during Z’s soccer practice the other day. How funny is her squishy face? She slept like that for an hour in a noisy gym. I enjoyed every moment of her on my chest.

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Better Than Hallmark

I used to roam greeting card stores and think “I could do that”. I love the messages, sweet poems and clever puns on them. I think it might be where my love of design and typography came from. I would spend tons of money on a bunch of cards that just caught my eye… and I often didn’t even have a recipient in mind. I’d just keep them to pull from when an occassion came up or if I needed to send a thank you or something. But started playing with making my own cards and bought a bunch of blank ones at Michael’s on clearance ages ago. They have lasted me a long time. Recently O started to show interest in coloring. And of course feed her interest with coloring books, crayons, an easel and such. I think I can handle having a little artist on my hands. When we were invited to a birthday party I realized O could make the card!

I just used my blank cards and a silver marker to write “Happy Birthday”. I knew crayon wouldn’t conceal the silver marker but I think black or another color could work as well.

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I gave O some crayons and let her loose on the card. Coloring is a really good exercise for when she is patching. While patching, it is best if she focusses and follows things that are close to her (since she is farsighted). Anyway, she obviously loved coloring. She hasn’t yet chosen a dominate hand to use. Can you tell? Her current style is just hashing the paper over and over with the crayon. She hasn’t become interested in making shapes or anything but she loves all the colors. And I think orange might be the favorite. And no, I’m never letting her paint her room orange like my mom let me because I had to paint over it and it was torture.

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This kept her busy for about 20 minutes which impressed me. She was having so much fun that it I let her do a Thanksgiving card for my Grandma. I traced her hand and made a little turkey and then she colored all over… I wish I had gotten a picture of it.

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When she was finished we had a homemade birthday card for her friend Riley who was turning 6 that weekend. She too is a little artist and I had a blast shopping for her gift with O. We got her practically one of everything from the Crayola section at Target…..everything I would have wanted as a 6 year old artist. Riley squealed when she opened the pad of art paper. Her mom chuckled at how much joy she got from paper… but I remember being thrilled to use real art paper rather than the stuff I stole out of my dad’s giant laser printer at his office. Riley and I are a lot alike.

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So there you have it. A simple homemade card with a little more meaning. It doesn’t hurt that it entertained my toddler for so long AND it was during patch time.

Posh Patching

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O had another appointment at her Pediatric Ophthalmologist to check up on how her glasses are working for her. You can read my post about O, her condition and our experiences in Pediatric Opthalmology here. The doctor was impressed with how well she has adjusted to her glasses and even more impressed with how much she embraces her “dasses” as she calls them. Not only does she leave them on, but she will adjust them for comfort or wiggle them on her face to be funny. My favorite part of the appointment was when the doctor was using a light to guide her eyes in different directions and O was opening her mouth saying “Ahhh!”. She went to the dentist with me the other day and the hygienist had her sit and watch my cleaning while she explained each step so that next time O can have a smooth first dentist visit. At the dentist’s visit, we taught her to open her mouth wide and say “Ahhh”… so she obviously was paying attention. Too bad she applied it at the wrong doctor’s office but it made me laugh!

The results of the visit were fairly simple. First, her glasses are working well for her. She seems comfortable with them and the prescription seems right. Also, her left eye is responding to the prescription (meaning its not crossing as much when she is wearing her glasses).  Second, there is room for improvement. Her left eye is the weak eye (with the +4.50 prescription and the esotropia/crossing) and could still use some strengthening. So the doctor wants her to “patch” for 4 hours a day until our next appointment in March. Patching means she will have her strong eye (in her case the right eye) covered with either a cloth patch over the glasses or a sticky band-aid style patch directly over the eye. Covering the strong eye will give the weak eye (her left) an opportunity to strengthen itself and encourage the brain to utilize the weaker left eye.

Fortunately, O has been cooperative wearing the patch. Although we’ve only done it twice so far, she hasn’t attempted to rip it off. The first time I put it on her I tried to make it fun. She likes to play with my make up brushes so while we were playing with the brushes and tickling each others cheeks, I took out the sticky patch and presented it to her. I put it on over her eye while we were looking in the mirror. I let her touch it and fiddle with it for a moment and then I slipped her glasses on so she could see herself in the mirror. Her response was “Oh, woo woo!” which in our house means “So pretty!” …For me I felt like that was a success. She was physically comfortable AND she felt like she looked pretty. Don’t get me wrong, her being pretty isn’t what is important. What is important is that she didn’t feel like she looks different than her usual self or funny. It doesn’t hurt that the sticky patches are printed with fun designs so it’s like a pretty new shirt for her. You can see an example in the photo above. I did give a feeble attempt to have her try the fabric patch over the glasses but she repeatedly just tore her glasses off. To me, thats a fail. It seemed easier to get her used to the patch and then put the glasses on over it. I also think that the sticky patch is less irritating because it stays still on the face, whereas the fabric one moves a little as she smiles, talks and plays so she feels it against her skin more.

Overall things are going well for her and I’ve been told by several professionals and friends who have had similar experiences that realizing her condition so early and treating at such young age is a huge advantage.