Thursday, May 29, 2008

Word of the Day: Amblyopia

Ainsley failed her first test.

It was a vision screening done at her school, and while the vision in her right eye is seemingly perfect, she has blurred vision in her left eye and the optometrist doing the screening suspects a little something called amblyopia; in layman's terms, lazy eye.

Well, color me shocked.

She's had vision screenings done before at her doctor's office, but she had always passed just fine in both eyes. And her left eye doesn't look any different from the right; it isn't crossed, and it doesn't wander. Turns out most of us don't really know what lazy eye is and assume it always means that an eye crosses, or drifts in a different direction. Strabismus, or misaligned eyes, are responsible for some cases of amblyopia but not all. Sometimes the lazy eye is triggered by one eye that has a refractive error and one that doesn't.

According to my frantic research last night, this new problem with my kid really doesn't have so much to do with her left eye as with her brain; her eye has probably either started to become a little farsighted, or a little nearsighted (we'll find out for sure which at an appointment with an eye doctor on Tuesday) and her brain adapted by stopping processing the signals from that eye. It's an adaptive thing very young brains do. It's interesting, really; it's considered more of a neurological problem than an eye problem because, even with corrective lenses, her brain will not want to "see" from that eye until it has been re-trained to do so.

And that's also the scary thing; with amblyopia, your vision is impaired even with correction, and that impairment can be permanent. Especially when it's not caught early.

I feel really bad about it. Even though her previous screenings have been fine, she was supposed to have had her first real eye exam sometime this school year per her doctor's five-year-physical instructions. But then she went through hell this winter with her asthma and with two strep infections, and then her teeth started coming in all wonky, and with all that she was already spending a couple of mornings a month at a medical professional's office, and I decided to put it off until summer. After all, she's reading fine, and she can sit far back from the TV and read words off it, and she can solve jigsaw puzzles on Jason's laptop without squinting or straining, and I just assumed her eyes were fine. But we all know what happens when we assume. It makes an ass out of moms.

At first, I was in denial. No way, I thought. She could see which way the E's were turned in the screening in her pediatrician's office with either eye. So here at my school, after she handed me the note saying she had failed the screening, I asked her to cover her "good" eye and read a few posters I have in the library. When the letters were large, she could read them from a good distance away. When the letters were smaller, she couldn't. She says it's blurry through her left eye.

Oh, no. I screwed up, dudes. I should have taken her to the eye doctor months, maybe even years, ago. It's not like perfect vision runs in our families; in fact, she's got severe farsightedness is her dad's family tree and severe nearsightedness in mine. I guess we thought, when she didn't show signs of noticeable vision impairment by her toddler years like some in Jason's family have, that somehow our genes had cancelled each other out and she'd have perfect vision. For smart people, we are terribly dumb sometimes.

So now we wait to see what we'll have to do. I have prepared her for the possibility that she'll need glasses, or a patch, or both. And I've prepared myself for the fact that she has inherited bad eyes from both sides of the family and the beginning of the glasses starts here (though I do have hope, since she's sees 20/20 with the right eye, that once the other eye gets strong she'll only need glasses for distances like I used to.) For once, online discussion boards on this medical subject have been comforting instead of scary; most kids whose parents posted comments seemed to have much more severe problems than Ainsley has and could not even see the biggest letter on an eye chart at the time of diagnosis. As Jason and I asked her to make out things with her bad eye last night, it doesn't seem quite to that point. Yet. And yet those kids were able to make huge improvements with glasses and patching (though most will never have 20/20 vision from the ambylopic eye even with corrective lenses.)

As I looked into her gorgeous eyes this morning, the part of me that's more than a little vain felt bad that those big brown orbs would be hidden behind glasses and a patch for perhaps a long time. I wear glasses most days myself (now that spring allergy season has lulled, I am back to contacts a few days per week--hoorah!), and while they don't make me feel ugly, I do hate the way they feel, they way they make my eyes look a little small and a little beady,vthe way they just flat out seem to get in my way when I run, or exercise, or clean house, or cook, or go out into bright May sunlight. But I know, as far as childhood medical issues go, this is a minor point and she won't mind wearing glasses (until puberty.) And if she needs a patch, hopefully kids won't be too cruel.

I will try to look on the bright side: they make Disney Princess frames.

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