Monday, July 13, 2009

Eye/Vision Update

Randy had a follow up appointment with the ophthalmologist today. As usual, the orthoptist performed and eye exam. She shined lights in his eyes and watched his tracking. She asked me about his behavior while he was patched. I told her that his movements were more "infantile" while he was patched.

I brought DVD's of some of his MRI's and the ophthalmologist reviewed them. He wanted to see if he could get a good look at the optic nerve. Damage to this nerve can be an indication of his vision loss. When he entered I asked him what he saw. He said "Oh I could see the optic nerve some". I then asked if there was severe damage to it. He replied, "not severe". I finally had to ask him was he keeping something from me. I told him I can handle whatever it is. He assured me that he was telling me all he knew. He also said that the damage is not a direct indication as to the level of vision Randy will have. He said we will just have to keep treating him and we will have a better indication when he is older. I dropped the subject, but I still feel like he had speculations that he was not sharing with me.

As you can see from the pictures, his right eye wanders. This is a result if his strabismus. The bad part is that when it wanders, he is essentially "turning it off". If he turns it off long enough, he will essentially lose vision in this eye.

The patching forces him to use this wandering eye, thus preserving the vision in this eye. So he upped the patching time from 2 hours to 4 hours. I have to bring him back in 3 months for a full eye exam with dilation and everything. This is a 2-3 hour visit.

I did ask him about the future treatment plans for Randy's vision. He said we are patching now to save and maximize his vision. When he is older, we will pursue eye muscle surgery to straighten the eyes. He said this surgery is not as effective at such a young age. And since Randy has other neurological issues, his success rate with the surgery drops from 80% to 50%.

So right now I will continue patching.

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