No, not the kind that would warrant a biglenses hashtag. The kind that one fills with ‘grape juice for grown ups’ and olives skewered on sticks. This mama needs martini glasses, wine glasses, shot glasses. Okay, maybe not shot glasses, I get a cactus juice hangover just typing ‘tequila’. And not champagne glasses. A celebration this is not. But a glass of something. At least that’s the first thought that popped into my head when the doc said ‘surgery’*.

He said ‘surgery’ I thought ‘Sauvignon’.

Now I get that the above paragraph may be alarming to 99% of the planet, the 99% that doesn’t start their day with ‘Good morning, my name is… and I’m an…’ but bear with me, I’m an FTM** with a Little who is going to go under general anaesthetic and have the teeny tiny muscles in her eyes snipped and stretched and faffed and fiddled with before she has her first birthday party.

‘Somebody give the woman a glass’ I hear you say? Indeed.

Right, now that I’ve got the drama queen thing outta my system let me formulate this post “like a parent, not a child.”****

So, you’ve gathered that Little needs surgery******. In short, the glasses and patching haven’t worked. By ‘worked’ I mean that she’s still favouring one eye over the other and is unable to use both to focus. The fact that the glasses and patching hasn’t ‘worked’ confirms that she has Bilateral Congenital Esotropia*****. Bilateral meaning ‘in both eyes’, Congenital meaning ‘born with’, and Esotropia meaning ‘turns inwards’. It’s the type of ‘squint’ that littles don’t grow out of *******.

Bilateral meaning ‘in both eyes’, Congenital meaning ‘born with’, and Esotropia meaning ‘turns inwards’.

I came across this explanation online, which I think outlines Little’s diagnosis and need for treatment pretty succinctly:

“The baby with infantile esotropia usually cross fixates, which means that he or she uses either eye to look in the opposite direction. The right eye is used to look toward the left side, and the left eye is used to look toward the right side. By definition, they alternate which eye they are looking with. It is more difficult to help this type of strabismus with non-surgical methods, such as Vision Therapy and/or glasses.” [Source: www.strabismus.org]

Do we really, really need to go the surgical route?

If the inward turn of the eye is constant, and of a large amount, which Little’s is… then ya’ gotta go the surgical route to correct it. And, the earlier surgery is done, the better. The phrase that gets bandied about a lot is ‘early intervention’ – basically, from diagnosis of a squint you have a ‘golden window’ of sorts, a timeframe in which you should act to give your little the best chance at developing binocular vision. The older your little gets the less likely it is that their brain will be able to utilise information from both eyes simultaneously, so while surgery may achieve ‘cosmetic perfection’******** it won’t be able to give your little full range of vision.

…basically, from diagnosis of a squint you have a ‘golden window’ of sorts.

Does she really, really need to have the surgery right away?

Yes, Yeah, Yebo…

Little’s golden window is ‘under a year’, which is why her surgery is booked for the 18th of November – she’ll be just over 10-months old, which gives her little brain a really good chance of re-wiring itself and opening up the lines of communication between her left and right eyes.

…which gives her little brain a really good chance of re-wiring itself.

And, it’s not just for the good of her eyesight…

Her diagnosis might just explain why she’s not crawling “Some children who develop strabismus*********, in which coordination between the two eyes is poor, also have atypical gross motor development patterns. They typically skip the crawling stage with bilateral movements, and go right from creeping to standing.” And, as any OT worth their practical, neutral work wardrobe will tell ya’ – crawling is pretty darn important. But that’s another blog post, for another mom’s blog.

So, I get the upsides but are there any downsides?

She may need more than one surgery – “… parents must be committed to the possibility of multiple procedures to obtain perfect alignment of the two eyes for the patient.” And, it may not ‘work’ 100% – “…even multiple surgeries or ‘revisions’ may end up yielding cosmetic benefits only. That is, the two eyes might look normal or “straight” to outside observers, but normal two-eyed vision has not been achieved.”

So, about that glass of Sauvignon…

---

*Bilateral BMR (squint repair), to be precise.

**First Time Mom

*** I’m sipping on a lovely sensible cup of green tea, as I type this. 

**** a turn of phrase hubby likes to whip out when I’m “Nothing. I’m fine”-ing. 

***** “‘Congenital’ means from birth and, using this strict definition, most infants are born with eyes that are not aligned at birth. Only 23% of infants are born with straight eyes. In the majority of cases, one eye or the other actually turns outward during the neonatal period. Within the first three months the eyes gradually come into more consistent alignment as coordination of the two eyes together as a team develops. True congenital esotropia is an inward turn of a large amount, and is present in very few children, but the infant will not grow out of this turn. True infantile esotropia usually appears between the ages of 2 and 4 months.” Source: www.strabismus.org

****** “If the inward turn of the eye is constant, and of a large amount, surgery may be indicated. Note, however, that both the parent and surgeon have to be committed to multiple procedures to obtain perfect alignment of the two eyes for the patient. Furthermore, even multiple surgeries or “revisions” may end up yielding cosmetic benefits only. That is, the two eyes might look normal or “straight” to outside observers, but normal two-eyed vision has not been achieved.” Source: www.strabismus.org

******* I chose to bold this because I’d be waltzing around in Louboutins if I had ten bucks for every person that’s asked why she has glasses and then told me “not to worry, she’ll grow out of it” because their brother/sister/aunt/uncle/seventh cousin twice removed did.

******** There are two aspects to a squint – what we see and what they see. Sure, while what others see (perfectly straight eyes) is an important reason to seek treatment, what they see is the most important reason to seek treatment as soon as your ‘mom instinct’ kicks in. If you think something’s not right, get it checked out.

********* Fancy word for ‘squint’.