…we’re not having surgery. Well, we might and we might not, but we won’t be doing it next week as previously ‘freaked out about’.
You see, yesterday we did one of those things you should always do (like wear sunblock and Uber after the Christmas party) we went for a second opinion, which really upset the apple cart. By ‘upset’ I mean there we were all confident in Doc No.1’s diagnosis and prepping ourselves for Little’s (not so little) op. We were 100% convinced and assured by Doc No.1 that she definitely* had the type** of squint that you have to operate on, the type that can’t be fixed with glasses or eye exercises, the type that you have to fix so that her brain develops normally.
“We were 100% convinced that she definitely* had the type** of squint that you have to operate on…”
Today, we are only 50% convinced and assured that Little is indeed a perfect fit for this diagnosis. Why? Well Doc No.2 told us that “without her glasses on she presents as an infantile esotropia***, which definitely requires surgery” but**** “…with her glasses on she presents as an accommodative esotropia, which should never, ever be operated on.”
“Um, er, yeah… confused? So was I.”
However, after a little lunch and a little digestion of said lunch and unsettling ‘second opinion’, I was able to process what Doc No. 2 had said – “Your little girl is one of those extremely rare cases where she is a bit of both… infantile and accommodative. With the glasses on her eyes straighten and her brain fuses the images from both eyes, which means that her brain is developing normally. However, without her glasses on she ‘switches’ off her one eye, causing it to squint inwards, preventing her brain from ‘fusing’*****.”
“Your little girl is one of those extremely rare cases where she is a bit of both…“
So, to operate now, based on the second opinion we received yesterday would be foolish and reckless and just not the right thing to do because if she is a 50/50 case then correcting the muscles won’t solve the problem. It may ‘fix it’ cosmetically for a couple of months but eventually the ‘accommodative’ stuff will kick-in and we’ll have started a domino effect which means more surgeries.
“Long story short, we’re going to wait three months.”
If her eyes remain straight****** with her #littlelenses on and there’s an improvement when her glasses are off then no surgery… just annual trips to the optometrist to pick up newer, cooler, ever-more-fabulous frames ’til she’s in primary school.
“Without her glasses the squint is 35 prism diopters, with her glasses it’s just 2 prism diopters…”
If, in three months, she shows no improvement with her glasses off then it’s possible that she’s more the ‘Operate!’ type than the ‘Don’t operate!’ type.
Still staring at this screen with a slightly blank expression worthy of a ‘Doh!’ sound effect? Don’t blame ya’. I’m a creative not an academic, I’ve always leaned more towards ‘designer’ than ‘doctor’ so all the medical shmedical stuff is daunting and brain confuddling and just plain intimidating BUT if ever there were a time for hubby and I to do our homework, it’s now.
So, stay tuned. Who knows what the #littlelenses plan of action will be next week.
* as ‘definitely’ as the Pope is Catholic and a duck’s bum is watertight (you can blame my Dad for that little phrase)
** Bilateral Congenital Esotropia (an infantile squint in both eyes) – “‘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.”
*** fancy word for ‘squints inwards’
**** hold onto your fat free soya latté ladies (and gents) this ‘but’ is of the bootylicious variety.
***** “Binocular vision occurs in the visual centers of the brain, not in the eye muscles.” [Source: Strabismus.org]
****** Without her glasses the measurement of the inwards turn is 35 prism diopters, with her glasses on that inwards turn is minimal – just 2 prism diopters – so pretty darn close to GHD straight.