I’ve talked in the past that Owen’s eyes cross. Strabismus is the technical term. We have been going to Ophthalmology (world’s hardest word to spell, by the way) every 3 months because the degree of crossing has been changing. Once he has hit a stable level of crossing, then the plan is for him to have an outpatient surgery to correct it.
Last week when we went for our routine check in, we were told that Owen needs to start a patching routine. I was a little surprised because in the past, we’ve been told that patching and glasses wouldn’t help Owen’s eye crossing and that surgery would need to be his plan. So I asked if this new patch plan was in efforts to not need surgery. The answer from the Orthoptist was that surgery is for crossed eye. Patching, in Owen’s case, is for lazy eye.
Say what?! I thought Lazy Eye was the same as crossed eyes?
So, it seems my lifelong belief that Lazy Eye and Crossed Eye were the same thing has been debunked. I know I’m not the only one who didn’t know the difference because nearly everyone I
told whined to that we’d be doing patching also asked if that meant no surgery. Fortunately, Minnesota Lions Children’s Eye Clinic at Amplatz Children’s Hospital sent me home with a very handy peach brochure which helped me better understand the differences.
Strabismus (Crossed Eye or Wondering Eye) is a misalignment of the two eyes. One or both eyes can cross or drift out. In cases when vision is very poor and it’s suspected that the child is crossing his/her eyes in attempt to focus, glasses may correct strabismus. However, in most cases, eye crossing is related to how the brain gives signals to the eye muscles, not a vision issue. Therefore, muscle surgery is the recommended treatment for crossed eyes.
Amblyopia (Lazy Eye) occurs when one eye sees a blurred or different image than the other. Eventually, the brain will stop using the weaker eye and the child will lose vision in that eye. If it’s not corrected in childhood, that vision cannot be recovered, even with glasses. By patching the stronger eye, the brain is forced to use the weaker eye and the vision can be restored.
So, lazy eye and crossed eyes are very different, but here’s why you may have not realized it: Amblyopia can cause Strabismus and Strabismus can cause Amblyopia. The brain is efficient, and if it’s getting confusing information then it will adjust so it’s not longer confused. Therefore, often, if a child is treated for one eye disorder they will also be treated for the other.
Patching Tips: When we got word that Owen would need patching, I took to Facebook to get tips to make the patching process a little easier on Owen (and me). The overall consensus was distraction is key to the child not pulling it off. I’ve also read that some parents chose to put the patch on while the child is still sleeping to make application easier. What worked for us, was a tip from Early Intervention PT, Nancy. I put the adhesive patch on first and then put the elastic, pirate-style patch over the top. The pirate-style patch acts as a decoy, of sorts, and when he gets that off and still can’t see, he stopped. We did that the first 3-4 days and now he just takes the adhesive patch without too much fuss. He still cries at application, but once it’s on, he leaves it alone. I give him his electric toothbrush or jiggler during application to help keep him calm.
If you have other tips, please share. We are still new to this and I’m sure other readers are interested too.