Asking for directions

Once we decided to seek the help of a Developmental Optometrist the nagging feeling of doing anything and everything to help Kathryn catch up to her classmates disappeared. This had to be the way. Originally I thought I would make the appointment for President's Day so she wouldn't have to miss anymore school but once the decision was made I couldn't spare another moment. I called to make the appointment on Thursday and they were able to see us the next day.

Our peditrician consulted several specialists and referred us to Dr. Collier. I consulted the online community for our small city and found several positive reviews of Dr. Collier and his practice. There are a handful of Developmental Optomologists in our area, but based on his positive reviews and the his convenient location, he is the one we chose.

I had heard that he had a very dry sense of humor and used a lot of scientific language. He is said to be a brilliant man and if the layperson can adapt to his "bedside manner" he was an excellent resourse. To my surprise, Dr. Collier was very child friendly. He had playful toys for Kathryn to focus on and distracted her with imagination games.

The first procedure he performed with her involved her reciting a tongue twister "purple hippopotomus". No surprise that Kathryn stumbled over the words and wasn't able to pronounce hippopotamus. He pulled a set of lenses out of his drawer, placed them on her eyes and asked her to repeat "purple hippopotamus"... and she spoke with complete clarity like I've never heard her speak before! Could her vision been the crux of her past speech delays???
          
A Diagnosis

Strabismus is the misalignment of the eyes. When both eyes are properly aligned and aimed at the same target, the visual portion of the brain fuses the forms into a single image. When one eye turns inward, outward, upward, or downward, two different pictures are sent to the brain.The result is "double vision" or more like "quadruple vision" as Kathryn continues to report that she sees objects in groups of 4. Two or four, it is certain that her perception differs from actuality.

Further discoveries include that her right eye has a 8 degree difference from the other. So when she is gazing forward her right eye is 8 degrees inward. Her fidgeting is due to helping to regulate the timing of her cerebellum. The tilt of her head assists her with a inbalance in her vestibular system. All of these behaviors are coping mechanisms that she has discovered help her process the world around her.

In order to relieve symptoms of double vision, she is learning to ignore the misaligned eye's image and see only the image from the best-seeing eye. This results is a loss of binocular vision, impairing depth perception.

It takes a lot of effort to control her gaze and because she is still developing these compensations sometimes her brain will alternate which eye’s input to attend to causing the image or text to appear to wiggle or move.

Treatment

Through the help of her Developmental Optometrist, Dr. Collier, she has a treatment plan. In a few weeks she will start wearing glasses with special lenses that have a prism ground into them. The prisms alter the light entering the eye and assist in reducing the eye turn. Sometimes the prisms are able to fully compensate for and eliminate the eye turning reducing the double vision/moving text.

The glassess are like braces for her eyes. It is a step to help the eyes work together. She will also complete a structured program of visual activities prescribed to improve eye coordination and eye focusing abilities.

Through therapy we hope she gains comfortable, single, clear, normal binocular vision at all distances and directions of gaze.