The Eyes have it....

In August, right before the start of school, I took Nea in for her Kindergarten eye exam.  I wasn't sure how this was gonna go really....because, well...new situations are not on her list of "fun things I'd like to do today."  

As luck would have it, my research for optometrists in the area who might possibly deal with special needs kids actually worked!  There was one in town, who actually had an occupational therapist on staff!  Well now!

The staff and the physician were very personable, kid friendly and had lots of fun things to do an eye exam.  Actually they were so fun, Nea had no idea she was even getting an eye exam!  Now that's my kind of experience!

At the end of the exam, the doctor said...."Well it looks like she has alternating exotropia"

Huh?  (yah, me too)

Alternating exotropia is a form of eye misalignment.  Some people (us old medical people) call it strabismus.   This is where 1 or both eyes turn outward.  It's different than cross- eyed (that's esotropia) and it's different than lazy eye (more on that later).

So...welcome to your lesson on eyes.... :-)

Your eye has 6 muscles....4 that move it up and down and 2 that move it side to side.  All of these muscles coordinate in a very intricate dance for eye movment.  And they all have to work together well for our brains to be able to input visual information.  When one or more of them do not work correctly.....then the eye "floats out" or deviates outward.  The brains ability to see 3 dimensional objects relies on these muscles working together to move the eye.

The eye and it's 6 muscles

So....(stay with me)....

When both eyes are lined up correctly-at the same target then the visual part of your brain takes the image...fuses it together and forms a single image.  If one eye turns inward, outward, upward, downward, etc....then 2 different pictures are sent to the brain.

Now, back to that lazy-eye thing.

If the eyes keep floating outward....therefore 1 eye sees one thing, the other eye sees another....the brain finally gives up and says. ENOUGH!  The brain will stop telling the floating eye to turn back in, and will just stop communicating with it...leaving the eye permanently outward. It may float back and forth on it's own, but the brain has long ago cut off communication ties like a bad ex-husband. That "lazy-eye" thing.

Egads!

Now you would think a person would notice this.  Think of all the people that have been in Nea's life over the course of the last 5 years...the doctors she's seen, etc.  She certainly wasn't born with it but she developed it at some point. And as soon as the doctor described it, I knew exactly what she was talking about.

left eye float in

left eye float in

right eye float in

closing eye to make blurriness go away

Nea's had this "eye quirk" as long as I can remember.  She would bend her body when she was  a toddler in a way that tilted her head oddly as she looked at things.  I have pictures (lots of them) of that eye just seeming..." a bit off"  For a long time I believed that I just caught her eyes moving at a weird time.  But I caught that picture.....often.

She also covered her eye often.  Or, I would have pictures of her with one eye shut.  I have lots of these pictures too.  She was trying to compensate by covering the eye that was causing blurring.  And it wouldn't always be the same eye.

So yah, I knew on some level something wasn't right.  And I'll be darned if now that something doesn't have a name.

Only 2-4% of the population have exotropia (can't get these odds in Vegas!), 50% of them are autistic (thanks Autism) and of that 50%, over 35% are female (of course they are....).  In short, we weren't gonna outrun this thing.

Now understand, her visual acuity is 20/20.  She can see just perfectly.  But the muscles that support that acuity are too tight or too weak or both.    She's been working to compensate but eventually her brain is going to give up trying to get this corrected.

The optometrist wanted a re-eval in 6 months. We went back- it was worse.  Or I noticed it more.  I'm not sure which really.  Her eyes (alternating) float out most often for mid-vision.  So watching T.V. (far vision) it didn't happen often.....or coloring (close vision) I never noticed it.  It's her mid-vision....when she tries to look at camera for a picture....or follow a puck on the ice.

This is what happened to hockey.  It stopped being fun for her.  I heard a lot of "they won't let me play" and "I don't know where they put the puck" , etc.  Essentially, hockey became far too frustrating and she grew exhausted with it.  Then she spent most of February sick....and it faded.  (I do hope to get back to hockey if she wants after we fix these eyes.)

The optometrist sent us to the ophthalmologist.   Now this is a guy who realllly likes eyes!  I mean the man likes to talk about them a lot.  Which is great for me because I needed to learn a lot!

He noticed it immediately, then did his exam.   And he did his exam with prisms to double check her visual acuity.  Again her eye-sight is perfect.

We talked a very long time about options.  Patching does not work for this (the muscles are broken, can't fix that with a patch), eye training therapy (difficult at best with her-she would never cooperate), and surgery.

So, back we go to our Children's Hospital for surgery to fix those beautiful black eyes.