The following posts from the ROP list present opinions and suggestions on wearing glasses and patching during infancy and early childhood. The ROP list was moderated by Dr. Scott Richards until August, 2002. The list has closed now. For more information about lists of interest to people with visual impairments, please visit the email list index.
Date: March 22, 1999
From: Jennifer
Wasn't sure if I told you guys or not, but my husband took Madison to see Dr. Trese Sunday. He wanted to see her under anesthesia to have her fitted for glasses. I stayed home with her twin Ansley. I was just wondering if anyone could offer ANY advice on infants and glasses. I was thrilled to hear this afternoon that after Dr. Trese saw Madison, he told my husband that her eyes looked exceptionally well! He seems to really think that she will benefit from glasses. Both girls will see him again in three months and Ansley will be fitted for glasses as well. The girls are 18 months old. How do you keep glasses on an 18 month old child??????? Also, did anyone notice differences in their childs vision after being fitted? Did their vision really improve? Initially we were told by a doctor that they would only have light vision. So, we feel SO blessed that they even NEED glasses. I pick Hank (my husband) and Madie up from the airport tonight. He was flying stand by last night and got STUCK at the Atlanta airport from 3:00pm to 12:00am then still had to fly to Detroit! Needless to say he sounds exausted! He said that Madie was a little trooper though! Any advice is greatly appreciated!
Date: March 22, 1999
From: Paula Korelitz
Dear Jennifer,
My experience is that glasses are tough to get used to, but IF they are beneficial, kids soon discover that they are worth keeping on.
First hint - make sure you start good practices early - have a specific place for each child to leave their glasses when they aren't wearing them, and teach them to lay them down so that they are open, but upside down so they won't scratch their lenses (although that is almost inevitable!)
Talk about why they are wearing their glasses, and encourage them to look through their glasses at exciting new things, especially in the early stages.
Remember to use contrast and good lighting when you expect them to use their glasses.
Date: March 22, 1999
From: Barb
I just had my daughter fitted with glasses and she is now 21 months old or adjusted back to 17 months, she was born at 24 weeks 1lb 3 oz and I am blessed. She had laser surgery to both eyes before being released from the NICU. I am still trying to figure out what all the eye lingo is..... She is perfectly healthy except for her vision.
After about 1 week, she leaves them on and gets upset if you take them off and she doesn't want them off. I tried to make it fun, by having her put them on and showing her animals outside and things... I didn't push her to keep them on and I let her try to put them on and off herself... and really cheered when she put them on and gave her rewards for wearing them (little things, favorite food treats, or just playing)... She has had them about 3 weeks now, and though we visit the eye glass store weekly for adjustments (they get out of shape from her putting them on and off, and the nose pieces seem to be a good teething thing) she doesn't even mind them.
Her whole personality has changed... she isn't as clingy or as tempermental as before. They have really opened up her world. Her vision is -7 and -12 with a lot of eye lingo I just don't have here or can remember but the hope is the glasses will help improve or stop any damage...
So believe it or not, they will wear them if the prescription is correct and you don't force the issue.... My eye doctor said that if you force it, it will only make matters worse and any time she wears them is better than before she had them.... so lots of support, praise and attention is what worked for me...
Date: March 22, 1999
From: Kathy Burkleo
Jennifer,
For whatever it's worth...I remember my Mom telling me that when I was fitted with glasses at 2 yrs. of age she was worried that I wouldn't leave them on. Was she surprised! It apparently was so wonderful for me to be able to see with some clarity, I didn't want the glasses off. My parents told me that after getting my glasses, we ate dinner and then drove around the Chinatown area in Los Angeles, which was ablaze with a variety of brightly colored lights. I reportedly became so excited as I eagerly LOOKED at the brightly colored lights...and jabbered like a magpie about everything I saw. When we got home and it was time to go to sleep, I did NOT want to give up my glasses, so they let me go to sleep with them on. From that day to the present, for 49 years(!!!), my glasses are the last thing off at night, and the first thing on in the morning.
So, I don't think you have much to worry about when the girls are able to see things more clearly.
KathyDate: March 23, 1999
From: Jo
Dear Jennifer:
AnnaRose has been wearing glasses for almost a year now. We had to order the frames from California because no one made them that small. Now she is on her third pair since she has grown so much. She weighs 15 pounds now! I never thought we'd see the day. Anyway as far as keeping them on, she just does. I don't know though if it is because she sees better with them or she just doesn't know to pull them off. Her first pair had a stretchy strap around them to hold them up. This pair kind of wraps around her ear, not all the way, but ut keeps them on her face. The biggest problem is babies that age (she is 17 months now) don't have much of a bridge on their nose to hold them up.
I think Anna sees better with her glasses. We won't know for sure how much she sees till she can talk and tell us. Thats what the doctor says. Well, good luck
I hope they stay on.
Date: March 23, 1999
From: Darlene
Tommy got his first pair of glasses at 16 months (13 months corrected) and he never bothered them at all. They allowed him to see a bit farther than the end of his nose I guess. We had the wrap around temples (pieces that curve around the ears) so didn't need a strap. These hold the glasses pretty securely. Also, be sure to get a "saddle" nosepiece. It is like one piece that covers both sides of the nose and has a protective part so if the glasses get jammed back on their faces, the bridge of the glasses won't cut their face. We still get this put on Tommy's glasses and he is now 6.
Eager to hear how the girls react to their glasses. Good luck--you are in my thoughts.
Date: March 24, 1999
From: Angela Brady
Jennifer:
I don't know if I (or anyone else) mentioned that it's a good idea to have a special place to put the glasses when Madie & Ansley are napping, etc. AND, (don't recall if you have older children) make sure that location is out of the reach of the older children. Might not be a bad idea to have a backup pair, too!
Date: June 18, 1999
From: Angela Brady
Colin is 16 mos/12 adjusted. Legally blind in his L eye (-10.75), good vision in his R eye. We are "patching" the good eye 2-4 hours/day so that his brain will not "shut off" the connection to the weak eye. This does not rate high on Colin's list of favorite things to do!
How long is it generally recommended that a child be patched for? Up until age 2, age 8, etc? Colin will more than likely never attain "binocular" vision (vision in which both eyes work together), so I'm wondering why we are being told to dilegently pursue this patching regimen. We have been told that Colin's vision will not improve, but rather decline, over time. Unfortunately, his "good" eye is the one in which he had the higher level of ROP, so theoretically this places his better eye at increased risk for detachment and other problems down the road. So, why is the patching necessary and for how long should it continue?
Date: June 18, 1999
From: Sarah J. Blake
The first part of your question, the part about how long to patch, is most likely a question for your doctor. I don't know how long it's usually done, am not a medical professional, and suspect it may vary with the individual situation.
As to the second part of your question, if the better eye is at risk for more problems later on, this may be the reason for patching now, so that Collin will be able to rely on the other eye should those problems occur. When I was married, my husband was what is termed a high partial, 20/80 in one eye and 20/400 in the other eye. He had a different eye condition, but the principal is the same. Because of his dependence on his 20/80 eye, he couldn't use the 20/400 eye at all, even when the 20/80 eye was patched. His visual functioning at that point was as poor as mine. So in short, it may be of some benefit to continue the patching if possible.
That said, I remember that somewhere in my files I have some info about patches which fit over the lens of the glasses and might be tolerated better by the child. I will try to locate this if you all who are patching are interested. There was a thread regarding patching on another list that I was on many months ago, and this is where the info was posted.
Another point, though, is that all of this falls within your own personal choice. Patching may not be something you feel is worth the time, effort, and frustration. I remember that a while back we had a discussion about vision stimulation in which Lari pointed out that it didn't seem to be doing any good for Zane and they had discontinued. I look back over my own situation and see the value of such activities. Some of my peers feel differently. The bottom line of it is that how far you want to go in pushing treatment of ROP or enhancing vision is a matter of personal choice. If you don't feel that patching is effective or worthwhile, you have the right to discuss discontinuation with your doctor. Collin may experience a need to adjust at some point down the road, but he may experience that need regardless of whether you patch now or not. Dealing with that adjustment process is something that all of you will need to be prepared for, but it is not impossible. I don't know what most doctors tell parents now about the stability of vision in ROP. My parents were encouraged to develop my reading vision and told that by all appearances my vision should be stable, but enough information about the very slight possibility of complications was given them that they made the decision to have me taught as a dual print/braille reader. I'm glad now. For a child with only one legally blind eye and the other within normal range, it would be harder to do this because that child may not even qualify for the services of a teacher of the visually impaired.