Exotropia

Hi B.,
My daughter was about the same age when we started noticing her eyes turning in. In pictures, she would get a crazy 'red-eye' in most of them so I knew something was up. I took her to see one dr and he gave her glasses. That was it. So there she was, barely three wearing glasses. So I went to see a Pediatric Opthamologist (Dr. Antinone in FW, surgery ____@____.com was my daughter's second surgery there and we couldn't ask for a better staff!) We were told she had esotropia in both eyes, & far-sighted in her left and recommended a stronger prescription. Needless to say her eyes were rapidly declining. So he recommended patching her dominant eye, to strengthen the weaker one. Well, that didn't work and the brain was basically starting to 'shut-off' the one eye. So we had the surgery on both, last year and it's AMAZING how well my daughter is doing. The symetry is awesome and now we're just working on improving her vision. Glasses are the last resort, so we were patching (2 hours a day, 3 days a week) and for the last 6 weeks, we've been putting drops in her good eye to make her vision blurry so she'll use the 'bad' eye. In just 6 weeks, her vision went from 20/60 to 20/40 which is almost unheard of!! We couldn't believe it! So, in my opinion, try the glasses, and the patching and if it doesn't work, or show signs of improving fast enough...have the surgery. The recovery is quick and our only problem was the arm braces they have to wear for a week after the surgery (so they don't rub their eyes when they're sleeping). My DD sucks her thumb at night so when she couldn't do that, it was all out war!! But we got through it and now she's SOOO much better. If you'd like, I can send you before, during, and after pictures so you can see what you're in for. Like I said, I wouldn't wait. The younger the better, and it does tend to effect their vision VERY rapidly. Feel free to email me with any questions as we're still having follow-up visits with our Dr. and it's almost been a year to the day after surgery!

B.,
My son also has Exotropia. First you should know that you need to have a pediatric opthomologist that specializes in exotropia look at your child. The reason the eye wanders outward is due to the muscle being pulled to tight and it needs to be loosend. Many opthomologist will give glasses or patch the eye which does not do anything to help. The speicalized doctor will usually give you some excersises to do to help strengthen the eye and being your child is young, teach them some of the necessary things for them to perform accurate tests. they will usually only give glasses if there is a sight problem. Unfortunatley, my son was seen at the Childrens Hospital in RI, so I can't help with a referral. My son has had the surgery 2times the first when he was 3yrs and the second when he was 6yrs. the younger they are the better, they do heal faster and it seems less bothersome. You may need to have the surgery a few times throughout the coarse of younger years, due to growth patterns. I do notice that when my son has watched to much tv or played vidoes too long, his eye seems to act up again or when he is really tired or not feeling well. We have to have him seen every 6 months to ensure he is tracking correctly. Yes, this is a scary surgery, because it is dealing with the eye. No surgery is great. but i have to say that I am very happt we did this for our son. He does not wear any glasses or patches and you don't know he had surgery unless you or them tell someone. But other things to know is that most children with any type of eye issues exotropia,etc, have very sensitive eyes to light, dryness etc.none that will require medical attention, mostly a nervouse thing. My son is always messing with his eyes so keep this in mind. I know this post is a bit long, but make sure to get a second opinion, regardless of how good your dr. is make sure they are specialized in the care for exotropia. make sure you research it online or in books. Make sure you make an educated decision. I am very glad we did this for our son. And would do it again if and when he needs it. Please let me know if you should have any other questions. You can email me at ____@____.com
Good Luck,
K.

We love Dr. Weakley at Children's (and I am guessing he also sees patients at UTSW) ...he first diagnosed my son, Evan with Esotropia when he was 4 years old (he is now 11)...Evan's eyes have improved over the years and we didn't do a patch, (or surgery) but he has worn glasses since he was 4.

Hello,

My daughter (also 2 1/2) was just diagnosed with this condition as well. Her pediatric opthamologist is Dr. Beauchamp in Grapevine. He checked her vision and discovered that along with exotropia she has a very nearsigthed left eye. He has prescribed glasses for her to see if that will correct the exotropia in her right eye. He is thinking that maybe her eye is getting tired due to the strain from the left eye not seeing well. We're hoping that will work. If not, we will need for her to have surgery in the future. He told us that it would get worse in time and would eventually start happening more than once a day (the eye drifting outward). This isn't something that will go away according to him. We're very happy with our doctor. Good luck!

My 3 year old was diagnosed with esotropia(his eye turns inward) and amblyopia (he has decreased vision in that eye). Since it was also found out that he was farsighted in both eyes (more so in the eye that turns) (he was diagnosed in January) he wears glasses and because of the amblyopia he has to wear an eye patch(he's been doing it for a few months now). Has your Dr. recommended any treatment before he suggested the eye surgery? Because everywhere I have read says that eye surgery should be a last resort! Your daughter could be prescribed glasses temporarily to help the problem or eye patching to help strenghten that eye. You may only see it every now and then now, but it could get worse which could lead to vision problems in the future. Here is what I found:

http://www.pedseye.com/Exotropia.htm#Exotropia

Eye Muscle Surgery- to establish good ocular alignment is generally recommended if one or more of the following criteria are present:

If the exotropia is present for more than 50% of each day.
If the frequency of the exotropia is definitely increasing over time although it is not yet apparent for 50% of each day.
If there is a significant exotropia when your child intently views objects at near.

If there is evidence that your child is losing "binocular vision". This refers to the brain's ability to use both eyes together as a single unit. Among other benefits, binocular vision affords optimal depth perception.

If none of these criteria are met, surgical intervention is generally not recommended and simple observation with or without some form of eyeglass and/or patching therapy is then warranted.

If I were you I would type in exotropia and really educate yourself before your next eye dr.s appointment. You are the best advocate for your daughter and if you feel you need a second opinion you should get one. What I did learn about eye surgery is that it's not as scary as it sounds. It's a simple, outpatient procedure, it only takes about an hour, they go in, tighten up a muscle here and there and it's done. Your child's eye may just be a little sensitive for a day or two afterwards. But definitely ask about alternative treatments before you go that route. Eye surgery might be in my son's future, he has to go in about every 4-5 weeks to check his progress. I take my son to Pediatric Eye Specialists in downtown Fort Worth and they are awesome! My son sees Dr. Hunt, he and the whole team are absolutely amazing! My son loves going there. If you want a second opinion, I would take her there! Please write me if you have any other questions.

B.,
I have tons of experience with this and my 6 year old just had surgery, so I have to say that I would do it. Now, I did wait, but only because my dr said that we should, but I wish that we had not. Surgery is harder on kids as they get older, and the anesthesiolgist said the same thing. I was cross- eyed as a baby and had corrective surgery at 18 months. As I grew, it became obvious that the muscles were not reattached perfectly, so it looks as though I have a lazy eye, esp. when I am tired. My mother would not let me have the surgery again because it scared her too much ( she is quite anal though!!!) I wish that it had been done, as I have dealt with questions, and have never been pleased with a picture of myself because I really notice it! If the dr thinks that it is a muscle thing, that the only thing that will correct it is surgery. It definitely became more obvious as she got older. Her case, as with lots of my family members, involved detatching and reattatching the muscles in her bottom left eye because he said that they were too relaxed causing her upper eye muscles to pull harder on her eye. Wow, this is a long post, Im sorry, but I want you to have as much help as I can give!! Anyway, the surgery went fine, the next 2 days were rough cuz her eye was itchy, but you couldnt even tell she had anything done. The best thing I can say, is go for a 2nd opinion, and then send me a message if you want any more ideas. My mom, brother, nephew and myself have all had surgery, so I have a little experience :) Dr. Packwood with Cook Childrens did our surgery, I would hightly recommend him!!! Good luck!!

Hi B.,
by chance we have been to Dr. Weakley with my now 6 years old daughter and we have had the surgery done by him when she was about 3 and a half. My husband is an ophthalmologist in training and he trusted Dr. Weakley entirely. Each case is different - we had to go ahead with a second "corrective" surgery in 6 months after the 1st one to make the eye look just perfect. But it was all worth it. We did it mainly for cosmetic reasons, the surgery has not improved her vision in the "bad" eye, she still needs to wear glasses occasionally.
The surgery is very short, ours took about 20 minutes. The kids take it also better when they are smaller.
Good luck!

I have my 16 month old son with same issue. He goes to see eye specialist tomorrow for this.

Hi B.,

My 3 1/2 year old son has amblyopia. We have been dealing with it since March. He now wears glasses and patches his "good eye" everyday for at least 2 hours. In my experience I would do everything you can until you absolutely HAVE to have surgery. We haven't had surgery yet, but I think it is coming. If you want a second opinion we absolutely love our doctor and from what I understand a "pioneer" in the field. His name is Dr. David Stager, Sr. He is at Preston and Northwest Highway. Please email me if you want to talk further.

J.

My son has seen Dr. Weakley because we were dissatisfied with the first opthamologist that put in a tube in his tear duct. Dr. Weakley was excellent and much more thorough than the first doctor. My husband works at Children's and I work for a pediatrician that highly recommends Dr. Weakley to patients.
As for your daughter's eye, you may want to consider what it might be like for her in later years. It is much easier to correct now than it will be later.