To address Allie’s eye issue, Mr. W and I took Allie to her first pediatric ophthalmologist appointment yesterday. The doctor was a young(ish) Indian guy and I liked him. Could’ve been one of my UCLA friends. By that I mean he seemed cool and was one of my generation. Allie did really well, was cooperative, even with the dilation eye drops. The nurse was expecting a full-on fight and tantrum but the most Allie did was whimper, and even held the Kleenex to dab her own eyes after each of the drops (3 in each eye, 30 secs apart). So here’s the diagnosis.

Like I thought, Allie has intermittent exotropia. This only happens when she’s tired or otherwise not “feeling it.”
Unlike what I thought, the doctor says it’s alternating, meaning both eyes turn outward, and that it only appears to me like only her right eye turns out because Allie favors her left eye. So she’ll fix on the image with her left eye and let her right eye do its own thing.
He also found some mild hyperopia (far-sightedness) in both eyes. This could be due to her difficulty focusing inward (converging).

He said her intermittent exotropia has good control and good recovery, and that he measured the degree of outturn at 20 degrees.
Also interesting, he found no amblyopia.

His treatment plan: alternatingly patch both eyes for an indeterminate amount of time. Followup visit in 3 months.
So basically, I cover her right eye with a patch 4 hour a day on Mondays, Wednesdays, and Fridays. Then I cover up her left eye with a patch for 4 hours a day on Tuesdays, Thursdays, Saturdays. She gets a break on Sundays.

We bought a box of patches on the way home and Allie allowed us to put one on her in the afternoon, and she asked me to do one, too. So I did. She kept hers on for 20-30 mins before taking it off. I was nauseated and had a headache within the first 5 mins, started to feel edgy, like I was on the verge of a claustrophobic panic attack, and my patched eye had an over-sensitivity feel going on. I wanted to rip it off immediately but kept it on cuz Allie still was going around and playing with hers on. My headache and nausea persisted the rest of the night. I still have a headache now.

Mr. W and I also spoke with 3 people who had patching done in their childhood. It didn’t correct anything for any of the 3. Two of the three, however, didn’t have what Allie has (drifting eye), but instead had what used to be referred to as “lazy eye,” where one eye’s vision was just a lot worse than the other eye. Allie’s eyesight measured at good and even between the two eyes, altho the doctor wasn’t able to tell us in the quantitative measurement of the 20/20 scale because Allie wasn’t cooperative in identifying the Allen pictures (which are used in place of letters) on the chart. At home, however, I could ask her what each image in the Allen pictures are, and she would tell me, “Birdie. Hand. Bike (it was actually a stick figure of a car, but I can see why it looks more like a bike with a steering wheel). Telephone (this surprised me cuz it was a rotary phone and she’s never seen anything but cell phones in the house). Happy burday cake. Horsey.”

Christi also asked her pediatric ophthalmologist friend about Allie’s treatment plan, and the response was she would’ve done corrective eyeglasses, and that alternate patching wouldn’t have been her plan because it discourages the eyes from working together. I agree; since Allie’s problem only occurs infrequently and the eyes get a chance to cooperate most of the time, why would we make the brain separate the eyes and take away that benefit? Yeah, it’s a separate muscle training thing, but still, there’s gotta be a better way.

I’m still interested in vision therapy. Allie’s pediatric opth does SOME vision therapy, but only for older kids (age 5+) and doesn’t think it’s effective for Allie’s condition, and he pretty much said what I’d expected a Western doc to say about it, i.e. there’s no conclusive evidence it’s more effective than traditional methods, such as patching and surgery. He said he’s conservative in his approaches, so he would only do corrective glasses that force Allie’s eyes to work harder at convergence if Allie were already wearing glasses, and would only recommend surgery if her eyes were turned out more than 50% of the time. We’re at less than an hour a day of outturn presently. Probably less than half an hour. So I’ve called 2 local pediatric optometrists who do vision therapy already. One said they don’t do it for kids this young because they’re simply not old enough to follow instructions, which I understand. But the suggestion was to bring Allie to them for an evaluation in a year, since if she’s ahead of the curve in her abilities and understanding, she can start this earlier, too. The second office is going to have their vision therapy coordinator call me back and discuss. I expect this call some time today.
Earlier, a coworker came in and told me that her younger sister had much more severe exotropia in her childhood, and that instead of patching, they were recommended to take her to vision therapy in a local college of optometry/ophthalmology. It worked. The sister isn’t completely cured, just like Allie’s ped opth said she wouldn’t be, but it’s well-controlled to where the sister’s eyes are cooperative and straight all the time unless she’s exhausted, and she has no issues with 3D vision. Allie, btw, tested fine on 3D so her eyes ARE able to work together. (Doc put 3D glasses on her, showed her a picture of a fly and said, “Touch the bug’s wings.” And she swiped 2 inches above the picture.)