January 17, 2014

Ophthalmology Evaluation

As I said yesterday, this was quite a week for Addison.  Traveling to and from Michigan over the weekend.  His first black tie event.  A trip to the Henry Ford.  A stop at the Flight 93 Memorial.   Physical therapy.  A day at children's for Audiology and ENT.  And today we spent the bulk of the day having his ophthalmology evaluation.

Since he was about a month old, we suspected he may be near sighted.  Because so many children with DS have some degree of eye issues, Dr. AL routinely orders an ophthalmology evaluation by one year.  She was not overly concerned about his vision at his 6 month check up and booking appointments with the pediatric ophthalmologist is an ordeal in itself.  We finally got an appointment scheduled for the middle of May.  Even though we thought something might be up, Addison tracks very well and locks onto faces and responds to books so we have just been waiting.

At his PT appointment on Wednesday his therapist said she thinks there may be something up with his vision because of the way Addison leans over toward the floor when sitting to play.  She said it is not his muscles, as his tone is really great right now and he has gained adequate strength that he sits very well on his own.

We called to see if we could move his appointment in a little.  The receptionist said there were no openings until June.  Then she came back a few minutes later and said actually there was a cancellation on Friday.  God is really good!  So away we went.

Addison was his usual agreeable self.  Even with his eyes dilated, he kept on smiling and "talking" to us.  And he was so good to keep his sunglasses on to protect his eyes from the sun while dilated. 
 Dr. JL was one more great doctor in the growing list of Addison's caregivers.  She wasn't just interested in Addison's eyes but in him as a person.  She wanted to know all about him and his team of caregivers.  We feel like God has put our boy in good hands.

The long and the short of eyes for Addison is that we were correct in suspecting he is near sighted.  He also has an astigmatism.

However, the good news it is a relatively balanced astigmatism.   Symmetry is often a problem for people with Down Syndrome. When talking eyes this can be serious in that the brain compensates by shutting down the weaker eye and allowing the stronger eye to do all the work.  Loss of vision can not be recovered if left un-diagnosed because the brain simply will not turn it back on.  We knew this from the get go and that is one reason Dr. AL routinely orders eye exams for all kids with T21.  For Addison one eye is a 2 and the other is a 3.  This can change over time but for now it is good place to be.

And the near sighted issue?  You learn something every single day!  As it turns out in Addison's case actually having the two problems is a good thing.  I am not going to even pretend to completely understand this but I did get enough of it to know it is good.

I will try to explain... There is a base number you aim for in eyes, right?  And the astigmatism gives him one number... I can't remember which was which but this is a for instance... so let's assume his astigmatism number was a 3.  And his nearsightedness number is a -3.  And let's assume the base number we are aiming for is a 0.  So if he was just nearsighted he would be far worse off.  Or if he just had an astigmatism he would be far worse off.  But because he has the two they actually work together to cancel out the affects, to some degree.  So his combined number would be around 0.

He still will see things wavy (astigmatism) and his vision will lack sharpness (nearsightedness) but to some degree these two conditions help to correct each other.  For those of you who don't have vision issues... I have a severe astigmatism and looking at the world without my special contacts is like looking at things through the bottom of a curved glass.  It makes you feel off balance.  His level of nearsighted makes things "unsharp" but not as fuzzy or blurry as it would be for those of us who wear corrective glasses.

At this point Dr. JL said she could put Addison in glasses if we wanted.  Because of the way his conditions are balanced she doesn't feel that we are at a point where his vision will interfere with his development and glasses would be cumbersome for our little guy.  We opted to forgo them at this point.  He will be reevaluated every six months to watch for decline in the quality of his vision, a growing in-balance between the two eyes or a developing in-balance between the two issues.

So in the long and short of it, Addison will need glasses, like all of us Wachters.  He will just need them sooner (between 14 and 24 months) instead of 8 to 10 years.  Just so you know, the kids think this is really cool because they feel glasses will seriously add to the Physicist demeanor.

Dr. JL summed up our meeting by saying she thinks Addison is doing phenomenal when compared to many of the children she treats with Ds.  She commented on his strong muscle tone and his efforts at communicating even though he hears little to nothing.  She also was very positive about how alert he is and the way he observes everything going on around him.
Our fellow is such a trooper and we are so proud of him.  We are so grateful to God for the way He continues to put his hand on Addison.  Thanks to all of you who continue to encourage us and pray for our walk.

It has been one crazy week here in Wachter world.  In addition to all of Henry's stuff... in the last 7 days we had a trip to the midwest and back, a kid fall from the attic through the kitchen ceiling, 6 kids joined the band and took up new instruments, Allen had a trip to Southern Virginia, Nathaniel and Allen had birthdays and we spent several days working on the Sweetheart Banquet for church.  None of which we could have managed without the Lord.

1 comment :

  1. Wow, eventful days indeed! Glad Addison is doing so well.