Strabismus

A while ago we started noticing that one of Rian's eyes had a tendency to drift off to the side on its own under certain conditions. We usually only saw this when he was doing something that required the sight from only one eye, like looking through the viewfinder of a camera. At first, I thought he didn't know how to look through the viewfinder. It looked like he was holding the camera up to his face, and then looking to the side, as if trying to see around the camera. I mistakenly thought that he didn't know to look through the viewfinder, and tried to correct him.

But after seeing this happen a few times, we eventually figured out that his eyes weren't looking in the same direction. One eye would look through the viewfinder, and the other would just go off to the side, all on its own. This would happen just about every time he would look through my camera. Very strange.

So we mentioned it to the doctor. He referred us to an ophthalmologist, who examined Rian and ran him through some vision tests. He explained that this was normal, and that Rian's vision was fine. The eye, he explained, naturally reverts back to a different position when at rest. He demonstrated this effect to Lacey and told her that when Rian's eye would drift off to the side when looking through a camera, it was just at rest, and that happened to be where its resting point was. Everyone is a little different.

But that seemed a little strange, and when Lacey explained all of this to me when I got home, I was a little skeptical. She showed me an exercise the doctor recommended involving a string and a ball that is supposed to strengthen the muscles in the eye. I tried it, but grew even more agitated. It just didn't make sense to me.

But, after all, this is what the doctor told her, and he was an ophthalmologist. He probably sees this all the time. So I decided that I needed to trust the doctor.

Some time passed and everything seemed normal. His eye would wander occasionally, but it could usually be corrected by reminding him to "focus." But as time went on, we started seeing it happen more and more. Now it was happening in low-light conditions, like when tucking him in at night, or even in the living room during the evenings.

His teacher had noticed some things, too. She had seen him being very cautious when going up and down stairs. Having seen a few students with vision problems, she recommended a vision clinic that had a good reputation. We took him there and right away, the doctor could tell something was wrong. After running him through some tests, the doctor diagnosed Rian with strabismus. This guy actually specializes in this stuff, and told us that he was very surprised and disappointed that the first doctor hadn't seen it.

He explained that strabismus is a serious problem that can ruin depth perception and in some cases can lead to blindness in one eye (read about it at webmd or wikipedia). The doctor asked if Rian still preferred a tricycle to a bicycle, and if he seemed afraid of a ball when thrown to him. Of course! These are both indicators of a lack of depth perception. Sitting up high on a bicycle would make me pretty nervous too, if I couldn't see how close the ground was. And of course, it would be pretty hard to catch a ball if you can't tell how far away it is.

Since then, Rian has been back to see them several times. Although various forms of vision therapy are often enough to correct strabismus, because of the severity of Rian's case, he will need surgery. The surgery has been scheduled, and will take place one week from today.

And now, finally, I will explain the picture. Part of the preparation for the surgery is to identify exactly how far his eye wanders. This is so that they know how much they need to correct for during the surgery. They performed many vision tests, which we described to Rian as "eye games" (which he actually looks forward to "playing"), and they got a pretty accurate number. Then, they take a prism which bends the light by the appropriate amount to account for his eye looking in the wrong direction, and attach that to a pair of glasses. This allows both eyes to sit where they want to (looking in different directions), but because of the prism, both eyes see as if they were looking directly ahead. They needed Rian to wear these special glasses for 24 hours and then at the end of that period, they do a test to make sure they had the number right. They did.

One thing you'll notice right away is that the prism bends the light in both directions, so it looks like his eye is way out to the side instead of right in there next to his nose. This effect can be a little uncomfortable to see, because it changes the appearance of the shape of his face. It's not as obvious in this particular photo (which is why I chose it), but it is a lot more pronounced when you can see his eyes.

Anyway, please pray for Rian as he prepares for surgery on March 6th.