Because there is strabismus in the family, Valerie was determined to have the twins eyes checked early. The first time they went to the ophthalmologist, at 1 and a half, he didn't find anything, but he wanted to see them a year later. The second time, at 2 and a half, he said Perry was fine but that he had "a hunch" something might be going on with Jocelyn, but he could really see anything wrong. A few months after that, we began to notice that both twins were showing esotropia, that is, one eye was turning in. We took them back to the ophthalmologist. He agreed that there was esotropia, probably secondary to farsightedness. He wanted to send us home with eye-dilating drops to put in Jocelyn's eyes for THREE DAYS. It was August. The drops sting. The sun would have hurt her eyes. It would have been torture and we decided it was time for a second opinion. We got a recommendation for another doctor, and went to him. He said dilating the eyes was not necessary, and prescribed corrective lenses (for farsightedness). He also had us occlude the straight eye and do exercises using glasses with one green lens and one red one. Neither twin had depth perception or stereopsis at this point. The prescriptions were changed once.
It now appears that Jocelyn, at least, had some depth perception when last tested. She closes one eye when she is not wearing her glasses, which suggests that WITH glasses she is using both eyes together and getting fusion. Perry is difficult to test, so we don't know about him.
Jocelyn readily adjusted to wearing glasses. We got her the kind of temple pieces called "cables" (why?), which have soft ends which curve all the way around the ear. Children have no bridges to their noses, so their glasses tend to slide down. Cable frames counteract this tendency. Perry has a much larger head, and the frames which fit him did not come in cable-style. His glasses slid down his nose constantly and he was always taking them off and leaving them . . . on the floor, outdoors on the driveway, on the lawn by the swing set. They got battered and beat up and were constantly in need of adjusting. We had the special titanium tie-in-knots frames for him, and he managed to break them anyway.
We got him a keeper-strap and that helped keep them on, partly by gripping his head behind his ears, and partly by making it harder for him to take them off. But they still slid down a lot.
We went back to the optometrist prepared to demand that SOMEHOW, SOMEWAY they get us some cable frames for him. We succeeded, and the problem of Perry's glasses was solved. He almost never takes them off randomly, and they do not slide down his nose. Our advice: INSIST on cable frames for young children.
We suspect that the children might have had a better clinical course if they had been put in corrective lenses sooner, and for that we fault the first ophthalmologist. Even if he did not see any sign of strabismus, he must have seen that they were farsighted.
kdo@cosmos.phy.tufts.edu