Friday, February 04, 2011

Nathan's Situation

As Dr. Lloyd examined my children last Friday, I learned some additional things about Nathan.

"Nathan has a few things going on," Dr. Lloyd explained.  "He has his far-sightedness, amblyopia and sub-retinal fluid."

I kept nodding as Mike talked, assuming that I knew what he was talking about.  But when "sub-retinal fluid" was something different than "amblyopia", I knew I was getting new information.

"Wait.  What is am-blee-o-pia?"  I asked, working to repeat correctly a medical term I was clearly unfamiliar with.

Mike looked disconcerted.  Like I should have known about this before now.

"Amblyopia is a condition where the brain can't see 20/20.  Right now the best Nathan can see is 20/40.  It doesn't really matter what prescription I give him, his brain can't recognize the extra correcting.  You didn't know about that?"

I paused, thinking.  It did sound a little familiar.  When Nate was 4 the eye doctor we saw then said something about that.  He thought if we came back in 6 months, Nathan might have self corrected.  Six months later, he hadn't.  So glasses were ordered and even though we came back 6 months after that and the year after that and the year after that, the eye doctor seemed satisfied with Nate's condition and didn't mention it any more.  I assumed that glasses had fixed it.

Mike chose his words carefully.  He seemed frustrated that the other eye doctor had not tried to correct this condition already.  He conveyed that it would have been better had this been tackled a while ago, but it wasn't too late, Nathan still had a shot at getting 20/20 vision.  But not with his retinal condition.

"Part of why Nathan can't see is the fluid under his retinas.  It's hard to tell right now how much of his vision problem is the amblyopia verses the sub-retinal fluid.  What would be best is to get his retinas to lay down and if his vision doesn't improve, then I can do some work on the amblyopia.  I'd like to see Nathan again in 2-3 months."

I have to admit to feeling irritated with the other guy.  Why, when he saw a big thing in Nate's eye did he not refer us to a retinal specialist?  Why, when he knew about the amblyopia when Nate was 4 did he do nothing?

I remind myself that only this November did we have any idea what had happened in Emma's right eye.  She had seen 5 different doctors and left them all scratching their heads.  None of them, including the retinal specialist and the pediatric opthamologist, had ever seen anything like it before.  How could this sub par opthamologist be expected to know what to do?

But amblyopia (also called lazy eye), is THE MOST common childhood vision problem.  Guess when the optimal age is to fix this?  3-5.  Guess how old Nathan was when it was found?  4.  This should have been treated long ago.  Fortunately for me, there is a buffer time period.  Between the ages of 6-10, amblyopia can be treated with good results.  After age 10, only a partial vision recovery is possible.  Thank heavens Nate is 8 and a half.

The big question is, how quickly can we get Nate's retinas to flatten out?  At Emma's current rate, it could take a while.  But that is a post for another day.

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