Friday, April 1, 2011

Happy Applesauce Day

April Fool's Day ranks highly among the 3-5 year old demographic. Matt has been trying to trick me all day, stating things such as "your hair has fallen out, Mommy!" and then dissolving into giggles as he declares a hearty April Fool's Day to me.

Nolan, unfortunately, doesn't quite get the concept. He certainly gets the joke portion - he's been telling me it is warm outside all day long. Instead of shouting "April Fool's Day," however, he has been shouting, "Applesauce!"

Apparently, April Fool's sounds a lot like applesauce when you have a hearing loss. He has since modified his declaration to "criss cross applesauce!"

I tried to correct it a few times, but it is pretty cute. I sort of like Applesauce Day better than April Fool's Day.

In other news, Nolan's vision results are included on his screening form. This is just a screening test, so I'm not sure how accurate the results are.

His left eye appears to be farsighted, with very minimal astigmatism. The screening device shows the "sphere" to be +2.5, and the "cylinder" (astigmatism) to be +0.3. This is moderate farsightedness and mild astigmatism in that eye. They typically don't correct farsightedness under 4 diopters in preschoolers, since many will outgrow the condition. This eye isn't marked as having a problem on the screening form. The only odd thing about this reading is that his left eye used to be the more myopic of the two eyes - it's just strange that this eye went from being nearsighted to being farsighted.

His right eye appears to be nearsighted, with a "sphere" of -1.6. This is mild myopia, and not a huge deal in itself. The cylinder in this eye is +2.6, which is severe astigmatism. If the readings on this eye are correct, he will require a prescription (glasses) to correct the issue. A simulation of what his right eye can see is below - a little blurry, but it isn't horrible:


The real problem is the difference between the two eyes. Anisometropia is defined as a difference of more than 1.0 diopters between the eyes. Nolan has a difference of 4.1 diopters (if the screen is correct). This puts him at risk for amblyopia. A difference of 1.0 diopter for astigmatism also puts the eye at risk for amblyopia - Nolan has a difference of 2.3 diopters (cylinder) between his eyes.

This might explain why one eye wanders off every once in a while. With the vision in each eye differing to such a great extent, his brain might be "shutting off" the weaker eye.

The problem with amblyopia (if present) is that the eye can lose vision permanently if it isn't addressed. With the pre-existing hearing loss, we really don't want to lose an eye. I'm anxious to get into the ophthalmologist next week to get a more accurate reading on the eyes and to head off any problems.

8 comments:

Joey @ Big Teeth and Clouds said...

Happy Applesauce Day. Truthfully, I'm ready for this one to be over!

MB said...

Where did you find that cool vision loss simulation image?

Mine used to be 20/200 and now has randomly corrected itself to 20/40 in one eye and 20/80 in the other. At first they thought it was because of my pregnancy but then it just kept getting better and no one has been able to explain it!

Marielle was farsighted at 2 but the opth. said to wait and see and by 3 she was OK. I'm sure by 14 she'll be in glasses like I was though. Before my miraculous healing I used them for 20 years!

rouchi said...

I love this apple sauce day :).I too have a vision issue and am at -8.5 which a combination of spherical n cylindrical and even a .25 difference between them is strenuous for me.Hope and wish all is well with this lil boy.Do not want you guys in more mess.All the best.

tammy said...

Love the new term "applesauce day"! Too cute! Kailyn has horrible vision and something we have to watch closely every year. In fact this year, her Rx doubled and I'm going to take her to a pediatric optometrist to get a second opinion that everything is really "ok" like we were told. Last year she had something similar where her eyes had a significant difference in astigmatism, but they self corrected (with the correct Rx of course) before she had to wear a patch (in order to strengthen the weaker eye).

Herding Grasshoppers said...

Applesauce Day! I like that a LOT better than April Fool's Day ;D

Leah, you're so on top of things - no doubt Nolan will get what he needs. And I still think he'd be ADORABLE with glasses!

Julie

Julia said...

Happy Applesauce Day! Ben's just about where Nolan is on that one -- he gets that we're constantly making one-liner jokes that end in "April's Fools," but he hasn't figured out the full pattern yet. He does say it with gusto, though.

I have pretty traditional nearsightedness that gradually worsens over time -- in fact I should go in soon for a new Rx. *Everyone* in my family is nearsighted, some very badly. On the other hand, *nobody* has/had vision problems on Neil's side (his parents now wear reading glasses for a little farsightedness). So we don't know which way Ben will veer. That's one where I'd be glad for Neil's genes to dominate.

Terena said...

Applesauce day! I think he just invented a new holiday. :-)

I have amblyopia and unfortunately no one knew until I was in the 3rd grade and by then it was too late to fix it. But to be honest I don't notice it... well, occasionally I miss a step because my depth perception is horrible. But my brain learned to compensate really well and I pick up on depth clues I'm not consciously aware of. Interesting how the brain adapts.

leah said...

People do really well with one eye. I guess that is the reason kids with amblyopia are hard to detect - they don't show a "problem" with their vision, so it isn't detected until a good vision test gets each eye independently. Still, we'd rather keep both eyes if we can! ;-) I'm interested in what the Ophthalmologist wants to do - I dread patching, so hopefully it will just be glasses.