Another "Refer"

I'm really starting to dislike the word "refer." The last time we saw the word, it was with regard to Nolan's ears. This time, the referral comes complimentary of our local Lion's Club vision screening program.

When Nolan was a baby, I took him to a free InfantSee checkup at our optometrist. We just wanted to make sure that his eyes were relatively fine, since his hearing is affected. He passed the test with flying colors, with the small exception of some very mild myopia (near-sightedness) that needed no correction.

Last year, he had a vision screening from the Lion's Club at his preschool. They ran the test twice, and he passed with flying colors (his myopia was mild enough not to trigger the referral).

This year, Nolan came home with his big Lion's Club screening sticker, and I asked him if they checked his eyes. He said (with great enthusiasm), "No, Mommy, they checked my eyes THREE TIMES!"

Uh-oh.

Sure enough, his teacher handed me his results. Instead of a nice, thin sheet of paper with a check beside the "PASS" statement, it contained a thick packet.

Double uh-oh.

Sure enough, there was a check-mark beside the dreaded "refer" word.

"Refer"- a word I despise.

At first I thought they had marked off "anisometropia," (a difference in seeing ability between the two eyes, which can lead to amblyopia), but when I looked at the paperwork again, I realized they had marked astigmatism. They also marked the myopia box, which we already knew about.

I've also noticed one eye wandering outward on occasion - I've caught it on camera a few times, so I think I'll print one out to take to the eye doctor. Dr. Google says this is intermittent exotropia - not a big deal, but something that needs to be addressed.

Nolan's left eye wandering outward.

I called one of the ophthamologists recommended on the Lion's Club list, and secured an appointment for June 1. I managed to get the little guy on the cancellation list, so hopefully he'll get in a little earlier than June.

Our Lion's Club uses the Welch-Allyn Suresight for vision screening, and the screening criteria for Myopia is <-1.0 OD and >1.0 for astigmatism. We know is vision is (at best) 20/50 for distance (the minimum screening trigger), so there is a very high probability he needs glasses. Using a vision simulator, the best vision Nolan could have is shown on the right in the picture below (using a sphere value of -1.0 and a cylinder value of 1.0, the minimum referral requirements for myopia and astigmatism). It's not too bad, but definitely would inhibit reading anything at a distance.


Fortunately, his vision is fine for close-up work, but I'm anxious to get him in for a full exam. A part of me is hoping that we can hold off on glasses until kindergarten, but I know they usually recommend glasses for kids with vision worse than 20/50. If he needs glasses, we'll look for thin wire-frames to fit alongside his hearing aids.

The best news is that Nolan will look very scholarly in glasses, which will only add to his irresistible cuteness!