Explanation from Preston’s Eye Doctor
I had asked Preston’s doctor to please explain why he needed to start the Atropine again. Yorrk was not with me during this appointment so; she took the time out of her weekend to write an email about Preston’s eye condition that way Yorrk could have a better understanding about It.
Seeing this email is a little bit hard to look at, and realize his challenges. I also look at it and say Wow we have made great progress! And will continue too!
Let me see if I can clarify the reason I suggested trying Atropine again. My thoughts are a little easier to organize in writing and then your husband can have access to the information as well.
As you know, there are essentially 3 components to Preston's eye issues:
1. Refractive error. This refers to the shape of his eyes and is treated with his glasses.
2. Amblyopia- This refers to the shut down of the pathways from the left eye to the brain. It is being treated with patching. Sometimes we also treat amblyopia with atropine drops, which blur the vision at near in the better eye, thus causing the weaker eye to be used more. The best treatment, however, is to patch the better eye, occluding it completely to force use of the weaker eye.
3. Strabismus - This refers to the misalignment of the eyes. Early on, Preston's left eye crossed in toward his nose, which is called esotropia. Usually we treat esotropia using glasses to take the burden of focusing off the eyes so they can stay straight. As a child grows, sometimes a formerly esotropic eye will start to wander outward, which is called exotropia. This usually is treated by decreasing the power in the lenses so that the child can put forth some focusing effort. When we accommodate (focus at near) we converge our eyes, or bring them together, so the goal of allowing the child to do their own focusing sometimes causes them to converge, thus bringing the wandering eye to straight. This is what we're trying to accomplish with the atropine this time. Atropine temporarily paralyzes the accommodation in the better eye, thus causing the child to have to work even harder to focus. The hope is that Preston will bring his eye inward through this increased focusing effort.
Of course, as you know, the 3 above components are all very interrelated, and one problem can cause the others to occur.
Does that help?
Hope this lengthy message helps.