Children's Eye Care: Testing for Hyperopia

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When Aristotle was 3 years old, we had him tested for Amblyopia (better known as “lazy eye”). So now that Hercules is 3 years old, we figured it was time for him to get an eye check up as well. Since hubby has Hyperopia (better known as “long sightedness”) and Amblyopia, and I have Myopia (“short sightedness”), it is a strong likelihood that our boys might end up with some sort of eyesight problem. Our hope is to catch it early so the appropriate measures can be taken before it gets too bad or irreparable. The main concern is Amblyopia because early detection is important. If a child goes for too long without correction, vision impairment becomes permanent because the developing brain of a child learns to ignore the poor images coming from the weak eye.

Hubby has noticed that Hercules has been rubbing his eyes a lot lately whenever he concentrates on something near. I can’t say I have noticed him squinting which was somewhat of a relief because that usually means the eye problem is significant. Unlike Aristotle, Hercules doesn’t have the squint in one eye either – which is sometimes a telltale sign of possible Amblyopia. Since Aristotle was due for a follow-up – to make sure that he hasn’t develop Amblyopia since the last check-up and to make sure all his screen time hasn’t negatively impacted his eyesight – I booked both boys for an appointment to see the eye specialist. I did try to see a regular optometrist but they said they didn’t check children under 12…

ISEC – International Specialist Eye Centre Malaysia

We went to ISEC in Midvalley to see the same specialist that Aristotle went to previously – Dr Choong. He’s a paediatric opthalmologist so he’s trained to work with children’s eyes. He’s also pretty good with the kids – at least, he’s good with my boys. The only thing with him is that the appointments are very short and you can’t sit around chatting so make sure you have all your questions in your head or written on a piece of paper so you can ask them before the nurse shows you the door.

Aristotle’s eyes were fine but Hercules had hyperopia. Unfortunately, Dr Choong is unable to determine the extent of his long sightedness unless he uses the drops – Minims Cyclopentolate.

Minims cyclopentolate is used to aid eye examinations. It blocks muscarinic receptors in the muscles of the eye which control the size of the pupil and the shape of the lens causing the pupil to dilate so it is easier to examine structures inside the eyeball.

The drops will help him to assess the severity of Hercules’ long sight and whether glasses will be necessary. Unfortunately, the drops are very uncomfortable – they cause stinging – and the last time Aristotle had them, he cried the entire time. By the time we were done with the drops, Aristotle was so uncooperative that we couldn’t even get through the eye exam so we essentially put him through the trauma of applying the drops for no reason at all.

So I have been trying to decide whether to have Hercules’ tested to see if he needs glasses and weighing up the pros and cons:

Although Hercules’ has always had a much higher threshold of pain compared to Aristotle, I am also aware that pain to the face is generally one of the most difficult to endure (I think I recall hearing in a lecture once that this was because you can dissociate yourself from any part of your body and pretend it doesn’t belong to you but you can’t do that with your head). It is possible that he might end up with the same reaction as Aristotle and we would have traumatised him for no reason.
Aristotle also had long sight when we tested him at 3 years but we didn’t intervene. Now his vision is fine. The same might happen for Hercules. After all, he is only 3 and the eyes are still developing.
Even if we do decide that Hercules needs glasses, what would be the compliance to wearing them? Aristotle at 3 years old would have been fine. Hercules is another story altogether. Hercules’ has a pair of sunglasses and he plays with them – putting them on and taking them off. After a while, you don’t even know where he’s put them.

Also, when I looked up hyperopia and children, I found:

that although far sightedness starts in early childhood, normal growth can correct the problem (children’s eyes usually stop growing around about 9 years old so Hercules’ has time yet).
that the symptoms for far sightedness in children are headaches, rubbing eyes, and showing little interest in reading, but Hercules only displays one of those symptoms – rubbing eyes (but not all the time).

Hmmm… I guess the answer is no. We won’t test now. We’ll just adopt the wait and see approach. It would appear that Dr Greene is also of the same opinion.

If the farsightedness persists, then we will treat it with corrective lenses. By then, Hercules will be older and more cooperative. He will also be less likely to damage his glasses. He mangled the arm of one of my glasses so badly I can no longer wear it. If he can do that in the short time he spent handling my glasses, I can’t imagine what he would do to a pair of glasses that he had free reign over.