Vision/ seizures

[Denae]

About a year ago Riley had a "failed" vision test at the ped's office, I had my mom take her for a "real" eye exam and the doctor said there was nothing to worry about.She is slightly far sighted which is common and nothing to worry about, I think she said she had a slight "astigmatism" if I remember correctly? but that it wasn't anything to worry about.

Now ~

I get a letter from the school nurse saying that the vision screening they did at school showed her to have 20/30 in the left eye (far) and 20/50 on the right, which in looking back is identical to the first "failed" vision, except the right was 20/40 on a retest then.

The school nurse called me concerned about it and wanted to know when her last eye exam was- which was just this past July- was fine too. The school nurse wanted to re-check her eyes and make sure Riley understood the directions and that wasn't the issue with the chart on the wall tests.
She re-checked them Yesterday and she had the same results, almost. This time she checked them twice. The first time her left was 20/30, but the right was 20/40 once then the second time, few minutes later it was 20/50.

I have already gotten an appointment for her to have her eyes check again, but with a doctor her OT suggested that a lot of the kids at the clinic go to.

Everyones concern is - are the seizures affecting her vision?

Anyone? Her seizures start on the left side, the right side of her body is her weaker side, the school nurse has suggested that they may be the reason for the change. What I don't get is when her vision was checked by the opthomologist it is ok?

Would it matter if the vision problem was neurological in how she was tested? Is it even possible that her "failed" test are b/c of some neurological issue not because her eye(s) aren't working right?

[mpalmer118]

Do you know what kind of chart the school used? Ask the school if they used the standard letter chart, a picture, or directional (where they use a capital letter E pointed in different ways) chart. If they used a standard chart ask the school if they can try with different kind of chart.

[Denae]

Deby wasn't sure which one was use during the initial screening, but when she went back yesterday she used the E chart, except she called it a "table" chart.

Initially we thought she "failed" because she didn't understand the directions or know the shapes (the very first was shapes, they tried with the letter chart but she does not know enough letters to do it)

[mpalmer118]

I know some AED's have side effects regarding vision, but I think they are mostly eye movement related. I would definately follow up.

[just laurie]

An eye doctor will get more accurate results because they observe how the eye focuses so they can tell when a child is seeing something even if the child isn't able to indicate it appropriately. Hopefully an eye doctor will also have some input as to the seizure issue.

[RathyKay]

Okay, so some of this is more "gut feeling" than fact... just so you know up front. Somehow, I have a hard time believing the seizures are affecting her vision. I guess the reading I've done (from other people's posts... not scientific stuff), all vision and seizure-related info has been on seeing things that aren't there. Not a decline in vision. I guess since seizures affect the brain, they could affect her vision, it just seems strange to me.

In our case, Tom's eyes are fine. It's the processing in the brain that doesn't allow him to see as well. For a long time, he had a 60 degree field of view, versus our 180 degree FOV. Basically, he had no peripheral vision. It wasn't his eyes, it was his brain doing this. So, yes, she could "fail" the test because of neurological issues and not because of her eyes. You might look up cortical visual impairment (CVI). Tom does not technically have it, but he fits in somewhat. One of the things drilled in by various vision specialists is that Tom sees better on some days than others. (Maybe that's your seizure connection.) His teachers have commented that some days Tom walks into the doors and walls and "we haven't moved them since yesterday." He just doesn't see them somedays. I don't know why.

Another thing that pops in my head...Tom's eye is going out again. I need to call our opthalmologist (but first I need to find the appt card to find out when his next appt is. If it's next week, I won't bother calling). Originally, Tom was cross-eyed. We patched, we got glasses and things were stable. The glasses were just prescribed to straighten his eyes. We went GF, and his eye started going out. He was given a weaker lens prescription and his eyes straightened out again. We've been doing more vitamin / mineral supplementation and the eye is now going out again. I guess I'm wondering if your dietary changes are affecting Riley's vision, too? (She is getting a multi-vitamin, right?) When I have a chance, I'll PM you with the amount of vit A our DAN! doctor wants Tom getting.

When Tom goes to the opthalmologist, she has lots of different toys and testing materials to try and get the best results out of Tom. Maybe the difference between the school nurse and the opthalmologist is the opthalmologist can switch to another test method when Riley gets fed up with the current one, whereas the nurse has to call end of test. (Okay, I don't know if Riley gets fed up or not. I'm basing it on Tom's reactions when he's tested.)

[LIZARD]

If she's never been to an opthalmologist, I'd take her. That's the only real way to know. Her optic nerves could be thoroughly checked out so you'd have a more accurate idea.


Good luck!

LIZARD :)

[langansmom]

I don't think seizures could affect her acuity but they could certainly influence processing issues related to vision, which is what CVI is all about.

Langan has a CVI diagnosis, although she doesn't have any physical evidence of damage which usually comes along with a CVI diagnosis. Her eyes are fine but her vision is not "normal". And I can assure you that it is much worse on the days following a seizure. Dr. Roman- the CVI guru- told us that it is common to see CVI problems increase as seizures increase and that visual improvements are best when seizures are controlled.

So maybe you're getting some residual CVI type issues? A neuro-opthamologist would be your best bet on that issue, but I don't know how many of them there are out there.

My other thought is that maybe her comprehension of the testing, ability to follow the directions or even interest in following the directions is being impacted by seizure activity??? You know Riley better than anyone, so that would be something you would have to judge. I just know Langan has no interest in doing some things on the days after a seizure and nothing is going to make her do it. So maybe that's part of it?

(((hugs))) I hate that you have yet another issue to worry about with that sweet little redhead.

[lacyndarella]

Okay, I have been wondering about this myself. The new seizures are accompanied by Jimmie rubbing his eyes excessively and blinking like a madman baby.

Lacy

[Carly'sMa]

This isn't a Carly story - although she does need glasses and won't wear them. No, this has to do with school nurses who can be terrific but sometimes they screen kids in as a precaution. They send them to the opthomoligist (or optomitrist) to make certain things are ok.

Our school nurse kept telling us that Jeremy needed glasses. So, we took him in. No, he doesn't need them just yet. He will some day, the optomitrist said. So, we held off. He wasn't having problems in school. It just wasn't perfect vision. So, what you heard from you first doctor isn't that uncommon, I guess. In fact, our optomitrist is in the same office as the optician - so they were really being honest cause they could have sold us glasses.

This past year he got glasses. He was entering 7th grade and it seemed that the timing was appropriate. He only wears them at school to see things far away. He doesn't even wear them when doing homework.

If it's no problem to take her in - do so. But, you could call the doctor who did the prior exam and ask questions first. See if he saw the same thing the school nurse saw and just doesn't treat it just yet.

I can't give you any insight on the seizure connection. I can only relate what happened with my typical child - and it sounds the same.