A Little More Strabismus


This morning we were at UCLA before our 8am appointment. I know from past experience that two families will have 8am appointments, but one family will sign in first, and they will be first.

Alexander had an eye exam, no dilation, but an exam nonetheless. I thought that today they would schedule a surgery, unfortunately even after two sets of surgery, nine years of wearing glasses and diligent patching Alexander’s eyes aren’t in perfect alignment.

I thought his right eye turned out a little, but it’s actually his left eye coming up. My son cocks his head to the side when he’s concentrating. I thought it was adorable, but now that I see that it’s compensation for eyes that aren’t quite straight I find it crushing.

The doctor changed the prescription on his contact lens and we’ll see if that corrects the issue in the next three months. At the end of the quarter we’ll have another exam and evaluate the progress, the prognosis and make a decision about surgery. It’s a small surgery, only two, maybe three muscles, possibly only one eye.

Unless it’s your eye, then it’s a big surgery. Oh, or if it’s your child. That’s a big surgery too.

Alexander is old enough, and perceptive enough that he’s in on the discussions. He understands that we’re fighting to get him depth of vision, and he really loves sports, he wants to be able to see everything. It’s nice that he’s so mature, and that he can talk about what he needs and wants. We are somewhere beyond privileged that we live in Los Angeles and have the best physicians practicing here. We are just plain lucky that insurance handles everything.

But I still don’t feel lucky, happy or privileged today. Today I feel like vomiting. Tomorrow will be different.

How I Taught My Nine Year Old to Wear Contact Lenses


Alexander has worn glasses since he was five months old. I know there will be a million questions about how you get a five month old baby to wear glasses. I’ll address that another day, but in plain and simple terms: you just do. When your child needs to see, you find a way to give them vision.

When Alexander was seven he started asking about contact lenses. His doctor promised him that at nine he could get contacts. At eight and a half Alexander started nudging me to make his eye appointment.

We practically ran to the appointment a few days before Alexander’s ninth birthday. He had the standard exam and then the opthamaologist came into the room with a packet of daily wear contact lenses. She sat Alexander down in front of a mirror and showed him how to put in his lenses. Then it was Alexander’s turn.

It was a dismal failure. The three of us were tense in the room, I was sitting on my hands waiting for my son’s success so I could hop up and clap. Success was not on the horizon. Lining up a contact lens with an eye that’s out of focus is a really tough thing to do for an adult, for a nine year old it’s near impossible.

After watching Alexander try and fail at least two dozen times I asked if I could put his lens in. The Doctor seemed unsure, but I explained to her that I was with Alexander every morning of his life and that I’d be happy to help my son in the mornings.

It’s not easy to put a contact lens into someone else’s eye. It’s really tough when you have no experience with your own eyes. I’m sure a doctor of opthamology will guide you through this, but here’s how we did it every morning with my son’s right eye.

  • Wash and dry your hands (really more soap is better)
  • Stand slightly behind but next to him
  • Use your left middle finger and hold the top eye lid just above the lash line
  • Put the lens onto your right middle finger (be sure to check that it isn’t inside out)
  • Use your right middle finger to pull the eye down from just below the lower lashes
  • IMPORTANT: tell your child to breathe and open their eyes
  • Quickly pull the top lid up and the lower lid down while using your right index finger in a rolling motion to press the lens onto the eye
  • wait a beat or two before letting your child blink

For many months we had a pattern. I’d put his lens in each morning (Alexander only wears one) and he’d remove it every evening. We had a few stumbling blocks (one massive one in New York that I will post about later) but for the most part he really loved not wearing his glasses, and I was able to pop the lens in with ease.

After a few months of this we told Alexander that it was time for him to put in his own lenses. I wanted him to not get too frustrated (as we had at the doctor’s office) so I started by talking to him about it each morning for almost a week. Rather than just popping the lens in I’d say, “Now I’m pulling your eye open…” and I’d really talk him through each movement. After about five days of this I asked him to take a turn. He dropped the lens, he tore a lens, he pressed too hard and the lens flipped inside out. Everything that could go wrong did go wrong. Alexander got frustrated and we put it on hold until the next day.

This was a mistake that I’m cautioning you against making. We were smarter the next morning.

The next morning I had Alexander try three times to get his lens in, after three tries I went ahead and popped it in for him. We repeated this every day. By the third day Alexander had success, but it wasn’t consistent. There are plenty of mornings that he’s too frustrated to get the lens in himself, and it’s absolutely critical that I go ahead and put it in for him calmly, and that I remind him that I don’t always get it right the first time.

For the past month Alexander has put his own contact lens in every morning without needing any help. It’s been mostly stress free and a very real improvement for him.

I’d caution parents to only use disposable (one day) lenses. We did have a two week lens for a day. Yes, one day, it fell out and was lost forever. An expensive little lesson.