Seeing Straight

When is the right time to take my child for an eye exam?

Eye glasses 370 (photo credit: Marc Israel Sellem)
Eye glasses 370
(photo credit: Marc Israel Sellem)
Our eldest child, a girl, is graduating from compulsory kindergarten to first grade this year. She is healthy and happy, but I was wondering if we should take her to an ophthalmologist to test her eyesight, as seeing properly from the board is so important. Is it necessary?
C. and T.F., Haifa Prof. Moshe Snir, director of the ophthalmology unit at Schneider Children’s Medical Center for Israel in Petah Tikva, and his colleagues Dr. Ronit Frilling, Dr. Nitza Cohen and Dr. Yonina Ron-Kela comment: You’re absolutely right. Now is the time for you to take your daughter to the eye doctor. Various vision problems are liable to cause headaches and double vision in class. Of course, they may also result in errors in copying from the board. There could be a setback in first graders’ learning from the time they begin.
An eye examination is recommended even when the child doesn’t complain about vision problems and his parents aren’t aware of any difficulty. If there is a family history of vision problems as children, such as lazy eye, cross eye or wearing glasses from a young age, an examination is vital. When you go, tell your daughter that it doesn’t hurt or cause any discomfort.
Such an eye checkup includes sharpness of vision from a distance and, if possible, also from closeup.
Sharpness of vision is examined using numbers, letters, drawings or forms, according to the child’s preference and abilities. In addition, there are also 3-D examinations to determine depth of vision, focus and other characteristics. Of course, the examination includes an anatomical check of all parts of the eye.
Drops are put into the eye to expand the pupils so the doctor can see the interior of the eye, including the lens and the retina. On the basis of these results, the ophthalmologist will determine whether the child’s vision is normal or, if not, recommend treatment.
I am a 77-year-old woman, more or less healthy according to my age. What bothers me is that because of my osteoporosis, I took the oral drug Fosalan (biphosphonate) for many years, and after the treatment the level of bone loss did not improve. My family doctor advised me to get an injection of Aclasta, an injection of biphosphonate. The last one was three years ago.
Now I am having a problem with one back tooth, and lately it has caused me nerve pain. My dentist says that because of the Aclasta, it is very dangerous to even touch the tooth, as there are many cases which could develop into necrosis. At present, I don’t suffer from the pain any more because I was given antibiotics (doxycycline).
My question is if the pain comes back, is it worth to take the risk and get an Aclasta treatment again.
L.B., Ra’anana Dr. Raphael Zeltser, head of the department of oral surgery at the Hebrew University-Hadassah School of Dental Medicine, replies: Aclasta is the Novartis brand name of zoledronic acid or zoledronate, which is a bisphosphonate. The drug is used to treat osteoporosis in postmenopausal women and in men – specifically to prevent additional fractures in men or women who recently had a hip fracture. I suggest that the patient undergo a blood test called CTX crosslap to assess her bone health. If the result is over 150, the risk has declined significantly. In any case, there isn’t 100-percent certainty that there won’t be a problem.
I recently underwent an operation to remove a cyst from my spinal column, and during all the scans and checkups before the operation, I discovered that I have osteoporosis, probably as a result of an aromatase inhibitor I took for two years (and age!). The deterioration is mainly in my hip joints and lower vertebrae.
According to the neurosurgeon who operated on me, I should not be using an elliptical machine, which provides both aerobic and non-aerobic exercise that I like very much. This is the type in which one moves the legs in an oval motion so as not to stress the knees and also has a rowing function to strengthen the muscles of the arms. As far as I can remember, the neurosurgeon said that I shouldn’t use the elliptical machine because it would create pressure on the vertebrae where there is loss of cartilage. He recommended either a treadmill or an exercise bicycle.
I was puzzled as I can’t see the difference between a bicycle and elliptical machine, except the latter includes use of the arms, which shouldn’t be a problem for the back. I’m actually quite happy with my elliptical machine, and I don’t really want to relinquish it.
My concern is that I might cause harm to my body.
P.C., Binyamina Prof. Naama Constantini, director of the sports medicine center of the orthopedic surgery department at Hadassah-University Medical Center in Jerusalem’s Ein Kerem, replies:
It’s important to ask your neurosurgeon again exactly why he recommended that you do not use your elliptical machine. Maybe there is something he learned during the operation that is the reason for his recommendation, but I don’t see any difference between elliptical machines and a treadmill in protecting the back. Using a bicycle machine, there is less weight bearing, but it’s important to have weight bearing to strengthen the bones. You should exercise parts of your body that are vital to preventing bone fractures that result from osteoporosis – such as strengthening the muscles and promoting balance, posture and coordination.Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting.
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