4 yo with scratched corneas from sleeping with eyes slightly open?

[tiff]

Our daughter saw the eye doc today. It was her first visit to see KKN. He determined she has scratches on both corneas, presumably because her eyes don't close all the way when she sleeps. I check on her each night and never noticed they weren't all the way closed, though i do recall her saying she doesn't know how to close her eyes. With four year olds it's hard to know what to believe. Anyway, he prescribed a gel drop that he wants us to put in while she's sleeping (no idea how that will actually work) and see him again in 4 months. It just occurred to me that she received a glitter chapstick lip balm on Monday and got some of the glitter on her face near her eyes. I washed her face when I noticed, but I wonder whether perhaps she got some glitter in her eyes and that's what scratched them? Is there a way to know what happened? Wouldn't scraches from Monday have healed by now? It's been a longstanding practice that she gets artificial tears before bed, so I'd think that would have helped with scraches from the micro fine lip balm glitter. I'm not sure what to think. Any advice? Thanks.

[littlemermaid]

Tiff, I think he would have seen glitter at that magnification with the bright light, plus he adjusts the view slightly, doesn't he, so he would have caught it. Plus he was looking at tiny lesions so he would not have missed it.

Pinklady has been dealing with this under 5yo and puts in gel during the night - maybe PM her for ideas.

Rebecca has eye covers for the night for children, if it helps http://www.dryeyezone.com/.

Wagnermid has lots of experience on this - lots in her posts and maybe PM.

There is an optometrist test for lagophthalmos, if you want to ask one or Google. Basically they shine a penlight at an angle in complete darkness and if there's a gap, the eyelid margin lights up too. Otherwise, not.

He'll want to know what you're doing now she's his patient, if there's anything new.

If I try to think about it, I don't know how to close my eyes either, bless her.

Does she have the allergies and the steroid inhaler?

Good he's looking after your children. Lots of love from us. You've also got RH if needed.

[tiff]

Thank you, LM for your helpful response, as always.

If her eyes were scratched by the glitter three days prior to the appointment they glitter would not still be in them though, right?

I tried many times last night to put gel in while she was sleeping and it was impossible. She is a very stubborn little girl! I did manage to put some in before she went to sleep. She is the type of child who removes her pajama bottoms while sleeping because she doesn't like to feel confined, so I can't imagine she would wear a mask or goggles. Did I mention how stubborn she is?

Yes, she does have an inhaler because she has a mild case of asthma. We use a nebulizer when she gets a chest cold because she develops pneumonia from colds every year.

I see KN next Wednesday for my own appointment so I will ask him about the glitter.

Tiff, I think he would have seen glitter at that magnification with the bright light, plus he adjusts the view slightly, doesn't he, so he would have caught it. Plus he was looking at tiny lesions so he would not have missed it.

Pinklady has been dealing with this under 5yo and puts in gel during the night - maybe PM her for ideas.

Rebecca has eye covers for the night for children, if it helps http://www.dryeyezone.com/.

Wagnermid has lots of experience on this - lots in her posts and maybe PM.

There is an optometrist test for lagophthalmos, if you want to ask one or Google. Basically they shine a penlight at an angle in complete darkness and if there's a gap, the eyelid margin lights up too. Otherwise, not.

He'll want to know what you're doing now she's his patient, if there's anything new.

If I try to think about it, I don't know how to close my eyes either, bless her.

Does she have the allergies and the steroid inhaler?

Good he's looking after your children. Lots of love from us. You've also got RH if needed.

[liz56]

My cornea specialist said that he got Tranquileyes goggles for two little four-year-old twins who had corneal abrasions, due to lagophthalmos. It might be something to try with your little one.

Best wishes,
Liz

[wagnermid]

Hi Tiff,

My son has lagophthalmos, as well as other issues and gets erosions.

We put gel in before going to sleep, then I do it in his sleep before I go to bed. He's fine with it now and fine with his hourly eyedrops. I guess he's gotten used to it over the years. I'd suggest a reward chart (bribery), doing it in other family members eyes as a demonstration, letting her do it in a favourite teddies eyes (pretend)and just persevere and don't get too stressed!

My son wears quartz goggles at night, they are nice and soft, and come apart so they don't get caught around his neck. It took a while to get him to keep them on. They rarely stay on all night but at least they are there part of the time. He's a poor, restless sleeper which doesn't help.

It has always been easy to see his eyes are open at night, and even after having eyelid grafts done last December you can still see a tiny gap so I would think you would be able to see if your daughters eyes are not closing. My son has an underlying problem that makes him prone to erosions.

I hope your daughter is improving and it is not an ongoing problem.

Ann

[tiff]

I saw KKN myself today and asked about the glitter. He said the pattern of the scratches and the location of them is clearly from her eyes being partially open at night.

Our daughter is very stubborn. I have been trying to offer once tubes to get her to do the eye drops. She still puts up a fight. I am managing to get regular drips in once a day, but have not been successful with the gel no matter how or when I try.

When I look at her at night I don't see any opening between her lids at all.

How do people resolve this? There us no way she would wear goggles. I can't even get her to keep her pajamas on.




QUOTE=wagnermid;89547]Hi Tiff,

My son has lagophthalmos, as well as other issues and gets erosions.

We put gel in before going to sleep, then I do it in his sleep before I go to bed. He's fine with it now and fine with his hourly eyedrops. I guess he's gotten used to it over the years. I'd suggest a reward chart (bribery), doing it in other family members eyes as a demonstration, letting her do it in a favourite teddies eyes (pretend)and just persevere and don't get too stressed!

My son wears quartz goggles at night, they are nice and soft, and come apart so they don't get caught around his neck. It took a while to get him to keep them on. They rarely stay on all night but at least they are there part of the time. He's a poor, restless sleeper which doesn't help.

It has always been easy to see his eyes are open at night, and even after having eyelid grafts done last December you can still see a tiny gap so I would think you would be able to see if your daughters eyes are not closing. My son has an underlying problem that makes him prone to erosions.

I hope your daughter is improving and it is not an ongoing problem.

Ann[/QUOTE]

[littlemermaid]

Tiff, ask him to talk to her and you about it. He is very good at that. Make use of what you've got there. Ask him what the risks are too.

This struggle changes our relationship with the child. Eventually I got 'it's always all about the eyes, isn't it'. And if they are non-compliant, it gets that way. We have to make sure the good stuff does not get lost. Difficult to stay calm and strong. Do what you need to do to keep yourself well. It will get better.

[tiff]

When I expressed my fears about this he basically said its no big deal.

What are the risks? Do people grow out of this?


QUOTE=littlemermaid;89560]Tiff, ask him to talk to her and you about it. He is very good at that. Make use of what you've got there. Ask him what the risks are too.

This struggle changes our relationship with the child. Eventually I got 'it's always all about the eyes, isn't it'. And if they are non-compliant, it gets that way. We have to make sure the good stuff does not get lost. Difficult to stay calm and strong. Do what you need to do to keep yourself well. It will get better.[/QUOTE]

[wagnermid]

[QUOTE=tiff;89602]When I expressed my fears about this he basically said its no big deal.

What are the risks? Do people grow out of this?


Hi Tiff,

Does she have any symptoms? I guess if not then it may be no big deal. He is a good Dr so I guess you need to know the benefits versus risks and decide if it is worth upsetting her.

I don't know if it is possible to grow out of it.

I think slowly persevere and be patient. It has taken many years to get to the point where we are now. We tried for so long to get him to keep goggles or taping on, I have even stayed up all night to put them back on but all that achieved was to leave me exhausted.

If it is something the Dr wants you to do maybe you can get help from a child life specialist (play therapist) at a children's hospital. They have helped us a lot as my son has a huge phobia of medical procedures due to his many different medical conditions. We use social stories to let him know exactly what is going to happen, it doesn't cure it but makes it easier. We now use an app called Pictello and I can take photos and make a story in a very short time. They taught us how to distract him with singing or a timer etc whilst doing things.

This is not easy and it is really hard not to get stressed so I hope it all settles down for you.