Question
My four-month-old son's left eye sometimes appears smaller than the right, especially when he is sleepy or just woken up. It's quite subtle and predominantly noticeable from a foot or so away. When he falls asleep, the left eye seems on the other hand to remain slightly more *open* for longer than the other. On one occasion I saw him blink with the right eye only (again, he was nodding off to sleep when this happened.) It's as if the muscle in the eyelid is weaker.
It doesn't overhang his pupil or appear to obscure his vision in any way, but I've also noticed that the iris in the same (left) eye looks a slightly odd shape - not fully round at the bottom, and almost with a tiny point to it at the outer edge. (This very also very subtle and hard to spot.) He was born with red birth marks on both eyelids, which sometimes look a bit swollen.
My pediatrician seemed keen to refer him to a pediatric ophthamologist immediately, but we're about to go on holiday and I couldn't understand the urgency. Should we be worried? My husband also has a droopy eyelid the same side so I thought it was just a harmless heriditary thing, but it does seem to be getting a bit more pronounced.
Thanks in advance.
Answer
Well, you do definitely need to see a pediatric ophthalmologist. This sounds like a nerve deficit of some sort but you do need an official diagnosis from a specialist to know whether it is serious or just a harmless anomaly.
As for how urgent it is to have your son seen, I would say if your vacation is only a week or two, you could call for the appointment before you leave and make it for a day as soon as you get back. It may take a few weeks to get the appointment anyway - UNLESS your pediatrician wrote you a referral indicating it was urgent.
If the trip is longer than two weeks or so, I would consider other options, such as finding a pediatric ophthalmologist in the holiday location, if that is possible, or consider deferring the trip.
