|
It is not uncommon for children to have eye diseases. Yet, surprisingly, most of them might go unnoticed, and the eye disease is detected only when it is too late. However, early detection and timely care can prevent most of the diseases even without the need of surgical intervention. Following are some of the common diseases:
- Watering – Everybody was full of joy with birth of a child in the family. His parents noticed that only one eye watered, while the other one was normal. When more than a year had passed, they began to get worried and consulted an eye doctor. It was found that the child had “epiphora”, meaning that the drainage passage
which carries tears from the eye to the nose was blocked. The infant had to be given anaesthesia twice for “probing” to open up the passage. Even then, the recovery was only 90% as the child was already 11/2 years of age. This could be avoided if this problem was detected early. As the bones are very soft in infants, mere massage by the finger under the training of an eye doctor could have opened the passage and surgery would not have been required at all. If there is unusual and persistent watering in the eye of a child, do not delay in consulting an Ophthalmologist.
- Red eyes and itching – It is not uncommon for a child to keep rubbing his eyes. Once the hand goes near the eye, the child does not remove his hand. More the child rubs, more the eye turns red. Often there is frequent blinking of eyes and a forrign body sensation in the eyes. These symptoms are due to “allergic conjunctivitis”, meaning that there is roughness in the conjunctiva due to allergy possibly to dust, climate, soap, cosmetics, chocolates, etc etc. The list is endless. There may also be breathlessness along with eye symptoms. Few days of treatment with mild antibiotic and steroid combination can bring a cure, but it may recur again. It is becoming more and more common due to increasing air pollution etc. Long term and unsupervised use of most of the eyedrops should be avoided as these drops can lead to serious side effects and complications like cataract, glaucoma, fungal corneal ulcer, etc.
Sometimes a child, like an adult finds it difficult to open lids as they are are stuck up due to discharge. Their eyes are red and there is general discomfort, sometimes even mild pain in the eyes. Such difficulty is due to “red eyes”, commonly known as “eye flu”. This needs treatment with antibiotic drops. Majority of the patients recover in 5 – 10 days time.
 Top
- Refractive error (spectacle number) – Eyes “learn to see” till 6 – 8 years of age. If there is a spectacle number, it does not permit formation of clear image on retina. If this continues and corrective glasses are not used, it can lead to squint and even permanent “blunting of vision” or “amblyopia”. Timely detection, use of glasses if advised, and periodic eye checkup can lead to normal development of vision so that a child is not deprived of good job opportunities at 20 to 25 years of age when a pre-employment checkup can detect this amblyopia, but it is too late for correction.
An eye checkup at 4-5 years of age can save the sight of a child and avoid future frustration in life.
- Squint and lazy eye – Squint is “Looking at London and talking to Tokyo”. It is also known as cross eyes. The child having squint generally is the target of teasing by fellow children.
Long standing squint leads to permanent blunting of vision known as “lazy eye” or “amblyopia”. Also, children having squint do not develop binocular vision so their two eyes cannot see together and they cannot judge the depth properly. Later in life, they can be declared unsuitable for certain jobs and are deprived of good career opportunities.
There is no age for treatment of squint. With the help of modern knowledge, it is possible to treat the squint as early as possible so as to permit eyes to develop normally. Operation is not the only treatment of squint. Proper use of glasses and if required, certain exercises can cure the squint even without operation.
- Screwing of eyes – Lot of children tend to screw their eyes while watching tv or reading the blackboard. This is due to uncorrected refractive error. If you find a child seeing TV or reading with such a habit, an eye check up can tell you whether this is just a habit or it is due to an undetected eye disease.
- Poor performance in studies – A child was brought to us for a checkup. On detailed examination and questioning, the parents said that the child was intelligent, but did not perform well in school. An eye check up revealed that he had a spectacle number. He could not see the blackboard clearly. Since he had never been examined, he had never experienced clear vision and did not know what he was missing. Unable to copy from the blackboard, he used to miss lessons. Soon he lost interest in studies and did not perform well. Hence it is very essential that children who do not have satisfactory performance in school should get their eyes examined to rule out any eye problem.
- Family history of glasses – Spectacle number is partially hereditary. If one parent has a high spectacle number, the child has 50 % chance of having a spectacle number. If both the parents have a spectacle number, the child has almost 100 % chances of having a spectacle number.
- Malnutrition – Though this is not commonly seen in children in Mumbai, it is sometimes seen in street children. Also, children who do not eat vegetables or drink milk everyday are prone to this. One bout of diarrhea and all the vital elements are drained from the body. Malnutrition can cause white spots on the conjunctiva in the eye, near the cornea. Vitamin A supplements in the form of tablets and diet should be given. If not taken care of, this can sometimes lead to an ulcer in the eye, which can perforate and lead to blindness. Children who are adamant and do not listen to their parents have been found to be more compliant if a doctor asks them to follow a diet. A study was conducted by Surya in which over 15,000 children were examined. Out of these, 14,559 students were found to have changed their dietary pattern after an eye checkup.
Top
- Headache – Headache is a common complaint in children these days. Even small children can have migraine and suffer terribly from it. Uncorrected refractive error can be an important cause of headache and any child complaining of headache should have an eye examination to rule out refractive error. Other causes of headache are too much of TV / Computers, irregular meals, etc. But a headache due to any serious eye disease or brain problem should be ruled out if headache persists or does not respond to usual treatment in a few days time.
Excessive or Insufficient Blinking: Eyelid blink reflex problems can result in or be caused by dry eyes, irritation, infection or neurological dysfunction.
Neurological Developmental Problems: Symptoms are often similar to the problems outlined above. Lack of development of good visual acuity from misalignment or from a neurological anomaly, is called amblyopia. Also, there may be fixation problems, attention deficits, and binocular vision (3-D, stereopsis) defects.
Pupil Abnormalities. 1. Reflexes. The black-appearing pupils should be of equal size at any light level, clearly smaller when a penlight is shined onto the eye and larger when it is removed. 2. A white or cloudy looking pupil is a sign of potentially serious illness.
Computerized Eye Check up – An eye check up by auto refractors, generally called “computerized eye check up” actually detects a spectacle number only.
A detailed eye examination means establishing normalcy of each eye structure, spectacle number, health of retina and absence of a hidden serious disease like brain tumor or effect of diabetes or high blood pressure and measuring intraocular pressure (generally above 40 years of age) to rule out glaucoma. Such a detailed study is not possible by the so-called “computerized eye check up”. A 17 year old girl walked in for occasional blurring of vision and headache. She had a spectacle number which corrected her vision to normal, but a detailed eye check up revealed swelling on the nerve (it can be seen by a usual ophthalmoscope). The parents were called in the clinic and explained. A CT Scan revealed high intracranial pressure with tuberculoma (a type of tumor). The reports were sent to their doctor. In 10 days of treatment, she improved and was advised to follow the treatment for few months.
Your child is our most precious possession, ray of hope and most beloved belonging. The wellness of his eyes should be ascertained and checked up once at birth and one at 5 years of age. This is the most important age for the development of his vision. Delayed / late detection of a disease, spectacle number or a defect will deprive him of useful vision in future.
Top
Few Terminologies
Like a camera, the human eye must be properly focused to see an image clearly. If light does not bend or refract correctly and focus directly on the retina, the result is blurred vision, or a refractive error.
The most common refractive errors are
- myopia, or nearsightedness,
- hyperopia, or farsightedness,
- astigmatism, and
Myopia (Near Sightedness)
Myopia develops during childhood. The childs eyeball grows too long, which interferes with the light-focusing mechanism. Rays of light from distant objects focus in front of the retina rather than on the retina, resulting in blurry vision. This can also occur if the cornea is curved too acutely or the size of your eyeball is bigger than usual size.
Hyperopia (Far Sightedness)
Hyperopia, or farsightedness, is a disorder where distant objects are usually seen clearly, but close ones do not come into proper focus and are blurred. This occurs when the eyeball is too short or the cornea is too flat and light rays entering the eye focus behind the retina rather than directly on it. This happens because the size of the eyeball is smaller than its usual size.
Hyperopia is often present at birth, but sometimes, vision normalizes as the eyeball lengthens during the growth process. Young adults and children with mild to moderate cases of farsightedness often see close objects clearly
Astigmatism
If your child has astigmatism, it means that his or her eye is shaped more like a football, rather than a baseball. Astigmatism is very common and causes blurry vision. Astigmatism causes blurry vision when looking at objects that are close (e.g., reading a letter) and objects that are far away (e.g., reading a road sign). Vision with astigmatism is not necessarily uniformly blurry; some distances are more out of focus than others.
Strabismus
Misaligned eyes, or strabismus, can mean not only crossed eyes but also eyes that point outward, upward or downward in the relaxed position.
Amblyopia (Lazy Eye)
Amblyopia, also known as "lazy eye," is a condition characterized by diminished vision in one eye. It is not correctable by eyeglasses or contact lenses and is not usually triggered by an eye disease. Instead, amblyopia can develop when:
- the extraocular muscles fail to align the eyes properly and the part of the brain that controls vision "favors" one eye over the other;
- an eye with a significant refractive error in one eye goes uncorrected for a period of time; or
- there is a large difference in the refractive power, and one eye is favored.
All babies are born with poor eyesight that normally improves as they grow. In amblyopia, one eye becomes stronger. If the weaker eye is untreated, eyesight will progressively worsen. |
