Children may experience a number of eye disorders. The following are indications that a youngster may have visual issues :
The following symptoms might be present in a young infant with impaired vision :
- A child with poor vision may manifest in the following ways :
- Sits too close to the TV
- Has trouble reading the blackboard ormakes mistakes when copying from the black board
- Stumbles or trips over things easily
- keeps books or reading materials very close to the face
- Squinting or crossing of eyes
- Adopting an unusual position of head or face (looking through the sides)
- Shaking of the eyes
- Itching or rubbing of the eyes
- Discharge from the eyes
- Redness in the eyes
- Sensitivity to light
- Eyes appear to bulge
- White reflex in the center of the eye – which can be a sign of serious and potentially blinding eye diseases such as cataract, retinal detachment or uveitis
It is important to pay attention to your child’s complaints or any of the aforementioned signs. Certain eye disorders and illnesses are inherited and may also impact your child. To ensure that eye diseases are identified and treated as soon as possible, consult your child’s physician or an ophthalmologist right away.
COMMON CHILDHOOD EYE DISORDERS
PEDICATRIC CATARACTS
In India, 12.5% to 42.9% of all childhood blindness is caused by cataracts.
Causes of Pediatric cataract
Clouding can happen if the lens’ natural structure is disturbed in any way. This might be brought on by :
Buildup of abnormal breakdown products (metabolites) with water retention in the lens, disruption of normal lens formation due to a genetic defect, or as a result of virus, radiation, or medication infection.
The most frequent causes in our nation are Rubella virus infection in pregnant women and consanguineous marriages (marriages between relatives). If there is a family history of cataract, the likelihood of developing congenital cataract is quite high.
Treatment for Pediatric cataracts
The purpose of the procedure is to clear the visual axis (the centre of the eye) and remove the clouded lens so that light rays may enter the eye easily and form a clean image on the retina. Children are increasingly more likely to have intraocular lenses. The placement of an intraocular or artificial lens will depend on the child’s age, eye health, and the existence of any ocular conditions.
Nevertheless, because the eyeball is still developing and is tiny in size, they cannot be implanted in extremely young children. Even if the lens is not implanted during cataract surgery, it might still be thought of as a possibility as the kid becomes older. The procedure is carried out while the patient is unconscious. It is vital to rectify the child’s eyesight optically using glasses or contact lenses in order to improve their vision.
Only a surgeon with sufficient competence in paediatric cataract operations should undertake the procedure since it is technically more challenging for children than it is for adults. The problem of amblyopia treatment becomes crucial for the ultimate visual result if just one eye needs surgery.
SQUINT
Squinting happens when the eyes are not in line and each eye is pointing in a different direction. It is possible for one of the eyes to be tilted upwards, outwards, inwards, or downwards. Typically, both eyes point in the same direction and are completely aligned.
Squint is one of the most frequent eye conditions encountered in children and should be addressed right away since, if left untreated, it can cause amblyopia, or lazy eye, and reduced stereovision (3D vision).
Squinting might start in childhood or develop later in life. Nonetheless, there are several distinctions between an adult’s squint and one in a youngster. The main distinction is that children’s squinting can impair vision in the affected eye (LAZY EYE or AMBLYOPIA)
Squint Causes
The eyeball contains 6 muscles linked to it that allow it to move in various directions. Squinting might result from an imbalance in how these muscles are working. This imbalance may develop on its own or as a result of an eye condition, an injury, or a systemic illness that may directly impact the muscles or the nerves that feed these muscles.
Children can squint on their own or as a result of eye conditions including refractive errors, cataracts, or, very rarely, neurological illnesses. Adults, on the other hand, tend to squint as a result of neurological disorders, systemic illnesses like diabetes, or injury-related nerve damage.
Evaluation of Squint
With the use of the proper tests, a full assessment of squint is conducted and may involve the following :
- Vision
- Spectacle power
- Slit lamp examination
- Retina examination
- Squint examination – including tests for measurement of squint, stereovision and tests for suppression
- Orthoptic evaluation
- Diplopia charting
- HESS charting
- Prism trial
- Neuro-ophthalmologist consultation
- Pediatric neurologist/ neurologist consultation
If indicated your doctor may also request for a neurologist’s opinion or ask for brain imaging (MRI / CT Brain) to rule out a brain disease.
Treatment of Squint
The correction of amblyopia, or lazy eye, is the most important aspect of squint correction in children. Treatment options for lazy eye include occlusion or patching therapy, in which the better eye is covered so the kid can see more clearly with the squinting eye. Making the vision in the stronger eye blurry with eyedrops (punishment) or fogged glasses is another way to cure lazy eye.
Based on the cause, the type of squint and its severity, we may either choose to treat it with :
- Glasses
- Exercises
- Surgery – surgery may be done on muscles in one eye or both eyes
- Prisms/ occlusion (to avoid diplopia in adults)
- Treating the cause (underlying neurological problem)
In order to correct squint, surgeons may shorten the muscles and reconnect them to the surface of the eye. You will need to continue patching therapy and using glasses as prescribed by your paediatric eye doctor after squint surgery. All varieties of squint and related issues can be diagnosed.
REFRACTIVE ERRORS
Did you know that the most commonly cited reason for vision impairment is untreated refractive error? WHO estimates that 12.8 million people between the ages of 5 and 15 have visual impairment as a result of untreated or improperly corrected refractive error.
Types of Refractive Errors
Myopia (Nearsightedness)
Myopia, commonly known as nearsightedness, is a condition in which one can see close things clearly but not far ones. This happens because the longer eyeball or higher corneal curvature of a steep cornea causes light rays to concentrate in front of the retina. Myopia can range in severity from mild to severe. Your vision at a distance will be blurrier the more myopic you are, thus items will need to be closer to you for you to see them properly.
A indication of nearsightedness is trouble seeing distant things, such as a TV screen, which may cause a youngster to watch it up close. Another indicator is difficulty seeing the chalkboard at school, which may cause a child to copy from the student sitting next to them rather than the blackboard. Despite being consistent and doing well on their homework at home, many kids may have poor classwork or class notes. In these situations, a thorough eye exam is necessary to rule out nearsightedness. To visually correct nearsightedness, eyeglasses or contact lenses can be prescribed. You may just need to wear them when driving, watching TV, or other certain activities, or they may need to be worn all the time.
Hyperopia (Farsightedness)
Hyperopia, commonly known as farsightedness, is a condition in which nearby objects can’t generally be seen well while distant ones can. If your eyeball is shorter than average, your cornea is less curved than average or it is flat, light entering your eye is concentrated beyond the retina, resulting in farsightedness. Usually, it is inherited. Typically, a child has hyperopia at birth, which lessens as they become older.
The inability to see close things clearly, headaches, eye strain, and/or exhaustion after close work are typical symptoms of farsightedness. The routine vision exams, frequently conducted in schools, are generally poor in detecting hyperopia, despite the fact that it is less prevalent than myopia. All patients with the aforementioned conditions must have a thorough ophthalmological examination.
Patients with mild hyperopia may not require corrective lenses since their eyes may be able to make up for the condition by working harder. Your ophthalmologist may also recommend contact lenses or glasses in other circumstances to visually correct this issue.
Astigmatism (Distorted Vision)
Astigmatism is a disorder in which the cornea, the front surface of your eye, has an uneven shape; it is more oval than round, preventing the light from focusing at one place on the retina, the back surface of your eye. The outcome would be blurry vision at all distances. Astigmatism seldom develops on its own. It frequently goes along with myopia or hyperopia.
With correctly prescribed and fitting eyeglasses and/or contact lenses, the majority of astigmatism may be corrected.
Nevertheless, surgical procedures such astigmatic keratotomy or LASIK may be more effective in treating greater levels of astigmatism.