Pediatric Ophthalmology: Children's eyes need early attention

2. Children’seyesneedearlyattention Several hidden eye problems can be detected and prevented as early as birth. Furthermore, a routine eye examination from age 4 onwards is recommended forall children. vision, or a lazy eye. Children witha refractive error in only one eye may never complain of reduced vision so a vision test is ideally recommended from age 4. If parents or close family members have glasses since childhood, their childrenhave a higher chance of needing glassestoo. ChildhoodGlaucoma This rare condition in children occurs when increased eye pressure results in large eyes, optic nerve damage andclouding 1 ofthecornea.Itapotentiallyblindingconditionandmustbe treated immediately. Depending on the condition,childhood Glaucomacanbetreatedwitheyedropsorsurgery. Lazy Eye(Amblyopia) This is poorly developedvision in one eye at an earlyage due to‘lackofstimulation’ofthat eye. COMMON EYE PROBLEMS INCHILDREN ChildhoodCataract The Children’s Eye Clinic at Hinduja Healthcare Surgicaltreats themostcommoneyeproblemsinchildren: Thiscloudingofthelensoftheeye is responsible for 10% of blindness inchildren. Itaffects1-3.5%ofchildrenandcanoccurdueto: • Squint • Uncorrected refractiveerror • Droopyeyelid • Cloudy eye (cornealopacity) • Cataract Squint • Childhood Cataract can be causedby: • Congenital(Idiopathic) • Infections (e.g.Rubella) • Metabolic diseases (e.g.Galactosaemia) • Steroidintake • This condition must be treated as early as possible withsurgery. In fact, cataracts present at birthare best treated before • 6 weeks ofage. This condition is when one eye is straight and the other isturned away. A squint is not just acosmetic problem, but can leadto • a permanent reduction in vision in the lazy eye. Sometimes, a squint can be detectedat birth. And contrary tocommonbelief,asquintwillnotgoawaybyitself, • it needs to be treated as early aspossible. • Asquintcanbetreatedinanyofthefollowingways: • Glasses • Patching • Fusionexercises • Surgery • Botulinum toxin injection(Botox) Conventional treatments like glasses and patching are usually e�ective only till age 7-9. This is a silent condition and can only be detected withan eye examination. Both these reasons make it critical to treat a lazy eye as early aspossible. Droopy eyelid(Ptosis) Retinopathy of Prematurity(ROP) This is anabnormalvessel formationintheretinathatoccurs in preterm babies (under 34 weeks or 1.5 kg birth weight). A dilated eye examination at 4-6weeks after birth must be conductedanddependingontheseverity,eitheralaser treatment or regular monitoring is needed. Pretermchildren have a higher incidence of squints and refractive errors, and should have a routine eye examination before age4. Whether complete or partial, Ptosis is not just a cosmetic problem.Ifthelidobstructsthe vision, it can causepermanent reduced vision or a lazy eye. Children with a droopy eyelid should be checked as early as age one for refractiveerrors, and fitted with glasses if needed. A complete droopyeyelid Refractiveerrors may needsurgery. WateryorStickyEyeinNewborns This usually occurs dueto a blocked tear (Nasolacrimal) duct. Glaucoma and FB may be theother rare causes of wateringat this age andmustberuledoutfirst.Although90%ofblockedtearducts spontaneouslyrecoverbyage one,ifthisdoesnotrectifyonits own,wateryandstickyeyesshouldbetreatedwitha massage • Wealso treat conditions like: • Childhood Orbital conditions(Proptosis) • Eye problems related to learningdisabilities • and neurologically challengedchildren • Genetic eyeconditions • Blocked tear ducts (NLDObstruction) • Corneal transplant inchildren • Artificial eyes and contactlenses • Low vision aids (telescopes and magnifyingglass) Myopia Hypermetropia Astigmatism 10-12 % of children are a�ected by reduced vision due to the opticsoftheeyebeingoutoffocus.Myopia (Near Sightedness), Hypermetropia (Far Sightedness) and Astigmatism are common refractive errors and should be treated as early as possible with glasses or contact lenses. This helps prevent further lossof or probing(surgery).