Paediatric Ophthalmology & Squint

Paediatric Ophthalmology

Eye disease can strike at any age and many eye diseases do not cause symptoms until the disease has done damage therefore it should be diagnosed and treated early. Regular medical examinations by an ophthalmologist in children are very important. Eye problems in children need special care. Some common eye problems in children are:

Refractive errors:

Children can’t tell that they can’t see clearly, so eye examination in children should be done at early age of three. If parents suspect something wrong then it should be done even earlier.So parents have a big role to play.

Refractive errors can be corrected by glasses, but it needs detailed eye examination by putting dilating drops which makes the pupil large and relaxes the focussing muscles of eye.

A large pupil is helpful to examine the interior of the eye. Also, relaxing the focusing muscles of the eye allows for a more accurate determination of refractive error (need for glasses) in children.Effect of dilating eye drops can last from 4 to 24 hours, depending upon the strength of the drop and upon the individual patient.

If a child has refractive error, glasses are prescribed after this examination which improves child vision and can prevent amblyopia(Lazy eye ) & strabismus.

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Amblyopia ( lazy eye )

When the vision of one eye is significantly better than the other eye, and the brain begins to rely on the better eye and ignore the weaker one, so the weaker eye tends to become lazy,this is called Amblyopia.The management of amblyopia involves correcting of significant refractive errors and using techniques that encourage the brain to pay attention to the weaker eye such as patching the stronger eye.

Amblyopia should be diagnosed early enough to allow successful treatment. One of the most important treatments of amblyopia is correcting the refractive error with consistent use of glasses and/or contact lenses.

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Other mainstays of Amblyopia treatment are to enable as clear an image as possible (for example, by removing a cataract and correcting strabismus ), and forcing the child to use the nondominant eye (via patching or eyedrops to blur the better-seeing eye).

Strabismus

Strabismus/Squint is a misalignment of the eyes ,commonly referred to as “crossed-eyes” .Different types of misalignments, including an inward, outward, upward or downward turning of eye are called as esotropia, exotropia, hypertropia, and hypotropia.

The goal of strabismus treatment is to improve eye alignment which allows for better work together (binocular vision). Treatment should be done at early age and may involve eye glasses, eye exercises, prism, and/ or eye muscle surgery. Problems associated with strabismus (including amblyopia, ptosis, and cataract) are usually treated prior to eye muscle surgery.

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Blocked tear ducts

Abnormal or overflow tearing is a common condition in infants and babies. In fact, approximately one third of all newborns have excessive tears and mucus. It is also common for babies’ eyelashes to stick together after sleep.Overflow tearing in children is usually caused by the presence of a persistent membrane that blocks the lower end of the tear duct near the nose. Normally this membrane stretches or pops open before birth. In many infants, however, it remains closed, clogging the tear drainage system. The blockage may open spontaneously in a few months as the infant grows. Initially Antibiotic eye drops or ointment used, along with pressure (or massage) over the tear sac can open the block. Most tear blockage in infants disappears by six months of age. If the tearing persists, it may be necessary for the ophthalmologist to open the block by surgery.

Infections (conjunctivitis)

Commonly called as pink eyes.This needs needs treatment under eye doctor’s guidance as medicines can have side effects in children.

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Pediatric cataracts and Pediatric glaucoma are other common eye problems in children which needs expert treatment.

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We care for healthy vision of your children
Dr Rajesh kapoor