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Eye Problems in Children

Refractive error (requirement of glasses), amblyopia (lazy eye) and squint make up majority of the eye problems seen in children these days.

Refractive error or the need for glasses due to weak eyes is considered to be on the rise. Recent research has shown that nearly 20% of blindness (especially in the young) by proportion and about three fourth of visual impairment is caused by refractive error, the most common form of which is shortsightedness (myopia). Refractive error if not corrected may lead to amblyopia, squint and even a hindrance in the normal social development of a child. Children with refractive error may complain of not being able to see the blackboard or may sit close to the TV or may read their books from very close. If these signs are there, the child must be examined for need of glasses. In this process, some eye drops are put and the power of the eye checked with machines and manually. Refractive errors are easy to correct with glasses which need to be worn constantly in children.

Amblyopia refers to reduced vision in one or both eyes due to either a squint or non-use of glasses in early childhood. In this case, the weaker eye becomes lazy and the brain reduces its ability to see even though the problem may be corrected at a later age. Proper eye checkup and screening in the early childhood years can prevent this form of visual impairment. The treatment for amblyopia is best done at an early age and involves giving glasses and patching of one of the eyes and/or squint surgery.

Squint refers to misalignment of the two eyes whereby both the eyes are seeing in different directions. It is not only cosmetically bad looking but also reduces binocularity (the ability of the eyes to see together to perceive depth). The treatment of squint is done by prescribing glasses and surgery. The squint should be corrected early in childhood, sometimes even before 1 year of age, to get the best outcome.

Children will often not realize they are having an eye problem. It is the responsibility of the parents and teachers to ensure good eye health and regular eye checkup for them.

Glaucoma: The Silent Thief of Sight

 

Glaucoma is a disease in which there is progressive irreversible damage to the optic nerve, often as a result of high pressure in the eye. It results in loss of visual field (the area around us that we can see) and eventually vision loss and finally blindness. It is counted among the most common causes for blindness in India and is estimated to affect over 12 million people in India, around one fifth of the worldwide burden. In various studies in India, it has been observed that over 90% of glaucoma was undiagnosed and found only during the survey. The chances of developing glaucoma are high if anyone else in the family has glaucoma. Glaucoma is called as a silent thief of vision because in majority of the cases, it does not present with any symptoms or signs and by the time it is diagnosed, a significant part of the vision is lost. However, in a few cases it may present with heaviness and pain in the eye, coloured halos (rings of colour around light), blurred vision and redness in the eye. Diagnosis of glaucoma requires a few eye tests. These include measuring the pressure of the eye, inspection of the optic nerve, assessment of the visual fields and evaluation of the optic nerve in detail with machines like Optical Coherence Tomography (OCT).

 

Depiction of how a person with glaucoma sees the world

 

The treatment for glaucoma depends on the eye pressure, extent of damage to the optic nerve and type of glaucoma. It may include eye drops (which need to be put regularly at a specific time, often for life) or laser therapy (which generally involves creating a small opening in the iris to allow the fluid in the eye to drain effectively) or surgery (which involves creating an opening in the white sclera of the eye to allow the pressure in the eye to reduce). It is very important to be on a regular follow up with the eye doctor if glaucoma is diagnosed. Blindness due to glaucoma is preventable and avoidable. Be aware and go for a regular eye checkup if you are over 40 years of age, have a family history of glaucoma, have diabetes, use high powered glasses, have used steroids in the past or currently using, have a heart problem or history of previous eye surgery or eye disease.

 

  • DIGVIJAY SINGH,

MD, FAICO

Pediatric ophthalmology, squint and Glaucoma specialist,

Director, Noble Eye Care, Gurgaon

www.drdigvijaysingh.com