Being a parent is a tough job. While it has its own rewards, caring for your baby has a multitude of facets that require attention. One such aspect is your child's eyes. When a child is born their eyes start to evolve and grow so that they function optimally as they age. One of the most essential organs for a person, your child's eyes need special care and attention to ensure that they form well and can help him/her see clearly for a number of years to come. This is where taking your child to a doctor specialising in the ailments of the eyes is essential. According to Dr M. S. Sridhar, M.D. (AIIMS), senior phaco, LASIK surgeon and senior corneal consultant at Maxivision Eye Hospital the first eye check up for your children is recommended at about five to six years of age. If the child suffers from a squint or if you suffer from high refractive errors then a check up is suggested at an earlier age.Here is an article about the various conditions that can affect your child's vision and eyes.
Refractive errors: This is where a child cannot see properly due to a distortion in the way light from the outside strikes your child's optic nerve (the nerve that helps take visual impulses to the brain).
Hyperopia or long-sightedness: All children are born with about +2.5 diopters of power ( hyperopia or long-sightedness). In the first few years of age (often in first three years of his/her life) as the eye ball grows, the power reduces and reaches almost zero by 12 years. In some cases, a child's eyeballs are smaller than normal, leading to difficulty in seeing objects that are close to his/her eyes. And this may manifest as squint. Parents must understand that any squint in the child should not be ignored and must be checked by an ophthalmologist or a paediatric ophthalmologist for a high refractive error.
Myopia or shortsightedness: Usually this condition manifests around 11 to 12 years of age. It then increases between the ages of 11 to 15 years as the body is growing, after this, the error stabilises. But if one or both parents suffer from shortsightedness, a child may suffer from myopia as early as four to five years of age. Genes and reading, writing or playing in areas that are poorly lit at a very early age do predispose a child to develop shortsightedness as well.
Astigmatism: This is a kind of error where the point focus of an image cannot be obtained. Astigmatism can start very early in children due to the difference in curvature of the two axis of the cornea at birth.
Lazy eye: Lazy eye is a condition where the brain ignores signals from one eye, therefore the child cannot see properly from that eye beyond eight to nine years of age. In such a case a child's vision will be sub-optimal for the rest of his/her life. Hence it is important to have all errors ( hyperopia, myopia or astigmatism) corrected at a very early age to prevent lazy eye from developing.
Also, the treatment of myopia, hyperopia and astigmatism in children can be done by making them wear spectacles. Rarely, only one eye may have high error and in this situation treatment with contact lenses or LASIK surgery may be considered. Otherwise surgery for all refractive errors are usually considered after 18 years of age. After wearing spectacles, if a child's vision is not fully developed, occlusion therapy is suggested. Occlusion therapy is where the stronger eye is covered for few hours on a daily basis (based on the age of the child), so that the other eye works harder to develop better vision. It is essential to remember that this therapy must be supervised by a pediatric ophthalmologist, as too much of occlusion therapy can lead to reduced vision in the covered or occluded eye. Hence, choosing a right eye care specialist plays an important role.
Night blindness
Any child having difficulty in night vision is suspected to have Vitamin A deficiency (VAD). Children are seen to suffer from this deficiency if they suffer from a severe systemic illness or if the mother is malnourished as seen in lower socio-economic society. VAD is the most common cause of blindness in developing countries, but the vitamin can easily be supplemented through foods rich in Vitamin A like carrots, sweet potatoes, mangoes, whole milk, peas, dried apricots, tomatoes and spinach.
Keratoconous due to allergies
This is a condition where the cornea of a child's eyes become thinner than normal due to an allergy. Some common allergens include flower pollens, dust mite, cotton fibres, dog and cat hair. Common symptoms of an eye allergy include itching, burning, discharge and reddened eyes. Due to this a child will instinctively rub their eyes which can cause thinning of the cornea resulting in an increase in refractive errors and Keratoconus. The treatment for an allergy in the eyes includes avoiding common allergens and not rubbing the eyes. Instead you could try giving the affected eye cold compression or wash the eyes with with cold water. A doctor will normally prescribe eye drops to thwart the allergy. Apart from that modification of the child's environment also helps in mild to moderate cases. In cases where the eye allergy is severe a child will require a short course of steroid eye drops or injections.
Lid margin disease in children (Blepharitis)
Blepharitis is a condition where the child suffers from irritation and itching of lid margins. On examination by a doctor, scales will be seen on the eye lid margin. Cleaning with commercially available wipes or with diluted baby shampoo twice a day also helps. A parent can also apply an antibiotic ointment (prescribed by a doctor) twice a day for few weeks. But if the problem continues, it is recommended that you take your child to a eye care specialist.
Nasolacrimal duct obstruction
Some kids particularly within six months of age can face watering and discharge from one or both eyes. Normally it takes about six months for the nasolacrimal duct (the duct draining the tears into nose) to develop. If the duct is not open beyond this age then your doctor will usually prescribe nasolacrimal sac massage to open up the duct. This is usually to be done about four to five times a day along with cleaning the eyes and applying antibiotic drops. If the duct fails to open beyond one year of age, intervention like probing the duct under short general anesthesia is suggested. If duct fails to open with repeated probing, then surgery like dacryocystorhinostomy (a surgery to open up the nasolacrimal duct) is advised.
Lastly, it is important that you observe and communicate with your child on his health problems and visit a ophthalmologist at regular intervals. Early detection of children's vision problems is essential to make sure your kids have the visual skills they need to do well in school, sports and other activities.
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