EYE
CARE FOR CHILDREN
Detection
of eye problems in the young child is particularly important because
there is a critical difference between the vision system of a child and
that of an adult. Young children are susceptible to permanent vision loss
from uncorrected
refractive errors, strabismus, cataracts or other conditions that affect
the quality of the visual image
What
is normal visual development?
Newborn
infants are able to see, but as they use their eyes during the first
months of life, vision improves. During early childhood years, the visual
system changes quickly and vision continues to develop.
If a child cannot use his or her eyes normally, vision does not develop properly and may even decrease or lead to blindness. After the first nine years of life, the visual system is usually fully developed and usually cannot be changed. The development of equal vision in both eyes are necessary for normal vision.
Some
majority of eye problems in children?
Tear
duct blockage is a common problem that occurs in 1 in 20 newborns.
·
Tearing.
·
Discharge.
·
Recurrent eye
infections.
What
is Amblyopia or lazy eye ?
Amblyopia
or lazy eye is poor vision
in an eye that did not develop normal sight during early childhood. When
one eye develops good vision while the other does not, the eye with
poorer vision is called amblyopic.
Usually, only one eye is affected by amblyopia.
What
is the best time to correct this problem?
It
is during infancy or early childhood. Parents must be aware of this
potential problem if they want to protect their child's vision.
What
is strabismus?
See
under topic strabismus.
Can Cataracts in Children affects vision?
A
cataract is a clouding of the eye's normally clear lens. For more details
(click
cataract)
The
degree of visual impairment caused by a cataract varies and depends on
how much of the lens is obstructed by the cataract.
Although
most cataracts occur in older adults, infants and children can also be
affected. Occasionally, an infant is born with a cataract. Although
infant cataracts may be inherited or occur as a result of a viral
infections such as German Measles contracted during pregnancy, it is
usually impossible to determine the exact cause.
Some
cataracts may only partially cloud the lens and not interfere with
vision.
·
Small cataracts
:- Do not require treatment but should be observed periodically.
·Moderate
size cataracts :- Do
interfere with vision may require treatment with glasses or treatment for
amblyopia.
·Larger
cataracts :-Severely
interfere with vision require immediate cataract
surgery.
Eyes
that
jump, dance, wiggle or oscillate back and forth is called Nystagmus which
can develops in infancy. This condition may be caused by poor vision, defects in the
nerve pathway from the eye to the brain or albinism (Light-sensitive retinas
in albinos contain too little pigment for the eyes to function properly).
Nystagmus may also be inherited. Babies with nystagmus may have normal
vision or poor vision. If your child's nystagmus persists past age three
months, consult your pediatrician. retinas
in albinos contain too little pigment for the eyes to function properly).
Nystagmus may also be inherited. Babies with nystagmus may have normal
vision or poor vision. If your child's nystagmus persists past age three
months, consult your pediatrician.
Eyeglasses
may be prescribed for infants and children to improve vision, as well as
to prevent and treat Amblyopia / Lazy Eye or eye muscle problems. There
are also three different types of focusing problems
which may require the need for corrective lenses - nearsightedness,
farsightedness and astigmatism.
Myopia
or nearsightedness is
inherited and often discovered in children when they are 9 to 12 years
old. Hypermetropia or farsightedness is caused by light entering
the eye and focusing behind the retina. Older people who are farsighted
can sees far away objects better than those close at hand. Most children
are normally a little farsighted but have no problems seeing objects up
close or at a distance.
Astigmatism
occurs when light rays enter the eye and focus at different places on the
retina. It distorts and blurs vision for both near and far objects.
If
your child needs to wear glasses for any refractive error, getting him
involved in the glasses purchase is the best way to make sure he wears
the glasses. Explain that he needs them to see clearer, and give examples
that he can understand like he will be able to see the words in his books
better, or will be able to play better, discussing how lots of people he
knows wear glasses, and how they see much better.
Select
a few frame styles yourself, then give your child final choice on the
glasses he will wear. Make sure the frames you choose are comfortable to
wear, and fitted properly for your child. No one, especially a child,
will wear uncomfortable glasses. Before using glasses get it checked from
reputed ophthalmologist.
Is there any need for testing Vision?
It
is recommended that all children have their vision checked between ages 3
and 4. New techniques make it possible to test vision in infants and
young children. If there is a family history of misaligned eyes,
childhood cataracts or any other eye disease, an ophthalmologist can
check vision even earlier than age 3.
Accidents
resulting in eye injuries can happen to anyone. But the fact is, over
half of the victims are under the age of 25. Many of these injuries,
occur during sports or recreational activities. Perhaps the most
startling statistic of all is that 90 percent of all eye injuries could
have been prevented. Parents are advised to insist that their children
use protective eyewear when participating in sports or other hazardous
activities.
· Holding
a book too close
· Losing
his place while reading
· Consistently
sitting too close to the TV
· Tilting
the head to see better
· Using
a finger to follow along while reading
· Squinting
· Frequent
eye rubbing ,when your child is not sleeping
· Sensitivity
to light
· Excessive
tearing
· Complaining
of headaches or tired eyes
· Closing
one eye to read, watch TV or see better
· Avoiding
activities which require near vision, such as reading or
homework, or
distance vision, such as participating in sports or other recreational
activities
· Getting
poor marks or performance in school.
·
Poor handwriting
· Difficulty
with reading, writing or match
Routine
Eye Examination should be done as per following schedule:
At
Birth: to rule out any congenital eye disorders (e.g., cataract,
glaucoma, etc).
At
1 year: to rule out any developmental disorders of the eye (e.g.,
cataract, squint, retinoblastoma, etc.)
At
School Admission: to rule out refractive errors (need for spectacles),
amblyopia (lazy eye), squint, etc.
Then
Every 3-5 years till the age of 40 years .
Every
1-2 years after the age of 40: to detect presbyopia, glaucoma, cataract,
effects of any other disease of the body (e.g., Diabetes Mellitus), etc.
The First Eye Exam
If
your child exhibits no symptoms of a refractive error or other visual
problems, he should have an eye exam by the age of 3. Having a complete
eye exam even before the child enters school allows enough time to catch
and correct any problems while the visual system retains flexibility and
elasticity. Children without symptoms should receive an eye exam every
two years after age 3.
Should
your child requires correction for any visual problem, be it
nearsightedness, farsightedness or strabismus, he should be examined on a
yearly basis. A yearly exam allows your ophthalmologist to stay on top of
your child's visual needs, as well as ensure that your child's
prescription is still correct. The visual system is developing along with
your child, so annual prescription changes are not uncommon. After your
child's refractive error is stable, exams every two years are
appropriate.
School-age
children should see the ophthalmologist about age 6 and every two
to three years after that if they have no visual problems. If your child
requires glasses or contact lenses for refractive errors, schedule visits
every 12 months. Prescriptions frequently change because vision matures
along with your child. The ophthalmologist will also ensure that your
child has the visual skills necessary for succeeding in school, such as
using the eyes as a team, peripheral vision, ease of focusing from
distance to near and eye/hand coordination.
The
First 3 Months
Babies
usually see movement before anything else, as their vision is still
evolving. Full-term babies should be able to see their mother's facial
expression within a week of birth. Color vision is not yet fully
developed at this time. Depth perception will also mature during the
first year of life, as long as both of the child's eye are working as a
team.
Eye
muscle coordination in a newborn, as well as a small child, is also very
immature. Babies often exhibit eyes turned
in,
turned out or not working as a team, called
strabismus.
This
happens when the muscles of one side of the eye pull more than the
muscles on the other side. If this problem doesn't resolve itself by the
age of three or four months, consult your ophthalmologist
Signs
of Problems
Sometimes
you need to ask for help earlier, such as if your child's eye are
grossly turned in or out, don't move normally before age three months, if
the eye is crossed far into the nasal area (towards nose), one eye moves
while the other remains still or if one eye appears radically different
from the other. Large-scale eye movement problems can be corrected with
surgery if necessary.
Premature
babies take a bit longer than their full-term counterparts to develop
vision. A baby born before 38 weeks gestation is considered premature. A
month early usually develops normal vision, but children born before 33
weeks have a greater chance of developing strabismus or amblyopia. Your
infant should pay close attention to bright lights in the room. If your
child cannot follow a toy passed in front of him from side to side by the
age of three months, see your pediatrician. In some cases, children
develop their visual reflex later than average. This is called visual
maturation delay.
Between
ages 4 and 6 months, your child should start to reach or bat at the toys
you hold in front of him. Swatting a toy will happen by chance at first,
then become deliberate as your child's vision, depth perception, and
understanding grows. From six to eight months, your child will roll over
and may learn to crawl. Entice him visually with a toy to gain by rolling
over or moving a few inches. From eight to 12 months, your child may be
crawling and walking. Encourage crawling rather than early walking to
help your child develops eye-hand coordination. These newly infants will
encounter bumps and bruises as they explore more of their world with
developing vision.
Closely
supervise your crawler or early walker, especially while on the couch,
near steps or on the bed. Remember that depth perception is still
maturing, so tumbles on uneven surfaces are common. Children will not visually understand that the steps lead down, or the edge of the bed
leads off into empty space.
Many
toys, can help your child
develop vision and have a fun at the same time. Talk to your pediatrician
about age-appropriate developmental toys.
During
the preschool years from ages 3 to 6, your child will be fine-tuning the
vision he has already developed during the infant and toddler years.
Young preschoolers are learning to ride tricycles and master the complex
hand-eye coordination needed to pedal, steer and watch where they're
going at the same time.
Older
preschoolers are learning how to use more sophisticated sports and
working on the fine motor skills needed to write their names.
·
Always
wash your hands before handling medications
·
Begin by
expressing and discarding a ¼ inch of ointment from the tube at each
use.
·
If applying to
your eye's surface, form a pocket by gently pulling the skin of
your lower eye-lid between your thumb and index finger to create a pocket
for the ointment. Then express a ¼" to ½" strip of ointment
into the pocket (unless your doctor prescribes a different amount).
·
Twist your wrist
to break the strip of ointment from the tube.
·
After placing the
ointment in your eye, blink or close your eyes briefly. Your body heat
will melt the ointment so it can spread across the surface of your eyes.
·
If you are
applying the ointment to the edges of your eyelids, express about a ½-inch
strip of ointment onto your finger and glide it across the length of your
closed lids near the base of your lashes.
· Use a soft, clean tissue to remove any excess ointment from the skin around your eyes. Be sure not to disturb the ointment placed in your eyes or on the edges of your eyes.