Addressing Vision Problems in Children - Health Education - DesiMD Healthcare - India

Addressing Vision Problems in Children

Dr.Sridhar M S profile Authored by Dr.Sridhar M S on 21 Aug 2014 - 17:54.

One of the most common neglected areas of a child growth are the eyes. While the parents take every care to provide the child with the best of nutrition and attends to the child’s general health needs, the eye health is normally overlooked. Children need eye-check up just as adults do.

According to Dr. M.S. Sridhar, M.D. (AIIMS), senior phaco, LASIK surgeon and senior corneal consultant at Maxivision Eye Hospital, the first eye checkup for a child is recommended at about five to six years of age. If the child suffers from a squint or from high refractive errors then a check-up is suggested even earlier.

Let’s find out the various conditions that can affect your child’s vision and eyes. Here are the most common vision problems your child could suffer from:

Refractive errors: All children are born with about +2.5 diopters of power (Hyperopia or long-sightedness). In the first first three years of age as the eye ball grows, the plus power reduces and reaches almost zero by 12 years.

If the eye ball is smaller than normal, then the child will have plus power. This may manifest as squint. Any squint in the child should not be ignored and have the ophthalmologist/paediatric ophthalmologist checked up for high refractive error.

Usually Myopia or short-sightedness starts around 11 to 12 years of age. Then it increases during 11 to 15 years of age when the body grows rapidly and then stabilizes thereafter. But if one or both parents have short sightedness (low or high), myopia can start at around 4-5 years of age. If the child is constantly reading or writing in poor light or because of genetic reasons the child may be predisposed to develop short sighteness at a very early age.

Astigmatism: is that kind of error where point focus of image cannot be obtained. Astigmatism can start at very early age because of the difference in curvature of two axis of cornea by birth.

Lazy eye is that condition of the eye where the brain will ignore to see beyond 8-9 years of age and vision will be sub-optimal for the rest of the 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.

The first eye check-up for children is recommended at 5-6 years of age. If the child is having squint or parents are suffering from high refractive errors, eye checkup is suggested at a very early age.

Treatment of myopia, hyperopia and astigmatism in children is by spectalces.  Rarely, only one eye may have high error and in this situation contact lens or LASIK surgery may be considered. Otherwise surgery for all refractive errors is usually considered after 18 years of age. Diet has no role in refractive errors. After wearing spectacles, if the vision is not fully developed, then occlusion therapy is suggested. In occlusion therapy one eye is occluded for few hours in the evening every day (based on the age of the child) so that the other eye works more to develop more vision. The occlusion therapy has to be supervised by a pediatric ophthalmologist, as excessive occlusion can reduce vision in the occluded eye.

Nutritional problems in children: These days vitamin A deficiency is hardly seen among children. Children are seen to have Vitamin A deficiency if they have severe systemic illness or if the mother is malnourished as seen in lower socio-economic society. Any child having difficulty in night vision is suspected to have Vitamin A deficiency. Vitamin A can be easily supplemented orally by way of foods such as carrots, sweet potatoes, mangoes, whole milk, peas, dried apricots, tomatoes and spinach.

Allergy in children: Grown up kids can present with eye allergy. Symptoms of allergy include itching, burning, discharge and red eyes. Common allergens include flower pollens, dust mite, cotton fibres, dog hair and cat hair. Rubbing of eye because of allergy can cause thing of the Cornea resulting in spectacles power and also a corneal thinning problem called Keratoconus.

The treatment of eye allergy includes avoiding common allergens and by avoiding rubbing of eyes. Cold compression or washing with cold water helps. Anti-allergy eye drops with modification of environment helps mild to moderate cases. Severe eye allergy requires more drops including a short course of steroid eye drops or injection.

Eyelid margin disease in children (Blepharitis): These kids will come with irritation and itching of lid margins which are scaly. Cleaning with commercially available wipes or with diluted Johnson baby shampoo twice a day, with antibiotic ointment twice a day, for few weeks helps to treat blepharitis.

Nasolacrimal duct obstruction: Some kids particularly within 6 months of age could suffer from watering and discharge in one or both eyes. Normally it takes about 6 months for the nasolacrimal duct (the duct draining the tears into nose) to develop. If the duct does not open beyond one year of age, then massaging the duct about 4-5 times a day along with cleaning the eyes and antibiotic drops are could help. If the duct fails to open beyond one year of age, intervention like probing the duct under short general anaesthesia is suggested. If the duct fails to open even with repeated probing, then surgery like dacryocystorhinostomy is advised.

To conclude, it is important to keep a watch on the child’s vision and attend to any problem that the child may be suffering from. Constant communication with the child can help address any challenges the child may be suffering from, by immediately consulting an ophthalmologist.

*Disclaimer: This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.