Pediatric Eye Check

Recommendations for Eye Checkup for childrenA pediatrician should examine a new born’s eyes.Vision screening should be done between 3 and 3½ years of age.Detailed eye examination must be done if there is appearance of symptoms of visual impairment.Common eye problems in children

Refractive errors (spectacle number) account for 80% of visual impairment in children. This includes Myopia or near-sightedness, where distance vision is blurred, but a child can usually see well for reading or other near tasks. This occurs most often in school age children. The prescription for glasses will indicate a minus sign before the prescription (for example, -2.00 D).

Another problem is Hyperopia (far-sightedness), where problems such as crossing of the eyes, blurred vision, or discomfort may develop. However, most children are far-sighted early in life and it becomes a concern only in excessive cases where the focusing muscles are not able to keep the vision clear. A prescription for hyperopia will be preceded by a plus sign (+3.00 D).

Astigmatism is also common and is caused by a difference in the surface curve of the eye. Instead of being shaped like a perfect sphere (like a basketball), the eye is shaped with a greater curve in one axis (like a rugby ball) and this causes fine details to look blurred or distorted. Here, the prescribed glasses have greater strength in one direction of the lens than in the opposite direction.

Anisometropia causes children to have a different prescription in each eye. This can create a condition called ‘lazy eye’, where the vision in one eye does not develop normally. Glasses (and sometimes patching) are needed to ensure that each eye can see clearly.

Lazy eye or Amblyopia is seen in 1% of children. It is a failure of the eye to connect to the brain due to lack of use of one eye during infancy and childhood. Therefore, the vision in the amblyopic eye remains poorer than in the normal eye. To solve this, the poorer seeing eye is forced to be used by patching the preferred eye and combined with the use of glasses where necessary. Amblyopia must be corrected by 9 years of age by which time it becomes permanent. To detect and treat ambylopia, it is necessary to examine pre-school age children.

Squint or Strabismus, also called crossed-eyes, means that the eyes are not aligned but are pointing in different directions. They may either point inwards towards the nose (esotropia), outwards to the ear (exotropia) or up or down (vertical strabismus). The problem can be constant or intermittent. However, intermittent strabismus occurs in infants during the first few months of life, especially when the infant is tired, since they are still learning to focus their eyes and to move them in a coordinated fashion.

Most babies outgrow this intermittent strabismus by the age of 3 months. For other cases, various treatment options are available, including exercises for the eyes, called orthoptics.

Some of the uncommon eye problems in children include cataract, glaucoma and retinal problems, which are treated through different methods.