Affordable Cost Eye Treaments for Children in Mumbai

COMMON EYE PROBLEMS IN CHILDREN

• Refractive Errors
• Lazy Eye or Amblyopia
• Squint
• Watering – Blocked Tear Ducts
• Cataract
• Retinopathy of Prematurity (ROP)

REFRACTIVE ERRORS

When light rays from a distant object do not come to a focus on the retina, the image of the object appears blurred and the condition is called Ametropis.

When the size of the eyeball is longer than normal, these light rays are focused in front of the retina. This is Myopia or short sightedness. This can be corrected by concave lenses as spectacles or contact lenses.

When the size of the eyeball is shorter than normal, these light rays are focused behind the retina. This is Hypermetropia or long sightedness. This can be corrected by convex lenses as spectacles or contact lenses.

A normal eye has spherical cornea in all its meridians. When the cornea is steeper of flatter in any of its axii it gives rise to Astigmatism. This is corrected by cylindrical lenses as spectacles or toric contact lenses.

Parents should encourage the sporting activities and provide a balanced diet rich in vegetables, milk products, salad, fruits and avoid junk food to maintain good eye health and overall health of their children.

LAZY EYE OR AMBLYOPIA

Amblyopia is commonly known as lazy eye. This should not be confused with squint. Amblyopia is poor vision in an eye that could not develop normal sight during early childhood.

At the age of eight years, the development of the part of the brain that processes vision is almost complete. If the brain has not received clear images from the weak eye, it starts neglecting this eye. The eye is then said to be amblyopic or lazy as the vision does not develop.

COMMON CAUSES OF AMBLYOPIA

• Refractive errors such as Short Sightedness, Long Sightedness or Astigmatism.
• Large difference in spectacle powers between the two eyes.
• Strabismus or squint.
• Obstruction of vision by droopy eyelid, cataract or other diseases.

Management

Successful treatment depends on how severe the Amplyopia is and the age of the child when treatment begins. If the problem is detected early, successful treatment is possible and treatment time is shorter, if it is detected after the age of 8 years the success rate will be low.

..Spectacles

The child should be encouraged to wear his or her spectacles as much as possible throughout his waking hours if he or she is being treating for Amblyopia.

..Patching

The treatment consists of patching the GOOD EYE, so that the affected eye is made to work and the child is encouraged to see with it. It requires a tremendous amount of co-operation and understanding by the parents.

..Pharmacological treatment

Sometimes we prescribe some medications to help the amblyopic eye see well.

SQUINT

Squint or crossed eye is a condition where both eyes do not move together. One eye deviates either inwards, outwards, upwards or downwards while the other eye remains straight. It may also be alternating between the two eyes. Refractive errors are the most common causes of the squint, the other being lazy eye, nerve or muscle weaknesses and injury.

Management

Treatment of squint requires a combination of glasses, exercises and surgery. Surgery may be needed in one eye or both eyes depending upon the squint, essentially it is a combination of loosing or tightening of eye muscles.

It is important to correct squint as it can lead to deep Amblyopia and psychological problems in children, loss of binocular vision, and loss of depth perception. Many simple activities like threading a needle, ability to understand the depth of staircase or liquids in a glass and functioning on a microscope become difficult.

WATERING AND BLOCKED DUCT

Normally the tears are formed by the tear glands in the eyes and are drained off through two holes in the corners of the eyelids called punctae into the nose through a duct. The entire drainage system is called as Nasolacrimal duct system. Sometimes there can be a block at any level, at the punctum or in the ducts which may fail to open after birth resulting in persistent watering or discharge from the eyes. If left unattended this can lead to infection and painful swelling near the bridge of the nose.

Management

..Massaging

70 to 80% of times the duct opens on its own time. Massaging the tear ducts is important to open the ducts. Massaging is done with the thumb or the forefinger, the stroke is to be firm and in the direction from the eyes to the nose downwards and inwards.

..Probin

If massaging fails a wire probe might need to be passed through the duct forcing it to open. This is done under anesthesia or sedation in small children.

..Lacrimal Duct Surgery

If the above methods fail to open the blocked ducts, surgery is recommended in children above 1 year of age. The surgery is done under general anesthesia.

CHILDHOOD CATARACT

Introduction

Cataract can affect a child as young as a new born baby. Cataract in children cause severe damage to the development of vision and needs to be treated as an emergency.

There are various causes of cataract in children like hereditary, genetic, infectious, metabolic, eye injuries etc. It is not possible to ascertain the cause in every child.

However, sometimes investigations are needed to find the cause as they have a big impact on child's life span and future quality of life.

What is the treatment for Cataract?

• The treatment of cataract in a child is usually by surgery at the earliest.
• Cataract surgery in a child is totally different as compared to a cataract surgery in adults. There are many issues that are to be dealt with in a different manner in terms of examination as well as surgeries.

RETINOPATHY OF PREMATURITY (ROP)

ROP is a disease affecting the retina of premature infants. Very often premature babies are kept in tents of hyperbaric oxygen until they become fit to breath normally. The incidence of ROP is on a rise, this is due to improved survival rates of very low birth weight and extremely premature infants. The hyperbaric oxygen instigates the growth of abnormal vessels from the retina. The key disease element in ROP is growth of abnormal blood vessels with increased risk of bleeding or developing retinal detachment.

• Which babies are at risk? Who should be screened?

The criteria for screening babies are based on two critical factors – the birth weight and the gestational age. In general infants with birth weight less than 1700 grams and gestational age below 34 weeks need screening.

• When should screening be done? How frequently should the child be examined?

As a rule of thumb 1^st screening should be over by Day 30 of baby's life. Very small babies (Weight < 1200 grams or < 24 weeks age) need to be screened within 2 weeks. Depending on the stage of the disease immediate treatment or repeat exams may be required.

• What is the treatment for ROP?

Treatment is in the form of Retinal Lasers and surgery if Retinal detachment develops.

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