Eye Problems in Children

There are many eye problems that are commonly found in children. The major problem is the refractive error, the common mode of presentation is that the child is not able to see the distant objects usually seen in the school where the child fails to see clearly the letters written by the teacher on the blackboard. Most of the time the child holds the book very close to the eyes while reading. And also child watches TV and Computers from a very close distance.

The other problems are – Vitamin A deficiency, Squint eyes and Retinoblastoma (Eye Cancer).

Refractive Errors:

There are mainly three types of refractive errors. Myopia, Hypermetropia and Astigmatism.

Myopia : This is the most common refractive error found in children. Usually it is detected when the child is having problem in seeing distant objects. Occasionally the child may have a slight pain in the eyes after reading for many hours. The light rays are focused in front of the retina in myopia with the result that the objects appear hazy.( If we have to see a clear object it has to be focused on the retina.) Sometimes it has a strong family history. The eye has to be properly examined by a competent Ophthalmologist (not by an Optometrist) and suitable glasses prescribed at the earliest. Regular follow – up is also a must in these children.

Astigmatism is another refractive error seen in children not as frequently as Myopia. Hypermetropia where the child has + numbers in glass, is comparatively less in frequency. Suitable glasses correct both these refractive errors.

Vitamin A Deficiency:

Vitamin A Deficiency is demonstrated in school going children. Usually children in the age group of 6-12 years complain of night blindness. In other words those children have inability in seeing objects clearly in dim light. Sometimes small pigmented patches are seen by the side of the cornea. These are called Bitot’s spots. At this stage the child has lot of watering in the eyes.

A substance called visual purple has to be created in the retina to visualize objects clearly in the dim light. Vitamin A is necessary to create this object. When there is deficiency of Vitamin A in the diet, child gets night blindness. Sometimes some skin problems are associated along with eye problems.

Vitamin A deficiency is treated by giving capsules of Vit.A 2500-5000 IU or 750 mg of beta-carotene. In severe cases injections may be needed. Green leafy vegetables, carrots, milk, curd, butter, egg, liver etc., have rich contents of Vitamin A.

Squint Eyes : The two eyes normally should be in a definite visual axis. A manifest deviation of the visual axis of either eye is known as squint or strabismus. Mainly there are two types of squints – Paralytic and Non-paralytic or Concomitant. Concomitant is the one which is mostly seen in children. Concomitant deviations are for the most part, produced by anomalies of the power of convergence and divergence and the co-ordinated use of the two eyes to obtain binocular single vision. In these cases the amount and character of the deviation does not vary when the eyes are turned to the right or left.

The other classification of squint is – Convergent and Divergent. Convergent squint is the one in which one of the eye is turned inside, whereas in divergent squint one of the eye is turned outside.

Each child with squint has to be properly investigated before undertaking treatment. The common methods of treatment are – 1) Correcting the refractive errors by glasses whenever that is found to be the cause of the squint. 2) Deliberate occlusion or patching of the fixing eye so as to improve the vision of the squinting eye. 3) Suggesting special type of ( Orthoptic) exercises to improve the binocular faculties. 4) By surgery to restore parallelism of the visual axis. One or more of these methods or all four may be needed.

Retinoblastoma: It is the cancer or malignant tumor of the eye , usually seen in children below 5 years. It may be seen at birth or later. This disease not only affects the vision, but also life itself if it is not diagnosed and treated properly at an appropriate time. It may be seen in one eye or both.

Usually the child is brought to the eye specialist with the complaint that something white or yellow material is seen in the eye. If one eye is swollen enormously, it is understood that the disease is advanced. Treatment is usually removal of the eyeball as soon as the disease is diagnosed and the cut portion sent for biopsy. After the removal of the eyeball, if there are any signs of the disease,

Radiotherapy is advised. At this stage the other eye is examined and if any traces are found it is also subjected to radiotherapy. In the advanced stage of the disease, it is mandatory to treat with chemotherapy.