PAEDIATRIC OPHTHALMOLOGY AND SQUINT
Children are not miniature adults. Their eyes, visual needs, and disorders are entirely different than from those of adults. Since they are rapidly growing, and are yet to develop a fully mature eye-brain coordination, disorders of vision in children require special attention and focus. This is why pediatric ophthalmology has evolved as a specialized discipline, and indeed a subspecialty in ophthalmology.
What are the symptoms and signs of eye problems in children?
- Reading disability and problem in school in copying what is written on the board could be an indication of poor vision
- Any squint or misalignment of the eyes
- Any frequent headaches, eye rubbing, red eye, recurrent eye infections and watering from eyes
- Any family history of eye disorders including the need for glasses (refractive errors), can be passed from one generation to another and must be evaluated early on in life. The frequency and schedule of an eye examination in children are mentioned here.
What are the special tests and services that Centre offers for children?
- Vision assessment and refraction under dilation
- Squint assessment and evaluation of binocular vision
- Amblyopia therapy
- Synaptophore assisted eye exercises for stimulating the eye muscles and binocular vision.
- Management of all childhood infections and allergies
- Trauma services
- Examination under sedation or anesthesia, if indicated. Comprehensive pre-anesthetic check-up and post-operative care.
- Glasses and low vision aids
Squint
Squint (Strabismus) occurs when the eyes are not accurately aligned and point in different directions while focussing on an object. It is generally known as ‘turned,’ ‘lazy’ or ‘crossed’ eyes.
In Squint, one eye or both eyes may turn either inward (esotropia), outward (exotropia), upward (hypertropia) or downward (hypotropia). Squint may be constant or intermittent. While the causes of Squint are not fully understood, it is known that an abnormality in the muscles and/or under developed vision in one or both eyes are the contributing factors.
Correction and Treatment
A Non-Surgical Approach Strabismus (Squint)
Early diagnosis of Squint (Strabismus) is essential in preventing irreparable vision loss later in life. Squint treatment aims to enhance the alignment of the eyes and to correct the resulting vision loss (amblyopia). Squint and amblyopia can be treated with combination of glasses, eye patching and/or surgery.
TREATMENT FOR SQUINT (STRABISMUS Surgery)
Surgery includes treating one or more of the eye muscles to correct the position of the eye(s). The treatment is performed under local/general anesthesia in operation theatre. Now a days squint is treated with latest fornix method, leading no/ minimal scarring. this is a day care procedures and patient may resume his/her routine activities from the very next day.
Here are some common questions about Squint (Strabismus)
The management of squint is planned into two stages depending upon presence of refractive error and/or muscle weakness. first of all, a complete evaluation is done to see if there is any need of specs. we might see improvement in squint after proper use of prescription glasses. In second stage if the squint is not fully corrected even after using prescription glasses strabismus surgery for balancing of muscles is planned.
Squint may re-appear sometimes in later ages, which had been operated earlier. It needs to be thoroughly evaluated and accordingly a re-surgery may be needed.
As such, squint surgery does not enhance vision and instead aligns the eye. Aligning the retina is critical for treating amblyopia (lazy eyes) in children that actually in a way helps in improving the vision of kids. This does, however, actually improves cosmesis in adults.
Amblyopia
Amblyopia (Lazy Eyes) occurs when one eye is used less than the other from birth to seven years of age, which leads the brain to prefer the better eye. Rarely, amblyopia may affect both eyes.
Amblyopia (Lazy Eyes) is a neuro-developmental visual problem that starts during infancy and early childhood. Those with amblyopia experience reduced eyesight typically in one eye, even when best corrected with glasses or contacts. if left untreated, amblyopia can lead to squint and affect a child’s self-image, work, school, sports, friendships and may also lead towards depression.
What are the symptoms associated?
The most common symptoms associated with the lazy eye are:
- Eye turning in, out or up
- Closing one eye (particularly in bright sunlight)
- Squint
- Headaches or eyestrain
What are the causes of Amblyopia?
It develops when any of the following conditions occur in an infant or young child:
- Squint/strabismus (eyes not positioned straight)
- Congenital cataract (clouding of the lens in an infant)
- Uncorrected high nearsightedness (myopia) or farsightedness (hyperopia) in both eyes
- Uncorrected high myopia or hyperopia in one eye (one eye focuses differently from the other)
- Severe ptosis (droopy eyelids)
Treatment Options
1 Eyeglasses or contact lenses (proper lenses can Improve vision and reduce stress so that the under developed eye can start working more efficiently) along with amblyopia therapy (which includes patching therapy & exercise)
2.Restrain the visual system- pushing the weaker eye to work by blocking or fogging the favored eye with special lenses, an eye patch, or eye drops. Now a days, software based amblyopia therapies have been introduced and appear to be quite effective. Early diagnosis and proper amblyopia therapy can improve vision significantly.
