Thoneh

PAEDIATRIC EYE CONDITIONS

PAEDIATRIC EYE CONDITIONS

THONEH’s Paediatric Ophthalmologists aim to ensure that each child has a bright and clear future. With the latest technologies and internationally recognised best practices supporting our specialists, we ensure your child is given optimal eye care for the various conditions affecting the paediatric population.

Among the commonest eye problem in children are:-

  1. Refractive Error
  2. Amblyopia (long eye)
  3. Strabismus (squint)

What is refractive error?

Refractive errors occur when the refractive power of the eye does not connect with the axial length of the eye, so the image does not fall on the retina.

How to tell if your child may have vision problems?

  • Sitting very close to the television
  • Holding a book too close while reading
  • Squinting or tilting the head to see better
  • Frequent eye rubbing
  • Sensitive to light and/or excessive tearing
  • Squeezing the eyes to read or watch television
  • Avoiding activities such as reading (requiring near vision) or participating in sports or other recreational activities (requiring far vision)
  • Complains of headaches or tired eyes
  • Complains of being unable to see the whiteboard in class

Comprehensive Eye Examination for Children

Infants

All babies should have had their first eye examination at 6 months of age.

Toddlers

A second eye examination at age 3-4.

Children

All children should have an eye examination at the age of 6, just before starting school.

Children with refractive errors should have an annual eye check till adulthood.  

How are refractive errors in children treated?

Prescription eye glasses correct refractive errors and allow clear vision. In the recent year there are new options in the treatment of refractive errors. Myopia control treatment using special ophthalmic lenses can be opted for to prevent the progression of refractive error.  Contact lens wear using special hard lens and long term use of eye drops can also be opted.

Learn more about myopia control and prescription glasses

What is amblyopia?

Reduced vision in one or both eyes due to deprivation of vision.

Amblyopia is a term used when the vision of one eye is reduced because the affected eye and the brain do not work together properly.

  • Though the affected eye looks normal, it does not function normally.
  • The brain instead favours the other “normal” eye.
  • If the child is left untreated before the age of 8, it may result in permanent poor vision of the affected eye.

What causes amblyopia?

  1. Uncorrected refractive errors
  2. Squint
  3. Congenital cataract (formation of cataract at birth)
  4. Droopy eyelid
  5. Corneal opacity

What are the symptoms and signs of amblyopia?

  • Unable to read the whiteboard clearly in class.
  • Trouble catching a ball during play and other objects thrown through the air.
  • Avoidance of tasks involving depth perception (the ability to judge the space between two objects).
  • Bumping into doors and other stationary objects.
  • Avoidance in doing tasks that require near vision such as reading and doing homework.
  • Abnormal head posture such as tilting the head to one side to see better.

How is amblyopia diagnosed?

Amblyopia is diagnosed with refractive assessment and orthoptic assessment

How is amblyopia treated?

  • Correction of refractive errors by prescription spectacles.
  • Use of an eye patch over the normal eye to encourage the use of the affected eye. This treatment is more effective before the age of 8 years.

What can you do?

  • Make sure that your child’s treatment plan is followed.
  • Bring your child for regular follow-up to the orthoptist and ophthalmologist.

What is strabismus?

 Strabismus refers to the squinting of the eye.

  • This means that the eyes are not aligned.
  • It may be present at all times or appear intermittently.
  • It is important that strabismus is detected and treated early to prevent a child’s vision development from being affected severely:
    • The brain switches off the vision in the squinting eye
  • If left untreated, this effect will become permanent.
    • In adults, strabismus will present as double vision as each eye is seeing a different image.

What causes strabismus?

In children the following factors may cause strabismus:

      • A family history of strabismus
      • Refractive errors
      • Prematurity or low birth weight
      • Trauma

What are the symptoms and signs of strabismus?

      • Eyes that do not look at the same direction
      • Loss of depth perception
      • Tilting the head to one side

How is strabismus treated?

The treatment of strabismus depends on its root cause.

At times a combination of treatment modalities is required to obtain the best result possible.

      • Prescription spectacles to maintain best visual acuity to prevent amblyopia
      • Eye exercises that are useful to strengthen the ability of the eyes to work together as a pair.
      • Surgical procedure to correct the alignment of both eyes.

It is important that children with this condition have regular check-ups with their Paediatric Ophthalmologist and Orthoptist

 

What is Congenital Cataract?

Congenital cataract refers to lens opacity present at birth. Congenital cataracts may affect either one or both eyes. The severity may also vary where while some congenital cataract does not significantly affect vision, others may cause severe, long-term visual impairment.

Congenital cataract is responsible for nearly 10% of all vision loss in children world wide. It is one of the most common treatable causes of visual impairment and blindness during infancy, with an estimated prevalence of 1 to 6 cases per 10,000 live births worldwide.

What causes cataract in children?

Congenital cataract has a wide range of potential causes. This includes genetic, metabolic, infection, and even as a side effect from the medication that the mother took during pregnancy.

What are the symptoms of congenital cataract?

Congenital cataracts most often look different than other forms of cataract. Symptoms may include:

  • An infant does not seem to be visually aware of the world around him or her (if cataracts are in both eyes)
  • Gray or white cloudiness of the pupil (which is normally black)
  • The “red eye” glow of the pupil is missing in photos, or is different between the 2 eyes
  • Unusual rapid eye movements (nystagmus)

How is congenital cataract treated?

The cataract can be removed with surgery. The younger the child, the greater the urgency is to remove the cataract due to the risk of amblyopia. However, other factors will also be taken into account. If the cataract is too mild to affect vision, paediatric ophthalmologist may not consider performing the surgery immediately, but instead will continuously monitor the cataract and the child’s visual development until he/she reaches adulthood.

What can you do?

As parents, be wary of the symptoms stated above. Easiest sign to detect is the white appearance at the centre of the eye. If a parent suspects his/her child has congenital cataract, immediate consultation with paediatric ophthalmologist is needed. This is to ensure that the child’s visual development is not affected which may lead to life-long visual impairment.

What is ptosis?

Ptosis is a drooping or falling of the upper eyelid. If severe enough and the child left untreated, the drooping eyelid can cause other conditions, such as amblyopia or astigmatism. Ptosis can affect either one or both eyes.

What causes ptosis?

Ptosis occurs due to dysfunction of the muscles that raise the eyelid or their nerve supply. While mostly an acquired disease, congenital ptosis can be hereditary where a child is born with it. Congenital ptosis is also associated with Horner’s Syndrome.

What are the symptoms of ptosis?

Ptosis can be detected by the droopy appearance of the eyelid. In cases where it only affects only one eye, comparative position of the eyelids is the easiest method that parents can use to detect ptosis. In cases where it affects both eyes, parents may judge by the abnormally droopy appearance of the eyelids.

How is ptosis treated?

Congenital ptosis may require surgical correction if severe enough to interfere with vision or if cosmetics is a concern.

What can you do?

Parents who suspect ptosis in their children should seek immediate consultation with a paediatric ophthalmologist as ptosis may cause astigmatism and amblyopia.

Find a doctor - Book an appointment

DR. ZAINAL BIN MOHAMAD

Senior Consultant Ophthalmologist

DR. VIJAYA MOHAN

Senior Consultant Ophthalmologist

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