Children can have variety of eye problems. India has the highest number of children with blindness. Children can have vision impairment due to refractive error, Cataract, Glaucoma, Squint, lazy eye, retinal dystrophies, or even tumours of the eye. The Himalayan Eye Institute has trained Pediatric Ophthalmologist for diagnosis and management of various facets of pediatric eye disorders.At present, this service involves not only diagnosis and management of various facets of pediatric eye disorders like refractive error, childhood cataract, glaucoma, amblyopia, squint, retinal disorders, congenital anomalies, pediatric eye cancer etc.but also adult patients with squint/ double vision problems. The department provides appropriate therapeutic intervention for all stages of retinopathy of prematurity, a blinding disease of the premature newborn.The facility has a variety of equipments, necessary to perform an extensive pediatric ophthalmic examination including portable slit lamp, portable non contact tonometry, orthopticequipments, synoptophore etc. There is provision for examining uncooperative children under general anesthesia. We approach each patient with specialized attention and assess the problems for appropriate diagnosis and treatment strategies. The institute has facilities for all kinds of pediatric ophthalmic surgeries.
Children with following symptoms should be examined for eye problems:
The commonly encountered eye diseases in children are:
Refractive Error:
It can be far sightedness (Hypermetropia), Short sightedness (Myopia) or astigmatism (cylindrical error). Every child must be tested for visual acuity and for colour vision at an early age.
Squint:
All eye deviations should be brought to the pediatric ophthalmology clinic. Usually it is because of some type of refractive error and once treated appropriately, patient attains a good visual acuity and parallelism.
Amblyopia or Lazy Eye:
In children less than 10 years of age it can be very effectively treated by occlusion therapy. By occluding the better eye the child is forced to see from the lazy eye.
Injuries:
All black eyes, every injury in children should be treated as an emergency. Injury can be blunt, perforating or with retained intraocular foreign body. Many eyes can be saved, if treated on time. Chemical injuries due to lime, acid, holi colour, fevicol are also common in children, and must be treated as early as possible. Thermal injuries due to fire crackers also need immediate attention.
Childhood Infections:
Any discharge from the eye should be reported and treated immediately on lines of emergency.
Congenital Cataract:
Any suspicion of a white pupil (leukocoria) in child may be due to a congenital Cataract. Cataract in children is treatable and an intraocular lens can be implanted inside the eyes like adults.
Childhood Glaucoma:
There is minimal awareness that glaucoma exists even in childhood. The early symptoms may be increased watering, photophobia or cloudy cornea, or increase in size of eye ball. A thorough examination is required for diagnosing and if treated early gives excellent visual outcome.
Tumours of the eye:
Retinoblastoma is a vision and life-threatening tumour of the eye, which may be diagnosed early by retina examination. Any child with white reflex from pupillary area must have a retina check-up as early as possible.
Abnormalities of lacrimal drainage system:
This causes constant watering in one or both eyes with or without discharge from the eyes.
Congenital anomalies of lid/ eye ball:
Ptosis (drooping of eye lid) epicanthus (mongol eyes), microcornea (small corneal diameter), micro-ophthalmos (small eye ball).
As the child's height increases through his growing age (6-16 years), the length of his/her eyeball also may increase, resulting in increasing minus power. Usually this process becomes stable between 16-18 years. Increasing power >0.50 D in 6 months or >0.75D in one year is considered to be rapid progression.
A child patient with Esotropia (eye misalignment) underwent squint surgery at our institute. Thankfully the patient received treatment for amblyopia (lazy eye) at the right time to prevent blindness. An uncorrected vision problem can interfere with a child's ability to learn and reach his/her highest potential. In the absence of timely treatment, amblyopia (lazy eye) associated with squint may lead to irreversible vision loss in children. Hence, restoring eye sight of children is one of our top priorities.
A sudden vision loss can definitely be frightening for anyone! A 10-year old child with sudden & complete loss of vision in both eyes was brought to us by his anxious father 3 weeks ago. On examination by our Sr. Eye Surgeon, Dr. Swarup kr. Roy, the patient was diagnosed with bilateral Optic Neuritis, a rare eye problem. The boy had complete loss of vision in both eyes (HM +ve) and his vision gradually deteriorated. Optic neuritis is considered to be an autoimmune disorder, in which the immune system attacks the body’s own optic nerve tissue by mistake. The attack of the immune system may cause inflammation, swelling and impaired function of the optic nerve. The trigger for this immune reaction may be a viral illness, recent immunization, infection around the optic nerve, multiple sclerosis, or other neurological problems. However, in this case, with immediate intervention the condition was accurately diagnosed and successfully treated. Thankfully the boy has gained normal vision within 3 weeks and his parent’s happiness had no bounds.
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