Squint and Paediatric Ophthalmology

Why is Paediatric Ophthalmology Regarded as a Separate Specialty? What is the Scope of Paediatric Ophthalmology?

The occurrence of the cataract in the kid’s eye is a common problem in the present day. People take medication after a long time of having eye problems. The cataract problems in the children should be treated in a timely manner. Failing to take paediatric treatment results in complete optic vision loss. We, The Eye Foundation take special care in Paediatric Ophthalmology with our team of expertised doctors to educate the importance of taking medication for cataract eye problems in Children. The symptoms of Paediatric cataracts should not be taken at ease and it is the responsibility of every parent to look after their kid. Children generally ignore their eye problems as they are not educated about the seriousness of future infections. The Eye Foundation has the excellent facility and the best Ophthalmologist to treat all kinds of Paediatrics eye problems.

We at The Eye Foundation have a dedicated team of super specialists including strabismus specialists and neuro-ophthalmologists to take care of squint and are the most qualified to treat any misalignment of eyes. We provide best-in-class squint eyes surgery treatment at an affordable cost with the help of our newest technologies and facilities. Our ophthalmologists specialize in the care of children, Paediatric ophthalmologists, and squint treatment at affordable cost, especially for children.

What are the Common Eye Problems in Children?

We can divide the eye problems among children into two categories – the serious ones and the ones that are common and not so serious. Let us discuss the serious ones first.

• Strabismus/ Squint in children is often misconstrued as a sign of good luck. It could be the harbinger of a serious underlying disease. Strabismus disturbs the alignment of the two eyes and impairs three-dimensional viewing of objects ( what we call stereopsis ). Further strabismus can result in one eye becoming amblyopic, which needs to be treated with patching the good eye. All this apart, strabismus in children has important cosmetic ramifications and reduces the self-confidence of the child. We provide the best treatment to correct the child’s squint eyes. The correction of squint does not happen on its own, and its treatment or squint eyes surgery (if needed) must begin as early as possible for the best chances of improvement.
  
• Cataracts in children - it is a misnomer that cataracts occur in adults only. Cataracts in children are rarer, but assume the same significance if we consider the concept of blind years as children would live longer. Further delay in treatment can result in amblyopia, which can be very difficult to treat
  
• Tumors in Children – a number of tumors like retinoblastoma and rhabdomyosarcoma can occur in children. Regular reviews are needed if the child has received radiation for any reason or if the parents have a history of malignancy.
• Vitamin A Deficiency and keratomalacia Unfortunately this continues to be a serious problem. This can be common in nutritionally deprived children especially if there is an inter current illness. Exclusive breast feeding is mandatory in the first four to six months of life. Children who are weaned early are at particular risk for vitamin A deficiency. This condition can result in corneal melting and permanent often untreatable loss of vision
• Amblyopia The patients experience a delay in reacting to the command from the brain to focus the vision on the objects. Amblyopia generally occurs in either one of the eyes. The patient’s eyes do not follow the instruction at the earliest. The eyes react very slowly and time delay happens as the eye started searching for the objects. The lazy eye leads to amblyopia and severe vision loss occurs when treatment is ignored by the patients at the earliest of the complications.
• Ptosis this refers to drooping of the eyelids. This could be either myogenic or neurogenic. When severe it can interfere with vision and result in amblyopia. Milder cases are associated with refractive errors.
• Glaucoma this serious disorder if not treated early can result in irreversible loss of vision. It presents with large corneas since birth. The child may have watering and photophobia. Treatment is only surgical and medical therapy is only of adjunctive value
• Watering Fig 3. Often a symptom of congenital nasolacrimal duct obstruction. Other than causing annoying epiphora, it can also result in pooling of infective bacteria in the conjunctival sac. This could cause serious infections with minor trauma. Recurrent infection of the sac could also occur. Treatment is by sac massage in infancy and with probing and syringing later on
• Corneal and Conjunctival Foreign Bodies One reason why redness and foreign body sensation in children should never be taken lightly. Maggots have also been reported in the conjunctival sac. Delay in removal could result in serious infections
• Eyelid Hemangiomas Fig 4 – this mimics a swelling of the eye lid. Can cause ptosis and refractive errors. Many of these respond to topical beta blockers.

Common but Less Serious Issues

• Acute Conjunctivitis Quite common in children and spreads very easily espcially among those who live in dormitories. Spread can be checked by good hand hygiene. Often presents as redness of the eye with discharge. It can also occur in newborn babies if aseptic precautions have not been observed in labor and also in premature rupture of membranes. Some virulent bacteria and viruses can cause devastating infections in neonates
  
• Ocular Allergies again a common condition among children. Many times the allergies could be recurrent and will need repeated consultations with the Paediatric ophthalmologist. It is important to counsel parents and practitioners to avoid abuse of steroids and to discourage eye rubbing
• Refractive Errors they occur in around 2.5% of school going children in urban areas. Children often do not complain and the resultant poor vision hampers school performance. There may be unrelated complaints like headache, watering, redness of the eye etc. There are many misconceptions among parents on wearing glasses in children. However failure to comply with glasses when needed can result in amblyopia and Strabismus/ Squint