Children are not like small adults and it is recommended that their eye problems should be dealt with by a specialist paediatric ophthalmologist who, not only has studied in depth the pathology of the paediatric eye, but also has the manner to approach, examine and treat the child effectively.
The most common paediatric ophthalmology pathologies include:
– Amblyopia (lazy eye)
The amblyopic (lazy eye) is an anatomically perfect eye that has reduced vision due to the inability of its information to reach the brain
Amblyopia starts in childhood and if not treated continues into adult life. Vision does not develop normally in the amblyopic (lazy) eye during the first years of life, from birth until the age of 7-8 years.
During those years under normal circumstances neural connections between the eye and the brain develop. Should there be a problem during those sensitive years that blocks clear vision in one or both eyes of a child those connections are defective and lead to amblyopia.
Pathologies during the first 7-8 years of life that can cause to a lazy eye are :
• Strabismus (squint) (the eyes look at different directions)
• Anisometropia (difference in the refractive power of the eyes)
• Congenital cataract(a cataract that presents at birth)
• Congenital ptosis and other rare diseases
– Refractive errors
Refractive errors that are encountered at children, as well as adults, are myopia (short-sightedness), hypermetropia (long-sightedness) and astigmatism.
Refractive errors present with blurred vision and can be treated, once accurately diagnosed, with glasses or contact lenses. If not treated timely they can affect normal visual development in children and lead to amblyopia (lazy eye)
Refractive errors and in particular astigmatism can be inherited, so family history is important.
There are studies that have shown that myopia can be delayed in children with the use of medications.
– Strabismus (squint)
In strabismus the eyes of the child are not aligned and look at different directions.
Usually one eye is the dominant eye and is looking at the direction of vision whereas the other eye converges (to the nose) or diverges (out). In some occasions the eyes alternate directions.
Strabismus can be present early, just after birth (congenital strabismus) or at a later age.
The most common strabismus is idiopathic (with no particular cause)
Often strabismus can coexist with refractive errors and correcting those can fully or partially improve the angle of strabismus.
Finally and very importantly some brain disorders can cause or coexist with strabismus and it is really crucial for the paediatric ophthalmologist to decide whether further neurological tests are necessary in a child with strabismus.
– The watery eye
Children can be born with one or both watery eyes. This condition can last for several months after birth. Watery eyes are very common with about 20% of new-borns presenting with it.
In most occasions it is due to the delayed maturation of the nasolacrimal system and the failure of the Hasner valve, which connects the eye to the nose, to spontaneously open.
– Chalazion (Stye) and eyelid lesions
Chalazia are benign eyelid cysts and are caused by a blocked meibomian gland of the eyelid.
Those cysts are common in children and are usually accompanied by blepharitis. Blepharitis is a longstanding irritation of the eyelid which is often asymptomatic.
– Foreign bodies and trauma
Those are common conditions in children, can be missed and present with a red eye.
Correct diagnosis and treatment are necessary for avoiding long term visual consequences.
– Congenital cataract
Congenital cataract is an opacity of the lens of the eye that can be present at birth.
In congenital cataract the crystalloid lens of the eye is opaque and does not allow clear vision to the baby, resulting in amblyopia.
Congenital cataract can significantly affect the vision and 24% of blindness in children worldwide is due to congenital cataract. It can affect one or both eyes of a child.
Congenital cataract can be caused several metabolic or systemic diseases, intra-uteral infections, trauma etc.
It has to be treated timely and usually treatment is surgery and long follow up.
On the day of your appointment :
Try to arrive on time so that the child is not stressed and rushed before the examination
Bring old glasses with you.
During the examination it is very likely that we will use eyedrops that dilate the pupil of the eye. Time is necessary for the drops to act so please bring some favourite snacks and favourite toys with you in order to keep the child occupied and happy.
Please bring a hat or sunglasses with you as dilated pupils cause photophobia.
Be prepared to spend up to an hour in the ophthalmologist’s office if drops are necessary.