REFRACTIVE ERRORS

       Refractive errors are the most common vision problem in children. Because of this, eye cannot clearly focus the images, resulting in blurring of vision.

       Children are usually unaware of their vision problems. So the adults who take care of them should watch out for the symptoms like frequent blinking and rubbing of eyes, squeezing of eyes while reading, watching TV by sitting closer to the screen, reading with books held closer to face, headaches, eyestrain, squinting etc. Only very few children realize their vision problem and complain of blurring of vision for near or distance

The main types of refractive errors in children are

Myopia:

      It is the most common refractive error in children. It is otherwise known as nearsightedness.

    In myopia the image from the object falls in front of the retina. So only a blurred image forms on the retina.

Hypermetropia:

       It is otherwise called farsightedness. In hypermetropia, the image from the object falls behind the retina.

Astigmatism:

     Astigmatism can be myopic or hypermetropic. This is the most common refractive error found in children now-a-days.

Causes of refractive errors

        It can be both genetic and environmental. Refractive errors develop earlier in children with genetic susceptibility (ie if either of the parent has refractive error), when the environmental factors become favourable.

Some factors leading to early onset and progression of refractive errors, especially myopia are

• Excessive accommodation and near work
• Reading in poor lighting conditions
• Closer reading distance
• Poor sunlight exposure
• Vit D deficiency
• Nutritional deficiencies
• Higher intake of foods with high glycemic index, saturated fatty acids etc.
• Some genetic conditions like Marfans syndrome, autoimmune disorders etc.

Treatment of refractive errors

          Doctors usually prescribe eye glasses or contact lenses to temporarily correct the refractive errors in children. In younger children eye glasses are preferred over contact lenses

      Children with refractive errors need regular follow up atleast once  every 6 months.

AMBLYOPIA/LAZY EYE

       It is decreased vision in one or both eyes caused by abnormal visual stimulus early in life. It is the most common cause of decreased vision in children. It generally develops from birth to 10 years of age.

       In children with decreased vision in one eye, their brain gradually begins to ignore the impaired visual impulse from that eye resulting in permanent decreased vision

 Early diagnosis and treatment can revert this condition.

Symptoms:

   Squinting

    Poor depth perception

    Head tilting

Causes :

   Refractive error in one or either eye

   Strabismus – when either one or both eye looks at different targets, the brain begins to suppress the image from one eye

   Obstruction of light entering the eye – Lid abnormalities, corneal scars, cataracts etc can cause obstruction to light entering the eye resulting in lazy eye.

Treatment

  Main treatment of lazy eye is correcting the cause for visual problem such as refractive error, strabismus, cataract etc. Lazy eye treatment aims to force the weak eye to work more in order to develop proper vision over time.

SQUINT

    Squint also known as strabismus is a condition where the eyes are not aligneds in the same direction.While one eye looks straight othereye may turn in,out or even go up and down.

Causes:

• Hereditary
• Uncorrected refractive error
• Childhood illness
• Nerve palsy
• Obstruction to light entering the eye
• A pseudo squint may occur due to flat or broad nasal bridge

Complications of not seeking treatment for squint:

• Diplopia
• Decreased vision in one or either eye
• Loss of binocular vision causing loss of stereopsis(depth perception )

Treatment

The main goal of treatment is finding the cause of squint if there is any and correcting that

Treatment options include

• Glasses
• Eye exercises
• Patching
• Surgery
• Injections into eye muscles etc