Common Childhood Eye Problems
Eyes and vision rank among the health issues of most concern to parents. While serious eye disease is uncommon in children, it is estimated that one in 20 preschool children and one in four school-age children has a vision problem that needs correcting and could cause permanent vision loss if left untreated.
Uncorrected vision problems are a serious problem for parents and children. Parents need to be aware because children may not realize something is wrong with their vision. A child assumes others see the world as she does. If it’s what she always knew, then it seems normal.
Vision exams performed by trained professionals are one of the strongest medical methods available for ensuring the long-term health and well-being of your child. Numerous learning and behavior problems stem from poor vision, yet too many children begin school without undergoing a complete and professional eye exam. Parents need to know the signs of vision problems and seek evaluation and treatment early.
Catch Visual Problems Early!
More than 90 percent of vision development and eye health problems are treatable and can be more easily corrected if treatment is started early. Be observant in detecting the early warning signs in your children.
Eye Examinations: When, How Often?
Vision screening is aimed at detecting eye disorders in children that can be treated when they are young. In addition to normal pediatric checkups, children without symptoms and who are at low risk for eye problems should have their eyes screened by:
- six months of age
- age three
- start of school
Risk-free children should continue to have their eyes examined every two years throughout school. If there are risk factors more frequent eye exams are necessary. They include:
- developmental delays
- turned or crossed eyes
- family history of eye disease
- history of eye injury
- other physical illness or disease
Signs and Symptoms of Eye Disease
If a child has one of the problems listed below, he or she should have an examination by an eye doctor as soon as possible. No infant or child is too young to have an eye exam.
You see the following signs:
- a white pupil
- a lump, swelling or drooping of the eyelid
- tearing, discharge or redness of the eyes
- one pupil – the black center of the eye – is larger than the other the cornea – clear outside layer of the eye – is large in one or both eyes
You observe the following behavior:
- one eye looks or turn in or out
- the eyes seem to jiggle or rotate
- turns or tilts head to look at things
- head tilted to one side or one shoulder higher
- squinting or closing of one eye
- excessive blinking, squinting and/or watering
- poor hand-eye coordination or motor skills
- eyes don’t “track” or follow objects
- problems moving in space, frequently bumps into things or drops things
While reading or doing close work your child:
- only able to read for short periods of time
- headaches or eyestrain
- nausea or dizziness
- motion sickness
- double vision
Early treatment can prevent vision loss. In some cases, if an eye disease is not treated your child could lose her sight. Treatment for eye diseases may include medications, eye patches, eye exercises or surgery.
Common Childhood Eye Diseases
- Myopia: Nearsightedness. Your child can’t see objects at a distance.
- Hyperopia: Farsightedness. Visual disorder in which your child can’t see up close.
- Astigmatism: If your child has astigmatism, it means that his or her eye is shaped more like a football, rather than a baseball. Astigmatism is very common and causes blurry vision.
- Treatment: Glasses are the most common correction for children, but contact lenses are also an option.
Eye Movement Disorders
- Strabismus: Misaligned eyes, or strabismus, can mean not only crossed eyes but also eyes that point outward, upward or downward.
- Amblyopia (Lazy Eye): If your child squints or closes one eye to see, check for amblyopia. If not diagnosed and treated early, it can result in permanent vision loss.
- Nystagmus: If your child’s eyes move involuntarily, slow and fast movements that are repetitive or “jerky,” it may be a sign of Nystagmus.
Conjunctivitis or “Pink Eye”
- Cause: Bacterial, viral, or fungal infection of the membrane lining the eyelids.
- Contagious: Yes, usually
- Signs and Symptoms: Redness, itchiness, light sensitivity, and a discharge that crusts.
- Treatment: Your doctor may recommend ointments, eye drops or oral antibiotics with warm compresses for bacterial forms. Some viral forms often resolve on their own.
- Cause: Inflammation due to allergies.
- Signs and Symptoms: Red, itching, watery eyes. No discharge.
- Treatment: Use cool compresses to soothe the eyes and antiallergenic eye drops, over the counter or by prescription. Avoid the allergen.
- Cause: Eyelid gland becomes clogged. Children often get sties by rubbing their eyes with dirty hands.
- Signs and Symptoms: Bump on eyelid with occasional discharge. Pain indicates infection.
- Treatment: Apply warm compresses; use antibiotic drops or ointment if stye is infected.
Blocked Tear Duct
- Cause: Inflammation that occurs when tear ducts are blocked because of infection, injury, or narrowness of duct.
- Signs and Symptoms: Watery eyes; inside corner is red, swollen and painful.
- Treatment: Open duct with warm compresses; massage the affected area at the nose; use antibiotic drops if infected. See doctor.
- Cause: Scratch in the membrane covering the eye, caused by a foreign object. May lead to an infection.
- Signs and Symptoms: Light sensitivity, tearing, and pain.
- Treatment: Apply antibiotic ointment frequently until healing is complete along with warm compresses four times a day.
Applying Eye Medications
A problem parents face when their child has pink eye or other eye infection is how to administer eye drops? While your child is sitting down, tilt her head back, gently pull the lower eye lid down and place the eye drops or ointment into her eye. If this isn’t successful, have her close her eyes and then place the drops on the inner corner of his eyes and then have her open her eyes. The drops should go into her eye.
Children’s Eye Movement Disorders
Eye Movement Disorders are a group of conditions that affect the way one eye or both eyes together move. Most of us are fortunate because our eyes started to work as a team very early in infancy and have continued to work together ever since. We are able to focus each eye on whatever we look at, regardless of the direction, and our brain combines the picture or image from each eye into the mental picture we actually see in three dimensions.
About four to five percent of children have some form of Eye Movement Disorder. For a number of reasons their eyes do not move properly or work together as a team. It is important that these conditions be diagnosed and treated as early as possible when the eye is still developing.
Signs and Symptoms of Eye Movement Disorders
- Eyes that look misaligned
- Eyes that do not appear to move together
- Frequent blinking or squinting, especially in bright sunlight
- Eyes that have jerky movements up and down or back and forth
- Tilting head to look at things
- Faulty depth perception
- Double vision
What is Strabismus?
Strabismus is a visual condition in which the eyes point in different directions and are out of alignment. One eye may be straight and the other turned in, out, up or down. It may be constant or come and go. There are three basic kinds of strabismus:
- Esotropia: When either one or both eyes turn inward toward the nose, esotropia is the most common form of strabismus.
- Exotropia: The second most common kind of strabismus, exotropia is when one or both eyes turn out. It usually begins at age two or three.
- Hypertropia: The least common type of strabismus, hypertropia is when one eye is higher than the other and the child often tilts her head to avoid double vision.
Causes of Strabismus
Though we know the brain controls the eye muscles that control the eye movement, and that the muscles in both eyes must be coordinated for the eyes to move together, we don’t know the exact cause of strabismus.
How common is Strabismus?
It is estimated that 4 percent of children have some form of Strabismus. Males and females are affected equally and it may run in families.
Symptoms of Strabismus
Children may sometimes squint one eye in the sunlight or tilt their head to use both eyes together.
Diagnosis of Strabismus
The child with strabismus rarely complains. In most cases, it is the appearance of the eye that first catches the parent’s attention. A child should be examined by an ophthalmologist whenever the eyes appear not to be working together.
How is Strabismus Treated
After a thorough eye exam your doctor can recommend the best treatment, which may involve patching, eyeglasses, surgery or a combination of these therapies.
Amblyopia is caused when the brain favors one eye and refuses to use the other. If for any reason the visual stimuli from each eye are different, the brain responds by suppressing one eye. The suppressed eye may look normal, but it is not being used normally. The brain favors the stronger eye and vision does not develop in the weaker eye. This condition is also sometimes called lazy eye.
How common is amblyopia?
Amblyopia is the most common cause of visual impairment in childhood. The condition affects approximately 2 to 3 percent of children under six. Unless it is successfully treated in early childhood, amblyopia will persist into adulthood and is the most common cause of one-eye or monocular visual impairment among children and young and middle-aged adults.
What causes amblyopia?
Any condition that affects normal visual development or use of either eye during the critical period (birth to 6 years of age) may cause amblyopia. The most common causes of amblyopia are strabismus and when one eye is more nearsighted, farsighted, or astigmatic than the other eye.
Diagnosis of Amblyopia
Because amblyopia usually occurs in only one eye, many children are unaware of their condition and they either can’t or don’t know how to tell their parents. If parents don’t take their infants and toddlers for a comprehensive vision examination, many children will go undiagnosed until a later age-often when they begin school.
How is amblyopia treated in children?
Amblyopia treatment is most effective when done early in the child’s life, usually before age 6. Treatment involves making the child use the eye with the reduced vision (weaker eye) and is usually simple, employing glasses, drops, exercises and/or patching.
- Patching: To make the child use the weaker eye, a patch can be put over the stronger eye. Patching stimulates vision in the weaker eye and helps the part of the brain that manages vision develop more completely.
- Atropine: Sometimes, a drop of a drug called atropine is placed in the stronger eye once a day to temporarily blur the vision so that the child will prefer to use the eye with amblyopia. Treatment with atropine stimulates vision in the weaker eye.
Why is early treatment important?
The vision pathways in the brain must become strong early, when children are very young. The first few years of life are the most important for eyesight. After a child is 8 to 10, the brain’s vision system is complete. If the amblyopia hasn’t been treated by this age, the child could have poor vision for life. With early detection, accurate diagnosis and proper treatment, the prognosis with amblyopia is excellent. Treatment before age 6 years of age, and especially before 2 years of age, gives the best results.
Nystagmus an involuntary movement of the eyes-usually a mixture of slow and fast movements of the eyes that are repetitive. The direct cause of nystagmus is an instability in the motor system controlling the eyes. There is no known cure however, certain types of nystagmus show spontaneous improvement up to age 10. Treatment may include having the child sit in the front row at school, special eye glasses or surgery.
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