Common paediatric eye conditions and how to look after children’s eyes – Dr Sanjay Lalloo (Ophthalmologist)

Children’s eyes and vision are constantly developing and changing as they grow. Therefore, it is important to detect and treat any eye problems early, before it affects their learning and development. Some of the common paediatric eye conditions are:
• Refractive errors: These are vision problems caused by the shape or length of the eye, such as nearsightedness(myopia), farsightedness, and astigmatism. They can cause blurred vision and can sometimes lead to headaches and eye strain. They can be corrected with spectacles or contact lenses.
• Myopia: By 2050 one out of two people(50%) will have it. The eye is longer than normal or the cornea(clear window in the front of the eye) is too steeply curved. This makes things that are far away from you look blurry. Myopia is corrected with glasses, contact lenses or in some cases surgery.
• Potential problems from myopia: It can increase your chance of developing some eye problems later, like cataract, glaucoma and retinal detachment.
• Myopia progression(worsening): Studies show myopia is becoming more common among children. Research suggests that children who spend more time indoors doing near-focused activities (such as screen usage, video games, and reading) have higher rates of myopia than those who spend more time outdoors.

• Treatment options for progression:
• Low-dose atropine eye drops: When given to children in small amounts for 2 to 3 years, atropine eye drops slows the progression of myopia. Doctors do not know exactly how it works, but they think these drops may keep the eye from lengthening too much. Myopia worsens as the eye grows longer. Low-dose atropine for myopia is used for children between 5 and 18 years old.
• Peripheral defocus contact lenses (Multifocal): usually worn between 6 and 12 years. Blurring of peripheral vision is thought to slow eyeball growth.
Other additional measures: Make sure your child spends more time outdoors, for at least 1-2 hours a day. Limit screen time on computers or other digital devices.

• Ocular allergies: These can cause eye rubbing, frequent blinking and blurred vision. Prolonged eye rubbing can cause a change in the shape of the cornea resulting in astigmatism and keratoconus. These resultant conditions will need spectacles and possible surgery later. The astigmatism and keratoconus can be prevented by treating the allergies early with a combination of topical allergy drops, ointments and oral medications. Regular monitoring by the ophthalmologist and avoiding eye rubbing is important.

• Amblyopia(lazy eye): One eye has weaker vision than the other, due to a lack of stimulation or coordination between the eyes. It can result from refractive errors, strabismus, or other eye diseases. This can cause reduced visual acuity, depth perception, and eye-hand coordination. Amblyopia can only be discovered by a visual acuity test, and can be treated with patching, glasses, eye drops, or surgery. If discovered later than 9 years of age, response to treatment is not as good as earlier treatment.

• Strabismus(squint): This is a condition where the eyes are not aligned properly and point in different directions. It can be caused by muscle imbalance, nerve damage, or brain disorders and can lead to amblyopia, double vision, and poor binocular vision. Strabismus can be treated with glasses, eye exercises, prisms, or surgery. Children who have a squint should not delay to have this evaluated. It should be evaluated by the ophthalmologist when it is first discovered.

To look after children’s eyes and prevent or detect eye problems early, parents and caregivers should:
• Take their children for regular eye exams to an optometrist or ophthalmologist from an early age. Recommendations for checks are between 6-12 months, at least once between 3 to 5 years, and then before first grade and then annually from 6 to 17 years.
• Watch out for any signs or symptoms of eye problems in their children, such as squinting, rubbing, blinking, tilting the head, avoiding reading or close work, or complaining of headaches or blurred vision
• Provide a healthy and balanced diet rich in vitamins and antioxidants for their children
• Limit their children’s screen time and encourage them to take breaks and blink often
• Ensure their children wear protective eyewear when playing sports or doing activities that may involve eye injuries
• Educate their children about the importance of eye health and hygiene
By following these tips, parents and caregivers can help their children maintain good eye health and vision throughout their lives.