Squint And Paediatric
COMMON CHILDREN EYE PROBLEMS
amblyopia is a developmental defect of central visual processing leading to a reduced vision. During the first 6 years of life our vision is vulnerable. Any disturbance in these formative years whether anatomical or functional can lead to loss of perfect vision in one or both eyes. With increasing age this is harder to reverse and becomes permanent by about8-10 years of age.
Most common causes of amblyopia are
Reduced visual acuity in the absence of an organic cause
The critical period during which visual development may be influenced is upto 8 years. At younger ages there is more rapid response to treatment of Amblyopia.
The initial treatment is spectacle prescription and then either patching or atropine penalization.
HOW IS AMBLYOPIA DIAGNOSED
Just by looking at the child it is very difficult to know whether one or both the eyes are Amblyopic or not. The child himself might not be aware of having one strong eye and other weak eye
Amblyopia is detected by finding poor vision in one or both eyes. Since it is difficult to record vision in a toddler , the Ophthalmologist can get a fair idea by covering one eye and observing the behavior of the child. If the good eye is covered the child might cry and try removing occlusion of good eye.
Poor vision in one eye does not always mean that the child had Amblyopia. Vision can be improved in most cases by prescribing glasses.
At our center we will also be examining interior of the eye i.e. Retina to rule out other causes of poor vision at a young age.
WHAT IS SQUINT?
Squint is a visual defect of ocular alignment in which the eyes are misaligned and look in a different direction. One of the eyes might look in the intended direction and the other eye might point upwards, downwards, inwards or outwards.
The eye turn might be constant or it may come and go at intervals. Sometimes the deviated eyes also switch called as alternating squint.
Squints are seen in 4-5 % of children in our country. They are seen equally in males and females. Some Squints run in families but it can also happen with no one in family having a similar problem.
WHAT CAUSES SQUINT?
The exact cause of Squint is not fully understood. It could be due to any factor which causes a disturbance in Binocular vision or causes weakness of the eye muscle. Occasionally children with Downs syndrome or other neurological conditions can present with Squint.
WHAT ARE INDICATIONS OF SQUINT.
The parents can easily notice misalignment of eyes if they look carefully. Squinting of eyes should not be accepted as just another habit of the child. A child might sometimes tilt or turn his head to see objects which is also an indication of Squint.
WHAT IS PSEUDOESOTROPIA?
In certain situations, the child’s eye might appear crossed. This can be a false Squint which appears so because of a flat nasal bridge or a thick fold of skin around inner part of eye. A Squint Specialist can help you differentiate between true and false Squints.
MOST COMMON TYPES OF SQUINT IN CHILDREN ARE :
Most common form of squint which is diagnosed before 6 months of age. The eyes are deviated inwards. Surgery is essential in early childhood to restore the eye alignment and give the child a chance to use both eyes simultaneously for a binocular vision.
A form of Squint in which eye shows inward deviation. This deviation is marked when the child is using accommodation for a clearer near vision. Children above 2 years usually present with this and respond very well to corrective glasses. In certain circumstances they also require surgery.
Outward deviation of eye is called exodeviation. Usually seen when the child looks at a distance. Becomes more pronounced when the child is tired or sick. Surgical correction is the treatment of choice once exodeviation goes into constancy.
HOW ARE SQUINTS TREATED IN CHILDREN?
After a complete medical examination, the child might be prescribed glasses. These glasses not only take care of deviation but also squint.
If glasses are not sufficient take care of alignment or are not needed at all, then surgical correction is recommended for ocular alignment and Binocular single vision.
HOW IS SQUINT SURGERY PERFORMED ON CHILDREN?
Squint Surgery is usually performed under General Anaesthesia for young children who are not eligible for surgery under Local Anaesthesia. Our anesthetist are fully equipped and vastly experienced to take up pediatric anaestheisa.
The eye muscle which is causing the eye to move Outward or Inward is ‘tightened’ or ‘loosened’ as required. The eyes are patched for a few hours following which child can resume normal activities within a few days.