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Paeditaric Ophthalmology

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    Description & Process

    Paediatric Ophthalmology -Is a sub-speciality of ophthalmology concerned with visual development, vision care and various eye diseases in children. Children experience a variety of eye problems, many quite distinct from adult eye diseases.

    Some of the common paediatric eye disorders are as follows:

    Refractive errors Refractive, or optical, errors – myopia, hyperopia and astigmatism – cause blurred vision due to an inability to focus images on the retina. If not corrected, their consequences can be particularly harmful for children, since vision is developed in the first years of life. Symptoms of poor vision and asthenopia result, and in childhood, amblyopia can also occur, making refractive errors in childhood more complex than in adult patients. In addition, children may not be able to participate fully in the examination, leaving diagnosis
    and treatment up to the objective measurements and experience of the examiner.

    Amblyopia: Amblyopia is decreased vision in one or both eyes due to abnormal vision development in infancy or childhood and is a common problem in babies and young children. In the first few years of life, the brain must learn to see or interpret the images provided by the eyes. In amblyopia, the brain receives a poor image from the eye and thus does not “learn to see well . Vision loss occurs in this case because nerve pathways between the brain and the eye are not properly stimulated. In amblyopia, there may not be an obvious problem of the eye.
    Another word for amblyopia is often “ lazy eye .” It is the leading cause of vision loss amongst children. It is very important to diagnose and  treat amblyopia  as early as possible. Otherwise, a child with amblyopia will not develop normal, healthy vision.

    • Strabismus Strabismus (crossed eyes) is a common eye condition among children. It is when the eyes are not lined up properly and they point in different directions (misaligned). One eye may look straight ahead while the other eye turns in, out, up, or down. The misalignment can shift from one eye to the other.
    • Blocked tear duct: -Congenital nasolacrimal duct obstruction (CNLDO) is a common condition causing excessive tearing or mucoid discharge from the eyes, due to blockage of the nasolacrimal duct system.
    • Ptosis- Ptosis is drooping of the upper eyelid.
    • Nystagmus: - Nystagmus is involuntary/uncontrollable movements of the eyes. It may be side to side (horizontal nystagmus): up and down (vertical nystagmus) or rotary (rotary or torsional nystagmus). May be in both eyes or just one eye affecting vision, balance, and coordination
    • Visual inattention: -Visual inattention affects a person’s ability to process visual information received from our eyes.
    • Paediatric cataracts: - Many people are under the impression that cataracts occurs only in older people. Children can get cataract viz Paediatric Cataracts. In the case of adults, cataracts set in after the eyes and vision develops. Most adults regain good vision after their cataracts are removed. Children's eyes and brains are still developing till the age of 8-10 years. As such untreated cataracts can have serious, permanent effects on their vision.
    • Binocular Vision Dysfunction - Children can also suffer from Binocular Vision Dysfunction. The condition can be caused by facial asymmetry similar to adults, or by a concussion or injury while playing sports or falling from a bike. And just as with adults, BVD symptoms in children can harm their quality of life.
    • Infections ( Conjunctivitis ):- Conjunctivitis, also known as “pink eye,” is a common eye disease. It is called “pink eye” because it can cause the white of the eye to become pink or red. It occurs when there is an irritation or inflammation of the conjunctiva. Conjunctivitis is typically a minor infection that may affect one or both of the eyes. It may be highly contagious and can sometimes develop into a more severe condition.
    • Paediatric Glaucoma:-Paediatric glaucoma is a relatively rare condition that frequently results in visual impairment. It is usually classified as primary, secondary, or acquired. The primary form includes two major categories depending on the age of onset. It is termed primary congenital glaucoma (PCG) if it presents in the first 4 years of life, and juvenile primary open-angle glaucoma if it occurs after that age. The primary congenital form is the most common form of paediatric glaucoma and is also the most responsive to treatment. Secondary glaucoma is frequently due to congenital conditions (such as aniridia and aphakia) or various syndromic disorders, whereas acquired glaucoma typically arises from non-congenital factors such as inflammation and drugs.

    Types and Causes of Cataracts in Children.

    • Cataracts in a child can be congenital (present at birth) or acquired (develop as an infant, child, or adolescent).
    • Cataracts can happen in one or both eyes. When both eyes have a cataract, one can be worse than the other.
    • Cataracts may appear in different parts of the lens and range in size from tiny dots to dense clouds.
    • Genetics, metabolic disorders like diabetes, and eye injury can all cause cataracts.

    Abnormality in child behaviour requiring eye check-up

    • Keeps object close to his eyes or sitting very close to the TV
    • Frequently blinking or rubbing one eye.
    • Running into objects or falling down at night or in places that are dimly lit.
    • Not being able to see the blackboard at school.
    • Crossed eyes
    • Things looking blurry or funny.
    • Scratchy sensation in the eyes burning or itching.
    • Closing one eye or turning or tilting to see things.
    • Squinting to see things in the distance.
    • Abnormal head posture , turning or tillting head.