frequently asked questions

A child can be checked for any abnormality in eye structures in as young as a newborn baby. If the child was born preterm or with low birth weight (<2kg), it would mandate retinal examination as well. Assessment of visual function can also be done as early as in a 6 month baby. In addition, assessment of squint, nystagmus and refractive errors can also be done in this age group.

All children should mandatorily get at least 2 complete eye checkups before 5 years of age, preferably at 3 and 5 years of age. In addition, children born to parents who wore glasses at an early age are more likely to require glasses at an early age. Even if your child appears to have good vision, there are other reasons to have your child’s eyes checked.

An ophthalmologist can detect the need for glasses through a complete eye exam. Typically, the pupils are dilated in order to relax the focusing muscles, so that an accurate measurement can be obtained. By using a special instrument, called a retinoscope, your eye doctor can arrive at an accurate prescription. The doctor will then take a call about the need for glasses based on the eye examination.

Glasses in children may be required for many purposes unlike in adults where it mainly serves the purpose of improving the vision. Glasses are advised in children to either improve vision, to control or improve the squint or for improving the eye muscle function. It may also be given for protection in children with allergy or in children with vision in only one eye.

Squint or strabismus is a condition where the visual axes of both the eyes do not coincide resulting in suppression of one eye. It can lead to lazy eye or amblyopia if not detected and treated early.

Squint can be of different types based on the direction the eye has moved towards. Inward squint is termed esotropia, outward squint is called exotropia. Squint can also be noted in vertical and torsional plane as well.

Most strabismus is the result of an abnormality of the poorly understood neuromuscular (including brain) control of eye movement. Less commonly, a problem with the actual eye muscle causes strabismus.

Strabismus often occurs in children who are otherwise completely normal. However, disorders that affect the brain such as cerebral palsy, Down syndrome, hydrocephalus and brain tumor are more likely to develop strabismus. Also, children with uncorrected refractive errors and those who are born preterm are also at risk of developing squint.

The goal of strabismus treatment is to improve eye alignment which improves the binocular vision. Treatment may involve eye glasses, eye exercises, prism, and/ or eye muscle surgery. Problems associated with strabismus (including amblyopia, ptosis, and cataract) are usually treated prior to eye muscle surgery.

Amblyopia or lazy eye can be corrected by the use of glasses, patching or penalisation. Certain cases may require vision therapy to improve the vision.

Opacification of crystalline lens is termed cataract and can occur even in pediatric age group. Heredity is a common cause of congenital cataracts in babies. Other causes include infection, inflammation, drug usage during pregnancy. When mothers come down with measels, rubella, or other infections while they are pregnant, the child may also be born with cataracts in one or both eyes.

Congenital cataracts are treatable. Based on its location and size, it is decided whether it would require medical or surgical management. A few kids may require glasses alone as a treatment. Others might require surgery to clear the visual axis. Following surgery, the child may require treatment for amblyopia or lazy eye.

Nystagmus is an involuntary rhythmic shaking or wobbling of the eyes. The eyes move constantly in various directions, although horizontal movements are the most common. The presence of nystagmus in a child is often an indication of visual problems. Treatment will depend on the cause. Sometimes, the presence of a nystagmus can indicate neurological dysfunction, and rarely, it can be a side effect of medication.

A child may adopt an abnormal head position to minimize the nystagmus in order to be able to see clearly. The constant head turn or tilt can affect the development of the cervical spine adversely. By performing surgery to change the ocular position an improvement in the abnormal head position can be achieved.

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