COMMON PEDIATRIC EYE PROBLEMS

Care of eyes at the time of birth and afterwards

Eyes should be cleaned properly at the time of the birth. Antibiotic drops should be instilled in the eyes. If there is any pus discharge it can be dangerous, particularly if it is caused by a bacteria known as "gonococci". These organism attack the infant’s cornea and pus spreads in the eye causing permanent blindness.

Congenital cataract

Congenital cataract is the one the baby is born with. German measles (viral infection) can cause it if this virus affects the mother during pregnancy. It needs urgent ophthalmic opinion and can be treated surgically if required.

Watering of the eyes in the early months

The most common cause of watering in the first six months is due to dacryocystitis, which is caused by obstruction of the normal passage of tears from the eye into the nose, which can be treated with antibiotic drops on ophthalmologist’s advice. If required, probing can be done to dilate the
punctum( opening of the passage ) and clearout any blockage in this passage (nasolacrimal ) or syringing the passage with antibiotic solutions.

Conjunctivitis

Inflammation of conjunctiva is known as conjunctivitis. In children it can be due to bacterial or viral infection. It can be treated with antibiotic drops.

If the cause is allergy, it can be treated with anti-allergy drops combined with
antibiotic and short-term use of topical steroid if required. If required, oral (antihistamine) syrups/tablets may be given. Avoiding exposure to those things one is allergic to may prevent allergic conjunctivitis.

Stye

It is an infection of the eyelash hair follicle (root). It causes pain and swelling of the eyelids. It is treated with oral medications (antibiotics) and hot fomentation over the effected eyelids. It usually clears in 2-3 days.

Chalazion

It is a non-infective swelling (cyst) situated over the eyelids. It is a painless cyst. It may reduce in size by hot fomentation and eyelid message. However surgical treatment is required in most cases. It can be prevented by maintaining good cleanliness of the eyelids.

Eye Trauma

If a child is playing with any sharp instrument like pencils, pen, knife, bow & arrows one should be careful that it does not hurt/injure the eyes as it can be very dangerous & may cause perforation of the eye and loss of vision. It may require an urgent ophthalmic opinion.

Xerophthalmia (Vitamin A deficiency)

Xerophthalmia is caused due to deficiency of Vitamin ‘A’. It leads to dryness of eyes, patches on conjunctiva & corneal ulcer. It is also a major cause of night blindness. It can be treated by giving oral dose of vitamin ‘A’. Vitamin ‘A’ is found abundantly in carrots & fruits like papaya, mango & green vegetable. (Drumstick is the cheapest source of vitamin A)

Refractive errors (Child may require spectacles)

If a child holds books close to eyes or watches T.V. from very close distance or complains of regular headache & eye strain one should be suspicious that he/she may have a refractive error like myopia (short sightedness), Hypermetropia (long sightedness), Astigmatism (irregular curvature of cornea). It can be corrected by giving desired glasses & vision can be improved. Refractive error may be due to hereditary or developmental causes.

In such cases ophthalmic check-up is required at regular intervals to detect changes in power of the glasses.

Squint

Squint is a condition where two eyes do not function together. This can be:

Convergent squint is the condition where eyeballs turn towards each other close to nose.

Divergent squint where eyeballs turn away from each other.

Squint can be corrected by giving glasses and if necessary surgically.

Nystagmus

Nystagmus is involuntary oscillation of the eyes. It may or may not be associated with albinism (absence of pigment melanin). If associated with albinism it causes photophobia, so dark glasses are advised.

Amblyopia (lazy eye)

When high refractive error is left untreated for longer time or when there is large difference in refractive error between the two eyes, the non-dominating (weaker) eye becomes "lazy" (amblyopia). There are other causes of amblyopia. For this a thorough ophthalmic check-up is required and appropriate treatment can be given.

NOTE:

Care of eyes

Clean the eyes of the child whenever possible.
Keep the hands of the child clean.
Avoid rubbing of the eyes.
Keep sharp objects away from children.
Regular eye check-up to detect any eye problems at an early stage.

Last updated on 28-03-2001