Pediatric Ophthalmology

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What Is Pediatric Ophthalmology ?

Every child is unique and so do their eyes, in their growth years, having healthy eyes plays key role in overall development. For instance, an undiagnosed problem with their eyes can impact everything from socializing to how your child learns. Eye examinations also ensure your child has no visual problems that could affect their safety.

We at Tej Eye Center understands the importance of Early detection and treatment of many sight-threatening diseases may prevent visual loss, which can be caused by misalignment of the eyes, strabismus (crossed eye), refractive error and opacity such as pediatric cataracts or amblyopia (lazy eye). When it comes to children, the most important preventive steps are routine eye examinations, visual screening tests and preventing eye trauma.,

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Please Complete This Questionnaire. It Will Help Us To Know If Your Child Needs An Eye Examination Or Not

Have you ever taken your child for an eye examination?

yes no

Do your child’s Eyes burn or feel strained after short periods of reading or other close work?

yes no

Does your child skip words or lines, or has to re-read?

yes no

Does your child get headaches when reading?

yes no

Does your child face difficulty copying from a board or book?

yes no

Is your child's schoolwork below average?

yes no

Why A Timely Scheduled Eye Checkup Is Important

  • 80% of learning in a child’s first 12 years comes through the eyes
  • Vision assessment by using appropriate chart according to the age of child
  • Refractive errors are 2nd major cause of blindness
  • Incidence of myopia in Gujarat is 13.3% (Minus power)
  • Some children are labelled “LEARNING DISABLED”-what they need is an eye exam and appropriate vision correction
  • From birth, your child uses vision for learning and development. Vision then guides motor and cognitive processes as your child begins to reach, grab, crawl, sit-up, play with toys, interpret facial expressions, and watch lip movements when learning how to speak.

Common Eye Problems

Several eye conditions can affect kids. Most are detected by a vision screening using an acuity chart during the preschool years.

  • Refractive errorsmean that the shape of the eye doesn't refract (bend) light properly, so images appear blurred. Refractive errors also can cause amblyopia. Nearsightedness is the most common refractive error in school-age children; others include farsightedness and astigmatism:
  • Nearsightedness is poor distance vision (also called myopia), which is usually treated with glasses or contacts.
  • Farsightedness (also called hyperopia), which is usually treated with glasses or contacts.
  • Astigmatism is an imperfect curvature of the front surface of the eye, which is usually treated with glasses if it causes blurred vision or discomfort.

When Should Kids Get An Eye Exam?

Doctors of optometry recommend comprehensive eye exams for children of all ages

  • Infants First exam at 6-9 months
  • Toddlers + Preschoolers At least one exam between 2 to 5
  • School-age children An exam every year
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Amblyopia
  • ("lazy eye") is poor vision in an eye that may appear to be normal. Two common causes are crossed eyes and a difference in the refractive error between the two eyes. If untreated, amblyopia can cause irreversible visual loss in the affected eye. (By then, the brain's "programming" will ignore signals from that eye.) Amblyopia is best treated as early as possible, ideally before a child is 8 years old. It can be treated by prescribing an eye glasses and patching therapy or vision therapy
Strabismus Or Squinting Of The Eye
  • It is a misalignment of the eyes. they may turn in, out, up, or down. It can occur either due to refractive errors, any congenital pathological condition, or weakness of eye muscles. Risk Factors for squint may be a family history, prematurity or low birth weight or may be cerebral palsy. If the same eye is chronically misaligned, amblyopia may also develop in that eye. With early detection, vision can be restored by patching the properly aligned eye, which forces the misaligned one to work. Some of the time squint can be corrected with spectacle glasses or vision therapy. At last Surgery also may help the eyes to align.
Childhood Tearing
  • Epiphora is the term for excessive tearing. Childhood epiphora is often noted soon after birth, but can be acquired later. When noted during infancy, it is usually due to blockage of the tear drainage system. This type of tearing often improves spontaneously by 6-12 months of age. Medical treatment includes tear sac massage and eye drops, but if tearing persists, surgical probing of the drainage system may be required.
Nystagmus
  • Nystagmus is an involuntary, rhythmic oscillation of the eyes. The eye movements can be side-to-side, up and down, or rotary. Nystagmus may be present at birth or acquired later in life. It may result from abnormal binocular fixation early in life. It also may accompany a number of eye disorders and neurological disorders.
Pediatric Ptosis (Drooping Eyelid)
  • Ptosis, or drooping of the upper eyelid, occurs in both children and adults. Children can be born with ptosis (congenital) or acquire it during childhood. It is caused by weakness in the muscle that elevates the eyelid. A droopy eyelid can block light passing to the retina in the back of the eye and/or create significant astigmatism that produces a blurry image in the affected eye. These situations cause lazy eye (amblyopia) and, if untreated, can result in permanent loss of vision. Also, children may develop a chin-up head position due to the droopy eyelid. If the ptosis is significant, surgical correction may be necessary.
Pediatric Glaucoma
  • Glaucoma is a condition that is associated with high pressure within the eye. This pressure can damage the optic nerve, which is critical for vision, resulting in permanent vision loss. Pediatric glaucoma is a rare condition that can present in the newborn or during childhood. Signs and symptoms of pediatric glaucoma include cloudy cornea, tearing, frequent blinking, light sensitivity, and redness of the eye.
Developmental Abnormalities
  • During development of the fetus, abnormalities in the visual system can occur. Some developmental abnormalities include coloboma, microphthalmia (small eye), and optic nerve hypoplasia. These abnormalities often result in vision loss.
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Tej Eye Centre offers state-of-the-art technology in child vision care, with the empathy and compassion that is the hallmark of the patient care. The eye tests for children, in addition to primary eye care, include

  • Detailed systemic, Ocular History Analysis With Chief Complaint
  • Vision Assessment By Using Appropriate Chart According To The Age Of Child
  • Refractive Error Assessment By Using Cycloplegic Agents.
  • Squint Assessment With Measuring Deviation Of Angle
  • Ocular Motility (Muscle Balancing) Test
  • Binocular Vision Assessment
  • Stereopsis (3D Vision) Test
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Special Screening Programme

Many vision problems go undetected by parents, teachers and the children themselves without a formal vision assessment. Many eye problems cause no pain or discomfort so again go unrecognized. Children with a family history of vision problems & premature births - greater risk for vision problems. children adjust to poor eyesight by sitting close to the blackboard, holding books close to their eyes, avoid work that needs visual concentration like coloring, puzzles etc.

Tej eye center is doing multiple screening programmes in private and government schools to identify the vision problems among the childrens. Activities done by tej eye center are as.

  • Training of school teachers and parents
  • Vision screening of school children and other staff
  • Detection and treatment of eye problems
  • Prescription of glasses
  • Provision of glasses to students of low socioeconomic strata
  • Anterior segment assessment to rule out pathology
  • Detail Retina evaluation
  • Vision therapy as per the diagnosis
  • Recommendation for best optical solution as per the conditions
Vision Therapy Programme

Vision Therapy -- a type of physical therapy for the eyes and brain -- is a highly effective non-surgical treatment for many common visual problems such as lazy eye, crossed eyes, double vision, convergence insufficiency and some reading and learning disabilities.

Aim is to improve overall vision by strengthening skills such as tracking (eye movement), teaming (eye coordination) and focusing.

The program of exercises is customized for each patient, and can be done in the office or at home — or, ideally, in both settings.

  • A progressive program of vision "exercises" or procedures
  • Performed under doctor supervision
  • Individualized to fit the visual needs of each patient
  • Generally conducted in-office, in once or twice weekly sessions of 30 minutes to an hour
  • Occasionally supplemented with procedures done at home between office visits ("home reinforcement" or "homework")
  • Depending on the case, the procedures are prescribed to:
    • Help patients develop or improve fundamental visual skills and abilities
    • Improve visual comfort, ease, and efficiency
    • Change how a patient processes or interprets visual information.

Frequently Asked Questions

Pre-term children with a birth weight of less than 1500gr should be examined around the fourth week after birth to exclude or confirm the existence of retinopathy of prematurity. These individuals should be continuous monitored throughout their childhood.

Children with hearing deficits, muscle problems and neurological deficits should be examined as soon as possible.

Children with a family history of strabismus or amblyopia should be tested around the age of 2 years. Normal children are tested by their pediatrician with regard to visual function and are referred to the pediatric ophthalmologist if there is a problem. If at time parents feel that something is wrong with their child's eyes, they may ask for the advice of a pediatric ophthalmologist.

As we age, changes in the shape and flexibility of the eye's lens can cause changes in vision, including an increase in eye power. However, there are several steps you can take to potentially slow or prevent further increases in eye power. These include:

Getting regular eye exams: Regular eye exams can help detect changes in vision early on, allowing for timely intervention.

Taking breaks from screen time: Prolonged periods of screen time can strain the eyes and contribute to changes in vision. Taking regular breaks can help reduce this strain.

Practicing good eye hygiene: This includes things like washing your hands before touching your eyes and avoiding rubbing your eyes excessively.

Eating a healthy diet: A diet rich in fruits, vegetables, and omega-3 fatty acids can help support eye health.

Wearing proper eyewear: Wearing proper eyewear, such as glasses or contact lenses, can help reduce strain on the eyes and prevent further changes in vision.

It's important to note that these steps may not completely stop increases in eye power, but they can help slow the progression and promote overall eye health. It's always a good idea to consult with an eye doctor for personalized advice and guidance.

Most children love to watch TV close up. If there are no other findings, such behavior is considered normal.

Visual function is often indirectly concluded from behavior. There are tests that do not require the child's verbal confirmation. Most times the comparison of the two eyes it is more important. In older children, who are able to speak, games or cards are used to test their vision. Also there are objective tests to check vision at any age or the need for corrective spectacles without the need of the child's response.

The complete anatomical examination of the bulb by the pediatric ophthalmologist will reveal anatomical abnormalities that may affect the child's vision.

Pseudostrabismus is the most common reason for referral to a pediatric ophthalmologist. Most young children give the impression that their eyes are turned toward the nose. This is due to their head being small and large base of the nose, which hides part of the white of the eye on the side of the nose. As the child grows this cross-eyed impression ceases to exist. This led to the misconception that the child can overcome the problem (pseudostrabismus). When there is true strabismus, however, the child needs help from the pediatric ophthalmologist because the problem will not go away on its own.

There are various causes of headache. The examination must be started by your pediatrician. Most pediatricians will also refer the child to a pediatric ophthalmologist for the examination of eye disorders. An eye assessment may give an interpretation of the headaches even though in most cases these are not caused by eye problems.

The children's eyes resemble those of their parents. If parents wore glasses in kindergarten, children must be examined before the age of three, unless they are cross-eyed or there is suspicion of visual impairment and therefore should be examined as soon as possible. School myopia usually begins in elementary school and detected by the child or the pediatrician.

Dyslexia and related problems are usually encountered by specialist psychologists. On occasion an ophthalmological assessment is required to exclude visual problems, which are rare.

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