A child eye is different from adults, because it’s a growing eye. It undergoes series of developmental changes. Therefore, it is important to identify and treat the eye conditions at an early age as to achieve the best quality vision in them.
Dr. Kruti Shah is specialised in paediatric ophthalmology and is abreast with all latest technology and skills to give the best possible treatment to the child.
Refractive errors correction & Control of myopia progression
It is condition in which, the parallel rays of light entering the eye do not get focused on retina. Therefore, the child has to wear glasses to get clear vision.
Refractive error can develop as early as infancy.
So, it is ideal to get the child’s routine eye check-up as early as 2-3years of age, followed by 5 years or when he starts school and then annually.
A test called ‘cycloplegic retinoscopy’ is mandatorily done in children to measure their glass power, as it is more accurate and objective method of testing. This test also helps to derive an accurate measurement in preverbal and preschool children.
The prevalence of myopia in India has significantly increased over the last 2 decades. The myopic power in a child is also seen progressing in their growing age. This can affect the retina
There are various modalities available by which you can reduce the progression if not stop the progression, like-
Eye drops – atropine with different concentrations
You can discuss with the doctor, the best suited modality for your child.
Amblyopia (Lazy eye) treatment:
Lazy eye is a condition in which the child has poor vision in one or both eyes due to the uncorrected refractive error or squint or due to certain eye disorders like cataract, corneal opacity etc
It is very important to start the treatment at an early age to achieve better results.
The misalignment of two eyes is called a squint / strabismus. It may be present from birth or may be acquired later in life. It is a myth that squint cannot be corrected.
Why squint should be corrected? – because there is
Loss of binocular vision (inability to use both eyes together)
Loss of stereoacuity (3 D vision)
Decreased vision in the squinting eye (amblyopia / lazy eye)
Abnormal head posture (head tilt or face turn)
Diplopia/ double vision
Negative psychosocial and emotional impact due to poor cosmesis.
Squint can be corrected at any age. The earlier it is corrected; the better quality of vision is achieved. There are various options to correct squint depending on its type and grade-
Squint Surgery: There are total 6 extra ocular muscles in each eye. Squint surgery is performed on these muscles. There is a thorough squint examination done before surgery for measuring the amount of squint. Depending on type and amount of squint, we decide the number of muscles and type of muscles to be operated on.
Squint surgery cannot be done by laser. All across the globe it is done with the help of sutures. It is a relatively a safer surgery with minimal risk of complications
The type of anaesthesia used is
Local anaesthesia – for adults
General anaesthesia – for children.
Other Treatment Modality
Patching / occlusion therapy
Exercises – home based & office based.
Nystagmus (Shaky Eyes)
Nystagmus is an involuntary, rhythmic to and fro movement of the eyes. It may be present from birth or acquired later in life
It can be seen in children and adults. The nystagmus can be caused by retinal diseases, vision deprivations or brain disorders
Cataract can develop in neonates, infants and toddlers. It may affect one eye or both the eyes. There can be many causes for its development like metabolic diseases, infection& sepsis, genetic disorders, trauma, medications or idiopathic.
Cataract should be operated as soon as it is noticed in the child to prevent permanent loss of vision, squint and other sequale
The intraocular lens may be put in the same sitting or at later date.
Use of glasses and contact lenses is common post cataract surgery in children.
Glaucoma is defined as the raised intraocular pressure of the eye causing damage to the optic nerves and thus decreasing the vision. It is multifactorial.
Watering of eyes,
Increased size of cornea
The mainstay of treatment is surgery. Followed by correction of refractive errors, lazy eye, squint if any Regular monitoring of eye pressure is mandatory.
Blocked tear duct treatment
Watering from the eyes of a child is most commonly caused due to blockage of nasolacrimal duct / tear duct that drain tears from the eye to the nose.
This is usually present since birth. It may affect one eye or both the eyes.
usually massage + eye drops are given till 1 year of age. If it does not resolve with that a procedure called lacrimal probing is done. If still no improvement surgical procedure called dacryocystorhinostomy is done.
Drooping of the eyelid is called ptosis. It may be present since birth or acquired later. If not treated the child may develop:
Poor vision (lazy eye) in the eye
Spectacle power (astigmatism)
Visual field defect
Negative psychosocial and emotional effects
Surgery is the mainstay of treatment. Depending on severity, your doctor may advice you the wait time to the surgery.
Retinopathy Of Prematurity is a condition in which the developing retinal vessels of preterm baby is damaged which can severely compromise the vision if not treated at right time.
ROP screening is recommended in preterm:
with gestational age ≤34 weeks or
with Birth weight≤ 2000gms or
with Gestational Age ≥34 weeks with various risk factors like sepsis, poor postnatal weight gain, respiratory distress etc
Monitoring, Intravitreal injections, Lasers, Surgery