Pediatric Eye Diseases
Children are a special group because of their inability to voice their eye complaints. As a parent, having information about the most common eye diseases in children will be a good step towards early diagnosis and treatment.
In the visual function, the rays of light coming to the eyes pass through the cornea, intraocular lens, vitreous and focus on the retina (retina). From the retina, they are transmitted to the brain via special nerves, analyzed and formed into a single image.
Children should be examined in the newborn period, at 6 months, 18 months, 3 and 5 years of age, during school age and every year thereafter. Good vision is very important for a child’s development and school success.
Common eye diseases in children include strabismus, lazy eye (amblyopia), uncorrected refractive errors, congenital cataracts, tear duct obstruction, glaucoma and conjunctivitis.
It is a disruption of parallelism in the eyes. When the parallelism of the eyes is disrupted, the child usually prefers one eye and prevents double vision. However, lazy eye develops in the non-preferred eye. Sometimes the drift in the eyes may be noticeable by the family or it may be of the type that cannot be detected by simple examination but can be detected by further examinations.
There are also types called hidden strabismus, which occur when the vision of one of the eyes is blocked (heterophoria; esophoria, exophoria), as well as types in which there is a continuous drift (heterotropia; esotropia, exotropia, hypotropia, hypertropia). The most common type of strabismus is the type in which the eyes drift towards the nose (esotropia).
There are also conditions that mimic strabismus called false strabismus (pseudostrabismus). Facial asymmetry, nasal root flattening, eyelid anomalies cause this. In this case, follow-up is sufficient. While some types of strabismus can be corrected with glasses, some require surgery. Treatment is organized by the ophthalmologist after a detailed examination.
Lazy eye (amblyopia):
The visual acuity of one or both eyes is lower than normal. Since the brain suppresses vision on the side with blurred vision, that eye cannot learn to see later. Children do not have any complaints as they can see with their eyes with good vision.
However, in order to create a 3-dimensional image, the images from the two eyes need to be evaluated and combined in the brain. It should be recognized and treated at an early age. The most common causes are strabismus, refractive errors, droopy eyelids covering the visual axis and congenital cataracts.
Any pathology on the visual axis can cause amblyopia. The earlier treatment is started, the more beneficial it is. Because the brain learns to see in childhood.
In the treatment, after the underlying cause is eliminated, closure treatment is applied by closing the healthy eye so that vision is provided with the eye with low vision.
This is the presence of opacity in the lens at birth. It can be in one or both eyes. It appears as a white image in the eye. It may accompany systemic diseases or may be observed only with eye involvement. Treatment is removal of the lens as soon as the diagnosis is made. In children older than 3 years of age, after the natural lens is
Tear Duct Obstruction:
Many children have blocked tear ducts at birth. 90% of them are expected to open by the age of 1 year. Until this time, families may notice and worry about this situation, but it is necessary to wait until at least 1 year of age. During this period, it is recommended to massage the lacrimal sac and use antibiotics for babies with complaints. If the complaints persist, the closed canal is tried to be opened with the help of a special probe when the child is 12-18 months old. If
necessary, silicone tube intubation is added to the canal opening process with the probe.
Eyelid Diseases in Children:
In children, structural disorders such as congenital droopy eyelids, narrow lid spaces, excessive skin folds at the root of the nose, less or more distance between the eyes can be seen. The underlying cause of congenital droopy lids may be localized dysfunction of the eye muscles, a neurological condition or general muscle diseases.
The underlying cause should be thoroughly investigated. Follow-up is recommended for
droopy eyelids that do not close the visual axis. However, if the visual axis is closed, surgery is recommended by explaining that these children may develop lazy eye in the future. Lazy eye is more common in droopy eyelids that cover the visual axis, especially in one eye.
There may also be swelling on the lids accompanying infections and allergies. These swellings should be taken seriously, especially in children who are too young to voice their complaints. Because infectious swellings can cause much more serious infections. Therefore, eyelid infections should be treated quickly in infants.
It is a disease characterized by high pressure inside the eye and optic nerve damage. It is a serious disease that can cause blindness if left untreated. In infancy, these children have watery eyes and sensitivity to light. The cornea starts to blur. These children have enlargement of the eyes. The treatment is surgical.
Inflammation of the membrane on the white layer called conjunctiva is called conjunctivitis. It can be infectious, allergic, immunologic. Hygiene is important for those of infectious origin. Bacteria, viruses and parasites can cause it. Crusting is in the foreground. Allergic ones can be seasonal or permanent. It is common in spring months. Itching and watering are at the forefront. While some may improve with treatment, others may be more serious.
Refractive defects (hyperopia, myopia, astigmatism) can be seen in children as in adults. When these refractive errors are not corrected at an early stage, and especially when one eye is more severely impaired than the other, lazy eye (amblyopia) is almost inevitable. This is because the brain does not use the eye that provides more blurred vision and that optic nerve does not complete its development.
Therefore, it is very important that children’s refractive errors are corrected quickly.
Causes of eye diseases in children:
Eye diseases in children may be present from birth or acquired. Heredity plays a very important role. Since these diseases can be passed on genetically, the risk is higher in those with a family history of eye disease. However, it can also be seen without a family history.
Today, with the use of devices such as tablets and phones, the time spent looking at close distances has increased. This leads to an increase in the anteroposterior diameter of the eye and spasm of the muscles that adapt, causing myopia.
Symptoms of Eye Diseases in Children:
In children, various symptoms such as headache, watery eyes, squinting, looking at objects at close range by bringing them too close, droopy eyelids, burrs, drifting eyes, tilting the head to one side, redness, whiteness in the eyes, itching in the eyes can be observed.
Causes of Headache in Children:
If the child complains of headache, it should be taken into consideration. Children can describe headache more clearly after the age of 3. Many underlying causes such as decayed teeth, refractive errors in the eye, colds, mass occupying space in the brain, blisters in the brain may cause headache. Or it may be related to diseases such as migraine, tension-type headache, the cause of which cannot be fully elucidated.
Diagnosis of Eye Diseases in Children:
In order to diagnose eye diseases in children in a timely manner, children should be brought for regular eye examinations. Generally, families do not take their children to the doctor because they have no complaints. However, children cannot voice their complaints. In the detailed examination, the child’s eye number is calculated, the ocular surface is evaluated, intraocular pressure is measured and the retina is examined. Eyelids and eye drift are evaluated. If any pathology is detected, treatment is organized after further examination.