Kashyap Memorial Eye Hospital is the 1st NABH accredited eye superspeciality hospital in North,East and West Zone of India. It is also ISO 9001-2008 Certified

Paediatric Ophthalmology

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Although any eye disease that affects an adult can affect a child’s eye; most common eye diseases seen in children are Squinting of eyes, Refractive error, Lazy eye disease, Watering from the eye, Developmental or Congenital Cataract, Eye allergies, Eye injuries,  Retinopathy of Prematurity (ROP) and uncommonly Tumors.

A squint is the common name for 'strabismus' which is the medical term used to describe eyes that are not pointing in the same direction.

Squinting of eyes may occur occasionally or may be present throughout the day. It may appear in only one eye or may alternate between the two eyes. A squint can occur for a number of reasons Squint can become obvious after chronic illness and it can also run in families.

Types of squints commonly seen include

  • Convergent squint also known as esotropia, where one eye is turned in towards the nose. This is the most common form of squint seen usually in children.

  • Divergent squint also known as exotropia, where one eye turns out away from the centre of the face.

Some babies may appear to have a squint that is not a true squint. It is called an 'epicanthus' and is caused by folds of skin on a wide nose. Epicanthus does not exclude the possibility of a squint being present and so you should always seek an expert opinion.
Squint is relatively common in children, and 2-3% of the population has a squint. Treatment is advisable as soon as possible.

In order to focus both eyes on an object all the eye muscles of each eye must be balanced and  coordinated. When one eye is squinting, it may not receive a focused image. This can lead to a deterioration of vision in the squinting eye (lazy eye). It is necessary to diagnose squint as soon as possible and to treat it appropriately to prevent development of Amblyopia.

If your child has been diagnosed with a squint, it will be managed or treated by one of the modalities of treatment:

  • Opticals (Spectacles)
  • Occlusion (Patching)
  • Orthoptics (Eye Exercises)

Operation (Surgical Correction)

Pre-Operative (Divergent Squint)
Post-Operative (Divergent Squint)
Pre-Operative (Convergent Squint)
Post-Operative (Convergent Squint)

Amblyopia (Lazy Eye)

What is Amblyopia (lazy eye)?

Amblyopia, commonly known as lazy eye, is an eye condition defined by an unexplained reduction of vision in one eye, unrelated to any obvious eye disease. The vision is not usually correctable by glasses or contact lenses. Amblyopia occurs when the vision in one eye does not develop properly during early childhood. If not treated on time; it can lead to a permanent visual impairment. Although it mostly affects one eye, both eyes can also have decreased vision due to amblyopia.

Why does amblyopia occur?

Babies are able to see when they are born, but they gradually learn how to use their eyes. Our visual development occurs up to the age of 9 years, the most critical phase lasting from birth to 6 years of age. Both eyes must receive clear images during this critical period. If the image is not clear, the brain shuts off the image which is out of focus and the child depends only on the better eye to see. Thus, anything that interferes with a normal image formation on retina in either eye during the crucial period, leads to amblyopia. The good eye and brain will inhibit (block, suppress, ignore) the eye with the blur. The inhibition process (suppression) can result in a permanent decrease in the vision in that eye that cannot be corrected with glasses, lenses, or lasik surgery

The most common causes of amblyopia are strabismus (an imbalance in the positioning of the two eyes) and anisometropia (when one eye has a high plus or minus number) . An eye disease like cataract or ptosis (drooping of eyelid) that prevents a clear image from being focused onto the retina can also cause amblyopia.

How to know if your child has Amblyopia?

You may not be able to tell that your child has lazy eye. While a deviating eye may be easily spotted, amblyopia is usually difficult to diagnose, as many children with this condition look absolutely normal and carry out all their activities with the normal eye. Only an eye doctor can confirm the diagnosis. That is why early infant and preschool eye examinations are so necessary. Still there are some signs which can help you in detecting if your child has amblypia or not :

  • If your child’s eye is turned in,out,or upwards.
  • If he/she closes one eye (especially in bright light).
  • If a small child/infant resists covering of a particular eye.
These are warning signs enough to raise a suspicion of amblyopia.

Doctor’s Role

Amblyopia is best treated by an ophthalmologist. The most important diagnostic tools are the special visual acuity tests other than the standard 20/20 letter charts currently used by schools, pediatricians and eye doctors. Treatment may involve use of spectacles to correct blurred vision or help straighten the eyes and use of eye patches on the better eye to enable the weaker eye to see by eliminating competition from the better eye. Surgery may be required to mechanically realign the eyes

Treatment of Amblyopia

Amblyopia can be treated up to the age of 17(in selected cases), but it is most effective when done early in child’s life usually before the age of 7 years. . Every amblyopic patient deserves an attempt at treatment .The aim of the treatment is to force the child to use the eye with less vision by obstructing vision in better eye.

Parent’s Role

Parents play a vital role in making sure that their child does not have this disability.

First, it is important to recognize any signs of a problem.
Second, you should never wait for a problem to be corrected on its own. Once suspicion is raised, contact an ophthalmologist as soon as possible. You play an important role in making sure that your child has a lifetime of good eyesight.

Far too many parents fail to take their infants and toddlers for an early comprehensive vision examination and many children go undiagnosed until they have their eyes examined at a much older age. Amblyopia is best treated at an early age and becomes less amenable to treatment as the child grows up. Good vision in both eyes is essential to allow good depth perception and for fine, near activities. Any trauma to the better eye may leave the person severely visually handicapped if the other eye has amblyopia.

Amblyopia is one of the most common causes of visual impairment which can be completely reversed if diagnosed early and treatment initiated on time. Unless it is successfully treated during early childhood, it usually persists into adulthood.

Pre-Operative (Divergent Squint)
Post-Operative (Divergent Squint)