Children’s Eye Health: Treating Common Vision Problems
Many parents don’t realize that a child’s eyes are actually more fragile in many ways than an adult’s, because the visual system continues to develop immediately after birth, and some parts of the eye and visual system can continue to change throughout childhood. Throughout childhood, it is not uncommon for a child to suffer an infection, allergic reaction or decreased vision.
While many of these issues are routine and may not require professional medical attention, other problems can develop into more serious conditions if not treated properly. Therefore, parents should err on the side of caution and seek medical attention if their child reports a loss of vision or continued pain or irritation.
Dr. Angela N. Buffenn, a pediatric ophthalmologist from The Vision Center at Children's Hospital Los Angeles, shares five common vision health issues in children.
Eye Injuries
Sports are the leading cause of eye injury in children. In one recent year, more than 14,000 children, age 14 and younger, suffered sports-related eye injuries serious enough to be treated in hospital emergency rooms. Toys and foreign objects such as sand, dirt or other small particles, also can cause damage to the eye including scratched corneas. Sometimes, a “black eye” may result from a blow to the eye. Black eyes are caused by swelling and blood under the tissues surrounding the eye. Treating a black eye with ice packs over the first 24 hours is a good idea, but do not use steak or raw meat, as this can introduce bacteria into the eye. Prevention is the best medicine when it comes to eye injuries. Use toys appropriately, wash out dirt and debris with cool running water, and wear eye protection such as safety glasses when participating in sports activities. If the eye continues to be irritated, or headaches, vomiting or loss of consciousness occur following a blow to the eye, seek prompt medical attention.
Seasonal Eye Allergies
Especially common in children with additional allergies or asthma, seasonal allergies can often cause both eyes to become red and swollen, as well as teary and itchy. Although generally harmless and treatable with antihistamines and/or eye drops, infection also can occur. Provide clean, warm washcloths and appropriate medications to help clear up symptoms.
Pink eye
The most common eye infection in young children is pink eye (conjunctivitis). This condition affects the transparent membrane (conjunctiva) that lines your eyelid and part of your eyeball. Pink eye usually is brought about by either bacterial or viral infections. The disease can easily be spread to other children. Your family physician can help determine the cause of conjunctivitis. If it is bacterial, it should be treated with topical antibiotics. If caused by a viral infection, antibiotics will not be effective.
Styes
A stye, or hordeolum, is a small bump that can appear on the outside or inside of the eyelid.
Styes tend to be caused by an eyelash follicle or an eyelid oil gland that becomes clogged, usually from excess oil. Most styes are minor and can be treated with a warm compress. Gently press a very warm washcloth against the eyelid for 10 minutes at least 4 times per day. If the condition persists or if your child’s eyes get styes often, you should seek medical attention because it may be associated with blepharitis, which may require treatment with antibiotics.
Blocked Tear Ducts
Common in newborns, a blocked tear duct (nasolacrimal duct obstruction) usually resolves on its own before the child’s first birthday. Causing a discharge and matting of the lashes, a blocked tear duct can sometimes be encouraged to unblock by gently massaging the area between the child’s nose and eye. The soft area between the eye and nose corresponds to the tear sac (nasolacrimal sac) and pressure on this area often clears a blocked tear duct over time. The eye should be kept clean by washing away the discharge with a warm washcloth. If the amount of the discharge becomes greater, or signs of infection develop such as a green or yellow color, the child may need antibiotics and should be seen by a doctor. In some cases, the duct fails to open during the first year and surgery may be required.
Near and Far Sighted
Myopia (nearsightedness) and hyperopia (farsightedness) are problems with the focusing area of the eye. In nearsightedness, the eye has difficulty focusing correctly when a child looks at objects in the distance, so the objects become blurry. Glasses help to refocus the eye allowing the child to see clearly in the distance. When children have abnormal degrees of farsightedness, the eyes actually have to work harder to keep that object in the correct focus and this can result in fatigue and sometimes ocular misalignment (crossed eyes). If a child complains of headaches, blurred vision and doesn’t like to read, they should be taken for an evaluation by their pediatrician or a pediatric ophthalmologist.
Amblyopia (decreased sight)
Amblyopia requires intervention when a child is young, before the age of 5 years, in order to avoid permanently decreased vision. Generally, the child’s pediatrician will notice that a child does not see well with one or both eyes. If nothing is done to correct the problem, the brain will “turn off” the image seen from one or both eyes and the child will never develop proper vision. Treatment, if diagnosed early, involves glasses in some cases. Treatment also involves patching the better “good” eye so that the “lazy” eye will work harder and become stronger, correcting the vision problem.
Strabismus (crossed eyes)
Strabismus requires intervention when the child is young (the earlier the better in most cases) in order to allow the visual system to use the two eyes together properly, develop depth perception, and avoid decreased vision. Generally, a pediatrician will notice that the eyes are not straight and are going in different directions when an eye exam is performed during a regular appointment. If nothing is done to correct the problem, the brain usually does not learn to use the two eyes together resulting in lack of depth perception. In some cases, loss of vision also occurs. Treatment often includes glasses, eye muscle surgery or a combination of the two.
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