Dr Ajeet Madhav Wagle
MBBS(India) FRCS(Edinburgh) FAMS(Ophthalmology)(Singapore)
By Dr Ajeet Madhav Wagle, Medical Director and Senior Consultant Ophthalmologist, International Eye Cataract Retina Centre at Mount Elizabeth Medical Centre and Farrer Park Medical Centre, Singapore
Children are special and so is their sight. Eye health and safety are very important components of a fulfilling childhood. The vast majority of learning during childhood occurs visually and good vision is critical for a child’s well-being, both physically and intellectually.
Common signs of concern are frequent rubbing of eyes, squinting, tilting or turning of the head to look at objects. The child might also squeeze his eyes or you might notice that his eyes wander.
In order to raise awareness of children’s eye health, the American Academy of Ophthalmology has designated August as Children’s Eye Health and Safety Awareness Month.
Here are some of the common eye health conditions found in children.
Short-sightedness, also known as myopia, is an eye condition in which an individual has difficulty seeing distant objects clearly without corrective lenses. Myopia usually begins in early childhood and progresses during the early years of life.
It is estimated that almost half of the world’s population will be myopic by 2050. Myopia is very common among school-going children in urban populations, especially in Asia Pacific countries such as Singapore. As many as 80% of 18-year-olds in Singapore have myopia, one of the highest in the world.
Myopia is a multifactorial condition and these factors may be genetic (eg, family history of myopia) and environmental (eg, excessive near work, lack of outdoor activities, poor illumination during visual tasks). As environmental factors are modifiable, tackling these can potentially reduce the progression of myopia.
Myopia is associated with a significantly increased risk of developing serious eye conditions such as macular degeneration, retinal tear, retinal detachment, cataract and glaucoma later in life. Some of these conditions have the potential risk of permanent blindness.
In childhood, myopia is usually treated with prescription glasses or contact lenses, especially in older children. Regular eye examinations are recommended to monitor the progress of myopia. Special eye drops (eg, atropine 0.01%) are prescribed to relax eye muscles and help reduce the progression of myopia in children.
LAZY EYE (AMBLYOPIA)
Lazy eye, also called amblyopia, is poor vision resulting from abnormal visual development in early childhood. This is a leading cause of vision loss among children. In this condition, the neural pathways between the eye and the brain are not properly stimulated, resulting in a lazy or weak eye. The brain tends to favour the good or stronger eye at the cost of the weaker eye. The weak eye loses the opportunity to improve vision if treatment is not initiated within the first decade of life, and the child can eventually end up with a permanent visual deficit.
If the lazy eye is detected early and treated promptly, the weaker eye can be stimulated to achieve better and often normal vision in the vast majority of children. Treatment modalities include eye patching of the stronger eye, eye drops to weaken the eye muscles of the stronger eye, corrective glasses and/or contact lenses. Occasionally, surgery is required to treat associated conditions such as crossed eyes or cataract.
CROSSED EYES (STRABISMUS)
Crossed eyes, also called strabismus, is a condition in which the two eyes do not align properly and appear to look in different directions. Some children are born with this condition while others develop it as they grow older.
Children with crossed eyes should have their eyes evaluated by an eye specialist. Treatment depends on the type and severity of the problem. The treatment modalities include special corrective glasses, treatment of any associated lazy eye and/or strabismus surgery.
Eye injuries are common among children as they are usually very active. Most of these injuries are either sports-related or accidental.
Appropriate protective eye wear is key to eye safety especially to prevent injuries associated with sports. As many as 90% of eye injuries can be prevented with the use of appropriate protective eye wear.
Certain sports have a higher risk of eye injuries. In general, contact sports (eg, boxing, martial arts), racquet sports (eg, badminton, squash, tennis), baseball, basketball, hockey and football are frequent causes of eye injuries.
If you child has a chemical eye injury, irrigate his eye immediately and thoroughly with tap water or saline solution, and seek medical attention immediately. If he has a physical eye injury, do not let your child rub or touch his eye, do not apply any medication into the eye without a doctor’s advice, and do not remove any debris or foreign object from the eye by yourself. Seek immediate medical attention from an eye specialist.
As younger children often do not verbalise their visual problems, it is the duty of parents and other adults involved in the care and upbringing of children to have their eyes regularly evaluated and to ensure that the eyes are appropriately protected from harmful injuries.
Children are encouraged to have regular comprehensive eye screenings in order to promptly detect eye conditions that may need further intervention. Children with visual symptoms are advised to seek specialist opinion as early as possible.
Don’t take your child’s eye health for granted. Make your child’s sight a priority.