Paediatric Eye Care – Child Eye

Good Vision Habits

administrator — Wed, 26 Aug 2020 08:51:20 +0000

Good vision habits in children

Encourage outdoor play

Sunlight is important to prevent myopia (short sightedness) and slow down its progression. Even reading outdoors (with the sun around you) rather than indoors, can have a protective effect against myopia. Physical activity keeps the body healthy and improves blood circulation to the eye.

Screen time

Essential (academic) screen time should be allowed, with a 1-2 min break every 20-30 minutes (by looking at something far for a few minutes, blinking slowly and keeping the eyes closed for a few seconds too).
Non-essential screen time (games, videos etc.,) should be less than 1-2 hours daily in total, with breaks every 30 minutes.
The further away the screen, the better it is for the eyes.
Outdoor screen time is preferred to indoor screen time.

Studies and reading

The book should be held at least 30cm away.
The environment should be well lit.
Should sit in a chair with the book on a table, to maintain the distance.
Take breaks every 20-30 minutes and look at a very distant object for a few minutes while blinking regularly. Alternatively, keep your eyes closed.
Discourage reading in bed and in moving vehicles.

These adjustments can relieve headaches, make the eyes feel comfortable, increase reading speeds and effectiveness of reading.

Go for regular eye-checks

Every two years, if everything is fine and there are no complaints.

Every year or six monthly (as advised) if there are eye conditions needing glasses or treatment.

Food to keep our eyes healthy

Leafy green vegetables, eggs and broccoli, all have high antioxidant concentrations.
Legumes and peanuts contain zinc - a mineral that protects from the harmful effects of light.
Citrus fruits have high levels of vitamin C, which perform an antioxidant role in our eyes.
Fish rich diets have high levels of Omega3 fatty acids.
Orange coloured vegetables that are high in beta-carotene - needed for night vision.

The post Good Vision Habits appeared first on Child Eye.

Procedures

administrator — Tue, 25 Aug 2020 12:19:19 +0000

Cleaning a Child’s Eye

Wash your hands thoroughly before and in between cleaning the eyes.
Use clean water (drinking water) to soak a clean piece of cloth in.
Wipe the closed eyelid from the inner corner outwards.
Once the above steps are complete, in an older child, clean water in a small container could be used to flush a slightly open eye. (Especially useful if a small foreign body, mild chemical contamination or ocular allergy is the diagnosis).

Eye Drops

Expect some resistance and struggle while instilling the drops.

All eye drops cause a mild stinging feeling and temporary blurred vision upon instilling.
In addition, dilating drops used in a clinic cause blurred vision.

Preparation for the drops

The last resort should be to hold the child down, force open the eyes and force the drop in, as the crying and the squeezing will wash the drop out.
If the child is old enough, explaining the benefits of the drops will definitely help.
Try to make it as fun as possible, even a game in a younger child.
Have a practice run with a dropper and a few drops of water.

Instilling the drop

Wash your hands with soap and water.
Do not let the tip of the bottle touch anything.
Tilt the head slightly back.
The drop can be instilled into the space created by pulling the lower lid down.
Ask the child to blink gently a few times and keep the eye closed for a few minutes.
Wipe only the excess medication that flows out of the eye.

The child could lie down with the eyes closed.
Place the drop in the depression between the lids and the bridge of the nose.
Slightly lift the upper lid and the drop will slide into the space between the lids.
This is good way to get the drop into a child’s eye while they are asleep, as there will be no crying to wash the tears away and can be much less traumatic too.

Remember

One drop is all that is needed.
If more than one type of drop is required, wait about 5-10 minutes between the drops.
Ointments can be squeezed inside the lower lid. Use a drop first, if used with an ointment.
If a wrong drop is instilled, wash and flush the eye immediately and then contact your clinic.
Check the expiry date and storing instructions.

Eye Injuries

Causes

Toys (sharp or projectile in nature)
Household objects (pens, pencils, tools, cords)
The child's own finger
A fall
Sports: contact sports, racquet sports, high velocity ball sports
Fireworks: Children should not use ANY kind of fireworks (explosive or sparkling).

Protective eye wear is available for most sports. A sport’s frame and polycarbonate lenses would be the most common combination.

If a significant sharp trauma is suspected, the eye needs to be closed with a sterile eye pad and referred immediately for further management.

Chemical Contamination

Chemicals can range from perfumes, cleaning liquids etc., which are present in most households.

The most important first step is to IMMEDIATELY and thoroughly (continuously at least for 10-15 minutes) wash the eye with any available source of water, to minimize the contact time the chemical has with the surface of the eye. The appropriate referral can be done after the washing.

Most household chemicals will, at most, cause chemical conjunctivitis without long term complications, which will be treated with drops to reduce the inflammation. More serious acid or alkaline contamination can cause considerable ocular damage and long term complications.

The post Procedures appeared first on Child Eye.

Common Eye Conditions

administrator — Tue, 25 Aug 2020 11:35:12 +0000

Common eye problems in children

Amblyopia (“lazy eye”)

This is poor vision in an eye that may appear to be structurally normal. Two common causes are refractive errors and squints. If untreated, amblyopia can cause irreversible visual reduction in the affected eye. The earlier the amblyopia is detected and treated, the better the visual outcome will be.

Strabismus (squints)

This is a misalignment of the eyes, where both eyes don’t focus on the same thing. If the same eye is constantly misaligned, amblyopia could result. Squints can be treated with glasses, exercises or surgeries.

Refractive errors

This means that the front layers of the eye do not focus light accurately on to the retina, resulting in a blurred image and can cause amblyopia. These focusing errors are usually treated with glasses, contact lenses and later by laser correction.

Nearsightedness (myopia)

Is the most common refractive error in school-age children causing poor distance vision.

Farsightedness (hyperopia)

Is poor near vision.

Astigmatism

Is the imperfect curvature of the front surface of the eye causing both, blurred distance and near vision.

Allergic Conjunctivitis

This causes an itchy, red and tearing eye and is associated with other allergies like asthma, allergic rhinitis and skin allergies. Allergic conjunctivitis can be treated with cold water compresses and observation if mild, but will require eye drops if symptoms are excessive.

Nasolacrimal Duct obstruction

This causes tearing in an infant by a blocked tear duct. The eye is usually white and spontaneously resolves by one year of age in most infants. A gentle massage of the side of the nose is usually all that is needed as treatment.

Infective Conjunctivitis

Viral or bacterial conjunctivitis is a contagious infection causing a pink, irritated and tearing eye commonly associated with discharge. It is spread via contact and can be observed with only washing the affected eye if mild, while more severe infections require eye drops. Children should be kept away from school for at least 10 days after the initial symptoms start.

Blepharitis (infected lid margins)

This inflammation in the oily glands of the eyelid usually results in swollen eyelids and excessive crusting of the eyelashes. This could cause tender lids, a foreign body sensation, increased blinking, tearing, pain and difficulty with looking at lights. Blepharitis can be treated with warm compresses and eyelid scrubs using baby shampoo. If an infection is present, antibiotics may be necessary.

Ptosis (droopy eyelids)

A lowered position of the upper lid. When ptosis is mild, it is primarily a cosmetic problem. However, a droopy upper lid can obstruct vision getting into the eye and can result in a lazy eye, in a young child. In such cases a surgery may be required to correct the lid position.

Less Common but More Serious Conditions

Retinopathy of Prematurity

A disease that affects the eyes of premature babies, and which needs regular screening and prompt treatment, if present.

Retinoblastoma

This is a rare malignant tumor that usually appears in the first 3 years of life. The affected eye may have visual loss and a white appearance of the pupil.

Cataract

Is the clouding of the eye’s lens and can cause a permanently lazy eye if not treated early in a young child.

Congenital Glaucoma

It is the result of the incomplete development of the eye’s drainage mechanism, resulting in raised intraocular pressure. This can be treated with medication and surgery.

The post Common Eye Conditions appeared first on Child Eye.

What To Expect At A Routine Visit

administrator — Fri, 21 Aug 2020 16:48:58 +0000

Possible Steps

Registration on arrival.
Vision checking: reading out charts with letters, numbers, symbols and pictures depending on the child's abilities and age.
Examination:

In very young children, the initial examination (or sometimes the complete examination) and if required an orthoptic assessment, might be performed while sitting on a parent’s lap, a few feet away from the examiner. The child will be shown toys and lights and a torch like instrument will be used to examine the front and the inside of the eye (ophthalmoscope).
When the child feels more comfortable and in older children the examination will be done using a slit lamp - a big camera like instrument that requires the child to place his chin on a stand and forehead against a band. Each eye will be examined using a bright light for a few seconds.

Refraction (checking for glasses): This is when the focusing ability of each eye is checked and corrected using lenses on a trial frame (worn like a pair of glasses). Usually performed if the vision is lower than should be, for the child’s age.
Dilated exam: This is where eye drops are used to dilate the pupil (enlarge the aperture that allows light into the eye). This will allow a better view into the back of the eyes and also will be used to get an accurate check for glasses (cycloplegic refraction). These drops will reduce the vision, especially the near vision, and glare will be a complaint for anywhere between a few hours to around 24 hours. Occasional allergies to the drops such as red eye, fever, headache etc., may occur.

Tips to help make it a pleasant visit

It might be better to not call the visit ``a visit to the eye doctor in hospital``. Instead maybe a ``visit to play some games and take some pictures to make sure the eyes are healthy``. Make all the procedures from vision checking to the examination all challenging games rather than procedures.
Take the child through the possible steps while at the exam, using the pictures below as reference. If the child is too small to understand, tell them they are going to take pictures of their eyes.
If drops might be needed, explain this to the child as the ‘Magic Swimming drop game’ (a drop that makes you feel you are under water in a pool...where the eyes sting slightly and everything appears blurry) and play it at home by using a medicine dropper and instilling a few drops of water into each eye.

The post What To Expect At A Routine Visit appeared first on Child Eye.