Our Services

Paediatric Ophthalmology & Squint

Paediatric ophthalmology is a sub-specialty of ophthalmology concerned with eye diseases and vision care in children.

About 80% of learning in the child's first 12 years come through his eyes. Children are not aware of their vision disorders and mostly grow with this. Truly, diagnosis can help prevent many eye diseases.

The Paediatric Ophthalmology and Squint Service at Aggarwal Eye Hospital provides comprehensive primary care for the diagnosis and management of common childhood vision disorders.

Children experience a variety of eye problems, many quite distinct from adult eye diseases. Some of the common eye problems are:

• Squint is a misalignment of the eyes that affects 2-4% of the population; it is often associated with amblyopia. The inward turning gaze commonly referred to as "crossed-eyes" is an example of strabismus. It also applies to other types of misalignments, including an upward, downward, or outward turning eye.

• Amblyopia (i.e. lazy eye) occurs when the vision of one eye is significantly better than the other eye, and the brain begins to rely on the better eye and ignore the weaker one. Amblyopia affects 4% of the population .

• Retinopathy of Prematurity: It is a serious condition, developing in premature babies, which can damage retina and unless properly managed, can cause irreversible blindness at an early age. Very low birth weight babies and those with exposure to high oxygen are at greater risk.

• Paediatric cataracts: Cataract is an opacity that develops in the crystalline lens of the eye or in its envelope. Cataract in the child's eye leads to vision loss and needs early management to prevent further problems like amblyopia. Surgery is done for its removal and depending on age, intraocular lens may be implanted.

• Paediatric glaucoma: High pressure in the eye leading to damage to the optic nerve is found in 0.1 - 0.2 % of paediatric patients. It may present with big eyes, watering or may have no symptoms at all. It requires early diagnosis and management.

• Refractive errors such as myopia (near-sightedness), hypermetropia (far-sightedness) and astigmatism can often be corrected with prescriptions for glasses or contact lenses.

• Convergence insufficiency, Accommodative insufficiency and asthenopia symptoms are very common in children. Asthenopia is an ophthalmologic condition that manifests itself through nonspecific symptoms such as fatigue, red eyes, eyestrain, pain in or around the eyes, blurred vision, headache and occasional double vision. Symptoms often occur after reading, computer work, or other activities that involve tedious visual tasks. Sometimes, asthenopia can be due to specific visual problems, such as uncorrected refractive errors or binocular vision problems like accommodative insufficiency or heterophoria.

• Evaluation of visual issues in education is vital in a child facing sudden deterioration of academic performance, which may be due to undiagnosed vision problems and may require glasses to correct refractive error.

Services Offered
Comprehensive preschool eye check
This involves a complete screening of a child for vision, squint, retina and optic nerve disorders. For preschool eye check, following examinations are carried out: vision testing, testing for the presence of any squinting of the eyes, examination of the retina and optic nerve.

Treatment
Medical

• Amblyopia (Lazy eye) management.

• Glass prescription.

• Eye excercises.

• Low vision aids.

• Allergic eye conditions.

• Eye infections.

• Glaucoma management.

• Retinal lasers.

Surgical

• Congenital cataract management.

• Glaucoma surgeries.

• Corneal transplant.

• Squint correction.

• Retinal surgeries in children.

WHAT SHOULD YOU LOOK FOR IN YOUR CHILD 
Take a good look at your child while he/she is playing or watching a book/TV and note if any of the following are present.

• Squeezing his/her eyes while looking at book/TV/Toys.

• Tilting the head while talking, walking/ playing.

• Going too close to the book or TV.

• Recurrent eye pains, headaches.

• Avoids reading, colouring most of the time.

• Has bad handwriting at school.

• Eyes turning inwards/outwards.

• Difficulty in seeing in sunlight, bright light in the evening.

• Itching, watering.

If any of the above are present then you should suspect the child to have a possibility of eye problem. The problem could be either glasses or squinting of the eyes. These are easily treated and a proper screening of the child having any of the above complaints is needed to rule out any other causes as well…3

SHOULD ALL CHILDREN BE SCREENED
All children should be seen by an eye doctor for the first time at 3-4 years of age. However, if any of the following are present then the child should be brought to the eye doctor at the earliest:

• One on both parents wearing glasses.

• History of consanguity (marriage among cousins) in family.

• Premature delivery.

• Birth weight less than 1.5 kg.

• History of any congenital defects like heart, kidney etc.

• History of febrile fits or any convulsion.

• History of admission in the ICU- incubation/ ventilation given to child.

• Behavioural disorders or any developmental delay in the child.

• History of colour blindness and retinal disease in family.

WHY SHOULD AN EYE DOCTOR SEE A CHILD?

• Early detection of eye sight problem gives rise to better vision development.

• Good vision correction causes good performance at school and home.

• Squinting of eye if diagnosed early can be treated with exercises and glasses in some cases.

• It is possible to give the child good binocular (coordinated) development of eyes.

• Other behavioural, social problems if present in the child will also benefit in their treatment.

WHEN IS THE BEST TIME TO BRING THE CHILD?
If the child has a problem then anytime is a good time to visit the eye doctor however specific visits can be planned as follows

• A preterm infant/low birth weight infant at 4 weeks after birth.

• A normal baby at 3 to 3½ years of age for a preschool eye check.