Amblyopia/Lazy eye
What is it?
Amblyopia, or lazy eye, almost always affects only one eye, but can result in vision reduction in both. It can be caused by the eye not receiving proper stimulation during early childhood, or it may result from a squint or one eye focusing better than the other, or even blockage of an eye duct due to cataract, trauma or lid droop.
Who is at risk?
Between 2 to 5 per cent of children have amblyopia, and it does run in families - so anyone who has a direct family member with amblyopia or a squint should get an eye test.
How to treat it:
The good news is, amblyopia is treatable before the age of eight, and research by the National Eye Institute in the US suggests between the ages of eight and 17, treatment could still make a difference. Treatment involves glasses, drops, vision therapy and patching on the good eye to force the brain to use the lazy one better.
Refractive Errors
What is it?
Short sight, long sight and astigmatisms are all considered to be refractive errors. Myopia, otherwise called short sight or near-sightedness occurs when the eye is a little too long so light is focused in front of the retina. Objects close to the eye are in focus, but things in the distance are not. Conversely, hyperopia, or long sight happens when the eye is a little too short so light is focused behind the eye rather than on the retina. The eye has to work hard all the time to keep things in focus and when it tires the vision goes blurry. Astigmatism is an abnormal curvature of the cornea, resulting in decreased vision. Some signs and symptoms of astigmatism may include headaches, eye strain, difficulty reading, and fatigue.
Who is at risk?
Many refractive errors do not get picked up until your child is school age and teachers notice they are having problems reading books or from the board. Eye sight naturally worsens with age, so frequent eye tests will spot any potential problems.
How to treat it:
In most cases refractive errors can be treated easily with glasses, but it is important to seek treatment as a delay in remedying refractive errors can cause decreased vision, visual discomfort (eye strain), and/or amblyopia.
Conjunctivitis
What is it?
Conjunctivitis is a redness of the thin skin covering the white of the eye; there are two types, one that results in a sticky white or yellowy discharge and one that is caused by allergies.
Who is at risk?
Contagious conjunctivitis is possibly one of the most common eye conditions in children as it can be spread very easily in small communities such as nurseries, schools and between siblings.
How to treat it:
It is not serious, but to avoid further spreading it is important to take preventive measures such as frequent eye bathing with cooled boiled water, always remembering to use a different cotton pad for each eye. Eye drops may be prescribed, although most cases tend to clear up by themselves within a fortnight. Allergic conjunctivitis on the other hand is an ongoing problem that requires specific treatment and sometimes anti-inflammatory drops.
Chalazions
What is it?
This is a cyst on the eyelid which occurs when one of the glands gets blocked, which leads to swelling. For the first few days the cyst is inflamed and you might see a small white head on the top of it which then tends to shrink, but might take months to disappear completely.
Who is at risk?
Anyone can get a cyst, but it is important to keep the eye area clean to minimise the risk.
How to treat it:
This is not a serious condition and no medical action is required in most cases. Antibiotic ointment or drops may be prescribed. To soothe, hot compresses can be applied four times a day. The cyst should disappear within two months, but it can be removed with a simple surgical procedure.
Nasal Lacrimal Duct Obstruction
What is it?
This is a blockage of the tear passages preventing tears from running which results in 'gunky' eyes.
Who is at risk?
It's relatively common among newborns.
How to treat it:
As well as bathing the eye regularly with cooled boiled water, if you put your finger on the side of your baby's nose underneath the inner corner of their eye, and run it down in a semi circular shape under the eye area, this is usually enough to open the tear duct. The eye may turn red, in which case a brief spell of antibiotics will be prescribed. If this persists in children over one year, there is a quick and effective procedure that your ophthalmologist can do to open the tear passage.
Strabismus/Squint
What is it?
This condition occurs when one or both eyes are misaligned and do not point in the same direction. The eyes may turn inwards (esotropic), which is commonly called crossed eyes, or outwards (exotropic), known as wall eyed. The eyes could even point up (hypertropic), or down (hypotropic), or a combination of these.
Who is at risk?
Affecting around 2 per cent of children; it can be present at birth or early infancy, and may be caused by a muscle imbalance or a need for glasses.
How to treat it:
A cover test or the Hirschberg test will help with diagnosis. A light is shone in the eye and, when looking directly at the light, a reflection can be seen on the pupil. If the eyes are aligned the reflection will be in the same spot of each eye. Typical treatment involves the use of glasses, orthoptic therapy, or eye muscle surgery.
Eye tests: what to expect
"Tests for children are quick, simple and painless and can help prevent serious problems in later childhood or in adulthood," says Dr Clare Roberts, a former consultant paediatric ophthalmologist and strabismus surgeon at Moorfield's Eye Hospital Dubai.
You child's eye exam should:
1) Check that the muscle balance is normal and that they see 3-D by identifying shapes, animals, or letters present on a random dot stereogram.
2) Measure the distance the child can see by using an age-specific linear vision chart at a distance of 6m.
3) Look at the structures of the eye front and back.
4) Check that both eyes are working together.
5) Measure the optics of the eye - refraction. In young children and in children who have a squint the refraction should be done after putting in eye drops that completely paralyse the focusing muscle of the eye in order to get an accurate result.
