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VISION PROBLEMS IN CHILDREN

(CHILD EXAMINATION.: EYES)
Vision Problems in Children

WHAT YOU NEED TO KNOW:

What do I need to know about vision problems in children? Your child may be born with vision problems or he may develop them over time. Most vision problems are diagnosed during routine eye exams. Early diagnosis and treatment is important to prevent permanent damage. The following are warning signs that your child has a problem with his vision:

  • Difficulty following an object with his eyes

  • Blinking or rubbing his eyes a lot

  • Crossed eyes or one eye pointing the wrong way

  • Watery, red eyes, or pain when he looks at light

  • A white pupil

  • Holding things close to his eyes when he looks at them

  • Shutting or covering up one eye when he tries to see something

  • Squinting or frowning while he looks at objects

What causes vision problems in children?

  • Eye injuries or infections

  • Medical conditions such as diabetes, cerebral palsy, or juvenile rheumatoid arthritis (JRA)

  • Certain genes passed from a parent to his child

  • Certain medicines, such as seizure medicine

What eye problems may my child be born with?

  • Retinopathy of prematurity (ROP) is when abnormal blood vessels develop in your baby's retinas. The retina is the part of the eye that captures light and sends information to the brain. ROP happens in premature babies or low birth weight babies. ROP most often affects both eyes.

  • A cataract is a clouding of the eye's lens. The lens is on the front of the eye. The lens helps focus light to create an image of what your child sees. Cataracts may affect one or both eyes.

  • Glaucoma is eye damage that is caused by high pressure in your child's eye. Glaucoma may happen from poor development of his eye drainage system. It may be passed from a parent.

What vision problems may my child develop?

  • Refractive errors means the eye does not bend light correctly, causing blurry vision. Your child may have trouble seeing things that are close to him or things that are far away. Astigmatism is a problem with the curve of your child's eye surface. Your child may not have symptoms or he may have blurry vision or eye discomfort.

  • Strabismus happens when the eyes do not move together at the same time. The eyes may face in different directions. One or both of your child's eyes may turn in, out, up, or down.

  • Amblyopia is also called lazy eye. Your child may have poorer vision in the lazy eye. This may cause him to only use his good eye to see. The lazy eye may look normal, or it may turn in. Early treatment is important to prevent permanent vision loss in the eye.

  • Ptosis is a condition that causes 1 or both of your child's eyelids to droop or sag. The eyelid may cover the eye and make it difficult for your child to see. Ptosis may cause amblyopia or astigmatism.

  • Nystagmus is a condition that causes the eyes to make repetitive, uncontrolled movements. Your child's eyes may move side to side, up and down, or in a circle. He may have blurry vision or trouble with his balance and coordination. Nystagmus may be caused by problems in your child's brain. Nystagmus may improve with treatment of the brain problems.

What other eye problems may affect my child's vision?

  • Color blindness means your child's eyes are not able to see some or all colors. Color blindness may run in families or develop after an injury to the eyes, nerves, or brain. In children, color blindness happens more commonly in boys than in girls.

  • Eye infections may be caused by different kinds of germs, such as bacteria, viruses, or fungi. A stye, or a bump on the edge of his eyelid, is a common eye infection. It is caused by an infected eyelash follicle. Conjunctivitis is another common eye infection. It is an infection of the white part of your child's eye.

  • A chalazion is a small lump on your child's eyelid. It happens when an eye gland that makes oil becomes clogged.

  • A blocked tear duct is a common problem in newborns. Your baby's pediatrician may show you how to massage and unblock the tear duct.

  • Retinoblastoma is eye cancer that usually affects 1 eye.

How are eye problems diagnosed and treated? Your child's healthcare provider will examine his eyes. He will check the shape of your child's eyes and how they react to light. He may ask your child to read letters off of a chart or point to pictures. Tell his healthcare provider if you have noticed any problems with your child's eyes. If your child is born with vision problems or develops vision problems, he may need to see an ophthalmologist. An ophthalmologist is a doctor who diagnoses and treats eye and vision problems. Your child may need any of the following to treat an eye problem:

  • Medicines such as antibiotic or antifungal eyedrops may be given to treat a bacterial or fungal infection. Eyedrops may also be used to treat glaucoma, strabismus, or amblyopia.

  • Glasses can be worn by children of all ages. Glasses can help correct refractory errors or astigmatism. Choose lenses made of polycarbonate. This type of lens is less likely to scratch or break than other types. Choose plastic frames for children younger than 2 years. Attach a strap to both ends of your child's glasses. This will help keep your child's glasses in place.

  • Contacts may be appropriate for your child by around age 10 years. Contacts may help correct some types of refractory errors. Your child may still need glasses while his contacts are out. Teach your child to wash his hands before he touches his eye or contacts. Your child should clean and change his contacts as directed. He should not swim or sleep with his contacts in his eyes.

  • An eye patch may be used to treat strabismus or amblyopia (lazy eye). Apply the patch to your child's healthy eye as directed. He may need a bandage placed over his eye or a cloth patch that fits over his glasses. This will help improve vision in your child's weaker eye. Your child may need to wear the patch for 2 to 6 hours every day. Encourage your child to wear the patch. Distract him with toys and games to help him forget about the patch.

  • Surgery may be used to correct problems such as a lazy eye or strabismus. Surgery may also be used to remove a cataract or relieve a plugged duct.

When should I seek immediate care?

  • Your child gets chemicals in his eye.

  • Your child has a foreign object in his eye.

  • Your child's eye is bleeding or looks different than usual.

  • Your child has a sudden change in his vision.

  • Your child's contact gets stuck in his eye.

When should I contact my child's ophthalmologist or healthcare provider?

  • Your child gets hit in the eye with an object.

  • Your child has eye pain or sensitivity to light.

  • Your child has red eyes and yellow or green eye drainage.

  • Your child's eye is swollen or you see a bump on his eyelid.

  • Your child feels like there is something in his eye.

  • Your child says he has blurry vision or changes in his vision.

  • You have questions or concerns about your child's condition or care.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.