Common eye diseases in children

The eyes of your child are more than the windows to his soul. To explore the world around him, he needs them. There are, unfortunately, many diseases and conditions that can jeopardise his eye health.

Dr Hamza Tayob, an ophthalmologist at the Pretoria Eye Institute, provides insight into spotting common childhood eye diseases.

Signs of vision problems 

• Constant eye rubbing
• Extreme light sensitivity
• Poor focussing
• Poor visual tracking (following an object)
• Abnormal alignment or movement of the eyes (after six months of age)
• Chronic redness or tearing of the eyes
• A white, instead of a black pupil.
• Being unable to see objects at a distance
• Having trouble reading the blackboard
• Squinting
• Difficulty reading
• Sitting too close to the TV.

Common childhood eye diseases

Amblyopia

Amblyopia, also known as lazy eye, occurs when one eye does not receive as clear a picture as the other. The most common causes are strabismus, refractive error (incorrect focussing power), ptosis (droopy eyelid), and cataract (clouding or opacity in the lens).

Signs and symptoms of a lazy eye include:

• An eye that wanders inward or outward
• Eyes that appear not to work together
• Poor depth perception
• Squinting or shutting an eye
• Head tilting
• Abnormal results of vision screening tests.

Treatment options include patching and/or glasses. If treatment is started at an early age, vision can be improved significantly.

Chalazion 

Chalazion is a small swelling of the eyelid caused by a blockage in the glands, accompanied by redness and yellowy ooze. A child could have a number of these swellings on an eyelid at any one time. The condition can affect one or both eyes.

Signs and symptoms may include:

• A small bump which can usually be felt in the eyelid
• A gradual swelling of the eyelid
• Discomfort in the eye or difficulty with seeing if the chalazion is large. This condition is usually not painful.

Consult your family doctor who will suggest initial treatment. If there is no improvement after three or four months, an eye specialist should be consulted.

Epiphora

More commonly referred to as watery eyes, Epiphora is when there is excessive tear production or blocked tear ducts.

This can happen for several reasons:

• Overproduction of tears
• Infection
• Blocked tear ducts

Signs and symptoms include:

• Redness
• Enlarged, visible blood vessels
• Soreness
• Sharp pain
• Eyelid swelling
• Blurred vision
• Light sensitivity.

When treating watery eyes, you need to treat the underlying condition. Treatment options may vary from a conservative approach to surgical correction. Your doctor will give you the best course of action.

Conjunctivitis 

Pink eye can be either viral or bacterial. But, both infections are very contagious. A non-contagious allergic reaction can also cause pink eye. Either way, the eye appears red or pink due to the thin membrane’s inflammation covering the inside of the eyelids and the white part of the eye.

Signs and symptoms of conjunctivitis:

• A red or pink eye (or both eyes)
• Redness behind the eyelid
• Swelling of the eyelids, making them appear puffy
• Excessive tears
• A yellow-green discharge from the eye which dries when your child sleeps, causing crusting around the eyelids
• A dislike of bright lights (photophobia)
• A gritty feeling (like there is sand in the eye
• Itchiness of the eyes and eye rubbing.

Good to know: Children with contagious pink eye need to stay home from school or return home to avoid infecting others. The condition usually resolves itself within three to seven days. Once the tearing and discharge have stopped, the child can return to school.

Strabismus 

Strabismus happens when the eye points in different directions all the time or sporadically. It may be present at birth or appear later. Either way, the affected eye’s vision will not develop normally, and the child will not outgrow the condition.

Signs and symptoms of Strabismus:

• During the first 3 months of life, the eyes wander outward all the time, or they cross inward.
• After 3 months of age, one or both of the eyes wander out or cross in.
• Your child may tilt his head to effectively line up his eyes to use them together, or he may squint one eye, especially in bright sunlight, to block out a double image resulting from the misaligned eyes pointing in different directions.

Treatment is aimed at establishing sound vision and coordination in both eyes as well as improving appearance. The earlier treatment starts, the more effective it will be.

Treatment options include:

• Glasses
• Patching
• Exercises
• Surgery
• A combination of the above.

Protect your child’s eye health

• Newborn babies should be checked for general eye health by a paediatrician or family physician in the hospital nursery after birth.
• An eye specialist should examine high-risk newborn babies (including premature infants), children with a family history of eye problems, and those with obvious eye irregularities.
• In the first year of life, all infants should be routinely screened for eye health during check-ups with their paediatrician or family doctor.
• Kids should have eye health screenings and visual acuity tests (tests measuring the sharpness of vision) with their paediatrician or family doctor.
• Kids should have their vision and eye alignment checked by their paediatrician or family doctor around age five. If any of these tests are failed, an eye specialist should be consulted.
• After age five, routine screenings should be done regularly, especially if symptoms such as squinting and frequent headaches occur.
• Kids who wear prescription glasses or contact lenses should have annual check-ups with an eye doctor to monitor vision changes.