Paediatric eye care

The Eyes of a Child

Dr V.C.Parthasarathy FRCOphth (London)., DO, Consultant Ophthalmic Surgeon, at Bermuda International Institute of Ophthalmology discusses the importance of paediatric eye care

Examining children can sometimes be daunting and needs great skill and personality to get the best out of them. It does test the communication skills of the team in not only dealing with the child but also the parent who can sometimes be very anxious and uptight.

The next big challenge is not missing systemic associations and we can give valuable information to the paediatrician. A baby that is not thriving may have a cataract due to a systemic problem like galactosemia and the paediatrician could do a blood test that can clinch the diagnosis. Or a child with liver disease in infancy can have important condition called Alagille syndrome for which the infant may need a life-saving liver transplant. An older child with sudden neuro regression and abnormal movements of the limbs can have problems with metabolising copper which gets deposited classically in the eye apart from other tissues in the body and can easily be spotted by the Ophthalmologist. The list is simply endless. Occasionally a child with a small optic nerve could have abnormalities in the mid-line structures of the brain especially the pituitary. Diagnosing this condition of Optic nerve child’s growth and development as the paediatrician could start supplementing pituitary hormones to help in normal growth of the child. When one considers the fact that the whole life is in front of them then one realises how crucial the eye examination is.

Poor visual development can have enormous implications on education and visually handicapped children may need to go to special schools rather than mainstream education. Good vision is also imperative to good motor development of the child.

It has been found that children with a squint (ocular deviation or cross eye) have problems with socialising and in making meaningful relationships in childhood and also in adult life. There is only a 1 in 10 chance for an adult with a squint to be successful in an interview setting.

The common conditions we come across are kids with reduced vision in one eye or both eyes due to a refractive error (need for glasses). When not treated in time the kid gets a lazy eye (amblyopia) or may develop a squint. The biggest problem facing the world today is the explosion of Myopia or short sightedness due to excessive use of handheld electronic gadgets like mobile phones and tablets. This tendency has to be curtailed and parents will need to have a zero-tolerance policy as regards the use of