Which 8 eye conditions are most common in children?
05 November 2019
Common sight issues in children
Keeping an eye on your child’s vision is perhaps even more important than monitoring your own, as often they can’t or don’t communicate that there is anything wrong at all. This especially goes for young children who might have been born with an eye condition or severe refractive error, and so have never known anything different.
We’re going to talk through some of the most common visual issues that children suffer with, along with the symptoms, so that you know how to spot the problems.
Strabismus – also known as a squint or crossed eyes – is when a person’s two eyes do not line up with each other. This occurs because the eye’s muscles don’t work together properly, causing an imbalance. It can either be constant or intermittent, often with the eyes alternating when turning inwards or outwards. The turning can also involve upwards and downwards movements. With newborns and very young babies, some misalignment is normal as their eyes are still learning to focus on individual objects. However, if you still notice imbalances across both eyes after the age of four months, it’s a good idea to take your baby for an eye test. By the age of six months, a baby should be able to focus well on objects at all distances.
Strabismus doesn’t go away on its own or improve without treatment, but there are a range of options available to children suffering with strabismus. Glasses are the most common solution as they can “redirect the line of sight” and straighten the eyes. Medication is also sometimes offered to “selectively weaken an overactive eye muscle” but, if it doesn’t work, surgery is available to shorten particular muscles to pull the eye back around to its original position. Around 2% of children have strabismus and treatment is absolutely crucial as, if ignored, the condition can lead to amblyopia.
Amblyopia – more commonly known as a lazy eye – often occurs as a result of untreated strabismus and is a much more serious condition. While strabismus doesn’t affect the quality of the child’s vision, amblyopia involves deterioration in the visual acuity of the affected eye. The condition promotes an almost vicious cycle: the weaker the eye gets, the less the child uses it, causing it to lose visual acuity and be used even less.
Again, treatment for amblyopia is available and is similar to the solutions for strabismus. Most commonly, the child will wear an eye patch. This is placed over the stronger eye, encouraging the weaker eye to work harder and therefore become stronger. A similar effect can be achieved by using eye drops to blur the vision in the stronger eye. This also forces the child to rely on their weaker eye for good vision, strengthening it. Early diagnosis for amblyopia is key in preserving good sight in the affected eye, so if you notice any strabismic movements in your child’s eye, make them an appointment with an eye doctor as soon as possible. 2-3% of the population experience a lazy eye, and there are plenty of treatment options available, including surgery, so the earlier it is diagnosed, the better.
A chalazion (plural: chalazia) is defined as a “small swelling of the eyelid” and is often confused with a stye in the early stages of its development. It occurs when the glands in either the upper or lower eyelid become blocked. This leads to redness, swelling, and occasionally a pus-like discharge, always occurring along the edges of the eyelid. Your child may actually have multiple chalazia at any one time, although they’re not contagious. The infection can turn into hard lumps along the eyelid edge which often take weeks to disappear. Depending on the position and size of the chalazion, it might interfere with your child’s vision, particularly if it’s near the centre of the eyelid’s edge.
The general advice is that if the lump is still present after 3-4 months, take your child to an eye doctor to have it surgically removed. The surgery is a relatively minor procedure but is especially necessary if the chalazion impairs their vision at all.
- Blocked tear duct
A blocked tear duct, also known as epiphora, is often the cause of excessively watering eyes. Generally, it is first noticed soon after the baby is born, and tends to clear up on its own before they reach a year old. Although there are other causes of teary eyes, epiphora occurs when the duct that drains tears from the eye to the nose becomes blocked, leaving the tears with nowhere to go. The condition can be treated by massaging the tear sac and administering eye drops to clear the blockage. Most of the time, a blocked tear duct will get better without treatment but if it takes longer than 12 months to clear up, or if it becomes infected regularly, a minor surgery can also rectify it.
Conjunctivitis is a condition which can affect people of all ages, but generally is contracted by children more frequently than adults. This is because it’s contagious and – as any parent will know – children tend to spread germs and bacteria amongst themselves more often than adults do. Conjunctivitis is one of the most common eye infections and is where the conjunctiva becomes inflamed, provoking redness and irritation. Your child’s vision usually won’t be affected by conjunctivitis but they may be especially sensitive to light while suffering with it.
Conjunctivitis can go away on its own, but if it doesn’t show signs of improvement after a couple of days, visit an eye doctor just to make sure it’s nothing more serious. It can be either viral, bacterial, or caused by allergies, so a specialist doctor will be able to tell you the cause of it and prescribe the appropriate treatment.
This condition comes hand in hand with refractive errors – that is, your child will suffer with either short- or long-sight. Astigmatism is caused by “uneven curvature of the cornea”, stopping light from focusing on just one point of the retina. This results in blurry vision for objects at all distances and requires your child to wear glasses to achieve good vision. This type of refractive error might make it difficult for your child to focus on objects properly, and even to read, so if they complain of fuzzy vision or hold objects close to their face to look at them, take them for an eye test.
- Double vision
Double vision, as the name of the condition suggests, is when a person sees two images of the same object in front of them. It’s usually caused by strabismus and causes two identical images to appear next to (or above and below) each other. If your child seems to have trouble with their depth perception or frequently misses objects that they reach for, getting their eyes checked is especially important. As strabismus is often – but not always – the cause of double vision, eye muscle surgery is sometimes suggested as a solution for double vision, along with prism glasses and corrective injections.
Ptosis (pronounced tow-suhs) is the name for the drooping of the upper eyelid. The condition tends to be caused by weakness in the muscle which holds the eyelid up. Children can either be born with ptosis, or develop it at some stage in their childhood. It’s a particularly distressing condition as it is very noticeable and often causes strabismus or amblyopia to develop. This is because one eye has its vision impeded by the drooping eyelid, causing the brain to rely less on that eye and start using the stronger eye instead.
If left untreated, ptosis can lead to blindness when the brain fails to receive any visual signals from the affected eye. Surgical procedures to strengthen the muscle and lift the lid are available, and are certainly necessary in fixing the condition when it progresses to a severe stage. As well as affecting your child’s vision, it might also impact their posture. Children with ptosis tend to develop a “chin-up head position” to see from the gap underneath their partially-closed lid. This can have many negative knock-on effects, so the earlier the condition can be diagnosed, the better.
If you notice any changes in your child’s coordination or they start complaining of certain visual problems, book them in for an eye test as soon as possible. Generally, with children, early diagnoses of eye conditions means that they have a high chance of recovery, so don’t delay.
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