Your eyes are important for your well being. You depend on your eyes for vision and make sense of the surrounding world. There are some eye diseases that cause vision loss, therefore, it is important to identify eye diseases as early as possible and seek treatment for those. Just like it is important to keep your body healthy, it is as vital to keep your eyes healthy and get them checked regularly.
It is recommended to have children undergo their first comprehensive eye exams from six months of age to make sure their eyes are developing normally. After the initial visit, you must bring your child for a second eye examination between the ages 3-5, and then again before entering first grade.
As your child’s age increases, annual exams are important to ensure that their eyes continue to develop normally and detect any changes in vision or eye health. You must note that the vision screenings conducted by schools are not a substitute for comprehensive eye exams— ocular diseases and many vision problems can’t be diagnosed through a screening. Ophthalmologists employ specific clinical and diagnostic tools and assessments to find out if your child’s ocular health and visual abilities.
Ocular development starts in the womb and continues throughout adolescence and childhood. Development of good vision is important for the first six years of a child’s life. This period is considered a “vulnerable period” as it is a time when children are most susceptible to developing vision problems.
Many vision problems that are sight-threatening can occur due to an eye disease or trauma to the eye, occuring in the first six years of a child’s life. Young children may not report feeling something wrong simply because they may not realise it. It is vital for parents to pay close attention to the signs of an eye or a vision problem that their child may be exhibiting.
The signs indicating of an eye disease include eye turns, blurry vision, watery eyes, redness of eyes, frequent blinking, difficulty maintaining eye contact, difficulty recognising familiar objects, focusing difficulties, intolerance to bright lights, reduced peripheral vision, specific colour preference, frequent falls and trips, preference for looking at lights, delayed visual responses, and unusual visual behaviours. The sooner the condition is diagnosed, the sooner it can be treated, resulting in better prognosis.
Congenital cataract is an eye disease that occurs in young children and is characterised by clouding of the natural lens of one's eyes present since birth. An infantile cataract is one that occurs in the first year of life. As many congenital cataract cases are not detected at birth, rather those are detected within the first year of life, these two names indicate the same eye condition and are usually used interchangeably.
Even though rare, childhood cataracts are one of the commonest causes of blindness and other severe visual problems in children. Worldwide, 20% of paediatric blindness is caused by cataracts and 200,000 children have developed blindness secondary to the disease. Every year, 20,000-40,000 children are born with congenital cataract.
Generally, a cataract develops as a white spot on the pupil which makes the vision cloudy, making you feel that you are looking through a dirty window. The degree of severity varies from being insignificant to causing severe loss of vision.
Babies are usually born with congenital cataracts if any of the following are present in intrauterine life:
Other risks include the mother having any of the following diseases during pregnancy:
To prevent developing complications like amblyopia or lazy eye, congenital cataracts need to be treated early. Lazy eye leads to reduced vision and misalignment, impacting a child’s appearance, learning ability, and self esteem.
The location and density of the cataract helps determine the appropriate treatment plan. If severe, cataract surgery is recommended during infancy to restore normal development of vision and prevent vision problems like amblyopia. Other treatment modalities used along with surgery include contact lenses, eyeglasses, bifocals, and eye-patching.
Retinopathy of Prematurity is also known as Terry syndrome or Retrolental fibroplasia (RLF). This disease affects prematurely born babies, those who are born before completing 32 weeks of gestation and have been supplied with oxygen therapy for premature lung development. Worldwide, around 32,000 infants become blind or develop several visual impairments secondary to retinopathy of prematurity every year.
Retinopathy of prematurity is a progressive ophthalmological condition caused by abnormal development of retinal blood vessels causing vision-threatening complications like strabismus (eye misalignment), myopia (nearsightedness), retinal detachment (causes blindness), and cataract (clouding of eye lens). While spontaneous improvement is shown by most infants, more severe cases require laser treatment.
The risk factors for retinopathy of prematurity include low birth weight (2.76 lbs), prematurity ( birth before 32 gestational weeks), cardiac defects, various types of infections, and high exposure to oxygen. You must schedule an appointment with an ophthalmologist to diagnose and treat any eye conditions your child may have.
Retinitis Pigmentosa (RP) is a relatively rare genetic disorder that causes loss of vision. Worldwide, it affects approximately 1 in 4,000 children and is one of the commonest types of inherited retinal degeneration. Retinitis pigmentosa leads to retinal damage, as the retinal cells start breaking down and degenerating.
In the initial stages, the cell degeneration starts in the part of the retina that is responsible for mid-peripheral vision - causing nyctalopia or decreased night vision, difficulty seeing in low light or mid-peripheral visual field loss. The rapid progression of the condition keeps destroying the cells in the central field of vision, which causes tunnel vision, loss of colour vision, and reduced visual acuity.
Retinitis pigmentosa progression leads to symptoms in both the eyes at the same rate. In advanced stages, the disease causes bright light sensitivity due to the appearance of photophobia or an intense glare and the appearance of shimmering, blinking, or swirling lights in the field of vision.
As retinitis pigmentosa can develop due to a number of genetic mutations, its progression can vary from one person to another. In some cases, the central vision is not adversely affected until the person becomes 50 years of age. In other cases, people experience a significant degree of vision loss in early adulthood.
No cure for retinitis pigmentosa is currently available. When children are first diagnosed with the disease, they are usually referred to a specialist for further assessment. Many children benefit from low vision aids aimed at magnifying existing central vision so that the field of view is widened and glare is eliminated.
Several low vision devices are available to support patients of retinitis pigmentosa such as:
Diabetic retinopathy can affect children who already have diabetes. This condition leads to retinal damage causing distorted or blurred vision, and even permanent loss of vision, if proper treatment is not provided.
Risk factors
In children with type 1 diabetes, the risk of developing diabetic retinopathy rises by 4.6 % every year. In those who have type 2 diabetes, male children have double the risk. All children above the age of 12 who have been diagnosed with diabetes should be regularly screened. If the diabetes is not controlled adequately, children need to be screened even earlier.
While there are generally no symptoms until the disease reaches an advanced stage, early diagnosis is possible through regular diabetic retinopathy screenings. This helps prevent or decrease the loss of vision. The treatment of diabetic retinopathy usually relies on surgery and laser treatments.
Optic nerve hypoplasia (ONH) is a congenital disorder that involves incomplete development of the optic nerves— the nerves that are responsible for carrying visual information from the eye’s retina to the brain.
The exact cause of optic nerve hypoplasia is not known. Most people with the disease present with nystagmus or abnormal eye movements. The severity of the disorder varies - ranges from an inability to perceive light to functional vision that is unaffected, and sometimes full loss of vision in one eye. Apart from that, children with optic nerve hypoplasia are affected in different ways - some do well at school, while others face developmental delays or learning disabilities.
Cortical visual impairment (CVI) can occur as a result of brain malformation, brain damage, seizure, infection, or any other neurological problem affecting the visual part of the brain. A child with cortical visual impairment usually has a normal eye structure. The primary problem that occurs due to the disease is that the visual information sent to the brain from the eye is not processed properly due to abnormal brain function.
The symptoms of cortical visual impairment include:
Many children who have cortical visual impairment successfully regain their vision as new neural connections are formed to recover from the initial deficiency or injury. If you suspect that your child is suffering from a vision problem, you must schedule an eye exam immediately for a more comprehensive assessment.
After performing a comprehensive eye examination, your ophthalmologist will be able to identify signs of eye disease or problems of vision. Consult our team of ophthalmologists for the best possible treatment for any eye conditions.
Following are some steps you can follow to help keep your eyes healthy and make sure you are seeing your best:
Every individual needs to have their eyesight checked to look for vision and eye problems every now and then. Children typically have vision screening in school or at their doctor’s office during a checkup. Adults may also get vision screenings during their checkups. However, many adults require more than a vision screening. They need a comprehensive dilated eye exam.
Getting comprehensive dilated eye exams is especially vital since some ocular diseases may not have warning signs. The exams are the only way to diagnose these diseases in their early stages, when their treatment is relatively easier.
The exam includes several tests including:
How often you need these tests and at what age you should start getting them depends on a number of factors. They include your race, age, and overall health. If you have diabetes, you will need to undergo an eye exam every year. You must check with your health care provider about if and when you need these exams.
The Department of Ophthalmology at Kokilaben Dhirubhai Ambani Hospital, Indore offers primary ophthalmological care services, including ophthalmologic checkups and routine and emergency medical and surgical management of a vast range of ophthalmological conditions. Annual ophthalmological exams, consultation for eyeglasses, and referrals for fitting contact lenses are also offered by experienced eye specialists in Indore at our hospital.
Our department has a team of highly qualified ophthalmologists in Indore who have years of experience in the field and is equipped with the latest state-of-the-art technology and ophthalmologic instruments.
Comprehensive diagnostic services available include assessment of refractive errors, visual acuity, slit lamp evaluation, tonometry, ophthalmoscopy, gonioscopy, pachymetry, visual field testing, and fundus photography. The typical disorders diagnosed and treated in the department include contact-lens-related problems, blepharitis and dry eye, corneal ulcers, pterygium, herpes zoster and herpes simplex infections, allergic conjunctivitis, cataract, diabetes, glaucoma, macular degeneration, refractive errors like myopia, hypermetropia, and astigmatism, and ocular trauma.
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