Common Eye Disorders in Children

Introduction:

Many body systems and parts work together to provide a clear vision. It is challenging to check if the child is having any problems related to health due to their limited ability to communicate. Only a doctor or parents can check and look for abnormal behavior or signs to get an idea about the condition. Until the age of 12 to 16 weeks, the infants’ eyesight can only identify objects as far as ten inches away from them. And until they develop a deep perception of things, the condition related to the eyes is almost neglected by parents. From twitching to pink eye, there could be many reasons that cause this condition, and caregivers need to know the right symptoms to recognize the abnormality.

What Is the Anatomy of an Eye?

There are many parts of the eyes that work together to form a clear image of the object:

• The Pupil: A black dot at the center of the eye is the pathway for light to enter.

• The Sclera: A white part around the pupil that protects the eyeball.

• The Iris: The colored part surrounding the pupil controls the amount of light entering the pupil.

• The Cornea: Clear cover in front of the pupil and iris.

• A Lens: It is located behind the pupil to focus light onto the retina at the back.

• The Retina: It is made of ten different cell layers to detect light and convert it into electrical impulses. It is located at the back of an eye.

How Does the Eye Process the Vision?

Usually, when the eye sees an object, several sequences take place, and all arrangements together create a clear vision.

• From the object, light reflects by entering the cornea of the eye.

• It passes through aqueous humor (the watery fluid) to reach the lens through the pupil.

• In order to bend the light, the thickness of the lens is naturally adjusted, which helps to focus the image onto the retina.

• At the back of the eye, when the light is on its way to the retina, it has to cross a thick clear watery fluid called the vitreous humor.

• Once the light reaches the retina, it is converted into electrical impulses.

• Electrical impulses are carried to the brain by the optic nerve, where the visual cortex (center of the brain) interprets them to be able to see an object.

What Are the Common Signs and Symptoms of Eye Disorders in Children?

In many cases, the symptoms of an eye problem are silent and do not show any apparent signs. However, there are common signs that might reflect the issue related to eye or vision, such as:

• Red or pink eye.

• Tears.

• Eye rubbing.

• Pus.

• Headache.

• Loss of vision (sudden or gradual).

• Crossed eyes.

• Crust.

• Unable to open their eyes to the light.

• Droopy eyelids.

• Unfocused vision.

• White, yellow, or grey material is discharged into the pupil.

What Are the Most Common Eye Problems in Children?

At the age of 18 years, almost 20 % of children are diagnosed with disorders related to the eyes. It is essential to diagnose the problem at an early stage before they become chronic and the ability of vision is lost. The most commonly seen eye disorders are:

• Refractive Errors:

  • It is a vision-related problem due to an issue between the coordination of the cornea and the lens in focusing the object.

  • Causes: Aging of the lens, longer or shorter eyeball, or changes in the shape of the cornea.

  • Signs to look for:

    • Head tilting.

    • Headache.

    • Strain to eyes.

    • Holding objects like books very close to read correctly.

    • Sitting very close to electronics like computers at work or television.

  • Common refractive errors:

    • Myopia: Close objects can be seen clearly, but objects at a distance are a little blurry, hence the name nearsightedness.

    • Hyperopia: Close objects are blurry, but the things at a distance look clear, hence farsightedness.

    • Presbyopia: A person cannot focus on close objects due to aging (primarily seen in adults).

    • Astigmatism: Cornea is unable to focus.

• Amblyopia:

  • If one eye is weaker than another, it causes vision-related problems. It is also known as lazy eye. Due to its symptoms and the child’s age, many cases are diagnosed very late.

  • Signs:

    • Frequent eye rubbing.

    • Squinting.

    • Head tilting.

    • Difficulty in attention or focus.

    • Frequently closing eyes.

• Convergence Insufficiency:

  • Almost 15 % of school-going children are affected by this disorder, where vision and eye muscle coordination are impaired.

  • Signs:

    • Blurred vision.

    • Headaches.

    • Concentration difficulties.

    • Fatigue.

    • Vertigo.

    • Words appear as moving.

    • Reading problems in the classroom.

    • Double vision.

• Binocular Vision Dysfunction (BVD):

  • Due to misalignment between two eyes, both catch different images of the object, and the brain gets confused in decoding them as a unified image resulting in blurred vision.

  • Signs are:

    • Double vision.

    • Motion sickness.

    • Anxiety.

    • Stress.

    • Fatigue.

    • Dizziness.

• Pediatric Cataracts:

  • There is a myth that cataracts only happen to older people. On the contrary, the clouding of the eyes can be seen in young ones, also called pediatric cataracts.

  • Usually, the retina sees the image focused by a clear lens sent to the brain as electric impulses. However, in cataracts, the light is prevented from reaching the retina. As a result, the cloudy lens distorts the image and causes blurring vision or blindness.

  • Signs:

    • Difficulty in seeing the objects.

    • The direction of the eyes is different from normal vision.

    • Gray or white-colored pupil.

    • Nystagmus.

• Nystagmus:

  • It is involuntary and frequent movement of the eyes. The movements are usually vertical or horizontal or “to and fro.”

  • There are two types of nystagmus:

    • Congenital nystagmus: It is usually seen in seven days to six months old children. Children are seen with either normal or abnormal vision.

    • Acquired nystagmus: It is usually seen in children at six months or later. The etiological factors affecting the conditions are medication side-effects, functional abnormalities of the brain, cancer, or genetic and metabolic disorders.

  • There are usually a few conditions associated with this disorder, such as:

    • Cataract.

    • Optic nerve hypoplasia.

    • Severe refractive error.

    • Albinism.

    • Amblyopia.

    • Leber’s congenital amaurosis, etc.

• Strabismus

  • It is a disorder where eyes are crossed and misaligned permanently if not treated on time. Also, it may lead to blindness in children.

    • Causes:

      • Severe farsightedness.

      • Head trauma.

      • Brain tumor.

      • Ocular muscle weakness.

      • Lazy eyes.

      • Poor development of eye coordination.

    • Signs to look for:

      • Either of the eyes or both eyes are pointed inwards, upwards, outwards, or downwards.

      • Frequent squinting.

      • Head tilting.

      • Double vision.

      • Reading difficulties.

      • Eyestrain.

Conclusion:

Other than those described above, many disorders affect children's eyesight. However, regardless of the plethora of etiological factors, there are still chances of managing them if diagnosed early. Moreover, doctors can suggest specialized vision therapy for each disorder's severity and type.