The first ophthalmological examination of a child is one of the most important examinations that should be performed by 3-4. years of age. Intensive vision development lasts until the end of the 8th year of life. Disorders that occur at this age can and must be treated to allow for the normal development of a child’s eye and visual acuity.
The most common reason for examining a child is poor visual acuity (myopia, hyperopia, astigmatism), which, if not detected and removed in time, causes permanent low vision.
At regular pediatric examinations in as many as 90-95% of children, such disorders remain unrecognized or are detected too late: if the brain of a small child does not learn to process visual stimuli from a diseased eye, it will result in the so-called. suppression, and that eye will be “suppressed” and remain visually impaired for life.
Since the child’s eye is developing, any refractive error needs to be corrected correctly. Children are given glasses or contact lenses to correct refractive errors.
Visual impairment or amblyopia is the most common pathology of vision in children, and it can be treated and cured only in the early period of growth and development of the child.
When visual acuity is reduced in both eyes, the child clearly shows signs of impaired vision, and parents in most cases notice this in a timely manner and seek medical help.
If vision is impaired in only one eye, parents do not notice the problem, because the child’s brain takes over information coming from the “stronger” eye, since it cannot put together two different images, information from the “weaker” eye is suppressed.
When visually impaired, the so-called “lazy eye”, it is necessary to give the child an appropriate correction with glasses and to close (occlusion) a healthy eye in order to force the weaker eye to look, and thus develop. The period of eye closure depends on the severity of the amblyopia and the age of the child. In some cases, strabismus surgery also has a positive effect on low vision.
Strabismus is a disorder of the position or mobility of the eyes in which the eyes do not have a common direction of view.
Healthy eyes look straight at the same point, and movements are synchronized.
In some cases, strabismus occurs because the mobility of one eye in a certain direction is limited.
The eye usually looks inwards, “towards the nose” (esotropia) or outwards, “from the nose” (exotropia), the vertical deviation of the eye is somewhat rarer. It is also often associated with other visual disorders (low vision, refractive errors, nystagmus).
In children, strabismus is most often congenital or develops in early childhood, but it can also occur with mechanical injuries and various neurological and internal diseases.
Strabismus in children interferes with the healthy development of vision and that is why it is important to start treatment as early as possible.
The most common consequence of strabismus is the development of low vision (amblyopia) on the eye that is not placed in a flat position, low vision can be treated only in childhood and therefore strabismus would be best operated while vision is in the developmental stage.
In very young children, even in infancy, parents often come to care because the child “tears the eye.”
It is much more often the result of not opening the canal located between the eye and the nose, which leads to the accumulation of excess tears in the tear sac located at the beginning of the canal and the return of excess tears to the eye.
Since our tears are not sterile, ie they contain natural bacterial flora, due to reduced flow, ie increased accumulation of tears, there is an exponential multiplication of our “good bacteria” that create a thick secretion inside the eye and on the edges of the eyelids, while only the eye or sclera generally calm.
This is very easy to check by the pressure in the area of the canal which will cause a sudden release of whitish secretion towards the eye. Until the eye is inflamed, it is not necessary to give any antibiotics but only regular rinsing and massaging in the area of the canal as directed by a specialist to aid spontaneous opening. It is also recommended to rinse the nasal mucosa with drops based on sea water or saline.