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PEDIATRIC OPTHALMOLOGY
Pediatric Optomology at Grewal Eye Institute

New-borns And Common Eye Disorders Among Them

Arrival of a new-born brings happiness to the entire family. The baby becomes the cynosure of all eyes. But for the parents, it is important to look beyond the color of their little one’s eyes. They should examine the baby’s eyes to ensure there aren’t any gross abnormalities.
Any eye abnormality detected at birth should be immediately brought to the notice of an eye specialist. A neonate’s eyes are slightly smaller than adults. It takes only two years for a baby’s eyes to develop to adult size.
Eye infection in newborns are common. Between birth till four weeks, a baby can suffer neonatal conjunctivitis. This infection needs to be controlled by using appropriate antibiotics.
Continuous watering from one or both eyes, accompanied by copious discharge is a frequent problem in babies. During the first four weeks of a baby’s life, tear secretions are less than normal. Any watering from eyes during this period is abnormal. Discharge and watering from the eyes at birth suggests infection, while the same symptoms in a three week or older baby, suggest failure of tear ducts to open.
An examination is required to make a diagnosis. If watering does not stop by four months, probing the passage may be required to open them. Delay in treatment may result in a major surgery later on to make alternate passage.
Buphthalmos or infantile glaucoma is a baby born with ‘Kala Motia’ and symptoms include watering and sensitivity to light. The eye is bluish and big in size due to increased pressure in the eye. It needs treatment with drops followed by surgery. Repeated examinations may be done under anaesthesia. Failure to treat leads to permanent damage to optic nerve and complete blindness.
The cornea should appear normal at this stage. An opacity or raised mass on the front part of eye is abnormal. It could be a dermoid, a benign but cosmetic situation that is treatable with surgery.
Any obvious abnormality of the eyelid should be taken seriously. It is not often, but a child may have a congenital coloboma, a condition in which a part of eyelid may be missing. Normally lids cover upper 1-2mm of cornea. In case it covers more than that, it’s a condition called drooping of the eyelid or Ptosis. The lid can be lifted up with surgery.
It is important to make assessment of the alignment of the eyes and vision. Parents must keep an eye on baby’s eyes. Early identification and treatment is important and can actually change the way your baby looks at the world.

SQUINT- Treatment


The treatment of squint depends upon the type of deviation. A thorough evaluation should be carried out to determine the type of squint. This is best done by an ophthalmologist, specifically trained and experienced in handling squint cases. In children the evaluation includes a refraction done under cycloplegia which is basically a temporary paralysis of the eye muscles responsible for accommodation. This is achieved by instilling ointment or drops in the eye. The effect of these medicines may last from a couple of days to a fortnight or so.

Spectacles & Exercise


In some children correction of the refractive error alone will correct the squint. This is known as 'Accomodative Squint'. These children will be slowly weaned away from spectacles with time. Some cases which have a 'Latent Squint', i.e, the squint is not present all the time may benefit from exercises. In all children, lazy eye must be diagnosed and treated in the beginning.

Surgery


Most children who have a 'Manifest Squint' which does not get corrected with spectacles will need surgery. The results of surgery vary with type of squint. For most squints which appear early in life, surgery provides excellent results and long term success. Early surgery helps to avoid dense Amblyopia and is must for helping normalize visual development.
It is very important to diagnose and treat early. Myths such as waiting till the child attains maturity before management of squint must be dispelled. If your child has squint don't ignore it. Get it thoroughly evaluated and treated in time.
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