CATARACT informationVentura Cataract SurgeonLASIK InfoVentura Cataract SurgeonVisian ICL Info

Detecting Vision Problems and Eye Safety


Symptoms of Vision Problems
Glasses for Children - How do the Doctors know?
UV Light Protection
Fireworks Safety

SYMPTOMS of VISION PROBLEMS
Infants up to 1 year of age
If your baby can't make steady eye contact by 2 or 3 months of age, or seems unable to see, you should consult your pediatrician. A constant crossing of the eyes or one eye that turns out is usually abnormal; however, most babies do occasionally cross their eyes during their first 6 months of life. Babies older than 3 months of age can usually follow or "track" an object with their eyes as it moves across their field of vision. You can test this by holding a colored object, like a toy or a ball, in front of your baby until he or she can see it. Then, slowly move the object and watch as your baby's eyes follow. Be careful to avoid clues aided by voices or other sounds.

Preschool children
The presence of any of the following requires immediate consultation with your pediatrician or ophthalmologist. If the eyes become misaligned (strabismus), the child should be evaluated immediately. This may be a situation that is easily corrected with glasses or it may represent a more serious eye disorder. The presence of a white pupil suggests a number of eye disorders ranging from a cataract to a tumor of the eye. Immediate evaluation is indicated. The sudden development of pain and redness in one eye or both eyes can represent a number of different conditions ranging from simple pink eye to blinding eye problems. If this occurs, a simple visit to your pediatrician will generally result in the correct diagnosis and proper treatment.

Warning signs at any age
No matter how old your child is, if you spot any one of the following, consult your pediatrician:

  • Your child's eyes flutter quickly from side-to-side or up-and-down (nystagmus).
  • The eyes are always watery.
  • The eyes are always sensitive to light.
  • Any change in the eyes from their usual appearance.
  • You see white, grayish-white, or yellow-colored material in the pupil.
  • There is redness in either eye that doesn't go away in several days.
  • There is continued pus or crust in either eye.
  • The eyes look crossed, turn out, or don't focus together (strabismus).
  • Your child often rubs the eye(s).
  • Your child often squints.
  • Your child often tilts (or turns) his or her head.
  • The eyelid(s) appears to droop.
  • The eye(s) appears to bulge.

GLASSES FOR CHILDREN - HOW DO DOCTORS KNOW?
How do doctors know what strength to make glasses for babies and non-verbal or pre-verbal children? We use an instrument called a retinoscope to calibrate the eye as if it were an optical instrument. The measurement is usually just as precise as a prescription obtained by the usual adult refraction where the patient decides which is better between several choices. So prescribing glasses for children is part science. The other part is art and depends on a whole host of factors, which come into play depending on the child. A pediatric ophthalmologist is best qualified to perform such a refraction.

PROTECTION from ULTRAVIOLET LIGHT

How Can You Protect Your Children's Eyes From Ultraviolet (UV) Rays?
Infants and children are more susceptible to UV damage because the lenses in their eyes are clearer.

Please take the following steps when taking your children outdoors:

  • Teach your children to never look directly into or stare at the sun.
  • To help ensure your children wear their sunglasses, allow them to select a style they like. Many manufacturers make frames with cartoon characters or multi-colored frames.
  • Make sure your child wears a wide-brimmed hat or a baseball-cap, which provides some UV protection, if he/she will not tolerate sunglasses.
  • Remind children to wear their sunglasses and hat even on cloudy days. Most of the sun's rays can come through the clouds on an overcast day.
  • Try to keep children out of the sun between 10 a.m. and 4 p.m. The sun's rays are the strongest at these hours.
  • Keep children younger than six months old out of direct sunlight. Choose the shade, a baby stroller with a canopy, or an umbrella when outside with a very young child or infant.
  • Be sure to wear your sunglasses and hat when outside. Children often follow the example of their parents.

Fireworks Eye Safety Information

1. The American Academy of Ophthalmology and Eye M.D.s around the nation suggest that you attend a public fireworks display as a safe, patriotic way to honor tradition, family values and to ensure the health and safety of your family.

  • View public fireworks displays from at least 500 feet away
  • Respect the safety barriers the pyro-technicians have set up
  • Let trained professionals light the fireworks
  • Follow the directions of local firemen and police at public displays
  • Do not touch unexploded fireworks, contact fireman or police immediately.

2. Although illegal fireworks, such as bottle rockets and Roman candles, account for the majority of injuries, legal "Class C Common Fireworks" cause thousands of injuries each year - the types that are legal in many states.

  • Boys between the ages of 13 and 15 sustain three-fourths of all fireworks related eye injuries.
  • Bottle rockets are the most dangerous. They fly erratically, causing bystander injuries.
  • The bottles or cans used to launch the rockets also often explode, showering fragments of glass or metal.
  • For children under the age of 5, sparklers account for three-quarters of all fireworks injuries. Fascinated by the bright sparks, children find these sticks of fire burning as hot as 1,800 degrees, hot enough to melt gold, irresistible to touch.

3. It is true that firework injuries in the United States have decreased during recent years. However, there are still approximately 8,500 fireworks-related injuries each year, with 2,000 of those affecting the eyes.

  • Consumer fireworks cause one-third of recorded eye injuries each year.
  • One-fourth of eye injuries result in permanent vision loss or blindness.
  • 1 in 20 lose all useful vision or require removal of the eye.
  • Young people suffer the great majority of firework injuries.
  • An estimated 10% of children injured by fireworks suffer permanent damage, such as a loss of an eye, finger or hand.

top of page

Copyright © July 2004 American Academy of Ophthalmology®
 

PEDIATRIC OPHTHALMOLOGY
Vision problems in Children

Astigmatism
Blepharitis (swollen eyelids)
Cataract (cloudy lens)
Corneal Abrasion (scratched cornea)
Falsely Misaligned Eyes (pseudostrabismus)
Farsightedness (hyperopia)
Glaucoma (elevated eye pressure)
Lazy Eye (amblyopia)
Misaligned Eyes (strabismus)
Nearsightedness (myopia)
"Pink Eye" (conjunctivitis)
Ptosis (droopy eyelids)
Tearing

Falsely Misaligned Eyes (pseudostrabismus)
Sometimes infants appear to have crossed eyes, yet the eyes are truly straight. The cause for pseudostrabismus is presence of a wide nasal bridge or extra folds of skin between the nose and the inside of the eye that make the child have a cross-eyed appearance. Most children outgrow this problem, but you should contact your doctor for an examination. Your pediatrician can tell whether a child has misaligned eyes or just pseudostrabismus, but in some instances, a visit to an ophthalmologist is necessary for further tests.

Misaligned Eyes (strabismus)
With strabismus, the eyes are not aligned. Strabismus is quite common and occurs in about 4% of children. One eye may gaze straight ahead while the other eye turns inward, upward, downward, or outward. When an eye turns inward, the child has "crossed" eyes (esotropia). There are two common causes for esotropia. Some children are born with crossed eyes (or develop it shortly after birth), and in this situation the muscles are too tight. Treatment for this most commonly involves surgery on the eye muscles, generally performed prior to the age of 2.

The second most common cause for esotropia is excessive farsightedness. This problem can be present at birth, but most commonly occurs between the age of 2 and 6 years. This type of esotropia is corrected with glasses.

When an eye turns outward, the child has exotropia. Exotropia may be present from birth, but most commonly is seen in children 2 to 7 years of age. Generally the eyes turn out on rare occasions at first but with time more frequent outward turning of the eyes is noted. Children with exotropia occasionally squint one eye when exposed to bright sunlight. The treatment for large amounts of exotropia is usually eye muscle surgery.

Children with misaligned eyes will generally turn off the vision in the turned eye so that they are not plagued with double vision. Children with strabismus should have a careful examination by an ophthalmologist because untreated strabismus may lead to a lazy eye (amblyopia) or loss of depth perception. Rarely, strabismus may indicate a more serious condition, such as cataract or eye tumor (retinoblastoma).

top of page

Lazy Eye (amblyopia)
Lazy eye is reduced vision from lack of use in an otherwise normal eye. It usually happens only in one eye. Any condition that prevents a clear image can interfere with the development of vision and result in amblyopia.

Amblyopia is common, affecting about 2% of children. Some causes of amblyopia include strabismus, droopy eyelids (ptosis), cataracts, or refractive errors. Because early treatment offers the best results, your pediatrician will refer you to an ophthalmologist.

Cataract (cloudy lens)
A cataract is a clouding of the eye's normally clear lens. The lens is located behind the pupil and helps focus images on to the back of the eye (retina). Cataracts may be present at birth or may appear later in life. Injury may also cause this condition. Early detection and treatment are crucial in infants and children so that normal visual development can occur. For this reason, most cataracts should be surgically removed soon after they are discovered. It should be noted that cataracts in infants and children are uncommon and not related to cataracts that occur in adults.

Glaucoma (elevated eye pressure)
Glaucoma is a condition in which the pressure inside the eye is too high. If left untreated, glaucoma will eventually lead to total blindness. Warning symptoms are extreme sensitivity to light, tearing, and persistent pain. Signs include an enlarged eye, cloudy cornea, and lid spasm. If any of these are present, your pediatrician will refer you to an ophthalmologist immediately. Glaucoma in childhood usually requires surgery to prevent blindness.

top of page

Tearing
The tear duct system, which allows the tears to drain from the eyes into the nose, usually opens in the first few months of life. In some infants, however, the system remains blocked, resulting in the eyes overflowing with tears and collecting mucus. Tearing may result from other ocular conditions, the most serious of which is glaucoma (see above). If your child suffers from continued tearing or watering from the eyes, please consult your pediatrician. Gentle massage of the tear duct can occasionally assist in relieving the blockage. If massage and observation are unsuccessful, a tear duct probe or more involved surgery is occasionally required.

Ptosis (droopy eyelids)
Ptosis refers to a situation in which the eyelids are not as open as they should be. This situation is caused by a weakness of a muscle that opens the upper eyelid. When ptosis is mild, it is just a cosmetic problem. However, ptosis can interfere with vision if it is severe enough to block the vision in the eye. In infancy, it is important that ptosis be eliminated so that vision will develop normally. Correction of ptosis usually requires surgery on the eyelid(s).

Blepharitis (swollen eyelids)
Blepharitis refers to an inflammation in the oily glands of the eyelid. This usually results in swollen eyelids and excessive crusting of the eyelashes, most evident in the morning. Tenderness of the eyelids and a foreign body sensation in the eye may occur as well. Blepharitis can be treated with warm compresses and eyelid scrubs using baby shampoo. If an infection is present, antibiotics may be necessary. If any of these findings are present, please consult your pediatrician.

"Pink Eye" (conjunctivitis)
Pink eye appears as a reddening of the white part of the eye. It is usually associated with excessive tearing, a discharge, and a foreign body sensation in the eyes. Conjunctivitis has many causes and can occur at any age. In infants and children, pink eye is usually caused by a viral or bacterial infection. In older children, it may also be caused by allergy. Depending on the cause of conjunctivitis, eye drops or ointment may be indicated. If your child has conjunctivitis, regular hand washing will help prevent the spread of the infection to other family members. If conjunctivitis occurs, call your pediatrician's office.

top of page

Corneal Abrasion (scratched cornea)
A corneal abrasion refers to a scratch of the front clear surface of the eye (cornea). These abrasions are very painful and usually associated with light sensitivity and tearing. Treatment consists of antibiotics to prevent infection and a patch to allow for the healing of the scrape. This may be monitored by your pediatrician although more serious injuries often need follow up by an ophthalmologist.

Nearsightedness (myopia)
Children who are "nearsighted" see objects that are close to them clearly, but objects that are far away are unclear. Nearsightedness is very rare in infants and toddlers, but becomes more common in school-age children. Eyeglasses will help clear the vision but will not "cure" the problem. Despite using glasses, near-sightedness will generally increase in amount until the mid-teenage years so that periodic follow-up examinations by an ophthalmologist are indicated.

Farsightedness (hyperopia)
A small degree of farsightedness is normal in infants and children. It does not interfere with vision and requires no correction. It is only when the farsightedness becomes excessive, or causes the eyes to cross, that glasses are required.

Astigmatism
Astigmatism is the result of an eye that has an irregular corneal shape. Astigmatism may result in blurred vision. Children with astigmatism may need glasses if the amount of astigmatism is large.

Learning disabilities are quite common in childhood years and have many causes. The eyes are often suspected but are almost never the cause of learning problems. Your pediatrician may refer you for an evaluation by an educational specialist to pinpoint the exact cause.

top of page