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Child Eye Care and Squint: What we all should know?

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Title: Brain body s computer Author: Hemant Last modified by: Hemant Created Date: 11/2/2014 2:03:00 PM Company: Hewlett-Packard Document presentation format – PowerPoint PPT presentation

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Title: Child Eye Care and Squint: What we all should know?


1
Child Eye Care and Squint What we all should
know?
  • Dr Hemant D Anaspure
  • Assistant Professor
  • Dept of Ophthalmology

2
Childhood Blindness
3
Childhood blindness
  • Globally approx 1.4 million children who are
    blind1
  • 2/3rd live in developing countries
  • The prevalence of blindness approx 0.3 1.2
    /1,000 children2
  • 40of the blindness in children is avoidable
  • 1. World Health Organization, Geneva. Global
    Initiative for the Elimination of Avoidable
    Blindness. Geneva WHO/PBL/97.61
  • 2. Gilbert C E, Foster A. Childhood blindness in
    the context of VISION 2020 Ð The Right to Sight.
    Bull WHO 2001 79 227-232.

4
What we can do?
5
The Eyes Don't See What the Mind Don't Know
The Eyes See What the Mind Know
6
Amblyopia (Lazy Eyes)
7
Amblyopia
  • Amblyopia or "lazy eye" is weak vision or vision
    loss in one or both apparently normal eyes that
    cannot be fully corrected with lenses
  • Causes Anisometropia, Squint, High refractive
    error in both eyes, Visual deprivation due to
    congenital cataract, glaucoma,corneal opacity

8

9
What we should know?
  • Amblyopia is one of the most common causes of
    visual impairment in both children and adults 
  • Prevalence 0.2 - 12 (average 2-3)
  • Failure to develop binocular vision and prevent
    the individual from pursuing certain occupations
  • Amblyopia increases the chances of blindness in
    the healthy eye, mostly from trauma

10
  • Fortunately , completely treatable cause of
    blindness
  • Timely diagnosis and treatment is
  • key for successful treatment
  • Using glasses at early age can
  • prevent amblyopia in many cases
  • Best age for treatment is lt 8 years
  • (Max 16 years)

11
Refractive Errors in Children
12
Refractive Errors in Children
  • Refractive errors occur when the shape of the eye
    prevents light from focusing directly on the
    retina
  • Types
  • - Myopia
  • - Hypermetropia

13
  • Factors
  • Length of the eyeball (Axial
    Myopia/Hypermetropia)
  • Shape of the cornea (Astigmatism)
  • Refractive power of lens (Index)

14
What we should know?
  • Wandering eye moments, no response to mothers
    face or attractive colourful objects, shaking of
    the eyes by 3 months
  • Watching TV from too close distance, frequent eye
    rubbing, holding books close to face, squinting,
    poor academic performance Think of glasses
  • All children should have one vision screening
    between 3 to 5 years

15
What we should know?
  • Myths about glasses
  • If your child wear glasses all the time, the
    number will reduce
  • Your child watches too much T. V. and hence
    has glasses
  • With Plenty of vegetables and drinking carrot
    juice his number should go away
  • Vitamin A tablets help increase eye power
  • Using glasses will make him habituate

16
Squint
17
Squint
  • While one eye looks straight ahead, the other eye
    is turned either inwards or outwards. This is
    called a squint.
  • Major types
  • Esotropia
  • Exotropia

18
What we should know?
  • Effects
  • Children can lose stereopsis / binocularity
  • Loss of vision in the crossing eye (amblyopia)
  • Loss of confidence and self esteem
  • Depending on cause, treatment varies from glasses
    to surgery
  • In infantile cases, best time for surgery is less
    then 2 years of age to restore binocularity

19
What we should know?
  • Keep in Mind Retinoblastoma can present as
    squint at early age .

20
Retinopathy of Prematurity (ROP)
21
Retinopathy of Prematurity
22
Retinopathy of Prematurity
  • The incidence of ROP in India 38 51.9 in low
    birth weight infants
  • Annual live births in India approx 26 million
  • In India 8.7 of newborns birth weight lt 2000
    grams
  • Almost 2 million newborns are at risk for
    developing ROP

23
What we should know?
  • Birth weight have an inverse relationship with
    development of ROP
  • NNF Criterias
  • In whom . lt 34 weeks / Birth wt lt 1750gms
  • . 34 36 weeks / Birth wt
    1750 2000 gms with risk factors
  • When Born gt 28 wks 4 weeks
  • Born lt 28 wk/ lt 1200gms 2
    3 wks

24
What we should know?
  • The children have more chances of refractive
    errors and squint
  • Recommended follow up 6 months, one year, 3 years
    and 7 years

25
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26
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27
Retinoblastoma
28
Bruchners Test
29
What we should know?
  • Retinoblastoma is the most common malignant
    tumour of the eye occuring in childhood
  • White pupillary reflex is most common
    presentation
  • 5 year Survival rate is gt 95
  • Early diagnosis helps not only to save life but
    to save eye and vision

30
Paediatric Cataract
31
Paediatric Cataract
  • A cataract is any cloudiness or opacity of the
    lens of the eye
  • White opacity seen in a childs eye may be due to
    several reasons. The most common of all is
    cataract
  • Causes
  • - Heredity
  • - German measles
  • - Injury to the eye
  • - Steroids use

32
What we should know?
  • Preventable and Treatable cause of blindness
  • Amblyopia sets in very early if not treated on
    time
  • Ideal time for congenital cataract
  • Unilateral lt 1.5 months
  • Bilateral lt 3 months
  • Requires long term follow up and treatment

33
Summary
  • Amblyopia Timely intervention is key
  • Refractive error One check up bet 3 to 5 yrs
  • Squint Needs early treatment to restore
    binocularity
  • ROP Screen any child lt 2 kg birth weight
  • Retinoblastoma White pupillary reflex is
    dangerous sign
  • Pediatric cataract Dont waste time

34
  • Child's future success depend on ability to see
    well
  • While most children have good vision, any vision
    problem needs to be caught early
  • Rarely will a child complain about his/her vision
  • Young children think that everyone sees the way
    they do

35
  • Thank You ..
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