Paeditaric Ophthalmology

New-borns have primarily hazy vision after they are born. The visual system matures with time and is fully constituted by adolescence.

Regular eye tests for children are recommended to ensure that their eyes are healthy and that they do not have any vision abnormalities that could interfere with their school performance or jeopardise their safety.

When should you have a comprehensive exam done for your child?

• If your child fails a vision screening, seek a full eye exam for him or her.
• Has an inconclusive or unable to be completed vision screening.
• A paediatrician or school nurse may refer you.
• Has a vision complaint, has noticed atypical visual behaviour, or is at risk of developing eye difficulties.
• Children with Down syndrome, prematurity, juvenile idiopathic arthritis, neurofibromatosis, or a family history of amblyopia, strabismus, retinoblastoma, congenital cataracts, or glaucoma are more likely to develop paediatric eye disorders.
• Has a learning difficulty, developmental delay, neuropsychological disorder, or behavioural problem.

Our Paediatric ophthalmologist would evaluate your child’s vision as well as your eye alignment and pupil response to light. Your child’s pupils may be dilated using eyedrops to see if he or she needs glasses. Young babies may also require glasses.

Our doctors will beam a light into the eye with an instrument. This light is reflected by the retina and is used to calculate the prescription. Pupil dilation also enables the doctor to inspect the back of the eye, particularly the optic nerve and retina’s health. Depending on the symptoms and family history, additional testing may be required.

Another condition that exists and attacks children is Retinopathy of prematurity (ROP) which is a vision condition caused by improper blood vessel growth in the light-sensitive region of premature new-borns’ eyes (retina).

ROP typically affects new-borns weighing 1,250 g or less at birth and born before week 31 of pregnancy. ROP resolves without therapy in the majority of cases, producing no harm. Advanced ROP, on the other hand, might result in lifelong vision problems or blindness.

ROP causes blood vessels in the light-sensitive layer of nerves in the retina at the back of the eye to expand and overgrow. When the disease progresses, the aberrant retinal veins spread into the jelly-like substance (vitreous) that fills the centre of the eye. Bleeding from these veins can damage the retina and stress its attachment to the back of the eye, resulting in retinal detachment and probable blindness.

ROP treatment is determined by the severity of the condition. Some of the treatments have their own negative effects. Narayna Nethradhama uses current technologies in conjunction with traditional procedures such as therapy and medications.

• Laser treatment. Laser therapy, the usual treatment for severe ROP, burns away the region around the edge of the retina that has no normal blood vessels. This treatment often saves sight in the central region of the visual field at the expense of peripheral (side) vision. Laser surgery also necessitates general anaesthesia, which can be dangerous for premature babies.
• This was the first ROP treatment. Cryotherapy involves freezing a specific area of the eye that goes beyond the margins of the retina with an instrument.
• Anti-vascular endothelial growth factor (anti-VEGF) medicines are being developed for the treatment of ROP. Anti-VEGF medications act by preventing the formation of new blood vessels in the retina. The drug is injected into the infant’s eye while the infant is sedated.