Eye Defects in Children

Eyes are the most precious gift of God - they act as our window to the world. So it is important to take due care of eyes during the development of the child. In India, children constitute 40% of the population and millions of them get visually handicapped even before they reach the age of ten. This tragedy can be prevented if the parents and teachers are more observant and take proper care of the eyes of their wards.

According to Dr. Vishal Grover, Director, Netrayatan, GK II, who is an expert in laser surgery, microsurgery and phacoemulsification, it is very important to be properly informed about the normal development process of serial visual milestones and also about warning signals which indicate visual abnormalities so as to enable them to plan preventive and curative measures in time.

The new - born child, upto three months of age, normally does not follow light shown to him. Also some squinting is normal with them because of immature muscle control and immature fixation. Then he starts following light and movement of an object by steady movements of the eyes. By this time he can also converge and focus his eyes. If the child fails to do so, it indicates some congenital defects. At the age of six months to one year the child is capable of discriminating between objects. In this age group, if the child cover or closes one eye in bright light, strikes against objects while crawling, moves his eyes excessively, or does not notice the presence of bright or coloured objects, the child should be subjected to thorough screening.

The child between the age of 1 to 3 years becomes much active and interested in the things happening around him. Picture books interest him and he starts turning the pages. At this stage, if the child keeps playthings or books very close or far from the eyes, narrows his eyes while looking at the TV or other objects at a distance, strikes against objects while walking or has difficulty in finding things in dim light, a thorough check-up of the eyes is warranted, Dr. Grover advises.

Between the age of 3 to 5 years and above direction of visual effects becomes easy as the child may himself complain of his visual deficiency / handicap. However, the following symptoms should be viewed with concern:

• The child does not evince keen interest in outdoor games or is not inclined to meet / interact socially.
• An otherwise normal child performs poorly at school or shows falling grades.
• Shows poor interest in the work where visual concentration is needed.
• Complains of headache / eyestrain, watering of the eyes or blurring of vision on prolonged close work.
• Is not able to see blackboard clearly while sitting at the back of the class.
• Complains of inability to recognise colours.
• Eyes of the child turn inward or outward or are misaligned.

Early detection of visual defects is very important for the overall development of the child. Therefore basic visual screening should start right from birth. Parents and teachers should be imparted adequate knowledge about basic ocular hygiene knowledge about basic ocular hygiene and basic eye care through health education material and lectures. Harmful effect of surmas of unknown constitution and self-medicaton should be explained clearly with conviction. Fads against use of spectacles in children suffering from refractive errors and their possible substitution by fancy exercise, Vitamin A capsules or strolls should be extinguished with appropriate motivational skills.

The first eye check-up should be conducted at the primary school level ( 3 to 4 years) and the second at the age of 5 years followed by a yearly check-up which should include detection of any eye infection, squint, lazy eye or any other organic problem like cataract or glaucoma.

In a survey conducted by the National Society for the Prevention of Blindness, it was found that nearly 25% of the children surveyed had eye problems. Refractive error was the single largest and most important defect accounting for 60% of all eye problems. Children with refractive errors should be properly evaluated and provided with glasses followed by yearly review, lest their status further deteriorates.

Working on the Computer? Take these precautions

The computer has become an integral part of our lives and more and more people spend a major part of the day before the computers, oblivious of the fact how they affect the eyes. Reports have shown that increasing number of computer users have symptoms of ocular surface disorders, called the Computer Vision Syndrome. The symptoms are grittiness, tiredness, itching, dryness and watering of the eyes on prolonged computer work. The reason is that people blink less while working on the computers. As a result, the tear film is not replenished regularly and in addition it evaporates faster and deprives the eye of lubrication and comfort. The problem can be easily corrected by taking the following precautions and consulting and eye specialist:

1. Video display units (VDU) in work areas should be so located that there is no glare on the screen. If glare exists, it should be eliminated by adjusting the light source, or at least reduced by installing a special cover on the screen or wearing anti-glare glasses.
2. It should be positioned at a comfortable height, and angle of viewing should be adjustable. The screen, as well as any reference material should be 350 to 500 millimetres away from the eyes. Also, the chair should provide good back support.
3. Lastly, to avoid possible headache, eyestrain or blurred vision, take a break of at least 15 minutes after two hours of work.

TV and your eyes

While watching TV, the following precautions should be observed:

1. Have additional lighting in the viewing area. The contrast between the bright screen and surroundings should be minimum to avoid undue strain. Soft indirect light should be used while making sure that no light is reflected by the screen towards the viewer's eyes.
2. The ideal distances for TV watching should normally be seven times the size of the TV screens. A good rule is that the minimum distance should be at least 3 metres. In general, a large screen permits more comfortable viewing because it gives a clear vision. However, a large screen in a small room is not recommended.
3. The TV and the viewer should be at the same level. Children often watch TV while sitting on the floor or lying in bed. This may result in fatigue of the eyes and the neck muscles.
4. TV should not be watched for long hours at a stretch. It should be interspersed with rest periods away from the set to avoid strain.