Eye Diseases in Children

Eye diseases in children are many, but are often overlooked for low awareness on the subject among child care providers. Many children who visit pediatricians for delayed milestones are actually suffering from vision defects.

Several form of disorders occur on path of vision

Infections and allergies in children that cause red eyes or excessive watering are promptly taken care of. But eye pain and inability to see, when not obvious, get often mistaken for temper tantrums, behavior problems, delayed milestones, poor interpersonal relationships and emotional disturbances like panic attack.

Predisposing factors of eye diseases

Generalized chronic illness influence children's vision

Obesity in children and teenagers
Metabolic disorders; both acquired and congenital
Childhood diabetes: Diabetic micro vascular disease increases the risk of retinopathy, cataract and glaucoma.
Coeliac disease
Juvenile rheumatoid arthritis

Essential nutrition in eye health

Protein deficiency
Deficiency of antioxidants results in toxic retinal degeneration; attributed to their ability to neutralize free radicals; vitamin C, E and yellow pigments - beta carotene and xanthophylls (lutein and zeaxanthin) found in fresh fruits and vegetables counteract the ill effects of toxic substances like organic solvents, tobacco smoke, radiation, pollutants and so on.
Vitamin A deficiency leads to -

Night blindness
Conjunctival xerosis; dryness of conjunctiva.
Corneal xerosis; dryness of cornea which may even ulcerate (keratomalacia) with progression of the disease. The ulcers form scars as they heal leading to opacification of cornea thereby severe vision loss.
Bitot spots; small lustreless greyish white triangular deposits on conjunctiva that is visible between the two eyelids (palpebral fissure). Usually occur simultaneously in both the eyes
Xerophthalmic fundus; small white circular retinal lesions along with constriction of the visual fields.

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Prenatal causes of eye diseases in childhood

Genetic disorders: Recessive are most commonly associated with eye diseases, but it is also noted in some autosomal and x-linked disorders. Families with eye diseases should therefore watch for vision disorders in their children.
Congenital malformations; birth defects of cerebral visual pathway
Infections: Toxoplasmosis, Rubella, Cytomegalovirus, Herpes simplex and more.
Exposure to toxic levels of organic solvents in mother's womb.
Second hand tobacco smoke toxicity.
Alcohol consumption by the mother - fetal alcohol syndrome.

Perinatal causes of vision disorder in infants

Effect of child birth on newborn baby; low oxygen supply, birth trauma and neonatal eye infections endanger eye health.
Low birth weight babies; with advancements in newborn care systems more and more premature and IUGR babies survive. These babies are at high risk of retinopathy and neurodevelopmental disorders.

The risk increase if the birth weight is less than 1500 grams and gestational age below 28 weeks. At the onset, majority of them suffer only from a mild form of eye disease.

Therefore, evaluation by an ophthalmologist at 4 weeks of age and regularly thereafter will help in timely management of eye diseases and prevent vision loss.

Eye injuries are common during childhood; if left unattended, they can lead to visual disorders.

Poor hygiene; unclean water supply, use of shared eye makeup

Infections: Generalized sever infections like measles, herpes, chickenpox etc. are known to cause permanent vision defects. It is therefore best to follow recommended immunization schedule religiously.

Screen exposure; below 3 years of age impedes the development of normal vision pathway, mars cognitive development and school readiness gets delayed. In older children screen addiction leaves practically no time for daytime outdoor activities, which increases the risk of myopia initiation and progression.

Psychological disturbances can manifest visual disorders. These children need thorough evaluation to rule out eye diseases followed by sympathetic reassurance.

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