Common Eye Problems in Children | Children’s Eye Conditions | Strabismus/lazy eye/crossed eye


hello viewers welcome to our channel three
doctor Venkateshwara is with us consultant ophthalmologist hello Doctor yeah I’m dr. Venkateshwara Rao – hello pediatric ophthalmologist and strabismus
specialist and also neuro-ophthalmologist so my I’m
practicing at SRI eye care center which is located in the Greenland’s Begum paid
doctor what are the common eye problems in children see I problems there are
variety of eye problems which can happen in children but we’re going to talk
mostly about the common ones which are which are seen in children which cause
problems with the vision these problems if they are not treated early it can
cause problem with the vision and cause a decreased vision in one of the eye or
both eyes which is condition called as a lazy eye okay now all these other is
known as amblyopia the most common cause for amblyopia is strabismus or squint
what we call as now this amblyopia the percentage of prevalence of amblyopia or
lazy eye or in a sense decreased vision in one eye because of lack of non using
of the dye is close to about 5% and normal population okay so the most
common cause for this is strabismus no strabismus is a condition where you have
a cross-ice okay well there’s misalignment of the eyes yeah both eyes
are not looking straight okay either their cross towards one side or their
cross towards out of sight in the more common ones are the outer ones okay but
some of them can have cross ice this cross eyes are there which is which are
noticed in the first one here itself the cross eyes now because of the cross eyes
some of the children who have cross eyes can go into lazy eye in one of the eye
because the brain tends to prefer one eye and because of this abnormal
situation of the eyes where the brain is getting two different images one from
the image from the seeing eye and another is the image which is coming
from the cross time these two different images when they go into the
the brain is in a state of confusion so to get out of the confusion it will it
will elect to ignore one eye or that is called as separation phenomenon okay
this is the first ill effect of squint now the causes of having strabismus are
basically a muscle imbalance okay the imbalance in the CIL’s either the tone
in the muscles which may be abnormal or there could be a strong convergence
phenomenon or increased tone in the medial rectus muscles or medial muscles
which causes the eye to drift inwards okay or sometimes there could be
associated refractive error or glasses power like a hyper Metropia or a + power
glasses which can induce a squinting of ice or inward deviation of ice or
sometimes people some children can have refractive error high refractive error
like a high – power myopia in one eye and as a result of which the that eye is
not saying and as the fish that I could rift out and causes it as it causes
strabismus but primarily this the cause for a strabismus or ask when is an
imbalance in my muscles now nobody knows why this imbalance happens in eye
muscles now if you look at the incidence of strabismus it’s again about 5% in
overall population the prevalence of it now the this Travis knows what we’re
talking about the common ones as I told you the ISA propia which causes
amblyopia rambley remains a lazy eye okay now when
we were discussing as it was telling about the brain tends to ignore one eye
which is called a separation phenomenon now this operation phenomenon stays for
more than 3 to 4 months in a small child was about 2 years or 3 years now this
the the strabismus what I was talking about the cross-ice
which which is commonly seen in the first 1 year and sometimes between 2 3 2
to 3 years of age now these children who have cross eyes the brain tends to kind
of disregard overnight to get out of the confusion what it has and when it tends
to disregard this phenomenon is called as a separation phenomenon separation of
one of the eye so as a result of which one eye becomes a dominant eye and other
comes in non-dominant I and if this separation of one of the I which comes
from the cortical system or from the brain if it stays for a longer period of
time let’s say more than three to four months slowly that I will go into a lazy
eye or it will slowly go into amblyopia where the vision development will get
arrested in that time and the machine goes down this is the first ill effect
of squint so what will happen here the vision will go down in one of the eye
one of the eye will become in down down permanently if you don’t correct it
early okay so what happens is die which is a stronger eye it will tend to
suppress the weaker eye okay now this separation phenomenon is
because of the squinting of the eyes now if you allow the screen to be present
for continuously for a longer period of time the the cells which which you know
are responsible for the vision which go up to the brain cortical system all
those cells over a period of time because of non using or lack of use they
go into atrophy okay so because of this atrophy of the monocular neurons what we
call as the neurons which serve for the vision for one eye these are called as
monocular neurons now they need to be charged in the first few years of life
otherwise they go into atrophy so when they go into a trophy that vision that I
irreversibly will below and it will not improve after a certain period of time
now this treatment for this condition would be to correct the squint as soon
as possible first is to diagnose it or go to a ophthalmologist or pediatric
ophthalmologist and diagnose what is the cause for this quaint whether it is
related to any glasses power if it’s related to glasses power like a hyper
Metropia or a high plus power once you give those glasses some of these squints
might get character but most of them which are not related to the hyper
Metropia our glasses power will require a surgical correction to straighten eyes
the sooner you get the eyes into the straight position the better it is and
that lazy eye or the amber appear which we should not allow the embryo pair to
set in if it sets in then we need to reverse it by straightening the eyes as
soon as possible and also to close the good eye we need to close the good eye
at the dominant eye or the stronger I for a few hours in a day what
we call as a patch in therapy or occupational therapy so we close let’s
say this is the good eye or a stronger eye and because of the squinting of
squinting and this has gone into lazy eye you start patching the good idea to
allow the lazy eye to improve otherwise when both eyes are open the stronger I
will suppress the weaker eye so the brain will not get give a chance to the
Vica right to improve so always the stronger I will overpower the lake
arrive so you need to close the stronger eye for a few hours in a day so that the
weaker eye gets the chance to get stimulated and the cell starts getting
reactivated and the vision tends to improve this is what we do prior to the
surgery once we once we see a patient which was quite a stir squint for some
some period of time and where the amblyopia has set in one eye we start
patching therapy prior to doing surgery if it is not late for the glasses power
so we close one eye daily about minimum about two hours maximum up to six hours
in a day which is called as what time patching of the eye so we do this
part-time patching we start the part-time patching therapy and then we
straighten the eyes after six to eight weeks when the child comes back and for
follow-up and if the squint purses and if it stays like that we need to
straighten the eyes the sooner the better it is sometimes even after
straightening the eyes we need to kind of do some amount of patching therapy
for the residual amblyopia which was which was set in already before to cure
that Amber appeared to improve the vision in that eye even after stating
lean eyes you need to do continual patching therapy for some more time I
would say predominantly 80 to 90 percent of the screen tha patients who have
strabismus which is not related to the hyper Metropia plus four glasses will
require surgery okay some strabismus or some squint patients they who have high
plays power they are called as a refractive accommodative ISA Tropius
there because of the high place power in them whenever they see or whenever they
try to read something they use their accommodation too much they have to use
excess accommodation to clear the hyper Metropia
so in the bargain they cross okay so they have to put more focusing effort
that more focusing effort to clear the place power
we’ll make the ice cross okay initially they start intermittently sometimes the
eyes of states sometimes they’re crossing sometimes they’re straight
sometimes they’re crossing and that’s the time I should diagnose them that’s
the time the parents have to whenever they see some abnormality like squinting
of the eyes even intermittently sometimes in squinting of the I
sometimes they’re normal they should go and get a check okay these as soon as
possible you know I would say that immediately on the very next day but you
know they should get it checked the sooner the better it is okay because
what happens is in the intermittent stage itself if you check them and you
see that they have a glasses underlying hyper Metropia or plus power you give
glasses to them they become straight and the state through the state through
throughout and they don’t require any surgery but if from intermittent stage
they become constant and you you didn’t don’t get them checked for a longer
period of time with the constant squint like that and then when they come to you
at that stage when they have had a constant screen for some eight months to
nine months slowly one of the eye will be lazy the vision in that eye would be
less they have high glasses power like +5 or +6 power but at that time when you
give glasses sometimes the screen doesn’t get connected okay a squint
which would have been corrected with the glasses when they when they were
intermittent okay it loses the opportunity to get corrected once they
become constant so they would they would require a surgical correction later on
so the idea is basically whenever a child has an intermittent squinting of
the eyes they which is where the parent should go and get them checked so that
if there is any underlying glasses power because of which the child is focusing
more do you give the glasses power the eyes become straight okay that is that
is which is what we call as refractive accommodative ecetera
this is the one which gets corrected with the glasses now rest all different
types of strabismus or squint cases which we see they all most of them they
require surgical correction to correct it doctor is watching TV too much can
cause children in problems like eye problems
see a lot of times parents do when they come with the children they they ask us
you know did this problem result from watching
too much of TV there’s no clear-cut you know proof that you know watch too much
of TV that you know children tend to get glasses power or children tend to get
squinting of the eyes or strabismus there’s nothing like that it’s only
thing is if somebody is watching the TV very close buying they were normal at
least viewing distance would be I would say 3 meter distance okay or minimum 3
meter distance for the viewing distance for a TV office moderate sized TV okay
but if you are watching the TV for too much of a time kids watching the TV very
sitting close to the TV watching the TV too much in a darker room with bright
lights sometimes it causes you know strain on their eyes it causes little I
would call as basically an astronomic symptoms or sometimes they can have
headaches and sometimes you know some children they you know they don’t blink
the eyes yes they’re just looking at the TV they don’t bring the eyes you know
yeah and then you know they start watering the eyes and so on so forth but
primarily the major things which I would recommend to the parents would be is to
avoid giving cell phone tablet phones to the children because those cell phones
and tablet phones they have smaller screens they’re going to put it at so
close distance okay so your normal reading distance is here 33 centimeters
is a normal reading distance for all all of us now children or children when you
give the stab phone cell phones invariably they’re going to put it like
this so when they’re putting at this ultra short distance they have the eye
has to exert more effort when the eye exerts more effort sometimes it
translates into stimulation of growth and though it’s not clearly proven but
there is a chance that you know the glasses power can increase faster in
some of the children who do this ultra network and sometimes you know it also
produces if you are putting at this this distance and doing is your accommodation
tends to kind of get fatigued and so you develop a synoptic symptoms again we
tend to develop headaches astronomic symptoms okay and so on so forth but
that’s the reason why I tell all my patients parents would they come if they
have glasses error so not to give gadgets and tap
cell phones tablet phones complete no to them okay even they can watch TV for
some time not more than an hour okay but you can’t avoid it of course you know TV
and computer sometimes they can watch it but cell phone and tablet phones and
gadgets and playing video games and things like that smaller screens is not
advisable not it was not at all invisible okay okay and so there’s
there’s been some studies studies which have been shown that you know the myopia
generally which is the most common error most common glasses error which is seen
in this part of the world Asia Asia Pacific region tends to increase more if
you do like all this ultra near work especially with the video games and
things like that on the cell on your cell phones and tablet phones especially
for younger children or less than ten years of age okay that’s the time when
the growth tends to be more more faster okay so I would recommend that they
should not give these things to the children they are completely avoid them
you know if you once you give it to them and to wean them out to get them out of
that will be very difficult the moment you try to take them out they start
throwing up they start throwing tantrums they keep crying and then and again you
have to you know to make them quiet again you give the phone to them so it’s
not advisable I think I would say no no completely no but TV and computer for
some time it is fine okay depending on the distance what they are viewing from
okay and so that’s how it is doctor what you suggest for the eyes what to eat or
what not to eat to improve eye vision see normally for the dietary thing for
the eye basically what is important for the eye is vitamin E and vitamin D so
both these things are crucial for the my eyes okay and so as you all know vitamin
E is very essential for lot of things in the eye one is to maintain the the
corneal clarity and also to maintain the prevent any dryness on the con the white
portion and also on the cornea you need to have vitamin E and also you need to
have vitamin E for your retinal cells okay to function well so that you see
well cooking so why do many rich foods like you know green leafy vegetables
carrots you know then spinach and then eggs make and so
on so forth and then cabbage cauliflower and and so on so forth you should you
should have and also fruits fruits rich in those juices I won’t really recommend
juices to be given to children okay but orange juice is pretty good okay and
which source of vitamins for the children you could you could give even
guava it’s good for them okay and so I think the seasonal fruits are pretty
good okay they should be given to the children okay and more than that you
know I think the proper diet healthy diet to be get taken at proper times
it’ll good water intake okay a lot of protein in taking children okay good
protein for children for the growth okay and milk is crucial essential okay okay
what for a job you know bones and you for everything else okay some of the
things which you should have okay doctor what do you say that watching TV in dark
see that’s what has a truly in the last time when I was talking about whether TV
is should we give it for children others also I feel that you know you should not
be watching TV in the dark completely dark environment okay watching a movie
is different in a movie hall it’s a bigger screen the distance is far off so
it’s okay but in a room so I would say total dark room which is
not advisable okay because of the brightness from the TVs some of these
TVs have too much of brightness from the from the back back distinguish three
screens it’s not a jet black screen the jet black screens are totally different
looking so I would say that you need to have a small light somewhere which is
not really can i hitting your eyes and causing you know kind of you’re not able
to see well so but i think total dark i won’t watch like that yeah doctor can we
go blinds using hair ties here dies and i don’t
think so you know that’s a bit again okay a lot of times people ask me you
know here dies someday it what the hair dye does is when they put the hair dye
on you because they in the instructions they
will read this condition see what happens is with the hair dye and the
commercially used hair dyes generally tends to produce little irritation to
the eyes because of the the toxin immense little fumes which are there or
what sometimes we have irritation in the eye we get expose if it falls into the
eye then you may have severe irritation redness of the eye sometimes you know
they may have little bit of a corneal epithelial changes which can happen but
they just tend to heal off over a period of time but causing blindness because of
the hair dye that’s not that’s not true at all here died cause blonde that’s the
case then you know then nobody would use a hair dyes so here here dyes your
application to the hair okay you’re not even going near the eye okay but you may
have little irritation in the eye little burning sensation in the a little
redness and I sometimes reactively for which you may just use some lubricating
eyedrops and try to take care of that but other than that the hair dyes
causing problem nothing we haven’t seen anything like that any take-home message
the take-home message basically since I’m a pediatric ophthalmologist and
strabismus specialist the take-home message is to get your children checked
on a lot of parents don’t know that they should get their children checked so
each child should be checked to first was first once in the first year of life
and then after that every year until they get up to 14 years of age the
reason being that if the the vision threatening problems like amblyopia what
I told it gets it gets missed you know if you don’t get the Chi your children
check early so strabismus which is a squinting eyes that also needs to be
treated early a lot of myth about sister isthmus you know people tend to get it
their children to check the later at late because somebody told them that’s
you know this can wait for our few years not necessarily sometimes some it’s an
old myth that you know if you have a squinting of eye if you have a squint
eyes it’s lucky for you this is all totally false people who have that
squinting of ice they lose vision in one eye 50% of the children will lose vision
in one eye we don’t cut the squint at an early age
and the 100% of the children will lose their binocular vision or 3d vision so
in the present world everything is in 3d all your movies are in 3d more and more
3d movies are coming so your child will ask you why I’m not seeing clean even
other child is same 3d now the reason is because of neglect neglect if you have a
squinting of ice and you don’t get it treated universally your 3d vision will
get affected and you’ll just be seeing only with one eye when you have
god-given gift of two eyes but you’re still not using through eyes together so
the the message is that squint should not be neglected squint should be
treated early parents when they notice the child squinting they should go to
the doctor to a pediatric ophthalmologist or squint specialist to
get it checked and treated accordingly Plus glasses are which are commonly seen
in children which can cause amblyopia or lazy eye should be treated early so so
these things will come out you know when you get your children checked every year
okay so on a routinely basis it’s it’s I would recommend children to be checked
every year even though they are normal until they get up to 14 years of age so
to prevent any amblyopia developing or any other problems causing your children
okay so this is a kind of a preventive thing so i’m they can be prevented but
once amblyopia sets in then to treat em later it’s a hard task it’s a tough task
to tease a teeth to q ramsley okay treated okay so it involves lot of
parental effort into that parental input into that parental time into that and
compliance from the from the from the patient itself for the child itself and
also the parent parental compliance is very much necessary so prevention is
better than cure so that’s the reason if you get your children checked okay thank
you thank you very much I hope you found this video useful so don’t forget to
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