Childhood Blindness And Low Vision Due To Refractive Error

Hi ALl,

I am Dr. Harshavardhan Ghorpade. Today I am going to talk to you about a very important condition in the eye that is childhood blindness and more importantly childhood low vision because of refractive errors. Now in children, there are many causes of blindness that could range from a simple refractive error that is powered glasses or cataract or glaucoma or optic nerve problems. So for children to be detected to have any kind of these conditions it is important to have a regular checkup with the ophthalmologist in the early ages. This is important because children do not complain of blindness especially if it is in only one eye. And they can see with the other eye so they neglect it. Even because they are small they cannot even tell their parents that they cannot see clearly. After the age of 5, of course, they start telling their parents but before that it is imperative for the parents to take their children to the doctor and get them examined because any of these conditions could be there and we could miss it out and later on it would be too late to improve the vision.

So usually we advise a checkup at around 1 to 2 years then the next checkup at around 3 to 4 years and last check up around 5 to 7 years before the child himself becomes smart enough to complain about vision problems. Now talking about refractive errors, they have powered glasses which come for children. If they come in one eye then that eye becomes weak or lazy and ultimately after the age of 8 that laziness cannot be removed very easily. Therefore children have to be checked for refractive errors especially in clinical programs that are conducted in schools or can be taken to an eye doctor for checkup. What happens in refractive errors? Because of refractive errors, the focusing of light does not go out to the retina of the child and the child is not able to see images clearly because the vision is blurred the images which are formed are blurred and the visual development of the child is affected and slowly that eye becomes lazy.

When both eyes are affected it is much easier to check or to understand the child’s problem. However, if only one eye is affected then he may not able to complain and even the parents may not notice that the child is not able to see. Now, what are the causes of refractive errors? The most common cause is hereditary because if the parents have glasses then the child is likely to have glasses. It is said that about 25% of children have some kind of a vision problem and most of them are because of powered glasses. Especially if the child is not eating properly if he has poor diet he has bad habits like watching mobile computer laptops for a long time and finally because his parents also have some kind of hereditary problems of minus power the child is likely to have glasses. In such conditions, it is very important to get the vision of the child tested. The other factors nowadays that we have found are less exposure to sunlight by children. So it is very important that you allow children to go out & play in the sun or walk in the sun to school. This helps to develop the vision of the child and avoids faster progress of power especially minus number.

Talking about plus number. Plus number is not very common in children however many children do have plus power which gets undetected because the child can use his accommodation to overcome it. However, if it is in one eye especially if it is more than plus 3 that eye is surely likely to become lazy over a period of time and the child is not able to use his vision especially after the age of 8. What is the treatment? The treatment is very important because if it improves the child’s vision before the age of 8 then long term his vision is going to remain fine and later after the age of 18 can get rid of the glasses using a laser or other procedure. The main treatment is of course glasses. When your glasses full time is important however if one eye is lazy we can cover the normal eye for 3 to 4 hours a day & allow the lesser eye to see everything with those glasses. This is called as patching therapy.

Patching therapy helps to improve the laziness of the eye and gets back the vision of the poor eye equivalent to the normal eye. This treatment is very important before the age of 8 because after the age of 8 this may not work. Finally, I would suggest that children do not wear contact lenses because even if glasses don’t look very good even if children in the school might tease them for glasses contact lense have long term poor effects like infection & dryness that can cause problems in children’s eyes. So, all in all, I would suggest a regular checkup a very healthy diet avoid mobile avoid laptop, ipads go out & play in the sun & get your eyes checked at regular intervals to avoid childhood blindness. Thank you very much. If you want to know more about it please contact me on Lybrate.com.

Thank you.