The Pediatric eye Care services at Saluja Eye Care Center specializes in the diagnosis and treatment of children suffering from strabismus (squinting) and sight disorders using advanced and state-of-the-art techniques.
At Saluja Eye Care Center, our aim is to provide the best, comprehensive, custom made, and cost effective Pediatric eye Care services.
Due to the immaturity of children's vision system, diseases that have minimal effect on adults, might cause irreversible damage to children, therefore early diagnosis and treatment is vital.
After birth some children might develop strabismus (squint), cataract, increased pressure inside of the eye(glaucoma), tumors of the retina or the eye socket, and other disorders that also affect adults.
THERE ARE DIFFERENCES THAT AFFECT THE APPROACH AND TREATMENT OF EYE PROBLEMS IN CHILDREN.
The Pediatric eye Care services offers eye tests for babies, early diagnosis of risk factors for amblyopia (lazy eye) identification of congenital eye diseases and follow-up of premature babies.
The Pediatric eye Care services are unique in its diagnostic and treatment approach in that it is adapted to the needs of each child. This is based on the child's age, level of development and medical condition.
A certain percentage of children are born with an obstruction of the tear ducts, which are responsible for the drainage of tears from the eye to the inside of the nose. Obstruction generally cause watering of eyes and recurrent eye infections, with pus discharge.
In most cases the tear ducts open spontaneously or by massage by the age of one, but in some cases surgery is required to treat the condition. The Pediatric eye Care service performs surgery to open blocked tear ducts on children depending upon requirement.
Retinopathy of prematurity (ROP) is a potentially blinding eye disorder that primarily affects premature infants weighing about 2000 grams or less that are born before 31 weeks of gestation (A full-term pregnancy has a gestation of 38–42 weeks).We Have a protocol based ROP management system at Saluja Eye Care Center.
When a baby is growing inside its mother, it is in a protected environment. The baby develops slowly, till it is able to continue growing outside the mother. The eyeball growth is completed normally just few days before actual birth of a child. In a premature baby a number of problems can occur in the eyes, as they are not fully developed. The most important of these is called as 'Retinopathy of ‘Prematurity' or 'ROP'.
Retinopathy of prematurity (ROP) is a potentially blinding eye disorder that primarily affects premature infants weighing about 2¾ pounds (1250 grams) or less that are born before 31 weeks of gestation (A full-term pregnancy has a gestation of 38–42 weeks). The smaller a baby is at birth, the more likely that baby is to develop ROP. This disorder—which usually develops in both eyes—is one of the most common causes of visual loss in childhood and can lead to lifelong vision impairment and blindness. ROP was first diagnosed in 1942.
A. Today, with advances in neonatal care, smaller and more premature infants are being saved. These infants are at a much higher risk for ROP. Not all babies who are premature develop ROP. The disease improves and leaves no permanent damage in milder cases of ROP. About 90 percent of all infants with ROP are in the milder category and do not need treatment. However, infants with more severe disease can develop impaired vision or even blindness
A. ROP is classified in five stages, ranging from mild (stage I) to severe (stage V):
Stage I — Mildly abnormal blood vessel growth. Many children who develop stage I improve with no treatment and eventually develop normal vision. The disease resolves on its own without further progression.
Stage II — Moderately abnormal blood vessel growth. Many children who develop stage II improve with no treatment and eventually develop normal vision. The disease resolves on its own without further progression.
Stage III — Severely abnormal blood vessel growth. The abnormal blood vessels grow toward the center of the eye instead of following their normal growth pattern along the surface of the retina. Some infants who develop stage III improve with no treatment and eventually develop normal vision. However, when infants have a certain degree of Stage III and “plus disease” develops, treatment is considered.
"Plus disease", means that the blood vessels of the retina have become enlarged and twisted, indicating a worsening of the disease. Treatment at this point has a good chance of preventing retinal detachment.
Stage IV — Partially detached retina. Traction from the scar produced by bleeding, abnormal vessels pulls the retina away from the wall of the eye.
Stage V — Completely detached retina and the end stage of the disease. If the eye is left alone at this stage, the baby can have severe visual impairment and even blindness.
Most babies who develop ROP have stages I or II. However, in a small number of babies, ROP worsens, sometimes very rapidly. Untreated ROP threatens to destroy vision.
A. Yes. Infants with ROP are considered to be at higher risk for developing certain eye problems later in life, such as retinal detachment, myopia (nearsightedness), strabismus (crossed eyes), amblyopia (lazy eye), and glaucoma. In many cases, these eye problems can be treated or controlled.
What causes ROP?
A. ROP occurs when abnormal blood vessels grow and spread throughout the retina, the tissue that lines the back of the eye. These abnormal blood vessels are fragile and can leak, scarring the retina and pulling it out of position. This causes a retinal detachment. Retinal detachment is the main cause of visual impairment and blindness in ROP.
Several complex factors may be responsible for the development of ROP. The eye starts to develop at about 16 weeks of pregnancy, when the blood vessels of the retina begin to form at the optic nerve in the back of the eye. The blood vessels grow gradually toward the edges of the developing retina, supplying oxygen and nutrients. During the last 12 weeks of a pregnancy, the eye develops rapidly. When a baby is born full-term, the retinal blood vessel growth is mostly complete (The retina usually finishes growing a few weeks to a month after birth). But if a baby is born prematurely, before these blood vessels have reached the edges of the retina, normal vessel growth may stop. The edges of the retina the periphery may not get enough oxygen and nutrients.
Scientists believe that the periphery of the retina then sends out signals to other areas of the retina for nourishment. As a result, new abnormal vessels begin to grow. These new blood vessels are fragile and weak and can bleed, leading to retinal scarring. When these scars shrink, they pull on the retina, causing it to detach from the back of the eye.
A. In addition to birth weight and how early a baby is born, other factors contributing to the risk of ROP include anemia, blood transfusions, respiratory distress, breathing difficulties, and the overall health of the infant.An ROP epidemic occurred in the 1940s and early 1950s when hospital nurseries began using excessively high levels of oxygen in incubators to save the lives of premature infants. With newer technology and methods to monitor the oxygen levels of infants, oxygen use as a risk factor has diminished in importance.
Lighting levels in hospital nurseries has no effect on the development of ROP.
How is ROP treated?
A. The most effective proven treatments for ROP are laser therapy or cryotherapy. Laser therapy "burns away" the periphery of the retina, which has no normal blood vessels. With cryotherapy, physicians use an instrument that generates freezing temperatures to briefly touch spots on the surface of the eye that overlie the periphery of the retina. Both laser treatment and cryotherapy destroy the peripheral areas of the retina, slowing or reversing the abnormal growth of blood vessels. Unfortunately, the treatments also destroy some side vision. This is done to save the most important part of our sightthe sharp, central vision we need for "straight ahead" activities such as reading, sewing, and driving.
Both laser treatments and cryotherapy are performed only on infants with advanced ROP, particularly stage III with “plus disease.” Both treatments are considered invasive surgeries on the eye, and doctors don’t know the long-term side effects of each.
In the later stages of ROP, other treatment options include:
A. While ROP treatment decreases the chances for vision loss, it does not always prevent it. Not all babies respond to ROP treatment, and the disease may get worse. If treatment for ROP does not work, a retinal detachment may develop. Often, only part of the retina detaches (stage IV). When this happens, no further treatments may be needed, since a partial detachment may remain the same or go away without treatment. However, in some instances, physicians may recommend treatment to try to prevent further advancement of the retinal detachment (stage V). If the center of the retina or the entire retina detaches, central vision is threatened, and surgery may be recommended to reattach the retina.
Strabismus (squinting) is a result of a lack of coordination between the various muscles in the eyes, so that the eyes are not able to simultaneously focus on a given target.
Squinting in children might cause disorders in the field and depth of vision, development of lazy eye, and esthetical problems that might affect the children socially and emotionally. Early diagnosis and treatment is therefore vital. The treatment of squinting can be done in one of several ways: suitable glasses, strengthening sight by covering the "good" eye or surgery.
Squinting in adults generally occurs as a result of paralysis to one of the muscles responsible for eye movement and causes double vision and esthetic problems. Treatment in adults involves the use of special glasses (prisms) and/or surgery.
A. Amblyopia is reduced vision in an eye that has not received adequate use during early childhood. When a child has poor vision in one or both eyes due to the uncorrected refractive error or squint or due to the inability of the light to reach the interior of the eye, it is called as 'Lazy eye disease'.
This disease can be treated with patching/occlusion therapy or penalization methods. The results are very satisfying, provided it is diagnosed in time and appropriately treated
A. It is estimated that two to three percent of the general population suffers from this form of visual impairment
A. Most often it results from either a misalignment of a child's eyes, such as crossed (Squinting) eyes, or a difference in image quality between the two eyes (one eye focusing better than the other.)
In both cases, one eye suppresses the image of the other eye. If this condition persists, the weaker eye may not work and will not have useful vision.
A. With early diagnosis and treatment, the sight in the "lazy eye" can be restored.
A. The earlier the treatment, the better the opportunity to gain the useful vision.
A. Before treating amblyopia, it may be necessary to first treat the underlying cause.
Glasses are commonly prescribed to improve focusing or misalignment of the eyes.
Surgery may be performed on the eye muscles to straighten the eyes if non-surgical means are unsuccessful. Surgery can help in the treatment of amblyopia by allowing the eyes to work together in aligned fashion.
A. The correction may be followed by:
Patching or covering one eye may be required for a period of time ranging from a few weeks to as long as a year. The better-seeing eye is patched, forcing the "lazy" one to work, thereby strengthening its vision.
Medication—in the form of eye drops or ointment (Penalization)—may be used to blur the vision of the good eye in order to force the weaker one to work. This is generally a less successful approach.
A. If not treated early enough, an amblyopic eye may never develop good vision and may even become functionally blind.