Diagnosis and Treatment

Our children's service covers all types of eye condition Our team includes Paediatric ophthalmolgist,consultant ophthalmologists (eye doctors specialized in Glaucoma,Retina) nurses, orthoptists and optometrists,counsellors as well as family support workers and play specialists.

1. Vision and refraction clinic for children:

Testing vision for babies and children is an art .We at Sathyan eye care do vision testing for Newborn babies,infants,preschoolers,children with special needs and school aged children  with age appropriate vision charts.Refraction is done with appropriate methods and glasses are prescribed.

2. Paediatric eye care:

The most common childhood eye diseases treated are squints (strabismus) and lazy eye (ambloyopia), refractive errors, problems with the eye socket, tear glands and lids, cataracts, corneal diseases, genetic conditions, glaucoma, retinal disorders, and inflammatory eye conditions (uveitis

In association with the Glaucoma clinic and  Retina Clinic, it conducts screening and offers treatment for Retinopathy of Prematurity  (ROP) and Congenital Glaucoma Leukocoria (also white pupillary reflex) is an abnormal white reflection from the retina of the eye. The common cause of leukocoria include

Childhood Cataract: 

Causes: Idiopathic,Genetic,Metabolic causes,Intrauterine infections

Most cases are diagnosed on routine screening whereas some may be diagnosed after the parents have noticed leukocoria

Unlike congenital cataracts, acquired cataracts develop sometime after birth. Most often, pediatricians diagnose them at vision screenings or after an eye injury.

For most children, surgery is just the first step to fix the eyes. Ongoing treatment must repair eye-brain connections. This involves teaching the eyes how to focus properly

After surgery, children often need some combination of:

• contact lenses,
• IOLs, and
• glasses.

If the child has lazy eye, he or she may need patching. You cover the stronger eye to stimulate vision in the weaker eye.

Children who receive timely treatment and follow-up have a good prognosis. Your child may need years of vision rehabilitation to have a successful outcome

Retinopathy of prematurity (ROP) is a potentially blinding disease caused by abnormal development of retinal blood vessels in premature infants.

Risk Factors:

Premature infants weighing about 1250 grams or less

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.

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.

Prevention of the development of severe ROP is the best strategy available at present to avoid visual impairment and blindness caused by ROP. Oxygen control and improvements in nutrition are the most important preventative strategies in avoidance of ROP-dependent blindness. ROP screening performed by an experienced ophthalmologist remains the most important pillar, on the other hand, in the management of ROP

• Intraocular infection (endophthalmitis)
• Retinal vascular abnormality (such as Coat's Disease), and
• Intraocular tumor (Retinoblastoma).

Most of these diseases can be easily avoided or treated by correct diagnosis based on a reliable eye examination and timely management

3. Strabismus Services for Children and Adults:

Squint, also called strabismus, is an eye condition where the eyes do not look in the same direction as each other. This means that while one eye looks forwards to focus on an object, the other eye turns either inwards, outwards, upwards or downwards.

Untreated, it can lead to amblyopia, or “lazy eye,” in which the brain starts ignoring input from one of the eyes.

The department investigates, diagnoses and treats all types of squint,eye disorders and abnormalities relating to the eye muscles and/or nerves.

Treatment options include:

• Glasses: If hypermetropia, or long-sightedness, is causing the squint, glasses can usually correct it.
• Surgery - Realign the eyes by operating on the eye muscles and placing them in straight position.
• Exercises are given to improve vision
•  Prompt treatment reduces the risk of complications, such as amblyopia, or lazy eye. The younger the patient is the more effective treatment is likely to be.

4. Amblyopia Clinic

Amblyopia (lazy eye), is a reduction in vision arising from a defect present in infancy or early childhood that prevents the eye from receiving adequate visual stimulation.

Electrophysiological Tests

Without treatment, your brain will learn to ignore the image that comes from the weaker eye. That could cause permanent vision problems.

5. Orthoptic clinic

Orthoptists are trained staff concerned with the diagnosis and treatment of ocular motility and problems relating to vision like:

1. Defective binocular vision, which is the inability to use the two eyes together in the correct way and which leads to impairment of depth perception.
2. Abnormal eye movements arising from injury or disease affecting the eye muscles or the nerve supplying the muscles, or a physical obstruction to eye movement.
3. Diplopia (double vision) resulting from abnormal eye movements or strabismus (squint)

Our Orthoptic clinic  has trained orthoptists, who specialize in evaluation and treatment of eye muscle problems. Our orthoptists work under the supervision of our pediatric ophthalmologists

6. Myopia Research Clinic

Myopia, or nearsightedness, is one of the most common vision problems in childhood Kids with this condition can usually see things close up, but struggle to see things far away.

What causes myopia? Myopia occurs when the eyeball is too long, relative to the focusing power of the cornea and lens of the eye. This causes light rays to focus at a point in front of the retina, rather than directly on its surface.

Myopia is the most common ocular disorder, predominantly in Asia It is estimated that around 2.5 billion people will have myopia by 2020,¹ and approximately half of the world population will become myopic, with 10% of them highly myopic by 2050.

NEWER TREATMENT OPTIONS AVAILABLE

The prevalence of myopia is increasing globally. Complications of myopia are associated with huge economic and social costs. It is believed that high myopia in adulthood can be traced back to school age onset myopia. Therefore, it is crucial and urgent to implement effective measures of myopia control, which may include preventing myopia onset as well as retarding myopia progression in school age children. 

Currently, treatment with low dose atropine eyedrops are showing promise for controlling myopia.

Applying atropine eye drops dilates the pupils and temporarily paralyzes the focusing muscle inside the eye. It also relaxes the eyes focusing mechanisms. Research has suggested that myopia in children may be connected to focusing fatigue and excess accomodation so using atropine can control myopia by relaxing the eye and minimizing the fatigue and excess accommodation.

In our clinic we routinely do a complete examination for all short sighted children including scan (LENSTAR)to assess the eyeball growth,convergence and accommodation tests.we prescribe low dose atropine to slow down the progression of myopia

We also educate them on myopia .Counselling done for routine review eye checkups,constant wear of glasses and use of  drops ,sibling eye checkups since myopia can be hereditary

(PE) HOW TO HELP SLOW THE PROGRESSION

Here are a few things that you can do at home to help slow the progression of myopia over time:

• Spend time outside each day. Research has shown that children who spend at least 90 minutes in natural sunlight each day have slower rates of myopia progression. We believe that being outside is helpful because they’re giving their eyes a break by looking at things further away. It also may be the brightness of the natural sunlight that helps.
• Take regular breaks from close work every 30 minutes. This includes tablets, phones, books, and drawing. It doesn’t have to be an extended break, just long enough to allow your eyes to relax. Look out the window, walk down the hallway, or get up to get some water.
• Keep a good working distance. Holding things closer to your face causes your eyes to strain and work harder to see. The recommended distance is approximately the same length of your child’s forearm, or the distance from their elbow to knuckles.

Utilize good lighting. Make sure your child utilizes good lighting when they’re reading or doing homework. This helps to prevent eye strain.

Detecting Myopia Early

The best way to control myopia is to detect nearsightedness early.

Even if your child does not complain of vision problems, it's important to schedule routine eye exams for your children.

Early childhood eye exams are especially important if you or your spouse are nearsighted or your child's older siblings have myopia or other vision problems. Heredity is a factor in myopia.

And don’t forget: Encourage your children to put down their phones and gaming consoles and go outside and play. More time outdoors seems to lessen the chances your child will develop myopia.

7. Cornea Services

Keratoconus is a progressive eye disease that causes a thinning of the clear front surface of the eye (cornea) and distorts the cornea into a cone-like shape. Keratoconus causes distorted vision that cannot be corrected with eyeglasses

A cone-shaped cornea causes blurred vision and may cause sensitivity to light and glare. Keratoconus usually affects both eyes and generally begins to first affect people ages 10 to 25 In the early stages of keratoconus, you can correct vision problems with glasses or soft contact lenses. Later, you may have to be fitted with rigid, gas permeable contact lenses or other types of lenses. If your condition progresses to an advanced stage, you may need a cornea transplant.

8. Low Vision Clinic

The Low Vision Clinic is a clinic for people who have visual impairment when medical treatment is no longer suitable or is unable to retrieve lost vision. The most common conditions are Age related macular degeneration, Diabetic retinopathy, Glaucoma, untreated cataracts and Nystagmus (continuous uncontrolled to and fro movement of the eyes etc.

Low-vision devices are designed to improve visual performance in children and adults with low vision, thus enabling academic and social adaptation and providing enrichment of daily experiences.They can be optical or optical and electronic.

Examples include standing and hand-held magnifiers, strong magnifying reading glasses, loupes, and small telescopes.

Also Low vision certificates and guidance for educational and occupational services given.

9. Child Friendly Optical Shop

A good collection of colorful, attractive and quality spectacle frames and glasses designed specifically for children are available

Surgical and laser procedures include:

• Paediatric cataract surgeries
• Surgical correction of Strabismus in children and adults  under Anaesthesia appropriate for age (General/ Local)
• Examination under Anaesthesia: For children who need detailed evaluation and for whom various specialty opinions are required at the same time

Laser for treating Keratoconus-C3R laser

School Screening:

Refractive errors are the second major cause of blindness in India after cataract and the most common reason for patients to consult ophthalmologist or ophthalmic assistant. Over a quarter of the outpatient attendance at all eye clinics and hospitals is due to refractive errors. The availability and access of infrastructure, services, trained manpower, cost of spectacles, and community awareness is an area of concern.

Poor vision in childhood affects performance in school and has a negative influence on the development and maturity. Further, most school children do not realize that they are suffering from the ocular disability as they adjust to poor eye sight in different ways. They compensate for their poor vision by sitting closer to the blackboard, or by holding their books close to their eyes

Children in the school going age (6-14 years) represent over 25 per cent of the population in the developing countries. Refractive error is an optical defect of the eye. This defect prevents light from being brought to a sharp focus by the cornea and lens on the central retina, the nervous tissue that  records light. The school children screening is very important as it helps in early diagnosis and treatment and  prevents lazy eye or ambylopia form developing  and follow up of children in school is also possible and effective

Activities under school eye health programme

A. Planning for school screening –Decide the goal, plan your screening methods

B. Conduct the screening- Procurement and distribution of the required materials (Snellens chart, rope etc.),Trained staff

Patient education and Eye awareness activities

In our hospital as a part of patient education and to create Eye health awareness

1.  Kids eye club-Conducting interactive sessions with kids, parents, Opthalmologists, Paediatricians, staff  to promote awareness. 
2. Outdoor activities and sports –To promote healthy lifestyle. 
3. Other awareness activities-Golu, Mime show etc

 Pediatric Clinic

Dr. J. Aruna. M.B.B.S, Dip.N.B..