Squint, or strabismus, is a key cause of eye problems in children. It describes eyes that are not pointing in the same direction; one eye or both may be turned in or out, up or down. The squint may be present all or part of the time, or may alternate between eyes. Squints can be caused by abnormal focusing or by an imbalance of the muscles in the eyes. The result is that the nerve pathways from the eye that is not aligned don’t develop well as the brain ignores incoming signals from that eye. As time goes on, sight is reduced and if a squint is not treated early, long-term eye problems and sight defects develop.
Eye problems in children such as squint may run in families or be triggered by illness or injury either at birth of afterwards.
Glasses, contact lenses or eye patches can help the eyes to focus, but won’t realign the eyes. Squints can be corrected with surgery to the eye muscles, which is performed under general anaesthetic and usually takes less than an hour.
A common cause of eye problems in children is watery eye, which can be due to impaired development of the nasolacrimal duct, preventing tears from draining away from the eyes. The duct can also become blocked due to other eye problems in children such as conjunctivitis. Watery eyes can lead to stickiness and discharge from the affected eyes.
These types of eye problems in children usually clear up spontaneously, and any infection can be treated with antibiotic drops. However, if your child still suffers by the age of 1–2, an operation known as probing may be needed. Probing is performed under a general anaesthetic and involves passing a thin wire through the duct to ensure it is clear.
Retinopathy of prematurity
Retinopathy of prematurity is damage to the retina caused by disruption to blood vessel formation in premature babies, which can lead to significant eye problems in children. All babies born before 32 weeks are routinely screened for retinopathy of prematurity. Earlier screening can improve the outcome. Your ophthalmologist will examine your baby’s eyes and may gently press around the eyes with a probe. Your baby will be given eye drops before the examination to dilate the pupils and to numb the area.
Mild cases of these types of eye problems in children may not need treatment. More severe cases may need laser treatment or more specialised surgical treatment.
Another cause of eye problems in children, nystagmus, is an involuntary movement of the eyes, causing disruptions to vision. It may be caused by defects in the eye or in the pathway from the eye to the brain. Nystagmus may appear in the first six months of life (early onset nystagmus, or congenital or infantile nystagmus) or may develop later in life (acquired nystagmus), and may or may not accompany other eye or health problems.
Nystagmus causes poor vision that can often be mistaken for other eye problems in children such as short-sightedness. Glasses or contact lenses do not specifically help nystagmus. Medications such as muscle relaxants may help, or surgery may be used to re-position the eye muscles. Newer treatments for nystagmus eye problems in children involve biofeedback.
Treatment for all of these eye problems in children, and a range of others are available in the NHS or from private ophthalmologists working throughout the UK.