An ophthalmological examination is required whenever there is a suspicion of an eye disease – regardless of age.
Parents, caution: When should you take your child to an ophthalmologist?, Dr. Sandra Jovanović Ophthalmological examination of children is adapted to their age and can be done from the first day of life, if there is a need for it. There are several situations when parents should be very prompt and bring their child to a specialist ophthalmologist.
If parents notice any abnormalities in the appearance of the eyes: some growth on the eyelids, a drooping eyelid, that the pupils are not black but whitish or greyish, are not properly round or are not the same width in both eyes, they should react.
Another signal is redness and discharge in the eyes that occur frequently and/or persist for a long time. Also, the signal is tearing and secretion from one (rarely two) eyes during the first year of the child’s life.
If the little one often rubs his eyes, squints, is bothered by the light, rolls his eyes and makes some “strange” eye movements, as well as if his eyes itch, parents should react and bring the child to an ophthalmologist.
It happens that parents themselves notice squint or poor eyesight in their child, which are not unfounded suspicions. There are also problems such as playing with the eyes, tilting the head, as well as when the child complains of seeing double (sees two moms, two toys). These are all examples that require expert consultation.
You will notice weaker vision if the child approaches objects to see them better, but also when a small child gets stuck very often, seems to be clumsy or when, for example, a student at school does not manage to copy from the blackboard.
Tiredness while reading is also noticed among schoolchildren, also a signal that it is time to visit an ophthalmologist.
Children also have headaches, and if they happen often and especially in the afternoon and evening hours or after reading and studying, it is necessary to react.
Genetics should not be ignored – the child will need an examination during the first year of life (ideally at nine months) if one of the immediate family members had eye problems in childhood, if they wore glasses with a larger diopter, had farsightedness or the so-called “lazy eye”. Parents should present the details of all these cases to an expert, who will conduct an examination and give his opinion.
In addition to established and often easily noticeable visual disturbances, children can also suffer from juvenile rheumatoid arthritis and juvenile diabetes. These are problems that need to be noticed in time, so it is extremely important not to delay the visit to the ophthalmologist – the problems in the future can only be bigger.
Another topic, which is almost taboo in society, is developmental delays and neurological problems in children. Since they can also lead to vision problems, it is up to parents to be maximally responsible and react in time.
For children who do not have any of the mentioned disorders and symptoms, basic screening must be done at the age of four, as well as before starting school.
What is basic screening?
Basic screening at the age of four includes testing the visual acuity of each eye separately and evaluating binocular vision. If any irregularity is observed during such an examination, a complete eye examination is performed, including a refraction examination in cycloplegia.
Premature children who, due to prematurity, are at risk of developing retinopathy of prematurity, are screened according to valid protocols at a very early age, and at the age of one year, refraction and oculomotor balance are checked. The ophthalmologist will inform the parents of all the details.
The most common ophthalmological problems in young children are:
Congenital obstruction of the tear ducts – occurs in the first months of life, it is manifested by persistent tearing, secretion and irritation of the skin of the eyelids, usually only in one eye. In most cases, it passes spontaneously with the implementation of massage and appropriate toilets, and sometimes surgical intervention is performed at the end of the first year of life.
Strabismus (farsightedness) – a condition where the visual axes are not in a parallel position in all or only in certain directions of sight. There are horizontal and vertical strabismus, as well as combinations of the above.
This disorder can be present all the time or occur only occasionally. In the first months of life, it often occurs occasionally, in healthy infants, as an expression of the immaturity of the visual system. If it continues after the third month of life, it is necessary to have an eye examination at the age of six months, even earlier.
What should arouse the suspicion and caution of parents in those first months of life is if the deviation is constant, that is, if the eye is constantly in a deviated position – this may be a sign of some organic disease such as, for example, congenital cataract.
Strabismus usually appears before the age of three, although it can also occur later.
On the other hand, children often have a false impression of strabismus, the so-called pseudostrabismus. It is usually due to the wide root of the nose and the special structure of the eyelids in the inner corner, and it is a neat finding that does not require treatment, unlike a true gap where it is important to carry out treatment as soon as it is noticed.
It is necessary to emphasize the importance of starting the treatment of strabismus as early as possible, which is especially true for convergent (where there is an inward turning of the eyes, towards the nose). The goal of strabismus treatment is to achieve the best possible visual acuity and enable the development of binocular vision. Treatment should be started immediately upon detection.
Amblyopia (low vision) – represents reduced visual acuity, which cannot be corrected with optical correction. It can occur in both eyes, which is a rare case, in the presence of congenital cataracts or a high refractive error, or only in one eye, most often due to strabismus or anisometropia – a condition where there is a large difference in diopter between the two eyes.
Success in the treatment of amblyopia and the period in which it is possible depends on the age at which it occurred and the cause that caused it. If detected early enough, it can almost always be successfully treated. In other words, the earlier it is started, the easier and faster the healing can be achieved.
Bring the child to the children’s ophthalmologist for an examination in time, so that the refractive anomaly can be detected in time and glasses will be given with the help of which the child’s vision will develop.
Unfortunately, in the underdeveloped countries of the world, apart from cataracts, uncorrected refractive anomalies still rank high as the second cause of low vision.
Where can you bring your child for an examination?
The best address for timely service for your little one is the “dr. Sandra Jovanović” ophthalmology practice at Bulevar Patrijarha Pavla 1a. Children are examined by a pediatric ophthalmologist, MSc. honey Dr. Ivanka Tanasijević Filipov, author of this text.
Appointments can be made by calling 066 403 174 and 021 403174. You can find information about all services on the official website www.drsandrajovanovic.rs, and follow the practice on Facebook and Instagram for current events.
Specialist ophthalmologist-retinologist Prim. Dr. Sci. honey Dr. Sandra Jovanović is our recognized expert in the diagnosis and treatment of diseases of the posterior segment of the eye, who has been providing excellent services to an increasing number of satisfied patients for years.