New guests to a bright and bustling world, children learn a lot in the first few years of life merely by seeing the world around them. For this reason it is essential to be well aware of some of the most common problems that arise with eyesight and eyecare in the young.

Children should have their eyes checked regularly. A paediatrician will check your child’s eyes in the first six months, at one year of age and then before going to school. It might be necessary, at the recommendation of your paediatrician, to consult an ophthalmologist. Reasons can vary from the child displaying problems with simple school tasks to being unable to keep up in class and perhaps even with friends during play.

It is important to note that children are often unable to vocalise their needs properly. It is probably beyond a child’s ability to explain that his vision is inadequate even if he has already started to speak.

Refractive errors

Refractive errors are the reason why most children need prescription eyewear. Refractive problems can be myopia (nearsightedness), hyperopia (far-sightedness) or astigmatism (which causes blurred vision). Refractive errors usually develop between two and four years of age although an element of hyperopia is considered normal in children six to 12 months old.

Adequate vision is necessary for a child’s early development. Uncorrected refractive errors in preschool children are also especially malicious because they could lead to long-term visual impairment.

On the other hand, refractive errors should always be considered in children who display problems in class, especially if they prove to be able to respond to verbal instruction. Inattentiveness in class might just mean that the child is unable to read properly or keep up with the board work.

It is also important to note that while an adult suffering from refractive errors might be apt at explaining and identifying the problem, a child probably will not. This means that a child who has a problem with his vision may ­present other problems such as distraction, inattentiveness and misbehaviour in class.

Strabismus and amblyopia

Strabismus is a condition in which one eye or both are misaligned or wander. The condition may present itself constantly, or occasionally, for example when the child is tired. Children who have close family members with the condition are at an increased risk, but in most instances, the condition’s origin is unknown.

Most children with strabismus will be noted by a close family member or a teacher between one to four years of age. If you notice this condition, it is important to contact a paediatrician or an ophthalmologist and they will guide you further.

In a child with strabismus, the vision in the straight eye remains normal because the messages relayed from the eye to the brain function as they should. The wandering or misaligned eye, however, does not focus properly. This ends up weakening the connection between the eye and the brain. If strabismus is left untreated, it could result in amblyopia.

If the word ‘amblyopia’ sounds unfamiliar, weird, and like another of those medical terms seemingly designed to scare you, then you might be more familiar with the term ‘lazy eye’. In amblyopia, the brain partially or wholly ignores input from one eye. Strabismus is not the only cause of amblyopia but it is by far the most common.

In amblyopia caused by strabismus, due to a prolonged period of the ‘wandering’ eye not focusing to the same extent as the eye with normal vision, the brain learns to ignore the misaligned eye, leading to possible vision loss in that eye.

Apart from amblyopia, prolonged strabismus can also lead to a fault in depth perception, a condition in which the child would be unable to view 3D things properly.

Chalazion

A chalazion is a small lump on the eyelid. It is caused when one of the glands which secrete oil into the eye is blocked. Thus oil builds up in the tissue of the eyelid and causes inflammation. It looks like a reddish bump, often on the lower eyelid. It can start out as small as a pin prick and over the course of days or weeks grow to the size of a pea.

If strabismus is left untreated, it could result in amblyopia

The eye may tear a little bit but it is not contagious. Chalazia usually disappear on their own within a few days or weeks; however, if this is the first time the child has had a chalazion, call a paediatrician. Chalazia rarely cause vision problems but when they do, it’s because they are sufficiently large enough to cause pressure on the eyeball. Unfortunately, once chalazia develop, they are likely to reoccur.

Pink eye

Pink eye or, rather, conjunctivitis is an irritation of the transparent covering (conjunctiva) of the eye. When this happens, the eye turns reddish (hence the name) and can develop some swelling. It is the most common eye inflammation in children.

Pink eye can be caused by bacteria, viruses, allergies and chemicals. Of these, a viral cause is the most common as it can be caused by viruses which spread other common paediatric diseases such as the common cold.

Pink eye tends to be very contagious, which is why it is easy for a child to get it if his siblings or playmates have it as well. It can be transmitted through contact with an infected person, sharing of tissues, cloths, towels and even through sneezing. It is important to note that this also includes self-to self transmission from one eye to another. So it is always wise to teach your child to wash their hands with warm water and soap regularly, especially after they touch their eye; and to do so yourself if you applied any treatment or wiped their eye. Most doctors will recommend that you keep your child away from school or childcare until the pink eye goes.

Viral conjunctivitis resolves itself spontaneously within seven to 10 days and does not require treatment; however, the child will need to be prescribed antibacterial eye drops if the cause is bacterial. Some more serious conditions can also mimic conjunctivitis; for the above reasons, it is important to visit your pediatrician, especially if the condition has not resolved itself within a week without treatment or after three days with treatment.

Sty

We can all remember our eight-year-old selves looking at that red, painful-looking lump on a classmate’s eye. So if that is not a chalazion, then what is it?

Sty is an ailment which haunts schoolchildren nationally. A sty looks like a red, sore lump near the edge of the eyelid. Unlike chalazion, it is caused by an infection. A sty is formed when bacteria infect one of the tiny oil glands at the base of the eyelash. The infection produces a tender, red pus-filled bump in the child’s eyelid. The eyelid might get a little crusty or cause white discharge.

A sty is not dangerous but it can be quite cumbersome. It should be treated to avoid a more serious infection from developing. In most cases, however, sties will open and drain on their own in a few days, but drainage can be encouraged with holding a warm (not hot!) washcloth to the child’s eye for a few minutes several times a day. As a general rule, someone attempting to pat your eye repeatedly with a warm cloth is unpleasant and might be irritating, therefore it’s wise to do this when the child is asleep or distracted.

A sty is not dangerous but it can be quite cumbersome. It should be treated to avoid a more serious infection from developing

Do not attempt to squeeze a sty as this might make the infection worse, and in line with this, if your child is old enough to understand, explain that they should not rub their infected eye. Once the sty drains, you can wash your child’s eyelid with a clean cloth and any residual swelling should disappear within a few days to a week.