Squint
A transitory squint in newborn babies is common and does
not need any treatment. Children with a fold of skin between
the eye and nose (epicanthic fold) or with a wide bridge of
the nose and increased distance between the two pupils may falsely appear to have a squint.
However, a true squint
must be attended to immediately or it may lead to permanent blindness. An eye specialist should be consulted and his
advice followed. Sometimes, the child just needs
glasses. At times, a squint may follow a serious head injury or a
tumour of the eye. Sometimes, surgical correction may be required.
Refractive Errors Needing Glasses
Every child should be subjected to an eye check-up
before joining school to ascertain if he has a squint or needs
glasses.
Infections Of The Eye
Watering of the eye in a newborn without sticky eyes or
puslike discharge from the eye is usually due to blockage of the tear duct connecting the eye to the nose. This is not
due to any infection and generally stops spontaneously before
the child is 6 months old. If you notice a pus-like
discharge from the eye, your doctor will teach you how to massage the
area between the eye and the nose and advise some eye drops
to be put after cleaning the eye with warm water. If
watering persists after 6 months, an eye specialist should be
seen. He may submit the child to a minor procedure to open the
tear duct. This is quite effective.
Redness of the eye or sticky discharge from the eye
could be due to a bacterial or viral infection. If the redness
is coupled with severe itching in the eye, the cause could
be an allergy. Do not use an antibiotic or cortisone eye drops without consulting your doctor.
In a newborn with conjunctivitis, you can safely instil
a drop or two of breast milk into the eye, 4 to 5 times a
day. It does help in some cases. If you are in a place where no
doctor is available, you may use an antibiotic eye ointment for conjunctivitis, but make sure that it
does not contain
any corticosteroid. If not indicated, medicines containing
cortisone can be harmful. In persistent cases, your doctor may
send an eye swab to the laboratory to ascertain the causative organisms and prescribe an antibiotic by mouth.
In rare cases, tuberculosis can manifest in the eye as ‘phlyctenular conjunctivitis’. In this
condition, a
pimple-like spot is seen on the outer side of the cornea. Thin blood vessels are
seen radiating from this spot. Further investigations are needed to confirm this.
If conjunctivitis suddenly starts affecting a large
number of people in the community, it is mostly due to a virus infection of the eye. It is highly infectious and may be
prevented by immediate hand washing after touching a patient and by keeping separate hand towels.
Antibiotics are of no use because of the viral origin. If the
redness persists, see a doctor who may prescribe antibiotic eye drops or an ointment if required. The antibiotic should
only be put in the affected eye every hour or two while the child is awake. This is advised because the
medicine is quickly washed out with the watering of the eye. Unaffected members of the
family should not use the medicine.
Eye Injuries
The commonest injury to the eye is caused by a small
foreign body like a grain of sand getting stuck to the
conjunctiva covering the white of the eye, or the lids. Wash the
eyes with plenty of water. If it does not come out, take a wick
made from cotton, moisten it and clean the speck from the conjunctiva. If you cannot see it and the eye is
irritated and watering profusely, the speck may be stuck under the
upper lid. To turn this lid up, ask the child to look down.
Put a matchstick (or use the finger of one hand) over the lid.
Catch the eyelashes of the upper lid with your thumb and index finger and quickly turn the lid up over the stick. The
foreign substance is generally seen on the upper lid below the eyelashes. Remove it with
moist cotton or the comer of a clean piece of cloth.
If some chemical has gone into the eye, keep washing the eye with water till you see a
doctor.
If the eye has been punched and the child cannot see (ignore the transitory loss of vision after
an injury),
see the doctor as soon as possible. If the child’s vision is
not affected, put an eye ointment into the eye, ask the child to
gently close the eye and put a thick pack of gauze on it and keep it
in place with leucoplast or a bandage till you see your doctor.
If the foreign substance is over the cornea (the cornea covers the pupil and the coloured portion of the eye
called the iris), do not try to remove it yourself. Let the doctor
handle it.
Problems Of The Eyelids
A boil-like painful swelling near the eyelid is due to a
stye (hordeolum). There may be more than one stye. Hot water fomentation thrice a day with application of an
antibiotic eye ointment after the fomentation clears the infection. The
use of an ointment must be continued for another 3 or 4 days
even after the stye subsides.
A stye should be differentiated from a chalazion that
results in a firm, non-painful swelling in the lid. It can
disappear on its own, but may also require simple surgery.
Sometimes, the margin of the eyelid presents with persistent itchy scales that stick together
during
sleep. The eyelid should be gently cleaned with warm water and the scales removed.
Then apply an antibiotic eye ointment.
This condition, called blephritis, tends to recur. Occasionally, local application of corticosteroids is needed.
Congenital Ptosis
This condition refers to drooping of the upper eyelid,
and could be familial. It needs surgical correction. Mild
ptosis is operated upon before the child joins regular school.
Ptosis that interferes with vision should be corrected earlier
as per the advice of an eye specialist.
Night Blindness
Inability to see properly in the dark may be the first
indication of Vitamin A deficiency. It is easily cured by a diet
rich in Vitamin A and the use of Vitamin A. If ignored, it can
lead to severe damage to the eye and permanent blindness. Prevention is possible by breastfeeding
the baby
(preferably for 2 years) and giving him dark green leafy vegetables
and red or yellow fruits and vegetables. Some of these
children may also have associated roundworm infestation that
should be treated as well.
