Retinoblastoma
It is a tumor that arises from the retinal precursors cells. It is a malignant tumor that can spread to others parts of the body. It commonly occurs in children with in the first decade. The presenting symptom can vary from case to case but the common symptoms are white reflex in the pupil area, deviated eyes, poor vision in the affected area etc. early detection can save the eye with good visual prognosis. The more the delay in diagnosing , the chance of loosing the eye is more. Early diagnosis and treatment by modern techniques is possible only when the child’s parents are aware the disease.
Congenital Dacryocystitis
It is a condition in which the natural passage that is present in between the eye conjunctival sac and the nose for the passage of tears is blocked at birth. Usually it opens by the first year of age. Watering , discharge are the common symptoms of the disease. Massage over the lacrimal sac area i.e. is the area where the eyes and nose meet will clear the block in the passage. If infection is present or the passage does not open by the first year, then it as to be treated accordingly. Minor procedure called probing of the nasolacrimal sac will cure the condition if done early. Sometimes surgery called Dacryocystorhinostomy has to be done.
Congenital Glaucoma
It is a condition where the pressure of the eye ball is increased which leads to optic nerve damage and abnormal large eyes due to defect in the development of the angle (passage for the fluid secreted inside the eye). Early detection and management can prevent the loss of vision and disfigurement. Medical and surgical treatment with a good follow up can maintain the near normal vision for the rest of the life. Surgeries like goniotomy, trabeculectomy and trabeculotomy are done at LOTUS .
Congenital cataract
Cataract is a condition where the normal transparent lens in the eye ball becomes opaque. It can be present at birth or it can develop in early childhood due to various causes. Early detection and treatment will restore normal vision development in the child. Delay can lead to development of a condition called Amblyopia or lazy eyes where the brain neglects the image from the affected eye. Phacoemulsification and intra ocular lens implantation with special techniques are done at Lotus as a routine for cataract removal.
Retinopathy of Pre-Maturity
The eye is often compared to a camera. The front of the eye contains a lens that focuses images on the inside of the back eye. This area, called the retina, is covered with special nerves that react to light.
Underneath the retina is a network of blood vessels. These blood vessels normally grow quickly in the last few weeks before a baby is born. If born prematurely, there can be a problem in this growth.
In some premature babies, the blood vessels grow into parts of the eye where they do not belong. This can cause scar tissue to form inside the eye. The scar tissue can damage the retina and cause significant loss of vision. This condition is called Retinopathy of Prematurity.
Why do babies get retinopathy of Prematurity?
Most infants who are born about 2 months or more premature & have low weight at birth will have some amount of retinopathy of prematurity. Fortunately, the condition is often not severe enough to harm vision, and will go away without needing treatment. In some infants, however, the retinopathy of prematurity will develop very quickly and could cause a loss of vision or even blindness.
Over the years, doctors have identified several things that seem to make retinopathy of prematurity worse, such as supplying too much oxygen to premature babies. Avoiding those things has reduced number of babies with severe retinopathy of prematurity, but not eliminated the condition.
There is no way to predict which baby will develop the more severe forms of retinopathy of prematurity. This is why it is very important for all babies born at 28 weeks or earlier, who weigh less than 1,500 grams (about 3 pounds, 5 ounces) at birth, or when neonatologist deems them to be a high risk to be examined by an eye doctor. This exam often takes places 4 to 6 weeks after birth.
How does the doctor know whether an infant has retinopathy of prematurity?
The doctor will use a special instrument to look inside the eye of the retina. An important part of this examination is to find out how much of the retina of each eye may be affected by retinopathy of prematurity.
The doctor will grade the results of the examination on a standard scale of five stages. Stage 1 retinopathy of prematurity is the least severe form of the condition, and stage 5 is the most severe.
How is retinopathy of prematurity treated?
Only a doctor can recommend the right treatment for a baby retinopathy of prematurity. The recommended treatment will depend on how severe the retinopathy is.
Stage 1 or 2 retinopathy usually does not require any treatment. Instead, the doctor will probably schedule frequent eye examinations to make sure that the baby’s condition does not get worse. It is very important to keep these appointments, because the abnormal blood vessels could start growing rapidly at any time.
The doctor might recommend treatment for higher stages of retinopathy of prematurity.
The procedures to treat retinopathy of prematurity include
- LASER PHOTOCOAGULATION This procedure is used to stop the abnormal growth of blood vessels in the retina. The surgeon applies a laser beam onto a small spot on the retina where blood vessels are growing. In most cases, the abnormal blood vessels then get smaller and disappear.
- CRYORETINOPEXY This procedure is also used to stop the growth of blood vessels. In this treatment, an instrument called cryoprobe is placed on the outside of the eye. The tip of instrument gets very cold –that it freezes the abnormal blood vessels growing inside the eye. This stops the growth of abnormal blood vessels.
- SCLERAL BUCKLING The abnormal blood vessels and scar tissue damage the retina by pulling it away from the inside surface of the eyeball. This is called a retinal detachment, and it causes cause a significant loss of vision. One way to reduce the tension on the retina is to push the wall of the eyeball inward. This can be done using something that looks like a rubber band. This elastic band is placed around the eyeball, and pushes the inside surface of the eye up against the retina is called scleral buckling.
- VITRECTOMY In eyes with a large amount of scar tissue and blood vessels, the surgeon might have to remove some gel-like fluid that fills most of the inside of the eye. This material is called the vitreous fluid, and the procedure to remove it is called a Vitrectomy. In addition to removing vitreous fluid, the surgeon will also remove the scar tissue which is pulling on the retina. This should help reduce the chances of a retinal detachment and prevent the loss of vision.
How successful is treatment for retinopathy of prematurity
In the small number of infants who need treatment for retinopathy of prematurity, it usually works well to prevent loss of vision. The most important thing parents can do to help the best result for their child is to keep all scheduled appointment and follow the doctor’s advice after any treatment.
Retinopathy of prematurity can be very worrisome for parents. There are several groups that offer advice and support for parents including the Association for Retinopathy of Prematurity and Diseases.
Refractive Errors
What do you mean by myopia or short sight?
The image formed from a far object is in front of the sensory part of the eye namely the retina. Near objects are clear and distant objects are blurred.. It is corrected by use of concave lens spectacles, contact lens or refractive surgery.
What do you mean by hypermetropia or long sight?
It is the refractory error in which the image formed from a far object falls behind the sensory part of the retina. The nearer objects appear blurred . it can be corrected by use of convex lens spectacles, contact lens or refractive surgery.
What do you mean by Astigmatism?
It is the refractive error in which the focusing of rays from distant object is not the same in the different meridians of the refracting system of the eye. This is corrected by cylindrical or toric spectacles, contact lens or refractive surgery.
What happens if the child does not wear glasses for refractive error?
The child can develop eye strain, headache, Amblyopia, squint, recurrent infection of the lids etc.
What is Amblyopia?
It is a developmental defect of spatial visual processing that occurs in the central visual pathways of the eyes. It is defined as a condition with unilateral ( or ) bilateral subnormal vision ( at least 2 times less than normal ) without any local ophthalmoscopic abnormality, which is reversible if treated appropriately at the proper time.
What is the importance of preschool children screening?
Preschool children are those who are in the age group of three to four years of age. This is the important age group in which certain diseases like squint, amblyopia , vitamin A deficiency, refractive errors when detected early and treated gives a better visual development. Always they should have at least one eye check up before going to the school.
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