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Good vision is essential for proper physical development and educational progress in growing children. The development of the visual system is extremely age sensitive and hence early detection and treatment of visual problems is ABSOLUTELY CRITICAL. The gift of vision is precious. Give your children the best start in life by visiting your eye doctor today. Because it's never to early to help your child have a bright future.
 
Recommendations for Eye Examination in children :
 
A paediatrician should examine a new born's eyes. An ophthalmologist should be asked to examine all premature infants.
   
Vision screening should be done between 3 and 3 ½ yrs of age. Routine screening school checks should be done.
   
Detailed eye examination must be done if there is appearance of symptoms of visual impairment.
 
Common eye problem in children :
 
Refractive errors (spectacle number) account for 80% of visual impairment in children. This includes Myopia or near-sightedness, where distance vision is blurred but a child can usually see well for reading or other near tasks. This occurs most often in school-age children. The prescription for glasses will indicate a minus sign before the prescription(for example,-2.00).
 
Another problem is Hyperopia (far-sightedness), where problems such as crossing of the eyes, blurred vision, or discomfort may develop. However, most children are far-sighted early in life and it becomes a concern only in excessive cases where the focusing muscles are not able to keep the vision clear. A prescription for hyperopia will be preceded by a plus sign (+3.00).
 
Astigmatism is also common and is caused by a difference in the surface curve of the eye. Instead of being shaped like a perfect sphere (like a basketball), the eye is shaped with a greater curve in one axis (like a rugby ball) and this causes fine details to look blurred or distorted. Here, the prescribed glasses have greater strength in one direction of the lens than in the opposite direction.
 
Anisometropia causes children to have a different prescription in each eye. This can create a condition called lazy eye, where the vision in one eye does not develop normally. Glasses(and sometimes patching) are needed to ensure that each eye can see clearly.
 
Lazy eye or Amblyopia is seen in 1% of children. It is a failure of the eye to connect to the brain due to lack of use of one eye during infancy and childhood. Therefore, the vision in the amblyopic eye remains poorer than in the normal eye. To solve this, the poorer seeing eye forced to be used by patching the preferred eye and combined with the use of corrected by 9 years of age by which time it becomes permanent. To detect and treat ambylopia, it is necessary to examine preschool age children.
 
Squint or Strabismus, also called crossed-eyes, means that the eyes are not aligned but are pointing in different directions. They may either point inwards towards the nose (esotropia), outwards to the ear (exotropia) or up or down (vertical strabismus). The problem can be constant or intermittent. However intermittent strabismus occurs in infants during the first few months of life, especially when the infants is tired, since they are still learning to focus their eyes and to move them in a coordinated fashion. Most babies outgrow this intermittent strabismus by the age of 3 months. For other cases, various treatment options are available, including exercise for the eyes, called orthoptics.
 
Squint
 
This is the condition when eyes are not straight or aligned properly. The eyes may go in or out and occasionally up or down. Eye movement - Eye movement is controlled by 6 muscles attached to the outside of each eyeball. In order to see correctly both eyes must move in same direction. This is done by pulling by one muscle in one direction and relaxing of other muscle. To see one object both eyes must look at it at the same time. Each eye sees it from different angle and each eye sends a slightly different picture to the brain (Binocular vision). Brain blends the two picture to give a three dimensional image. This process is known as fusion and it gives the ability to judge the relative distance in two objects (depth perception).
If the muscles are not coordinated the images of eyes sent to the brain will not fuse and one gets double vision. The child quickly and unconsciously learns to ignore the image of one eye (suppression) and the eye becomes lazy (amblyopic). The development of binocular vision starts at age of 6 months to be completed by age of 5 - 8 years. So the squint treatment should be done in this age.
 
False Squint
 
This is the condition where eye looks deviated because of structural factors as broad nose. But the examination by an eye doctor will diagnose this case. It normally gets corrected with age and needs no treatment.
 
Latent Squint
 
In this condition eye remains straight in normal gaze but gets squinted on strain and tiredness. Squint is seen on covering one eye - the covered eye becomes squinted. Actually the imbalance in this case is not so much to cause obvious squint. Eye muscles tries to maintain binocular vision. This causes strain and headache. Mostly it is due to refractive error and correction may give relief from headache.
 
Causes for Squint
 
Birth injuries
   
Hereditary
   
Faulty muscle balance
   
Need for glasses
   
Certain eye diseases interfering vision of one eye
   
Development of normal vision in both eyes
   
Straighten the eyes
   
To make both eyes work together
   
Treatment
 
Early check up by an eye doctor is must to diagnose and treat the case. It is time taking and needs lot of effort from parents to attain the goals.
 
To Develop Vision
 
Glasses/ Spectacles: some type of squint are corrected by glasses only.
   
Patching of the lazy eye: By this we stimulate bad eye to see more and improve vision. This is done under doctors supervision, who checks for development of vision in bad eye and deterioration of vision in good eye which may happen occasionally. In these cases he may have to reverse the patching.
   
Straighten the eyes - Surgery is done to straighten the eye. In this the weaker muscle is made stronger by cutting a piece and joining two ends (resection) and stronger muscle is made weak by cutting it from its attachment and taking the attachment back (recession) . Surgery may have to be done in one eye or both eyes depending on amount and type of squint.
   
To develop Binocular vision - Chances of developing binocular vision is normally very less. However some exercises after and before surgery may be recommended to develop binocular vision. This is done by person trained for it, known as Orthoptist.
   
Some of the uncommon eye problems in children include
 
Blocked tear ducts
   
Ptosis
   
Retinopathy of prematurity
   
Nystagmus
   
Visual inattention
   
Pediatric cataracts
   
Pediatric glaucoma
   
Abnormal vision development
   
Orbital tumours
   
Evaluation of visual issues in education, including dyslexia and attention deficit disorder, which are treated through different methods.
 
                 
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