Common eye ailments in children

By Carol Aloysius

It's back to studies for thousands of children who began their new school term last week. As many of them prepare to spend the better part of the day (and night) revising their lessons and doing their homework, they are likely to develop various eye problems which if not treated in time could affect their vision for life. Unlike in the past, when the school curriculam was not as crowded as it is today and students are forced to spend more time on book learning and home assignments. In addition, living as they do in an age of technological advancement where every home has a television and a computer, children tend to spend more time in front of a television set or a computer, than at play. All this has a detrimental effect on their eyesight.

Squints, blurred vision, inability to see the blackboard clearly, constant irritation and tearing of the eye, headaches, are some of the commonest visual problems that children have due to eye strain while studying. These defects need to be corrected immediately and early. If not it will affect not just only their academic performance, but their ability to take part in sports and other extra curricular activities. In fact, their overall development and outlook depends much on how their eyes see, since a child's eyes are their most precious connection to the outside world, says an eminent eye specialist.

Consultant Eye Surgeon, The Children's Eye Clinic, Rajagiriya, Dr AMILA DE ALWIS talks to the Sunday Observer on why it is important to check a child's eyes early and regularly, common eye defects in children, and most importantly how parents can protect their child's eyes, in the following interview.

Excerpts...

Q. Today, unlike in the past, many school children suffer from eye defects due to excessive straining of their eyes. Your comments?

A. A child's eyes are his most precious connection to the outside world. Their social interaction, academic performance, engagement in physical activities and their overall development and outlook depend much, on how their eyes see.

Q. Why is it more important to check a child's eyesight today unlike in the past?

A. As opposed to 20-30 years ago, with the advent of computers, phones, laptops and tablets, coupled with increased academic demand in the present day, the focus of most children's vision has shifted from distance to near.

This has resulted in a higher prevalence of ocular symptoms such as eye strain, blurring of vision, tearing and headaches, which in turn have resulted in more children requiring glasses. So it is very important that parents check their children's eyes.

Q. Should they be checked early and regularly?

A. Yes. The moment a child complains of an eye ailment, his /her parents should check it out with a qualified eye specialist. The earlier the better.

Q. Why?

A. Because children's eyes are very different to those of adults. Firstly, it is in the first decade of life that our vision develops and clear vision entering the eye is needed for our eyes to reach their maximum visual potential.

Therefore, if vision is low in one or both eyes, a young child will not be able to detect it.

Q. Can low vision affect a child's performance in school?

A. Many children who have been categorised as under performers, have surprised everyone by vastly improving their academic and physical performance overnight by just optimising their vision with a simple pair of glasses.

Q. How common are eye/vision disorders in children?

A. Certain eye conditions are very common in children, affecting up to 30 percent of children, but children are often too young to express/understand that they have low vision in one or both eyes.

When they are old enough to realise that their vision is low, it's often too late to correct the defect and lifelong reduced vision will persist. This is why early and regular checking of children's eyes and vision is compulsory

Q. When and how often should a child's eyes be checked?

A. According to the American Academy of Ophthalmology, children should be screened for eye disease by trained personnel during the following time periods:

Once between age newborn to 3 months
Once between age 6 months to 1 year
Once at age 3 years (approximately)
Once at age 5 years (approximately)

Every two years thereafter during schooling years

Q. What are common eye problems in children? How do you detect them?

A. 1. Need for glasses (refractive errors)

2. Injuries

3. Squints

4. Allergies

5. Infections

Q. Why does a child need glasses?

A. Children may need glasses for several reasons - some of which are different than from adults. Because a child’s visual system is growing and developing, especially during the first 5-6 years of life, glasses may play an important role in ensuring normal development of vision. The main reasons a child may need glasses are:

• To provide better vision, so that a child may function better in his/her environment
• To help straighten the eyes when they are crossed or misaligned (strabismus)
• To help strengthen the vision of a weak eye (amblyopia or “lazy eye”).

Q.What is amblyopia (lazy eye)?

A. A common vision problem in children is amblyopia or “lazy eye.” It is so common, in fact, that it is the reason for more vision loss in children than all other causes put together. Amblyopia is a decrease in the child’s vision that can happen even when there is no problem with the structure of the eye.

The decrease in vision results when one or both eyes send a blurry image to the brain. The brain then “learns” to only see blurry images with that eye, even when glasses are used. Only children can get amblyopia. If it is not treated, it can cause permanent loss of vision.

This may occur when there is a difference in prescription between the two eyes (anisometropia). For example, one eye may be normal, while the other eye may have a significant need for glasses caused by near-sightedness, far-sightedness or astigmatism. Also to provide protection for one eye if the other eye has poor vision.

Q. How could we help prevent eye injuries in children?

A. Children should wear sport's eye protectors made with polycarbonate lenses for baseball, basketball, football, racquet sports, soccer, hockey and paintball.

All chemicals and sprays must be kept out of reach of small children.

Parents and others who provide care and supervision for children need to practice safe use of common items that can cause serious eye injuries, such as paper clips, pencils, scissors, bungee cords, wire coat hangers and rubber bands.

Q. What is strabismus (squints) and how common is it?

A. Strabismus is any misalignment of the eyes. It is estimated that 4 percent of the general population has strabismus. Strabismus can cause a lazy eye, decreased 3D vision, eye strain, and social issues. The treatment for squints includes glasses, exercises and surgery.

Q What are ocular (eye) allergies or Allergic conjunctivitis?

A. Allergic conjunctivitis is a reaction of the eye to things in the environment such as dust, pollen, animal dander, and medications. It is not an infection and is not contagious but can be very irritating. Itching is the most common symptom for eye allergies.

Other symptoms often include stinging, tearing and burning. The conjunctiva (the thin membrane covering the white part of the eye and the inside of the eyelids) will be pink and bloodshot.

The conjunctiva can swell so it looks like a clear blister on the surface of the eye. The eyelid skin is very thin and can become quite swollen and red.

Children may rub their eyes, roll their eyes or blink hard to relieve the itch. Washing the eyes regularly, avoiding the cause of the allergy, ice fermenting and a variety of drops can treat allergic conjunctivitis.

Q. What is sore eyes (pink eye or conjunctivitis)?

A. Conjunctivitis or “pink eye” is a condition where the eyes look pink or red and may have discharge. Symptoms may include burning, itching, irritation, discharge or crusting of the lashes. Infective causes of Conjunctivitis may be caused by bacteria, viruses, and other infectious agents.

Q. How is conjunctivitis treated?

A. If the conjunctivitis is caused by bacteria, treatment with antibiotic drops or ointment may be indicated. Using the medication for the fully prescribed duration is necessary to prevent recurrence. Viral conjunctivitis does not respond to antibiotics.

Contact precautions should be taken to prevent the spread of this condition.

Exposure to traffic pollution during pregnancy can damage future child's lungs

Women who are exposed to traffic pollution while pregnant are increasing the chances of damaging the lungs of their unborn children, concludes a study published in Thorax.

Exposure to pollution during the second trimester of pregnancy in particular raises the risk of harm to a child's lungs, underlining the multiple public health benefits of policies to reduce exposure to air pollution, say researchers.

Existing research has often highlighted the adverse effects of air pollutants on lung function in school-age children and adolescents, but theeffects of a mother's exposure to pollution on the lung function of her unborn child and shortly after birth are less well known.

Researchers led by Dr Eva Morales of the Centre for Research in Environmental Epidemiology (CREAL), an ISGlobal research centre, Barcelona, Spain, set out to examine the association of exposure to air pollution during specific trimesters of pregnancy and postnatal life with lung function in preschool children.

Using data from the INfancia y Medio Ambiente (INMA) Project - a population-based mother-child cohort study set up in several geographic areas in Spain - the researchers assessed lung function with spirometry (measuring of breath).

From the 1,295 women enrolled in the study at the beginning of pregnancy, the researchers obtained data on exposure to both air pollution and lung function assessment at 4.5 years old for 620 (48 percent) of their children.

Nitrogen dioxide (NO2) is a widely used marker of traffic-related air pollution, and benzene levels can reflect industrial activities and are considered as a surrogate for a mixture of predominantly traffic-driven pollutants. Both were used as indicators of pollution in the areas in which the women lived.

Analysis of the results showed that exposure to higher levels of benzene and NO2 in pregnancy was associated with reduced lung function parameters in breathing tests.

The volume of breath that has been exhaled at the end of the first second of forced expiration, known as the FEV1 (forced expiratory volume) was -18.4 mL for benzene and -28.0 mL, for NO2 in women exposed to pollution during the second trimester of pregnancy. FEV1 is a marker of airway obstruction.

Children whose mothers lived in a high traffic air pollution area for benzene during the second trimester of pregnancy had a 22 percent higher risk of impaired lung function than those living in less polluted areas.

The risk for children of mothers living in a high traffic air pollution area for NO2 during their second trimester was 30 percent higher than those from less polluted areas.

Stronger associations between higher levels of pollution around pregnant women and poorer lung function in their subsequent children appeared among allergic children and those of lower social class.

However, there was no significant evidence of an association between early postnatal life (during the first year of life), recent and current exposures to outdoor air pollutants with lung function at preschool age.

The researchers conclude: “Results suggest that exposure to traffic-related air pollutants acting during the prenatal period could adversely impact the developing lung.

“Public policies to reduce exposure to traffic-related air pollution may avoid harmful effects on lung development and function with substantial public health benefits.”

In a linked editorial, Prof Peter Sly, deputy director of the executive of the Queensland Children's Medical Research Institute, University of Queensland, Brisbane, Australia says the study presents convincing evidence that prenatal exposure to pollution has long-term effects on lung function of children.

“Policy makers need to heed data such as those presented by Morales et al as limiting exposure to traffic-related pollution during fetal development and early postnatal life is one way that the burden of respiratory disease can be decreased.”

MNT

How to think positively: Change your walk

Studies suggest that you could walk your way to an improved state of mind

Most self-help advice on how to alter destructive thought patterns focuses on the thoughts themselves, encouraging people to reflect on their attitudes and replace them with more constructive alternatives. However, new research shows that there may be an additional way to gain control over your mind: by walking like a happy person.

“It is not surprising that our mood, the way we feel, affects how we walk, but we want to see whether the way we move also affects how we feel,” said Nikolaus Troje, professor at Queen’s University in Canada and co-author of the paper.

To address this question, Dr Troje and his colleagues set out to establish whether encouraging people to walk in a depressed or a happy manner would affect their memory of emotionally loaded words.

The way we retain emotionally charged information is affected by our mood, with those suffering from depression remembering negative material far more easily than positive messages, especially when the information is about them.

Using a treadmill and an optical motion capture system including 17 cameras, the researchers examined the gait of 47 subjects. Half of the participants were encouraged to mimic a depressive walking style, whilst the other half moved like a happy person. Walking speed was kept equal for both groups.

Not wanting the participants to know what the study was about, the researchers avoided using verbal descriptions of the desired walk, and instead used a visual gauge that responded to the subjects’ gait.

The examinees’ task was to play around with their walk until the dial moved to the extreme end of the scale, corresponding to either a happy or a depressed walking style. During the time on the treadmill, the experimenter read out a list of positive and negative words, asking the participants to decide whether or not each word described them well. Afterwards, subjects were asked to recite as many of the words as they could remember.

As expected, those who had been mimicking a depressed walk recalled significantly more negative words than those that had been marching along in a happy manner.

This finding indicates that our walk influences the way we process information, and the researchers believe that adapting walking style could have a place in treatments for depression. The memory bias favouring negative information makes those suffering from the disease feel even worse, creating a spiral effect that can be a challenge to escape.

“If you can break that self-perpetuating cycle, you might have a strong therapeutic tool to work with depressive patients,” said Dr Troje.

- The Independent

How thoughts and behaviour affect mood

The mood swings of people with bipolar disorder are influenced by their thoughts, according to researchers.

A study by Lancaster University showed that how people interpret everyday experience affects their behaviour and hence mood. The research “Response styles, bipolar risk and mood in students:

The Behaviour Checklist” published in Psychology and Psychotherapy: Theory, Research & Practice is by Dr Alyson Dodd, Claire Fisk and Dr Alan Collins.

They asked students to complete a Behaviours Checklist, which assessed goal-focused ‘ascent’ and ‘descent’ behaviour. Ascent behaviour include taking on more and risk-taking, whereas descent behaviours include withdrawing from other people and mulling over things.

This was completed alongside measures of beliefs people have about how they are feeling, response styles to positive and negative mood, mania, depression, and hypo-manic personality (bipolar risk).

They found that positive thoughts like “I will excel in whatever I'm doing” or negative like “I'm going to have a breakdown” influence mood in a way in which a more neutral thought such as “I have a lot on and need to wind down” does not.

Dr Dodd said: “These appraisals trigger attempts to control or enhance internal states, known as ascent and descent behaviour, which drive mood and activation levels upwards and downwards.”

- MNT