Pediatric & Squint

Pediatric eye care

What is pediatric eye care?

Pediatric eye care is a sub-speciality of ophthalmology that relates to vision care and eye diseases in children. Since good vision is a basic requirement for academic performance and social interaction and influences every aspect of a child’s life, regular eye examinations are a must.

Benefits of eye care for children:

In growing children, good vision is a prerequisite for proper development, both mental and physical. If there are vision problems, detecting them early can ensure timely treatment.

A reputed ophthalmologist, besides routine exams and lens fittings provides care and treatment for a range of sight-related problems in children such as:

  • Refractive errors related to near vision, far vision and astigmatism
  • Lazy eye or amblyopia assessment and treatment
  • Strabismus or crossed eye
  • Eye infections and inflammation
  • Blocked tear ducts
  • Eye injury
  • Screening for juvenile diabetes and rheumatoid arthritis
  • Retinopathy

The ophthalmologist has the expertise to diagnose the need for glasses based on a full eye health examination. This is usually done by dilating the pupils to relax the muscles as this allows the correct measurement. The physician then uses a retinoscope to examine the eye to decide on a course of treatment and write a prescription for glasses if required.

Pediatric eye care is critical, especially for parents of young children as visual skills are the foundation for success in educational activities, sports and interaction with others. Parents are responsible for monitoring their children’s eye health until the child is old enough to take care.

When is a good time to start eye health examinations?

The best time to begin is when the child is six months old. Early diagnosis helps in ensuring that problems if any, have a better chance of recovery. Some advantages of doing this are:

  • Any problems can be identified and treated before they get worse. Ophthalmologists have access to the necessary technology and specialised instruments to examine the eye thoroughly and diagnose conditions like astigmatism, nearsightedness and farsightedness and recommend the right course of action
  • Timely checks ensure proper development. A skilled pediatric eye care physician is qualified to monitor the child’s eyes and track its progress. This must be done at least once a year even if there is nothing obviously wrong with the child’s eyesight. If there is a problem, regular follow up and treatment can cure the problem or at least help manage it properly
  • Vision problems can cause learning disabilities in children. In a majority of cases, this is never diagnosed until the child is actually in school. Making it a practice to visit the doctor regularly can avoid a delay in diagnosis and ensure early detection. Since very young children cannot communicate that their vision is impaired, it is important to schedule regular visits to the ophthalmologist.

In newborns, pediatric eye care starts with a test called the red reflex test to check if the eyes are normal and whether there is a risk for vision disorders in the future. In infants and toddlers, regular screening can help diagnose strabismus or lazy eye and problems with focusing. Once the child starts school, an annual health check can help track problems if any, so that an appropriate treatment plan can be recommended.


Crossed eyes (or strabismus) occur when a person’s eyes are not able to align on the same point at the same time, and appear to be misaligned or pointed in different directions.

Usually this results from weakness of the muscles in one or both eyes. The weak eye will turn away from the object that it is supposed to be focused on. The eye that turns off-target may be the same in every incidence, or it could be a different eye at different times.

A young child with strabismus will unconsciously reject the image of the improperly aligned eye and the related nerve connections between their eye and brain may fail to develop. This can lead to reduction in vision in the eye - known as amblyopia, or lazy eye.

Crossed eyes develop most often in babies. It is easier to correct when caught early. This is often not a condition babies or children simply outgrow so children with eyes that seem to be misaligned should be examined and treated if necessary.

What Causes Crossed Eyes?

There are many different causes for crossed eyes and it does seem to run in families. In some cases, it may be caused by severe farsightedness that has been left untreated. Significant head trauma may also cause crossed eyes, as it can affect the portion of the brain that controls eye muscles.

Signs of Crossed Eyes

The most obvious sign of crossed eyes is when the eyes appear to be pointed in different directions. There are, however, more signs of crossed eyes that can most often be observed in children, including:

  • Eyes that do not move together
  • Unsymmetrical points of reflection in each eye
  • Tilting the head to one side
  • Inability to gauge depth
  • Squinting with only one eye

How Do Excimer Lasers Work?

Treatments for Crossed Eyes

In order to improve vision, the weakened muscles in the affected eye or eyes must be put to work. Several treatments may be used alone or in combination, depending on the type, severity, and cause of strabismus, including:

  • Eyeglasses or contact lenses – this method may help people who have crossed eyes due to an uncorrected farsightedness
  • Medication (eye drops) – In some cases, as an alternative to patching, eye drops are used in the stronger (good) eye to temporarily blur the vision in the good eye. This forces use of the weaker eye.
  • Surgery – straightens and realigns muscles in the eyes; this method has a high success rate although it is expensive and involves more risk than other options.
  • Patching or covering the better-seeing eye – similar to eye drops, this method works to strengthen the weakened eye.