Cataract is generally associated with old age. However, in some unfortunate cases, children could be affected by cataract as well. A cataract can be defined as a cloudy or opaque layer that forms on the eye's natural lens that lies behind the iris and the pupil, leading to eventual loss in vision. Cataract can affect children in one eye or both eyes.

Cataract can be a congenital birth defect or can develop as the child grows older. The latter case is known as pediatric cataracts. The exact cause of cataracts in children is not known, but it has been associated with a number of genetic disorders, low birth weight and infections during pregnancy. Traumatic events such as an injury to the eye can also cause cataracts.

The earlier a cataract is diagnosed and treated, the better it is. It is easier to identify a cataract that affects both eyes than a cataract that affects only one eye. If a congenital cataract is not treated in time, the part of the baby's brain used for sight may not develop properly. Hence it is crucial to recognize cataract symptoms.

Here are a few you should look out for:

    Not looking directly or responding to large, colourful objects.
    Not being able to find small objects while crawling.
    Excessive squinting or shielding their eyes to bright sunlight.
    Eyes that do not focus on the same point.
    White reflex instead of a red reflex in photographs.
    Uncontrolled movement of the eye.

Cataracts that are too small to affect sight can be treated with eye drops to dilate the pupil. However, this provides only temporary relief. Surgery is the most preferred form of cataract treatment. This surgery can be performed even in the first few weeks of a baby's life. The child is put under anesthesia and a microsurgical instrument is used to break the lens into small pieces and remove it.

This surgery is followed by the use of lenses or glasses to help the eye regain its power to focus again. In some cases, the lens may be implanted to replace the natural lens. In cases where cataract affects only one eye or one eye is more severely affected than the other, there may be a tendency to develop amblyopia or lazy eye syndrome. In such cases, it becomes necessary to patch the good eye shut and stimulate vision in the eye that has undergone surgery.

Cataract in Children

The most common vision problems are shortsightedness and farsightedness. Shortsightedness is when a person sees close objects clearly while distant objects appear blurry. It is more common than farsightedness and affects about 70% of the Asian population.

When there is a refractive issue, the prescription usually has a plus/minus with it and also a number. A  minus  symbol is used to represent shortsightedness; the greater the number of the glasses, the higher the shortsightedness. High myopia is a more severe form of shortsightedness where the power is -6.0 or higher.

Symptoms: 

As mentioned, the person will be able to see nearby objects but will have difficulty seeing far off objects.

Difficulty reading signs and boards
Squinting
Straining to reduce the strain on the eye
Tired and fatigue due to this eye strain, especially when in constant move like playing sports or travelling
How it happens?

Vision can be explained by a physical process where light passes through a lens and falls on the retina in the posterior portion of the eye where it forms an image. This is then sent to the brain where it is read and interpreted as a particular object. When the lens becomes elongated, the image that is formed is distorted in that it is formed in front of the retina and not on the retina. Though it gradually settles down with adulthood, in most cases, it progresses and requires corrective lenses. The corrective lenses ensure the image falls on the retina and visual perception is improved.

Treatment:

Corrective glasses are the most commonly used measure for nearsightedness. The lenses could be used either as spectacles or as contact lenses.
Laser surgery can also be used to correct the problem. A thin layer of the cornea is removed and the image formation is corrected.
Artificial intraocular lenses are also being used to treat this condition. They work like contact lenses and may need periodic replacement.
The most common technique, especially for high myopia is the use of surgery to correct the problem. This is a one-time correction and is a more durable solution than the earlier mentioned options.
Appropriate calculations are done to identify the lens to be used so that proper vision is restored.
Complications: 

Though not common, retinal detachment and variable postoperative refractive error can occur during the surgery.
It is very important to set realistic expectations with the patient in terms of what to expect before, during, and after surgery. If only one eye is going for repair, the chances of mismatch in vision could be present in the early stages. Being clear about what to expect will help in successful correction.

Myopia or Nearsightedness - How It Can Be Treated?

Amblyopia is commonly known as'lazy eye. It is a vision development disorder, which affects eyes and the brain during infancy and childhood. It signifies that the eye does not achieve a normal visual acuity even with refractive correction in form of glasses or contact lens. During normal visual development, the eye and brain learns to'see' and develop binocularity, that is the ability to perceive depth (stereoacuity). This occurs in the first 8 to 10 years of life. 

Each eye transmits a clear and identical image from retina to the brain, which fuses the two images into a single image with 3 dimensions (adding depth). When the image is formed on the retina of two eyes is too dissimilar, the brain cannot fuse the two images and suppresses the more blurred image. As a result, the worse eye does not learn to'see' and becomes'lazy. This condition is seen in 1-4% of population.

The common causes for dissimilar images or amblyopia are:
1. Misalignment of the eyes or squint: it is the primary reason for amblyopia is misalignment of the eyes. In case, both your eyes are not aimed in the same direction, the image captured by each eye is different, resulting in diplopia. The brain will see from the dominant eye and suppress image from the other eye. Over a prolonged period of time, the eye dissociates from the visual cortex of the brain.

2. Refractive amblyopia:
A. Unequal refractive error in both eye. When the eye power of both eyes differ by more than 1.5d of spherical equivalent, which results in dissimilar images between the two eyes. As a result, the visual development in restricted in the worse eye.
B. High refractive error or astigmatism in both eyes, since there is a blurred image in both eyes, the normal vision development does not occur in either eyes resulting in bilateral lazy eyes.

3. Cloudiness in visual system or visual deprivation amblyopia: any kind of obstruction or cloudiness in the normal visual axis of the eye tissues can lead to amblyopia. Disorder of any kind, which blocks a clear image from being focused blocks the formation of a clear image on your retina. Commonly due to congenital or developmental cataracts or corneal opacities or prolonged closure of one eye in early childhood (drooping of one eyelid, eyelid swelling, patching of one eye).

Treatment for amblyopia
For treatment of amblyopia, a child must be compelled to utilize his affected, weaker eye. This can be done by correction of causative factor such as, treating refractive error with glasses, surgical correction of misalignment of eyes followed by patching and vision therapy, cataract surgery.

Patching or occlusion of the good eye
This is done to force the brain to pay attention to visual input from the worse eye. This allows nerve connections between affected eye and brain to develop due to, which the eye'learns to see. Eye drops such as atropine are also used for blurring the vision of the good eye. Some form of vision therapy may also be required to train both eyes to see together and develop some degree of depth perception.

To be effective, treatment should be implement as early as possible, within the period of normal visual development best within first 8 years of life. Some visual gain has been seen in selected patients up to age of 14 to 18 years. This also highlights the importance of a comprehensive eye examination as a routine in young children.

About Amblyopia or Lazy Eye

People are well aware of the harmful effects that UV rays have on the skin, but very few know that UV rays can damage their eyes as well. The tissue that human eye is made up of is one of the most sensitive tissues in the body and hence, the most vulnerable. The increasing level of UV radiation reaching the Earth s surface every minute has made it indispensable to take the required precautionary measures to protect the eyes.

What are UV rays?

Sunlight consists of 3 types of radiations - Infrared, Visible light and UltraViolet. Artificial sources like lasers, tanning beds and welding machines also emit UV radiation.

There are three types of UV radiations - UV-A, UV-B and UV-C. 

UV-C is absorbed by the ozone layer and does not possess any risk. It is UV-A and UV-B radiations that adversely affect the eyes and vision.

Impact of UV rays on  eyes

Too much exposure to UV rays can affect vision, harm the eyes, and deteriorate overall eye health. There are various eye problems that are aggravated by excessive exposure to UV radiation:

Macular Degeneration: It is caused by damage to the retina over time by UV rays. It leads to age-related blindness. Too much exposure to UV rays increases the risk of developing macular degeneration.
Cataract: It is the clouding of eye s natural lens - the part of the eye that focuses the light we see. Too much exposure to UV rays increases the risk of developing cataracts. 
Pterygium: Often known as  surfer s eye , pterygium is a pink, non-cancerous growth that is formed on the conjunctiva. UV rays are believed to be responsible for the development of this growth.
Skin Cancer of the Eyelids: Too much exposure to UV rays can cause skin cancer in and around the eyelids.
Photokeratitis: Popularly known as corneal sunburn or  snow blindness , photokeratitis is caused due to excessive short-term exposure to UV-B rays. Photokeratitis occurs when you spend long hours at the beach or skiing. It sometimes leads to temporary vision loss. 
How to protect the eyes from harmful UV rays?

Here are some tips to help ensure that eyes are protected against harmful UV rays:

Always use quality sunglasses that block out 99-100 percent of both UV-A and UV-B radiation when outdoors.
Stay away from tanning beds, and if you use them occasionally, always wear eye protection. 
Wrap around frames should be used if you spend a lot of time outdoors.
Be sure to see your doctor at least every two years.

UV Rays - Are They Damaging Your Eyes?

People may suffer from visual impairment even though their eyes are perfectly normal. Such loss of vision may result from neurological impairment.

Vision is the combination of image formation and perception of various attributes of the image by the brain. When the brain is not able to perceive images or various attributes of images, the patient may suffer from neurological impairment of vision. Such impairment owes its origin to the nervous system.

Causes of Visual Impairment:

There are various areas in the brain that process some or the other attribute of the image that has formed on the retina. Occipital cortex, the area situated at the rear side of the brain is a very important site. It is responsible for processing visual stimuli and allowing people to make an idea about shape, distance, movement, color, etc. The severity of loss of vision depends on the extent and location of damage in the brain.

Neurological loss of vision may result from acquired brain injury, difficulties with visual perception, impairment in coordination of the eyes, etc. All these may stem from damage areas in the brain that are responsible for vision. There are many areas in the brain that are responsible for vision.

These areas can get damaged from various accidents like:

Stroke: If a person suffers a stroke, a part of his or her brain is likely to get damaged due to a haemorrhage or a blocked blood vessel.

Traumatic Brain Injury: A traumatic brain injury such as in a car accident or a violent fall can damage visual perception of the brain.

Infections: Infections such as meningitis attack the brain and may impair various areas of it.

Lack of Oxygen: People may suffer from lack of oxygen if they experience accidents like a near-drowning episode or a heart attack or something else, which has the effect of interrupting blood flow to the brain.

Diseases: Diseases such as brain tumors, multiple sclerosis etc. can precipitate neurological vision loss.

Symptoms of Visual Impairment:

Symptoms of neurological vision loss depend on the type of vision impairment and the location of damage in the brain. It may include:

Blurry vision: In Blurry vision, a person will not see things clearly or may see something in light but find it difficult to see them in dim light.

Double vision: In double vision, the patient sees a single object as two and cannot merge them as one.

Problems with depth perception of objects

Problem with bright light: In this type of problem, a person experiences difficulty seeing an object in a bright light. One may also feel pain or discomfort in the eye in bright light.

Difficulty with interpreting the object the person is looking at

Partial loss in the visual field: In this problem, half of the visual field in each eye is missing.

Treatment of Visual Impairment:

There is hardly any treatment for such vision loss since the rectification of visual acuity is of no help. Depending on the location and degree of neurological impairment, vision may improve over time. Some children with acquired brain injury or impairment in the coordination of the eyes and difficulties with visual perception also tend to improve with age.

Conclusion:

This is a type of vision loss where glasses, contact lenses, surgeries, or eye drops are not going to help. Such vision loss is usually permanent. Children with similar symptoms need to be presented with pictures, bright light, etc., which may help to form an idea about the object.

Visual Impairment Related To Nervous System!

7 Easy ways to get relief from computer eye strain

Do you spend long hours in front of the computer? If you do, you may be experiencing eye strain on a regular basis. Eye strain is a common problem and is characterised by fatigue, decreased productivity, red eyes and eye twitching. You can get rid of eye strain by making use of any one of these simple tips. 

1. Ensure that your workplace has correct lighting
Often eye strain occurs as a result of improper lighting. This can be caused by exposure to bright sunlight coming in from the windows and doors or excessively dazzling indoor lights. You can avoid extra lights by keeping blinds or shades closed and by avoiding high-intensity bulbs or fluorescent lights. Alternatively, opting for incandescent or halogen lighting can be beneficial.

2. Minimise glare
You can install an anti-glare screen on the monitor of your computer to minimise glare. Keep the windows covered to reduce glare caused by outdoor sources.

3. Modify the display settings of your computer
You can modify the display settings of your computer in the following manner to reduce eye strain:
• Brightness-Set the brightness of the display to a level, which equals the brightness of your workplace.
• Text size and contrast-Modify the text size and contrast according to the comfort level of your eyes. For most people, black text colour on a white background ensures minimum eye strain and maximum convenience.
• Colour temperature- The spectrum of visible light, which a colour display usually emits is its colour temperature. Blue light is considered to cause more eye strain. So, you should decrease the colour temperature to minimize the amount of blue light emitted by your computer’s display.

4. Try some eye exercises
You can practise some easy eye exercises to prevent your eyes from getting tired. Try staring at a distant object for 10-15 seconds and then looking at any nearby object for another 10-15 seconds. Return your gaze to the first object. Repeat 10 times.

5. Opt for some computer eyewear while working
Try wearing a pair of computer glasses while working. They ensure that your eyes remain correctly focussed on the computer screen, while reducing strain to a minimum. Computer glasses also prove to be very effective in diminishing glare. 

6. Take short breaks at regular intervals
Apply the 20-20 rule to your work regime. After each 20 minutes of work on the computer, give your eyes a 20 second break by looking away from the screen towards any object located 20 feet away from you.

7. Go for a comprehensive eye exam
Make sure that you go for a comprehensive eye exam every year to reduce vision problems caused by computers. This will also help in detecting the root cause behind your problem, so that you can effectively employ curative or preventive measures to control eye strain.

If you would like to consult with me privately, please click on 'Consult'.

7 Easy Ways to Get Relief from EveryDay Computer Eye Strain

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