When Should the First Examination Held for Children? 

All types of eye diseases and disorders like the need of glasses, strabismus, cataract, eye pressure, eye lid malformations, lachrymal duct obstruction, eye tumors and similar can occur in new born (neonate) children. The eye examination shall be held beginning from the neponatal period. The first examination is held by an experienced nurse or pediatrician in the neonatal room. The later examinations shall be held by the pediatrician as a general eye examination in the 6th and 18th months. 

In this period, parents shall apply to the ophthalmologist as soon as possible when they observe an abnormal evidence like cross - eye, lid lowerness, frequent blinking and eye friction. If an identified disease exists in the family history, this shall be observed in early period. All children shall attend an eye examination untill the age of 3 even if their eyes are in normal appearance. The strabismic amblyopia which occur in one eye, usually does not indicate any manifestation and cannot be diagnosed without examination. The examinations and tests shall be repeated at the age of 5 and before beginning to the school education. 

Is it Difficult to Examine  A Newborn Child? 

The examination of a newborn baby presents certain difficulties compared to the examination of an adult. Nontheless, if the examination of the baby is a must, the examination can be held by anaesthetizing the baby. However, the primary condition for the anaesthesia is that the baby does not have any health problem that may prevent the anaesthesia. For this reason, consulting with the pediatrician, the doctor will learn if any situation contradicting with the anaesthesia exists or not. There is nothing to fear to put babies to sleep under the supervision of an experienced anaesthesiologist.

What are the Most Common Eye Defect of Children?

The eye disorders that frequently occur in children are the in - corrected refraction defects and srabismus. For learning how to see, amblyopia shall be recovered by using glasses or by operation at the earliest age.  Even the strabismus can be recovered, a closure treatment is implemented for amblyopia. The recovery of amblyopia which had developped as a result of visual defects and which has not been trated until the age of 9 or 10, is impossible. 

What is the reason of the need for an early treatment of amblyopia? 

Since an eye with astigmatism or hypermetropia higher than a certain level sees the near environment too blurred, it can not learn how to see well and net in the childhood and thus it may remain amblyopic. Additionally, in cases where the sphere number difference is to high between the two eyes, the eye with higher sphere number shall remain amblyopic. The amblyopia is an eye problem that can only be recovered until the age of 9 or 10. The later amblyopia is treated, the less success can be obtained. For this reason it is suggested for children to attend eye examinations until the age of 3 or 4. The treatment of amblyopia is held by closing the eye with higher visual ability and forcing the other to learn how to see by itself. 

Does strabismus cause amblyopia? 

The strabismus is an eye defect where the eyes cannot look paralelly. While one of the eyes directly aimed at the taget, the other is directed to somewhere else. If only one of the eyes is strabismic, this eye has a very low visual strenght and will remain amblyopic. The strabismic eyes cannot or barely sense the depth. The Strabismus can be divided into three sub-groups as: childhood strabismus,  paralytic strabismus (cycloplegia) and secondary strabismus. 

The most common childhood strabismus are the inwards and outwards directed strabismus. They can be single or double sided. Inwards strabismus generally occur in hypermetropic eyes. This type of strabismus can be treated with eye glasses in some cases. The strabismus which cannot be corrected with glasses shall be operated. The eye which continuously  crosses has a very low visual strenght and will remain amblyopic.

The outwards childhood strabismus usually occur in myopic eyes. The outwards strabismus can be hidden or apparent. In this type of strabismus the sun light may reveal the hidden strabismus. The child usually tend to close the outward strabismic eye when exposed to the sunlight. It can be single or double sided. The sense of depth is weak in single sided outward crossing. Amblyopia may also develop. One of the main reasons of the strabismus is the paralysis of the nerves reaching to the eye muscles.  This paralysis may exist by born in certain cases while it may develop as a result of a trauma or inflammatory diseases in some cases. Additionally an obstacle in the optic environment of the eye may cause secondary strabismus (cataract, lid lowereness etc.) and inward - outward crossing of disable eye. 

Can wearing eye glasses affect the sphere number?

The diopter number of the eye is the refractive power  of the eye. This value is determined by the inclination of the cornea and the lenght of the eye. The diopter number of the eye does not change as a result of any habitude. To say, wearing glasses or not, wearing glasses with high or low diopter numbers, reading much or less do not increase or decrease the diopter value of the eyes. 

What does the color of the pupil indicate? 

The pupil is the black ball at the center of the colored section (iris) of the eye. A pupil with any other color than black like white, gray or yellow indicate serious diseases (cataract, tumors, infection, development disorders). 

What is the Inborn High Intraocular Pressure (Congenital Glaucoma)?

This is a serious disorder which causes permenant blindness if not intervened early. Sensitivity to light, dilution in eyes, squinting and enlargement of the transparent structure at the center of the eye (which we call cornea) and the colored layer of the eye are the most important indicators. If the intraocular pressure value continues to remain high, a cavitation in the eye nerves, that is the death of the nerve cells, occur. Unfortunately, no damage in the visual nerves can be corrected by implementing any treatment. The treatment is aimed to preserve the undamaged nerve tissue. The diagnosis can only be made by measuring the eye pressure. 

What is the Dilution in the Eye (Lacrimal Duct Obstruction) ?

The most common reason of this disorder is the obstruction or stenosis of the lacrimal duct. This can be concurrent with the occurence of blurring without rubor in eyes. The prulent liquids which causes blurr will emanate when pushed to the nose end.  This situation poses a difficult problem for parents in first year but usually at the end of this period the duct loosens and the copmlaints end. In order to facilitate the dilatation of the duct in this period it is suggested to massage the nose end. At the blurring period, antibiotic drops are used. 

If the duct is not open by the end of the first year, probing under the general anaesthesia can be operated. If the probing fails it can be repeated. If the duct cannot be loosen with the second probing the treatment will then be the surgical intervention after the age of 3 or 4.

What is Congenital Cataract? 

Cataract is the opacification of the eye lens which shall be normally transparent. Despite the fact that the cataract usually occurs in older people, it can occur in newly born babies or children as well. These types of cataracts are called as congenital cataract. They may occur in consanguineous marriages or in cases where the cataract exists in family history.

What is Conjunctivitis in Children?

There are various types of conjunctivitis as microbic and allergic. Their manifestate indications like dilution, blur, pruritus, irritation and rubor. It may become chronic if not treated timely. 

What are the Indications of Eye Disease in Children?

* Crossed Eye

* Eye lid lowereness

* Lacrimation

* Blurring 

* Panicula 

* Looking with one eye - closed

* Reading too closely  

* Watching TV too closely

* Squinting

* Missing the part s / he was reading 

* Using finger to track the part s / he is reading

* Low performance

* Head ache

* Dizziness

* Nauseation 

* Maladroitness 

* Oneirism

* Looking by inclining the head

* Scratchin eyes frequently

* Being unable to focus the sight by the end of first 3 months

* Parents shall evaluate the possibility of eye disease if a serious eye disease is recorded in the family history.

If any of above stated situations occurs child must attend to the eye examination as soon as possible.