Eye Diseases

Lazy eye:
It is a pathological condition that develops in childhood, in which a defect occurs in one or both eyes, which leads to failure of properly stimulating the neural pathways between the eye and the brain, because of which vision decreases. If one of the eyes is infected, concentration in vision will be on the safe eye, and it is considered as one of the common vision problems in children and is one of the most common causes of vision loss among children.

Causes:
It can develop in a child due to other eye and vision problems. Here are some conditions that may cause lazy eye in a child:

• Strabismus: To avoid double vision when strabismus, the child's brain may ignore the image from an eye that is not focused straight ahead, but that can prevent that eye from developing properly.
• Refractive errors: These are disorders in which the eye is unable to focus light on the retina. These include:

1. Myopia.
2. Farsightedness.
3. Astigmatism (blurred vision).

The refractive error may be worse in one eye than the other in the child. When this occurs, the brain begins to rely on the less damaged eye and vision will not develop properly.

• Cataracts (white water): Some babies are born with cataracts, where the normally clear lens of the eye is cloudy, and this can prevent vision from developing properly in that eye.
• Droopy eyelid: Drooping eyelids can impede vision in the child's eye and thus cause lazy eye.

Risk factors.
Some children are born with lazy eyes, others develop it later in one of the advanced stages of childhood, and the chances of infection increase in children who:

• Were born prematurely (premature babies).
• Their weight was below average at birth.
• Family history of lazy eye in childhood or other eye problems and diseases.
• Developmental disabilities.

Symptoms:
It may be difficult to distinguish the symptoms of the lazy eye unless there is a clear symptom (such as: squint). Younger children (less than 3 years old) often do not realize that there is a defect in their vision, and if they manage to realize it, they may find it difficult to explain that defect. As for older children Age (3 years and above) may complain of their inability to see with one eye, and that they suffer from problems in reading, writing and drawing, but in some cases, parents may be able to notice the difference between the eyes and their movement, as the signs and symptoms include:

• Having a squint in the eyes.
• Staring intensely, closing one eye, or tilting the head while looking at things.
• Asymmetry of movement between the eyes.
• Move one eye in and out (horizontal movement).
• Weakness in perceiving the depth of objects and things around them.
• Difficulty knowing how close or far something is.
• Drooping upper eyelid.

When to see a doctor:
Treatment of lazy eye requires diagnosis and early detection of the condition, as treatment is most effective before the age of 6 years, and since the symptoms of lazy eye are difficult to distinguish for a child, it may not be diagnosed until the child undergoes his first eye examination, so parents should not skip any of the eye examinations recommended by the Saudi Ministry of Health, and if any of the above-mentioned symptoms are noticed on the child, he must see the ophthalmologist immediately without waiting for the date of the next eye examination. .

Complications:
When treatment is delayed or not received, a child may have vision problems for life. Treatment for lazy eyes is usually less effective in adults than in children, and they may end up with permanent vision loss.

Diagnosis:
As part of a normal eye exam, the ophthalmologist looks for signs of strabismus or eye refractive error disorders (myopia, farsightedness, or astigmatism), as well as divergence of vision between the eyes or double vision in both eyes, using dilating drops that may cause blurred vision for several hours or for a day. The method used to test vision depends on the child's age and stage of development:

• Children under 3 years of age (before beginning to speak): An illuminated magnifying device can be used; To detect cataracts in addition to other tests to assess the ability of an infant or young child to fix their gaze and follow a moving object.
• Children aged 3 years and above: They can be examined using pictures or letters to assess the child's vision where one eye is covered to test the other and then the other is covered.

Treatment:
Most cases of vision loss caused by a lazy eye can be prevented or reversed with rapid intervention and choosing the right type of treatment. Treatment for lazy eye includes:

1. Treatment of the main problem that causes lazy eye:

• Medical glasses: to treat nearsightedness or farsightedness while examining the eyes regularly or correcting strabismus.
• Contact lenses, but for older children.
• Surgery: to treat cataracts, drooping eyelids (eyelid corrective surgery) or some cases of strabismus (plastic surgery); To help the eyes work together better.

   2. Stimulate the use of the lazy eye to see by using:

• Eye patch: It means covering the healthy eye so that the lazy eye is forced to work, from two to six hours a day.
• Eye drops: They are used to darken the vision in the healthy eye and blur the vision in it, to encourage the child to use the lazy eye.
• Medical glasses if both eyes are affected by lazy eye at the same level.

Prevention:
The lazy eye cannot be prevented, but the resulting vision loss can be avoided. Therefore, it is important to monitor the child's vision habits and to maintain the periodic examination of his eyes at the time specified by the Saudi Ministry of Health. When the lazy eye is detected and diagnosed and treated early, it can be then most of the child's vision is preserved.