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DOCTOR AT THE DESK

Eye See You

"Understanding myopia"
By: Lourdes Nena A. Cabison-Carlos, MDEye See You

During check-ups, mommies and daddies would usually ask for referral to eye doctors because “Jun-jun sits too close to the TV” or that “Hazel has difficulty reading her books”. Malabo ata ang mata, doktora.

One of the more common causes of eye problem and concurrent use of prescription eyeglasses is myopia or near sightedness. Recent research has shown an increase in incidence in myopia in developing countries. Speaking in non-technical terms, myopia or near sightedness is a visual condition in which people can see close objects clearly but far objects appear blurred. Children are physiologically hyperopic (farsighted) at birth, but premature babies are usually myopic with some degree of astigmatism.

As parents and caregivers, we should watch out for possible signs of myopia. These can manifest as:

·         Difficulty in seeing the blackboards at school

·         Sitting close to the TV

·         Squinting/ blurring of vision for distant objects

Sometimes, the child may complain of headache or eyestrain usually in the afternoon, but these can occur with other visual problems like astigmatism as well.

Diagnosing myopia

Every clinic visit is an opportunity to diagnose myopia and other visual problems. According to Dr delos Santos, formal evaluation for healthy children should be done at birth, 6 months, 3 years and 5 years of age. For infants, the doctor usually observes for your baby’s ability to fixate and follow an object. Preschool children may be tested using the tumbling Es and for those who know the alphabet, the Snellen chart (as what is used for adults). If a child is diagnosed to have an error of refraction, treatment is usually needed to avoid the development of ambylopia or “lazy eye”.  

Children who are “high risk”, meaning those with genetically inherited visual disorders or those who have systemic diseases such as diabetes, should be seen periodically by an ophthalmologist.

Treatment

There are several treatment options available for children with myopia. Among them are:

·         Corrective eye glasses. The most common choice for correction. According to Dr delos Santos, corrective glasses should be reassessed for possible adjustment of grade every 6 months to 1 year.

There are several things you have to consider when choosing the right eyeglasses for your child, but the most important thing is to have an exact and accurate grade. Because a child’s eye is different from an adult, Dr. delos Santos recommends visiting an ophthalmologist rather than doing a quick stop at optical shops.

·         Contact lenses. Discuss with your ophthalmologist about the pros and cons of using contacts in children (usually for teenagers).

·         Non-surgical/ surgical options such as the following should be discussed thoroughly with your doctor:

o   Corneal refractive therapy. This is a non-surgical procedure where the patient wears a series of rigid contact lenses to gradually shape the surface of the cornea.

o   Laser procedure like LASIK. Dr. delos Santos says that this is usually reserved for patients at least 18 years and above

o   Intraocular lens implantation

o   Vision therapy

According to Dr. delos Santos, ambylopia is the most common cause of impaired vision in children and if left untreated, can lead to the child being legally blind. And so while we are on the topic of visual health, let us segue to childhood blindness.

Childhood blindness refers to a group of diseases or conditions that occur in childhood or adolescence, which can lead to blindness or severe visual impairment. These conditions, if not addressed early on, are often untreatable later in life. The causes of childhood blindness vary, and they are mostly dependent on socioeconomic status and access to health care services. Moreover, the WHO approximates that 1/3 of the world’s blind children live in the poorest regions of Asia and Africa.  The usual culprits for these areas are corneal scarring from measles, vitamin A deficiency, cataract resulting from maternal rubella infection, and using harmful traditional eye remedies.

Prevention

Although there are no eye centers that cater mainly for children in our country, there are several hospitals that have eye centers which offer pediatric ophthalmology services such as the PGH, EAMC, Ospital ng Maynila and PCMC. The National Committee for Sight Preservation is a non-profit organization composed of various private and public agencies that aims to prevent blindness and promote eye health. Again, prevention, early detection and appropriate treatment are important factors in the campaign against blindness. These include the following:

·         Intensive information campaign for EVERYONE (parents, teachers, caregivers including primary health care providers) especially in remote areas.

·         Efficient and effective coordination of eye care services for those indentified to be at risk or with current visual problems.

·         Creation of a national registry for the blind and visually impaired to make the delivery of services and benefits easier and organized.

At present, our country has a vitamin A supplementation program that goes hand in hand with the immunization program. Studies have shown that measles vaccination has reduced the prevalence of eye complications.

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