Dr.Kasav is a child eye specialist in pune. A Pediatric ophthalmologist is an eye doctor who has specialized in diagnosing and treating the vision problems or conditions of children
Under guidance of Dr.Kavita Kasav who is a trained paediatric ophthalmologist (children’s eye specialist ] we have state of art infrastructure for paediatric eye care. Paediatric Ophthalmology & Squint Services
• Vision testing in pre verbal children with specially designed paediatric charts.
• Cycloplegic Refraction in Children
• Amblyopia (Lazy Eye)Treatment
• Childhood Cataract surgery
• Squint Evaluation & Correction
• Nystagmus (shaky eye) Treatment
• Retina check up of premature babies
• Watery eyes (Blocked lacrimal duct) surgery
• Ptosis (Lid Drooping)Surgery
• Special care for ophthalmianeonatorum cases
• Binocular & 3D vision testing
• Childhood allergy treatment
• Keratoconus Treatment with special lenses & C3R laser
• Congenital glaucoma treatment.
Cataract in a child
This is opacity in natural crystalline lens that can be seen even in a new-born baby .
If left untreated then it can cause permanent vision impairment.
Detail evaluation including dilated eye check up is done along with systemic evaluation by paediatrician to obtain fitness for general anaesthesia.
Cataract is removed surgically by phacoemulsification technique .
Decision of putting intraocular lens depends on age of the child &paediatric eye surgeon decidesabout the type & power of lens to be used.
Squint or strabismus
1. Misalignment of the eyes is a condition called squint or strabismus.
2. It can be congenital or acquired and can be classified based on the direction that eyeball is turned towards.
3. Convergent squint or esotropia –When both eyes are turned in wards
4. Divergent squint or exotropia-eyes are turned outwards
· Patient with squint may have
· Double Vision
· Loss of binocular vision
· Loss of steroaccity(3D vision)
· Abnormal head posture
4.Treatment Options
1. Prismatic glasses:-In selected cases of small angle squint with double vision ,we provide Fresnel prisms for the same.
2. Squint Surgery:-We do this surgery by the latest technique of fornix incision, to obtain best cosmetic results without any visible scar of eye .It is very safe & effective procedure to obtain alignment of eyes.
Amblyopia or lazy eye
What is Amblyopia?
Amblyopia means reduced vision in normal anatomical eye.
When does Amblyopia develop?
Amblyopia develops due to any of the following:
· Squint/strabismus (eyes not positioned straight)
· There is great difference in power of both eye (one eye focussing differently from the other)
· Cataract (clouding of the lens)
· Severe ptosis (droopy eyelids)
· PREMATURE BIRTH
· Heredity (parents with amblyopia or strabismus)
· Any disease that affects the eye.
Amblyopia develops during childhood .Children under 9 year of age whose vision it still
Developing are at a highest risk for amblyopia .Generally the younger the child the greater the risk.
Why Does Amblyopia Develop?
Amblyopia develops when one eye is turned as in squint .Two different pictures are sent to the brain. In a young child .the brain learns to ignore the image of the deviated eye and see only the image of better eye.
Similarly when there is difference in power of the both eyes, the blurred or defocused image formed by the eye with more power is avoided by the brain
For Retina to capture the objects, it needs adequate light and visual stimulus . This being absent in presence of cataract either in one or both eyes results in amblyopia .
High or moderate degree of refractive power present in both eyes when not corrected early and adequately also results in amblyopia.
What Should Be Done?
Amblyopia Can often be reversed,if detected and treated early. As soon as amblyopia detected, active measures should be taken to treat it.
Co –operation of the patient and parents is required to achieve good reduced vision or amblyopia becomes permanent and once it becomes permanent, vision cannot be improved by any means.
How is Amblyopia Treated?
The most effective way of treating amblyopia is to make the child use the amblyopic eye. Covering or patching the good eye to force use of the amblyopia eye may be necessary to ensure equal and normal vision .
This can be achieved by
• Prescribing proper spectacles to the patient found to have refractive error
• Removal of cataract when indicated
• Occluding the normal eye
• Surgery when amblyopia is accompanied by strabismus
Occlusion means closure of normal eye with a patch and this makes the child use the amblyopic eye. Occlusion is done from few hours to few days depending upon the age of patient, type and severity of amblyopia .
• Elder children can do reading exercises with patching of the normal eye at home .
Those patients who are doing patching need periodic fallow up which is decided by an ophthalmologist.
Though effect of patching is seen within few months ,Duration of treatment may extend from months to years.
Once the vision is improved up to the level of the normal eye.it has to be maintained by occluding the normal eye for few hours during critical years of age.
The ophthalmologist will decide whether or how long the occlusions should be continued. Loss of vision from amblyopia is preventable if treatment is begun early.
Nystagmus(Shaky eyes)
• Nystagmus is an involuntary, rhythmic to & pro movements of the eyes.
• It is seen in adults as well as children .
• It is caused due to retinal diseases, brain diseases or vision deprivation.
• It adults, it can start due to neurological diseases such as multiple sclerosis, cerebral strokes, brain tumors , certain drugs ,road accidents or certain ear disorders.
Treatment Options Include:-
• Simple spectacles or prismatic spectacles by including convergence to dampen nystagmus
• Oral & topical medicines
• Surgery in selected cases.
Watery eyes (blocked tear duct)
• It is due to blockage of nasolacrimal duct that drains tears from eyes to the nose.
• Child present with-
1. Watering & sticking of eyes
2. Swelling between nose & inner side of eye
3. Abnormal passage of tears through a opening on skin(fistula)
Treatment
• Antibiotic eye drops & lacrimal massage my help to cure the problem if performed correctly within year of age.
• For children more than 1 year, requires simple, effective & short procedure of probing.
• We may have to repeat probing in case of repeat block.
• In children more then 5-6 years of age we need to do DCR (Dacryocystorhinostomy) operation.
FACT ON PATCHING
- Patching is not a pleasant thing for a child.so initially the child will be reluctant to undergo it.
- In a young child, it is done for shorter periods initially and gradually the duration is increased to get better compliance.
- Acceptance is good as soon as vision is increased in amblyopia eye.
- Method of patching should be according to the interests of the child.
- Patch should be stuck directly on to the face over the eye.
- If the child wears glasses, the patch should still be placed on the face not on the glasses.
- Many children try to take the patch off. This problem usually disappears as the child gets used to wearing the patch.
- Elder children can be encouraged to read , and young children can be involved in playing some interesting games during patching.
- Patching schedule should be followed strictly.
- Patching should not be stopped abruptly. It should be tapered by ophthalmologists only.
- Regular follow up is must.