COMMON EYE PROBLEMS IN CHILDREN

Most penetrating or lacerating injuries of the eye in children justify examination under anesthesia to avoid further harm to an uncooperative patient. The pediatrician in doubt should merely apply a sterile dressing and have an ophthalmologist examine the injury in hospital. Nonperforating injuries may result in severe bleeding 48 to 72 hours later; this may be averted by bandaging the eyes and maintaining rest for four or five days. Removal of foreign bodies should be followed by application of antibiotic ointment and patching to prevent contamination.Congenital stenosis of the lacrimal duct may clear spontaneously or through application of decongestants and sympathomimetic drops. More severe effects, especially infection, justify probing at six months or earlier. The operation should be done under general anesthesia, preferably in hospital.Acute conjunctivitis is best treated by local application of antibiotics or sulfonamides only. Chronic infections may be better managed with the addition of corticosteroids, which reduce local inflammation and control bacterial reaction. Bacterial study should be done only if empirical antibiotic therapy fails. Bacterial desensitization may be helpful. The same methods are effective in blepharitis, aided by hygienic measures. Corticosteroids are most useful in allergic inflammations.Refractive difference is difficult to test before a child can read, and apparent defects may be due to lack of cooperation. Marked inequality of the eyes may signify organic disorder. Strabismus, on the other hand, can be detected as early as 12 or 15 months and should be treated as early as possible by proper lenses, surgery, or both. Pediatricians and parents should be aware that many children appear to have strabismus because of wide epicanthi and deep-set eyes.