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Q & A

You child has to wear glasses consistently for a period of time and get used to wearing glasses. Children with poor vision will strain their eyes in order to see. This will lock the eye muscles into one position. It takes time for the child’s eyes to relax muscles and be able to see clearly with the new glasses. It will take about three to five days of constant wear for your child’s eyes to relax and become accustomed to the new glasses.

Other possibilities may be that your child has outgrown his or her prescription. Please have your child see Dr. Fazilat before allowing them to go without glasses. What seems like an obvious decision could result in long-term damage to your child’s vision.

Glasses are typically used to improve vision. However in many cases they may be used to keep the eyes straight. The purpose of wearing glasses could be different in each child.

There are many different causes of crossed-eyes. Some children’s eyes cross because they are farsighted.

Normal eyes can focus on objects at any distance. When a child is looking close he or she will flex a muscle that changes the shape of the lens and gives them the power needed to see close up. While looking at a close distance the eyes need to turn inward to stay aligned on the object. The brain determines how far inward the eyes need to turn by sensing how hard the lens muscles flex. This muscle will relax when one is looking far.

A farsighted person will often over-flex the lens muscle in order to see nearby objects clearly. This will cause the brain to believe the eyes are looking at an object closer than the actual location. The brain then turns in the eyes further than normal. This causes the eyes to cross.

A patient with this type of crossing will benefit from correction of farsightedness with glasses. This will relax the lens muscles and therefore the crossed eyes. Your child will probably need to wear their glasses constantly for a few days before he or she sees clearly through them.

As the child grows the eye will grow as well. This causes a change in the prescription of glasses. In fact many farsighted children have their prescriptions reduced over time and some even outgrow their need for glasses. However, nearsighted children tend to become more nearsighted over time whether or not they wear glasses.

The fact is that natural growth and changes of the eye occur independently of wearing glasses. These naturally occurring growth and changes of the eye cause the nearsightedness prescription to get higher as time passes. Wearing glasses or not has essentially no effect on the prescription of the eye.

  • While your child is lying down gently pull the upper eyelid up and pull the lower eyelid down.
  • Ask your child to keep both eyes open and look at something on the ceiling.
  • Give drops before ointment.
  • Drop one drop directly on the eye or just inside the lower eyelid, near the corner closest to the nose, and release the eyelids.
  • Wait a few minutes before putting another eye drop.
  • You may put an extra drop if you think the first drop did not get into the eye.
  • Apply a ribbon of ointment approximately ¼ inch long directly from the tube or place on your clean finger or a wet Q-Tip and apply. Pull the lower lid and place the ointment into the eye.
  • Showers and baths are okay, but do not submerge the eye in water or splash water directly in the eye for at least one week. You may put a clean, dry towel on the eyes while taking a bath or shower.
  • No swimming for two weeks.
  • Try to discourage rubbing on or around the eyelids.
  • You can have your child wear their glasses right after the surgery
  • We recommend that your child remain at home with you for one or two days following surgery. If your child is very active we recommend remaining at home for up to one week.
  • There are no restrictions on how your child uses his or her eyes: reading, television, or video games are all okay.
  • Limit activity to lighter activities and non-contact sports. NO gym class or roughhousing for at least two weeks.

Tears normally leave the eye through small openings on the edges of the eyelids. After passing through these openings, the fluid drains into the nose through nasolacrimal ducts.

Sometimes babies are born before these ducts are completely open. This causes excessive tearing and discharge from the eyes. Most children grow out of it.

However, if tearing continues it can cause irritation and infection leading to a permanent blockage called nasolacrimal duct obstruction.

Strabismus is defined by misalignment of the eyes. Strabismus is commonly known as crossed or deviated eye or “lazy-eye”. Lazy eye has many meanings to different people. To some it means a droopy eyelid while to others it means a deviated eye or poor vision in the eye. Strabismus is a condition in which the eyes are not properly aligned with each other. This occurs as a result of an abnormality involving the neuromuscular control of the eye from the brain and less commonly as an actual eye muscle problem.

It occurs in 4 % of the population. In order to use both eyes at the same time and fuse, both images from each eye should superimpose in the same location in the brain. This requires both eyes to be aligned. This is called binocular fusion. The perception of three-dimensional depth is called stereoscopic vision. This is considered to be the highest level of binocularity. We use our stereoscopic vision or depth perception in daily activities such as driving, threatening a needle, or walking up and down the stairs. Binocular vision develops during early infancy. Proper alignment during this time is important for normal binocular development to occur. If not, then strabismus occurs, which can lead to many vision problems including double vision, impairment of visual attention, depth perception problems and motor skills problems.

There are different types of strabismus. They can be constant or intermittent. They can be binocular or monocular. It can be present when both eyes are uncovered (tropic) or only when fusion is broken by covering one eye (phoric).

1) Esotropia/esophoria is when the eyes are crossed inward

2) Exotropia/exophoria is when the eyes drift outward

3) Hypertropia/hyperphoria is when the eye goes up

4) Hypotropia/hypophoria is when the eye goes down

Strabismus can occur at birth or later in life. Up to approximately 10 years of age children will be able to shut down the image from one eye and develop amblyopia. They will not complain of double vision. However, older patients will complain of double vision.

Diagnosis and treatment is done only by a pediatric ophthalmologist. Treatment can include glasses, use of prism glasses, eye exercises, treating amblyopia with patching, and/or strabismus surgery.

Patients should be evaluated by a pediatric ophthalmologist as soon as ocular misalignment is suspected. Earlier treatment is essential for better results and success, especially in children. If diagnosis and treatment is delayed, amblyopia leading to permanent vision loss may occur.

Amblyopia is a common ocular disease in children. It is one of the main reasons for permanent vision loss in children. It occurs in 1 to 3% of the population. It is commonly referred to as “lazy eye.” Lazy eye has many meanings to different people. To some it means droopy eyelid to others it means a deviated eye. In ophthalmology the term amblyopia means a decrease in children’s vision because of a vision problem that occurs in early childhood and disrupts normal visual development. Amblyopia can happen even when there is no problem with the structure of the eye. The decrease in vision results when one or both eyes send a blurry image to the brain. The brain then “learns” to only see blurry with that eye, even when glasses are used. Amblyopia should be treated early on by a pediatric ophthalmologist to prevent permanent vision loss.

There are several different types of amblyopia. This includes Strabismic amblyopia, deprivation amblyopia, and refractive amblyopia. All types of amblyopia will result in reduced vision of the affected eye.