A squint (or Strabismus) is where the eyes are not aligned together so that when the patient looks straight ahead one or both eyes are either inturned (convergent) or out-turned (divergent) or can be higher or lower than the other eye. The patient may experience double vision and not appreciate 3D vision.
Assessment is made by the orthoptist and ophthalmologist and various treatments can be suggested, i.e. glasses, patching, surgery and/or botulinum toxin injection to the eye muscle.
Amblyopia is a condition where one eye sees less well than the other. This can sometimes be associated with other conditions such as squint/strabismus or cataract. Treatment for this is usually in the form of patching of the good eye. Sometimes dilating eye drops are used instead of patching.
A cataract is a lens that is not clear. The lens may be cloudy or totally white. There may be fine dots throughout a lens or a blob at the front or at the back of the centre of the lens. Cataracts in children are rare, occurring in 3-4 per 10,000 births per year. If a baby is born with dense cataracts it is usual to try and operate on these within the first 8 weeks of their life. This is so that the child can get the best opportunity for vision development. Surgery is in the form of removing the cataract, under general anaesthetic, and, depending upon the age and condition of the child, an intraocular lens is inserted. The child would still have to wear glasses or contact lenses.
Other cataracts are slow-growing which may never require surgical intervention.
Cataracts occurring in later years of life can cause blurring of vision and difficulty with reading and doing daily tasks. Surgical removal of the cataract with insertion of an intraocular lens is the main option. This is mainly done under local anaesthetic. The patient may still require corrective lenses i.e. glasses or contact lenses.
A chalazion, also known as a meibomian cyst, is a common condition affecting the eyelid. The fluid-filled swelling (cyst) is usually felt as a small lump. Occasionally, it can become infected. It is caused by blockage of a gland in the eyelid. If it is causing problems and does not settle on its own, it can be removed with a small operation.
Excessive watering or sticky eyes in babies from birth may be due to blocked tearducts rather than infection. This can be due to the tearducts being small and ‘squashed’ behind the nose. No treatment is required for this, just massage of the lacrimal sac and keeping the eye clean. If the symptoms haven’t settled down by the age of 15 months then surgical treatment, in the form of syringing and probing of the tearduct may be required. This would necessitate the child having a general anaesthetic.
Retinopathy of prematurity can occur when babies born prematurely develop abnormal blood vessels within the eye. Careful and regular eye examination of these babies is undertaken and in some cases treatment in the form of laser surgery is required.