Astigmatism in children: causes, symptoms, treatment

The optical system of the eyes, like most systems and organs, goes through the stage of the final formation in the first years of life of a newborn child. If the behavior of the child or parents is wrong, the probability of developing and progressing in the baby of some visual defects is great. In this article, we'll talk about astigmatism in children: what it is, what symptoms of the disease and how to treat it.

Definition of disease

The human eye is a perfect optical system, but its good functioning depends on many factors. The most influential on the quality of visual perception is the refractive media: the cornea, the lens, the vitreous. If changes occur in any element of the optical system, the image transmitted to the brain is distorted and a visual defect arises.

With astigmatism, there is not only a shift in the focus within the eyeball (as with myopia) or beyond it (as with farsightedness), but also there is a defocusing of images on different eyes.

As a result, the light rays do not converge at one point, but are projected onto the retina in the form of different points and even segments, circles, ovals. The image turns out to be indistinct, blurred, and it concerns not only distant, but also close objects.

Most children are born with a certain degree of astigmatism, but by the end of the first year of life, it is reduced to natural limits with an index less than 1 D.This astigmatism is observed in 85% of the entire population of the planet and, as a rule, does not cause discomfort, since in ordinary life it is almost invisible. This kind of visual defect is called physiological, it is stable throughout life and is not subject to treatment.

However, the remaining 15% have a significant degree of astigmatism, which does not decrease, and in some children even progresses, and therefore requires mandatory correction.

Causes

In the overwhelming majority of cases, the cause of developing astigmatism in children is a hereditary factor.If close relatives have such a visual defect, parents should be extremely cautious, since the likelihood of impaired visual perception in the baby is high. Just like the shape of the nose or ears, distortions in the cornea or lens, as well as the altered dimensions of the eyeball can be transmitted genetically.

However, in more rare cases, such a phenomenon can become acquired under the influence of a number of unfavorable factors:

• Traumatic damage to the cornea or lens;
• Postponed operations on the eyes;
• Development of certain diseases or conditions of the eyes that promote astigmatism: corneal dystrophy, cataract, albinism, retinitis pigmentosa, nystagmus, keratoconus, etc.

Astigmatism can occur as a complication in a child who has undergone the pathology of the dentoalveolar system followed by deformation of the orbit wall.

Symptoms

The most effective treatment is the early life of the baby.Therefore, it is recommended to undergo regular check-ups at an ophthalmologist. Although the diagnosis of a small child presents some difficulties, nevertheless, there are methods that allow the conclusion to be made with a sufficient degree of accuracy. Parents may suspect the onset of astigmatism in a child on the following grounds:

• The kid touches the corners of the furniture while walking;
• It causes certain difficulties such simple actions, as, for example, put a cup on the table;
• The child does not like to consider small drawings, does not want to learn to read or write, although usually young children are happy to consider everything new;
• The baby has headaches and dizziness, and it can be suspected by capricious behavior, as well as the reluctance to engage in interesting for the child his age affairs: drawing, modeling, "reading" books. Often parents perceive this as a sign of laziness, meanwhile this is due to poor health.

A characteristic sign of the child's visual defect is the squinting, as well as the viewing of objects from different angles with the inclination of the head in an attempt to get a clear image.

Depending on the symptoms present, the following forms of the disease are distinguished:

• Plain- presence of myopia or farsightedness in one eye;
• Complicated- the same defect is present in both eyes;
• Mixed- in one eye, hyperopia is diagnosed, and in the other - nearsightedness.

In addition, astigmatism is distinguished between cornea and lens, physiological and pathological (more than 1 D), congenital and acquired.

Possible complications

Since the eye's optical system in the child is still in the development stage, astigmatism treatment should be started as early as possible.In this case, it is possible to achieve the best results.

If the parents for some reason did not find a defect in time or the treatment was not performed correctly, the child's chances of developing serious complications are high:

• Amblyopia (lazy eye)- if the focus is disturbed, two uncombined images enter the visual analyzer. The brain can not combine them into one voluminous picture, so the functioning of one eye is suppressed, as a result, it begins to see worse - "lazy
• Strabismus- can develop with prolonged attempts of the child to get a clear image. In this case, the baby can resort to various methods - squinting, sloping the head, keeping the eyes in one place. If parents do not notice on time and do not resort to treatment, the likelihood of the child developing a friendly strabismus is great - when he reduces his eyes to the nose;
• Postoperative complications- may occur during surgical treatment by creating incisions or scars on the cornea. However, with the regeneration of tissues, the initial form is restored, and the visual defect is returned. More promising are methods of replacing the lens or installing a phakic lens, providing a lasting effect for many years.

In addition to purely physiological problems, the progression of astigmatism affects the child's mental development, causing him a sense of insecurity and discomfort. In addition, the headache when trying to focus the image often becomes the cause of a bad mood. These factors invariably slow down the development of the baby.

Treatment

To develop the correct treatment tactics, the suspicion of astigmatism is checked by the method of sciascopy (a shadow test), which can be carried out even in infants, and is based on the appearance and movement on the retina of the shadow from the mirror directed doctor.

However, usually an examination for astigmatism is carried out at 3 years of age, when the baby can already cooperate with a doctor. At the same time, it is possible to conduct other research:

• Visometry- Consideration of various sizes, allowing to determine visual acuity;
• Ophthalmoscopy- examination of the structures of the fundus;
• Slit lamp researchallows to increase the image of internal structures several times and to note possible minor lesions;
• Computer refractometry- allows to determine the degree of astigmatism;
• Keratometry- A method for determining the degree of curvature of the cornea.

  Conduction of ophthalmoscopy

Medication Therapy

Since astigmatism is not a pathology in the usual sense of the word, but a kind of vision defect, the main way to treat it in childhood is to correct, without the use of medication. Exceptions may include preparations for moisturizing the conjunctiva and vitamins for the eyes.

Correction methods:

• Glasses.This form - the most common in the treatment of child astigmatism. For the correction of vision in childhood is produced a huge number of very different glasses with a variety of design options and the choice of lenses. Glasses can be with elastic bands for very small ones and with lenses made of polymer glasses with reduced trauma;
• Contact lenses. The huge variety and aesthetic side of the case give the lenses an advantage over glasses when it comes to older children. However, it is possible only when the child reaches a certain age, when he will be aware of his responsibility when using this correction method;
• Hardware treatment- the use of a number of specially designed instruments. The courses of hardware treatment are held regularly at least once every 3 years, as prescribed by the doctor. The course of treatment lasts up to 10 days, each procedure - at least an hour, providing for the passage of at least 4-5 devices for the appointment of a doctor with constant control of the effect of treatment.

Additional measures include physiotherapy, a certain diet (on the recommendation of a doctor), performing gymnastics for the eye muscles, and observing eye hygiene.

Surgically

Operative methods are used in children only after 16 years of age when conservative methods have not yielded positive results. An exception may be cases of too rapid progression of the disease.

Surgical intervention can be carried out by several well-tried methods:

• Keratotomy- correction of the curvature of the cornea by the method of applying several incisions, reducing its curvature;
• Thermokerukoagulation- Increase the curvature of the cornea by touching a heated needle, as a result of which it "rises". Used for hypermetropic astigmatism;
• Laser thermokeratoplastyCorrection of the curvature of the cornea in the direction of increasing the application of burns by means of a laser beam;
• Conductive keratoplasty- the procedure is the same, only burns are applied by radio-frequency radiation;
• Photorefractive keratoectomy- the most accurate method that allows you to adjust the thickness of the cornea, even in the thinnest places;
• LASIK method- correction of the thickness of the cornea with a laser beam by cutting off excess layers;
• Implantation of phakic lenses- The method consists in placing special lenses in the anterior or posterior chamber of the eye;
• Keratoplasty- Replacing your own cornea with a donor or artificial implant.

  Thermokeratoplasty with laser.

The postoperative period lasts no more than 2 hours - during this time vision should be restored completely. However, protect your eyes from harmful effects for at least six months: avoid overexertion, physical activity, harmful effects (baths, swimming pools, ultraviolet, cold, friction).

Prevention

If your child has congenital astigmatism, then it is impossible to prevent the appearance of a defect. But to protect a baby from an acquired defect or its progression preventive measures may well be:

• Correct lighting. When practicing, make sure that the lighting is to the left of the child, not too bright or dim, avoid overlapping day and artificial lighting, as well as an illuminated screen (computer, telephone, TV) in the dark room;
• Elimination of overvoltage. For lengthy sessions at the computer, teach the child to take regular breaks, filling them with physical exercises and gymnastics for the eyes;
• Balanced diet. Eating of eye structures is an important moment in preserving vision, so try to saturate your baby's diet with natural vitamins and drug stores.

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conclusions

Astigmatism in children does not always grow into an adult problem, but one should not lose vigilance. Preventive examinations at the ophthalmologist should be carried out regularly. And even if the baby had minor deviations in the preschool period, when entering the school it is necessary to strengthen control and give maximum attention to prevention - this will help to avoid not only astigmatism, but also some other problems with sight.