Parents Should Get Schooled on Back-to-School Eye Care

Allan M. Eisenbaum, M.D., a pediatric ophthalmologist at Texas Tech Physicians of Lubbock Eye Clinic and an associate professor of the Texas Tech University Health Sciences Center Department of Ophthalmology, said to check out these symptoms of eye problems that should raise your suspicions.

Discharge
This often signifies an infection. Pus-like discharge is more common with a bacterial infection, while a watery or ropey discharge occurs more commonly with allergy. A clear discharge may occur with viral infections.

Pinkeye
A generic term that describes the white of the eye being red because of inflammation of the conjunctival tissue overlying the white of the eye and back of the eyelids. Like fever, this is a nonspecific term that does not address the cause of inflammation. There are multiple causes, including infection. In school-age children, it is not uncommon for a virus to be the cause. This is the pinkeye that is quite contagious when caused by adenovirus. While contagious, children with adenovirus should be removed from school. Contact with them should be minimal, particularly by anyone who has a compromised immune system. In preschool children infection-causing pinkeye is usually bacterial and responds well to the appropriate antibiotic. Viral infection does not respond to antibiotics. Bacterial conjunctivitis is usually limited to several days, while adenovirus can last two weeks or more.

Eye Misalignment
Eye misalignment or lazy eye can be obvious or quite subtle. There may be limitation in how far one or both eyes move. The child may adopt a head position to compensate for the misalignment. Squinting may also be present. Expect a child to have well-aligned eyes that move together over the full range of motion after two to three months of age.

Squinting
Children with eye misalignments may squint to avoid double vision. Other children squint because light causes pain in an inflamed eye. The most common cause for squinting is an uncorrected nearsightedness, requiring glasses. Expect both eyes to be equally wide open.

Tearing
Blocked tear ducts are the most common cause of excessive tearing in children but other causes are light sensitivity, allergy, a scratched eye or foreign body.

Eye Rubbing
This can be a symptom of allergy or habit. Chronic eye rubbing can be a concern because it can damage the cornea, the clear part of the eye. Some children who are blind or nearly blind rub their eyes to stimulate flashes of light.

Droopy Eyelid
Medically known as ptosis, this usually occurs on a congenital basis. It may be mild to quite severe. Causes include a weak muscle in the eyelid or sometimes a tumor in the affected eyelid. A droopy eyelid can be associated with poor vision and therefore needs evaluation. Possible treatments include glasses for nearsightedness and astigmatism, patching of the sound eye and surgical correction.

Blind or Nearly Blind
Besides rubbing their eyes, affected children may have a tendency to stare into bright light and wave their hands in front of their faces to contrast light and shadows. Another concern is the child who cannot navigate in a darkened room. This could be a form of night blindness.

Jiggling or Dancing Eyes
This occurs in a small percentage of children. These unstable eye movements are known as nystagmus. Nystagmus may interfere with vision or be associated with poor vision. Nystagmus needs to be evaluated promptly because it not only affects vision but also could be associated with systemic disease.

Abnormal Appearance of the Pupil
Instead of a normal black pupil in the center of each eye, the pupil turns white. Leukocoria is the term for a white pupil. This is a serious condition because it is caused often by problems that can seriously affect vision, like a cataract, or even cancer inside the eye of an infant. Abnormalities of the shape of the pupil also can occur and need to be evaluated.

“Be aware of your children’s vision and be vigilant for eye problems in our young ones,” Eisenbaum said. “Prompt evaluation of suspected eye problems and appropriate treatment when indicated will help maintain the sparkle in your child’s eyes this new school year.”