| Singapore
has one of the highest rates for myopia (short sightedness)
in the world. A sad fact is that many of our young children
of school-going age are already myopic, or have some
other refractive error such as astigmatism (cylinder)
or hyperopia (long-sightedness).
Myopia in children is more likely
if one or more parent has it, and if the child reads
3 or more storybooks a week, as was found in a Singapore
study. If your child has a myopic degree that is increasing
at an alarming rate, it is best to see an eye specialist
for an assessment.
Atropine is a prescription eyedrop
that has been shown to reduce or stop the rate of myopic
increase. Atropine acts in the eye to dilate the pupil
and also temporarily relaxes the muscle that does the
near focusing. It is thought that this has an effect
on reducing myopia progression. The common problems
with atropine eyedrop usage include sensitivity to bright
lights, and the need to wear bifocal glasses for near
work. Atropine is usually prescribed as a nightly eyedrop,
but may be reduced to weekly administration on a Friday
evening (to minimize impact on schoolwork) to reduce
the occurrence of side-effects, with minimal loss of
effectiveness.
Squints (also called strabismus),
or misaligned eyes are not too uncommon a problem. Common
squints involve one or both eyes turning either inwards
(convergent squint) or outwards (divergent squint),
especially if the child is not concentrating at the
time. Sometimes, this may be associated with an eye
drifting upwards. A squint may be a problem in itself,
or may signal other problems with the eyes. It is best
also for an assessment by the eye specialist.
If a squint needs to be corrected,
strabismus surgery is usually a quick day-case surgery,
and is very successful. This can be timed for the school
holidays so that the child does not miss school. If
a squint is left uncorrected, it may affect the child’s
sense of stereovision and distance judgement, cause
one or both eyes to be “lazy”, and will
affect self-esteem because of cruel teasing in school.
If your child has a squint or an
uncorrected refractive error, such as astigmatism or
long-sightedness, early detection and intervention can
prevent the occurrence of “lazy eye” (or
amblyopia). Intervention has to be done generally before
the age of about 7 years, because corrections after
this age give much poorer results. A consultation will
establish the problem, and we will be able to suggest
an appropriate method of treatment for your child.
During the assessment, your child’s
eye alignment will be checked for a squint, vision will
be measured, and a degree assessment made. If the child
is cooperative enough, eye pressure measurement will
be also performed. Pupil dilation using eyedrops will
be done to thoroughly examine the retina. If required,
drops to relax the muscles of focusing will be instilled
to accurately measure the eyes’ power. This whole
process is a very complete eye exam, and may take about
2-3 hours. So please be patient with us, as we want
the best eye exam for your child. It is preferable not
to bring along other children who are not being examined
during that visit, as they tend to get restless during
this time.
Live Well Baby
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