Astigmatism in a child: what is it, how to treat it

One of the congenital vision problems that every person faces is astigmatism in a child under one year old. It is quite difficult to identify it in a child who is not yet able to clearly describe his needs and nuances of sensations in words. But since physiological changes in the visual system occur by the age of 18-20, the key to health is early diagnosis and treatment of eye disorders using non-surgical methods. Astigmatism in a 1 year old child? What should I do and what should I pay attention to?

Description of the disease

Astigmatism is the inability of the eye to focus light on the retina. The reason is the altered shape of the eyeball. Depending on what caused the pathology, which part of the eye has undergone the greatest changes, and what image the patient receives, several types of disease are distinguished:

1. The cornea is curved. Visual defects are severe, the patient cannot obtain a clear image of either distant or close objects.
2. Disturbances in the lens are fraught with two types of visual distortions: myopia (myopic astigmatism) and farsightedness (hypermetropic astigmatism).
3. Depending on the number and type of lesions, a simple type is distinguished (one eye suffers), complex (both eyes suffer from the same problem), mixed (there are disorders in both eyes, but the type of disease is different).
4. The origin is distinguished: physiological (minor impairment, up to 1 diopter, goes away on its own during growing up), hereditary (genetic characteristics of vision were present in blood relatives), acquired (occurs as a side effect of certain bacterial diseases of the eyes, jaw or due to injuries) .

What is astigmatism in a child?

Astigmatism is the inability of the eye to focus light rays onto the retina to produce a clear image due to the irregular shape of the front surface of the eye (cornea).

Astigmatism in children is not a disease. Astigmatism, along with myopia (or myopia) and hypermetropia (farsightedness), refers to the so-called refractive errors of the eye. Very often, astigmatism is accompanied by myopia or hypermetropia.

Since astigmatism is not a disease, it is not treated (it is wrong to search on the Internet for an answer to the query “Treatment of astigmatism in children”), but is corrected (corrected) using special contact or spectacle lenses or surgically.

The use of these vision correction means allows you to obtain a clear image on the retina.

When does it appear?

Astigmatism can occur in a child at any age, as the child’s body (including the eyes) continues to develop. During the development process, a malfunction may occur, as a result of which the shape of the cornea becomes irregular.

The risk of astigmatism exists even in infants under 1 year of age. Many children have astigmatism from birth, which is why it is so important to have children's vision checked regularly.

Causes

The cornea of ​​a normal eye is spherical in shape. The spherical surface of the cornea ensures correct focusing of light rays and forms a clear image of the object on the retina of the eye.

With astigmatism, the shape of the cornea resembles the surface of a melon (the curvature of its surface in two mutually perpendicular sections is different). Light rays that form an image of an object are refracted differently when passing through such a cornea, and therefore the image turns out blurry.

Astigmatism in children is most often congenital, i.e. its appearance is predetermined by the genes of the child. The non-spherical shape of the cornea is a consequence of improper development of the child’s eye, the course of which is programmed genetically.

Astigmatism can also occur in a child as a result of eye injury and after eye surgery.

How to quickly check if your child has astigmatism at home?

1. Increase the size of the image shown. 2. Closing one eye, the child looks at the drawing from an arm's length distance. 3. Ask him if he sees some lines worse than others (some lines look lighter, others darker). 4. If so, he may need astigmatism correction. It is necessary to have your child's vision checked by an ophthalmologist.

Source https://www.optica4all.ru/index.php?option=com_content&view=article&id=1672&Itemid=385

Depending on the location of the foci, childhood astigmatism can be:

• simple,
• difficult,
• mixed.

Astigmatism options:

1. farsighted astigmatism in children;
2. myopic astigmatism in children;
3. mixed astigmatism in children.

Moreover, myopic astigmatism is called myopic astigmatism, and farsighted astigmatism is called hypermetropic astigmatism in children.

Source https://tvoelechenie.ru/oftalmologiya/astigmatizm-u-detej-lechenie.html

Classification of the disease

A disease in which there is a decrease in vision by more than 1 diopter is subject to urgent treatment. At the same time, age is not a contraindication to treatment, since independent “correction” of vision is recorded only in the range of 0.5-1 diopter. Classification of the severity of the disease in the early stages (until accompanying diseases appear) is carried out based on the severity of visual abnormalities:

• weak astigmatism – deviation up to 3 diopters;
• average – from 3 to 6;
• strong - more than 6 diopters.

It is worth noting that a baby may have congenital astigmatism of both weak and strong stages. The disease can progress only in less than 20% of cases. A form of progression of the disease can be the development of farsightedness or myopia.

Astigmatism: disease or feature?

People who have a focus disorder are not always aware of it. As long as the amount of astigmatism does not exceed 0.5 - 0.7 diopters, changes in vision do not occur. In this case, the person does not require special correction, and astigmatism is considered as a feature of the organ of vision.

In infants, astigmatism is considered physiological, and the presence of several focusing points of light rays is normal. The reason for this is the structure of the baby’s eye; a newborn is born with a convex cornea. The amount of astigmatism in a baby can reach 6 diopters, which is equivalent to severe pathology in an adult. Over time, the shape of the eyeball changes, and the severity of visual impairment decreases.

Astigmatism in an infant is not always considered normal; sometimes the condition may indicate a congenital pathology. To accurately determine whether the baby has a disease, it is worth showing the baby to a specialist. Dr. Komarovsky insists on early diagnosis of eye diseases in children, and recommends visiting an ophthalmologist starting from the age of 3 months. In this way, the doctor will be able to track the dynamics of changes that occur in the baby’s organ of vision and identify the disease in time.

Symptoms in one-year-olds

The direct responsibility of parents is to monitor the child. This is not about indulging whims, but about ensuring normal physiological and psychological growth. It is important, by carefully monitoring behavior, to identify possible deviations in health.

The reason for examining an ophthalmologist in the first 3 months of life is the presence in the anamnesis of any of the blood relatives of vision problems, difficult childbirth (including cesarean section), or illness of the mother during pregnancy.

After the sixth month of life, the following may cause concern:

• inability to concentrate vision on an object;
• nausea and vomiting when trying to move independently;
• unclear grasping reflexes (the child more often misses than reaches with his hand);
• when walking, he constantly looks at his feet and loses coordination;
• movements are constrained, timid, general physical activity is reduced;
• tilts his head from side to side when looking at something;
• squints;
• often cries, complains of headaches;
• there is a lag in development (inability to repeat a movement after someone, to recognize an object), low independent cognitive activity.

A direct survey of the child is not carried out, since the data obtained can be greatly distorted: the child will confirm or deny everything in order to attract attention to himself or not provoke manifestations of dissatisfaction on the part of the parents. In addition, the baby always sees the world in his own way, he just does not know that his vision may be impaired.

The list of these symptoms may indicate other diseases, but a trip to the ophthalmologist if at least 2-3 symptoms are detected is mandatory.

Causes of the disease

Often, astigmatism in a child under one year of age is a feature of its intrauterine development, although science knows the hereditary component of the disease.

In addition to genetic predisposition and physiological characteristics, it is worth highlighting children at risk who:

• there was injury to the cornea, eyelid, jaw;
• suffered a severe infectious disease in early childhood;
• there are other visual impairments, and astigmatism is just another consequence of a more serious disease.

It is difficult to foresee all risk factors. It is advisable that even a child without “eye” symptoms be examined by an ophthalmologist at the age of one.

Symptoms

Diagnosing astigmatism at such an early age is quite difficult. Firstly, the child does not understand that there is something wrong with his vision - after all, he initially sees the world blurry. And secondly, he is not yet able to clearly explain anything to his parents.

Children under one year old are often hung with all kinds of moving toys. This helps develop pupil accommodation and improve vision focusing.

The presence of astigmatism can be determined only by indirect signs, in particular:

• The child is irritable and often capricious (a reaction to increased fatigue and headaches).
• He often squints, brings toys closer to his face, or leans heavily over them.
• Regularly rubs his eyes and closes one of them.
• When studying new subjects, he shakes his head a lot, thus trying to find the optimal angle of view.
• Often bumps into furniture and people.
• Places objects past (the hands of those with whom he plays, the table or something else).

The optical system of a child’s eye is formed over 6 years from the moment of birth, and focusing is acquired only after six months of life. Therefore, diagnosing astigmatism at such an early age is almost impossible.

Diagnosis of the disease

Diagnosis of this disease can only be done in an ophthalmologist’s office, and not at home or at a pediatrician’s appointment.

A one-year-old child is diagnosed with astigmatism based on behavior and retinoscopy results. The total time spent on diagnostic procedures is no more than 30-40 minutes. Complex computer diagnostic methods are increasingly being used, making it possible to determine not only the type of pathology, but also the specific physiological changes that led to it, and the possible type of corrective methods.

Treatment of the disease

Astigmatism is one of the diseases that can be eliminated without surgery. The optimal means for correcting vision is glasses selected after careful research. With astigmatism, children 2 years old may have an increased interest in playing with glasses rather than simply wearing them. Moreover, the lenses have a fairly large volume and a specific curvature. It is advisable that parents patiently accustom their child to the adult form of treatment - glasses.

For astigmatism in a 2.5 year old child, additional means of correction can be nutrition and the use of vitamins and eye drops that reduce the feeling of tension in the eyes.

Gymnastics for the eyes

Daily eye exercises are another component of health. The task of looking at distant and close objects with both eyes, one eye at a time, will become a method of training the brain to receive a normal image, as well as a game. This will help with astigmatism in a child aged one and a half years or more. But if the child is older, additional measures are necessary.

Features of wearing lenses

From 8-14 years old, special lenses can be used to correct the shape of the eye. They wear them at night. The age of use is due to several reasons:

• Up to 6-7 years of age, defects associated with the size or shape of the eye are usually eliminated on their own.
• A child under the age of 7 years can rarely resist physical impact on the lenses (rubbing, displacement), which can lead to mechanical injury to the cornea.
• In primary school and adolescence, changes in the size and shape of the eye still occur, so this type of correction will help avoid surgical intervention after 18 years.

Treatment of concomitant diseases

Treatment also includes the elimination of concomitant eye diseases and training of nerve centers in the brain. The fact is that in the absence of treatment for astigmatism in a child of 3 years and later, the main brain stops qualitatively processing the information received from the eyes. The eyeball that produces a lower-quality image is blocked by the optic nerves and may completely lose the ability to receive and transmit visual information.

This disorder can be prevented by covering the healthier eye for several hours a day. In this case, the brain will have to compensate for the lack of information by more actively using the affected eye. The goal of such therapy is to prevent radical deterioration of vision and to maintain the diseased eye at a stable level of quality.

Causes of childhood astigmatism

The following main causes of this pathology in children can be identified:

• Both parents or one of them, grandparents suffer from astigmatism and can inherit this disorder to their children or grandchildren;
• Damage to the cornea, eye surgery;
• The presence of other diseases or eye conditions that contribute to the appearance of astigmatism.

For normal growth and development of the optical system, light must penetrate the eyes unhindered. If a child has clouding of the cornea (corneal dystrophy) or lens (cataract), not all light rays penetrate the eye and the image may be blurry. This interferes with normal eye growth and can lead to astigmatism.

It is most often observed in eyes with diseases such as albinism, retinitis pigmentosa, optic nerve hypoplasia, nystagmus, and keratoconus. These conditions themselves can cause blurred vision.

Drooping of the upper eyelid (ptosis) can sometimes cause astigmatism. The weight of the eyelid puts pressure on the eye and can cause the cornea to change shape, resulting in blurred vision.

But in most children, astigmatism is observed even when their parents are healthy and there are no other diseases that could affect its occurrence. This is the result of individual characteristics of the development of the eye even before birth.

Possible consequences of the disease

Astigmatism that is not treated promptly can lead to lazy eye syndrome, or strabismus. In 20 cases out of 100, there will be a permanent deterioration in vision in one or both eyes, up to complete loss of vision.

Lazy eye is the loss of the brain's ability to combine visual input from the eyes to produce a clear picture. Most often, attempts to cover, squint one eye, noticeable headaches, dizziness, and nausea are added to the existing symptoms.

Treatment consists of two parts: stopping further processes of loss of vision clarity, restorative therapy.

Strabismus is not just a cosmetic defect. Behind it is the lack of three-dimensional vision, systemic deterioration of vision in both eyes, and almost always a sharp decrease in image quality in the squinting eye. Treatment includes different techniques, depending on the type of disease:

• wearing glasses, lenses;
• laser correction;
• surgical intervention;
• constant physiotherapeutic procedures for the development and consolidation of binocular vision functions.

Farsightedness and myopia

Hypermetropic astigmatism in a 1-year-old child means poor vision at any distance. From a medical point of view, it is important to establish only the type of refraction and focusing of light beams in order to prescribe the correct treatment and wear lenses of the appropriate range.

Myopia always means poor clarity when distinguishing objects at a considerable distance, but, as with farsightedness, it is important to determine the degree of the disease. Lack of treatment for the last two pathologies is fraught with the development of strabismus and stable vision deterioration.

Early diagnosis of astigmatism in a child under one year old helps prevent severe complications in the functioning of the visual sensory system.

Diagnostics

A child suffering from congenital or acquired astigmatism as a result of injury, as a rule, does not complain of poor vision, since he has always seen it this way and does not know that it is wrong.
This factor complicates timely diagnosis. Astigmatism in children is detected only at an appointment with an ophthalmologist. Parents are advised to show their child to a doctor from the age of two months and, if the doctor diagnoses astigmatism, to visit this specialist every six months. To diagnose astigmatism, an ophthalmologist uses a special device - an autorefractometer. Symbol plates and a cylindrical lens are also used. Another examination method helps in diagnosing astigmatism - keratometry, which allows you to identify the degree of curvature of the meridians of the outer surface of the cornea.

In recent years, computer topography of the eye has become possible. This method allows you to create a three-dimensional image of the cornea of ​​the eye, which means you can more accurately assess the degree of curvature, shape and thickness of the cornea.

Prevention of disease development

Modern medicine is not yet able to correct birth defects. Planning a child from a genetic point of view will help reduce the risk. For example, the risk of having a sick child is higher in a couple where several generations have the same type of vision problems. If astigmatism can be traced only on the maternal or paternal side, then the risk of the disease in the baby is low.

During pregnancy, you should avoid exposure to chemicals as much as possible and eat a balanced diet.

Since astigmatism in a child under one year old can also occur under the influence of external factors, they monitor:

1. The quality of lighting in the room where the child spends the most time. The more natural sunlight, the better. It is unacceptable to use fluorescent lamps in a child’s nursery or workplace.
2. No postural disorders. Constant postures when playing or studying disrupt not only the bone component, but also the possibility of good vision.
3. The presence of different types of stress on the eyes. Constant contact with the phone, computer monitor (cartoons, games) must be alternated (if it is not possible to completely exclude gadgets) with walks in the fresh air, focusing on objects of varying degrees of distance.
4. Carrying out physical exercises for the eyes.
5. Timely treatment of infectious diseases.
6. History of neurological symptoms.
7. Timely correction of existing eye problems.
8. Complex vitamin nutrition for children.
9. Absence of factors directly damaging the eye.

Remember, astigmatism is a very serious disease in children. The baby will face trials and difficulties in everyday life if the parents do not diagnose the disease in time and do not take the child to the doctor. For prevention, it is important to visit doctors as planned for a medical examination from infancy. Under no circumstances should you ignore such visits to the clinic.

No preventive measures can guarantee 100% absence of astigmatism in a child’s history, but with timely treatment, this disease becomes a temporary defect and not a lifelong problem.

Symptoms of astigmatism in children

Astigmatism is quite often detected already in infancy, when the baby is not yet 1 year old. However, even at a later age, parents should carefully monitor the state of their children’s vision. You should consult a doctor immediately if your child exhibits the following symptoms:

• complaints about unclear images of objects;
• the child’s desire to tilt his head at different angles in order to see better;
• rapid eye fatigue and headaches;
• It is difficult for the child to focus his gaze.

Children under 3 years of age are often diagnosed with a mild degree of astigmatism. In the future, vision may improve without any correction. But the opposite can also happen - a worsening of the disorder and its complication by myopia or farsightedness. Therefore, it is extremely important to pay close attention to this issue and undergo timely preventive examinations by a specialist.

At the ARTOX clinic, you can always get advice from a qualified ophthalmologist, have your child’s vision examined and treated. Modern equipment and extensive experience of our doctors will help you solve vision problems.

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