Infants don’t necessarily seem like the most obvious candidates for an eye exam. They’re young, growing, and years away from the age-related vision disorders we spend so much time talking about on this site. However, even though they might not have the same worries about macular degeneration that you do, there’s still a wide range of eye issues that newborns are at risk for, and the only way to catch an awful lot of them is to go ahead and schedule that eye exam.
All About ROP
The first, and arguably most serious, disease that infants are checked for is retinopathy of prematurity, or ROP. ROP, as you may have guessed from the name, is a major threat to prematurely born children, particularly those who have received oxygen, and those who arrive with a low birth weight, various infections, or cardiac defects.
ROP occurs after tiny blood vessels in the eye grow abnormally. In normally delivered babies, these blood vessels are developed by the time a child is born; however, premature babies often arrive with the process incomplete. New stresses in the environment (such as oxygen-rich or oxygen-poor conditions) lead to those abnormally growing vessels. Scar tissue also forms, which can contract and, in serious cases, lead to detachment of the retina.
If there’s reason to believe that a baby might be at risk for ROP, most hospitals will have them examined by an experienced opthalmologist within the first four weeks of life, with subsequent monitoring – ROP can progress extremely quickly, and any interventions have a better chance of success if undertaken immediately.
Children who are diagnosed early have a solid chance of beating the disease. Treatment generally involves use of a solid state laser to cauterize the abnormal vessels. Cryotherapy, which involves using a probe to freeze and destroy the vessels, has largely fallen out of use, but is still practiced when laser coagulation isn’t an option.
Crossed and Lazy Eyes
Most children are actually born with at least slightly crossed eyes and aren’t exactly experts at focusing. While most will generally be on track by around four to six months of age, some children will still have misaligned eyes, a condition known as strabismus. If detected early on, strabismus is relatively easy to manage with the use of corrective lenses.
However, if allowed to progress, it can eventually result in amblyopia, or lazy eye. Amblyopia occurs when the brain corrects for misaligned eyes by prioritizing information from one and partly ignoring information from the other. Amblyopes generally suffer from poor depth perception, reductions in visual acuity, and several other vision disorders.
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Other Neonatal Threats
Eye infection is also a danger for newborns. Neonatal conjunctivitis occurs when a baby’s eyes are exposed to strains of various bacteria, particularly gonorrhea or chlaymidia, during passage through the birth canal. The resulting infection generally presents in the first month of life, and results in inflammation of the conjuctiva, which causes further problems for a baby. Non-infectious conjunctivitis is rarer, but can occur if a baby’s eyes are treated with silver nitrate, a common preventative measure against infection.
Some children are also born with their tear ducts (the passages responsible for carrying tears from the eye to the nose) blocked. The condition isn’t quite as grim as some of the others discussed in the article, and generally clears up on its own by the end of the first year of life. However, it can cause uncomfortable, excessively teary eyes and does increase the risk of eye infection. If blocked ducts are diagnosed early, your physician may recommend lightly massaging the inside of a child’s eye to help open the ducts.
And, surprising as it might be, some newborns do encounter diseases that we generally think of as being later-life onset. Cataracts, or clouding of the eye, occur in around .4% of newborns. Causes include infections affecting a pregnant mother, such as measles, rubella, influenza, or syphilis, use of tetracycline antibiotics, and inherited tendencies.
Surgery, which can be performed very early in a child’s life, is generally required to treat more extensive cases. Post-surgery use of corrective lenses also helps ensure that a baby’s vision develops normally.
Glaucoma is, again, a disease that we might normally associate with old age, but primary congenital glaucoma does affect a small percent of newborns. The causes and risk factors of the disease are poorly understood, making a thorough eye exam the only way to catch and diagnose it. If it is diagnosed early, the prognosis is relatively positive, with 80 to 90% of children coming through with no major later changes to vision.
An eye exam can also turn up other, secondary issues. Osteogenesis imperfecta isn’t exactly an eye disorder – it’s actually a disease primarily characterized by extremely brittle bones and defective connective tissue. However, an eye exam early in life can help detect OI early, as sufferers’ eyes have a characteristic blue tint that can alert doctors to the disease.
You don’t want to take chances with your baby’s vision. Most problems, if detected early enough, can be taken care of easily and quickly. Scheduling an eye exam for your infant is the first step in a long life of healthy, happy eyes.