Shaken Baby Syndrome

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Amniotic fluid problems

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Mastitis

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  • Shaken Baby Syndrome

    Tuesday, 21 July 2015 16:28
  • Amniotic fluid problems

    Thursday, 14 May 2015 12:54
  • Choosing a pre-school

    Friday, 10 April 2015 17:50
  • Newborn reflexes

    Tuesday, 03 March 2015 15:49
  • Mastitis

    Tuesday, 03 March 2015 15:41
  • Pelvic floor exercises

    Wednesday, 11 February 2015 17:20
  • Colic

    Wednesday, 11 February 2015 17:11
  • Antenatal Classes

    Monday, 03 June 2013 09:34
  • Strap-in-the-Future

    Thursday, 30 June 2011 13:52

Eye Problems

Discharging eyes

In infants, the problem of discharging eyes is usually caused by a blocked tear duct. By 3 weeks of age, most infants begin tearing. Normally, the tears drain from the nasal corner of the eyes into the nose via passages known as tear ducts. These ducts are covered by a thin membrane that usually breaks open shortly after birth, allowing tears to drain into the nose. In some babies, one or both of these membranes fails to open resulting in an accumulation of tears in the blocked eye. An infection may develop in the tear duct area and is evident when there is a yellow discharge from the eye. Treatment consists of gently massaging the affected tear duct for a few seconds, 6 times a day and the use of prescription, antibiotic eye drops. Massage exerts pressure on the fluid in the ducts and helps to open the membrane to allow for proper drainage. By 6 months of age, these ducts are usually open, if treated correctly (Leary, 1990).

 

A yellow discharge in babies or older children is usually a sign of infection, not only of the eyes but possibly of an underlying sinus, nose, throat or ear infection. If your child is irritable and has discharge of the eyes that is accompanied by cold symptoms, for example, it means that the problem is a cold. Medical attention is therefore required (Leary, 1990).

 

Conjunctivitis

Conjunctivitis, more commonly known as pink eye, is an inflammation of the conjunctiva – the  membrane lining of the white part of the eye – as well as the inner surface of the eyelids. Although pink eye may be quiet alarming because it makes the eyes extremely red and is highly contagious, it does not cause any long-term damage to the eyes nor to your child’s vision (Nemours, 1995-2010).

 

Causes

Pink eye can be caused by a number of bacteria or viruses, such as those that produce colds or other infections – including throat, ear and sinus infections – as well as those responsible for sexually transmitted diseases (STDs), like gonorrhoea (Nemours, 1995-2010).

 

Conjunctivitis as a result of an allergy is more likely to occur in children with an allergic condition. Grass, pollen, animal dander and dust mites are common triggers of allergic conjunctivitis. Environmental substances may also irritate the eye and cause pink eye; for example, chemicals (chlorine and soaps) or air pollutants (smoke and fumes) (Nemours, 1995-2010).

 

Symptoms

Symptoms of conjunctivitis vary from child to child and are also dependent on the type of pink eye they have contracted. The most common symptoms include:

·                Discomfort in the eye. Children often complain that it feels as though there is sand in their eyes.

·                Redness of the eye and inner eyelid, hence the term ‘pink eye’.

·                Itching or burning.

·                A clear or yellow discharge.

·                On waking in the morning, the eyelids may be stuck together.

·                Swollen eyelids.

·                Sensitivity to light that commonly occurs when conjunctivitis accompanies a viral illness, such as measles (Leary, 1990; Nemours, 1995-2010).

 

Treatment

If you suspect that your child has pink eye, it is important to contact your doctor to identify what is causing it and how to treat it. Viral pink eye generally goes away on its own, while bacterial conjunctivitis requires an antibiotic ointment or eye drops. Allergic conjunctivitis may be treated with antihistamines, either in a pill or liquid form, or as eye drops (Nemours, 1995-2010).

 

Styes

A stye is a pus-filled swelling that develops at the base of the eyelash or underneath the eyelid where it touches the eyeball. Styes are common in children and even though they are not dangerous, they can be very painful and uncomfortable (Collins, 2003; PaediatricPlanet.com).

 

Symptoms

·         A yellow head of pus on the eyelid, at the base of the eyelash.

·         A swollen, inflamed eyelid.

·         Tenderness to touch.

·         A sensation that there is something in the eye (Collins, 2003).

 

Causes

·                Eyelashes have oil (sebaceous) glands just below the skin to keep them healthy. Eyelids secrete mucus through other glands. This allows the lid to move smoothly over the eyeball. When the ducts of either of these glands become blocked, oil and mucus build up behind them, resulting in a painless inflammation. If the glands become infected, they will become more swollen, a stye forms, and it will become red and painful (PediatricPlanet.com).

·                Styes may develop as a complication of blepharitis, which is an inflammation of the eyelid edges; as a result of a viral or bacterial infection; seborrhoeic dermatitis, or an allergy (Collins).

·                Recurrent styes are common in children who frequently rub or pick their noses and then touch their eyes, thereby transmitting bacteria from their noses to their eyes (Leary, 1990).

 

Treatment

·                It is important to try get the blocked duct open. Do NOT squeeze a stye. To relieve your child’s discomfort, help the stye open and drain its contents, gently place a warm, moist cloth on the affected eyelid. Keep the compress on for 15-20 minutes and repeat 4 times a day. Ensure that you use a clean cloth and that it is warm, not hot. It is essential to continue the treatment until the duct opens and the infection drains.

·                Your doctor may prescribe an antibiotic ointment to treat the infection and prevent the stye from recurring.

·                In order to prevent spreading the infection, ensure that your child neither touches the infected eye nor shares a towel.

·                Styes can be prevented by washing the crusted eyelashes, especially upon waking in the morning, before eyelash secretions are able to build up, block the base of the eyelash hair and become infected (Collins, 2003; Leary, 1990; PediatricPlanet.com).

 

Cross-eyes

Strabismus, more commonly known as crossed or wandering eyes, occurs when there is abnormality in the direction of one or both eyes. When a child is focusing on an object and her eye turns too far in or out, it is known as convergent or divergent squint. In contrast, when the eye turns up or down it is known as a vertical squint (Collins, 2003; COVD).

 

It is quite common for your baby’s eyes to appear crossed or not perfectly straight at all times in the first 6 months. Your doctor will check this in the well-baby examinations. This occurs because she are still developing binocular vision, or the ability to use both eyes together as a team. If your child’s eyes are severely misaligned at all times or they remain cross-eyed after 6 months, your doctor may refer her to an eye specialist for further testing (EyecarePlus, 2002).

 

Young infants may appear to be cross-eyed when in fact they are not. Sometimes the distance between the nasal corners of the eyes is very prominent, especially when the bridge of the nose is very low or flat, or when some babies have very large irises (coloured part of the eye). These features combined, give the illusionary appearance of a strabismus problem because a large part of the white of the eye is not showing, especially the part closest to the nose. As your infant grows, the nasal bridge narrows, the iris becomes smaller and the eyes no longer have a cross-eyed appearance (EyecarePlus, 2002; Leary, 1990).

 

Causes

·                The condition may be caused by the brain’s inability to coordinate both eyes simultaneously and is therefore a neuromuscular problem. In other words, the problem lies in the signal between the brain and the muscles that control eye alignment. As a result, your child will fail to develop binocular vision or the ability to use both eyes at the same time.

·                A squint due to unequal refraction occurs when the eyes produce conflicting images. Your child or infant may over compensate, by tilting her head so that the lazy eye (amblyopia) can focus on the intended object, or she may mentally suppress the image produced by the lazy eye and use only the straight eye to see. As a result, the lazy eye becomes weaker and if the problem is not treated, it may result in permanent vision impairment.

·                Cross-eyes in infants is usually caused by a weakness in one of the eye muscles.

·                Pre-school children may develop strabismus due to an underlying vision problem. In the case of severe long-sightedness, the eyes adjust too strongly to near focus, forcing one eye inwards (COVD; EyecarePlus, 2002).

 

Treatment

Early recognition and treatment of cross-eyes is very important for several reasons:

·                Your child’s depth perception, balance and coordination may suffer because she has learnt to use only one eye at a time.

·                Severe squinting becomes a cosmetic issue; your child may become highly self-conscious and more prone to teasing by her peers.

·                Permanent vision problems, such as poor vision in the affected eye, or double or blurred vision (COVD).

 

Treatment may consist of patching the ‘good eye’ so that your child is forced to use the lazy eye, eye drops, prescription eyeglasses where necessary, eye exercises, or an operation on the muscles of the lazy eye. If treatment is provided immediately after a diagnosis is made, your child’s vision should develop normally (Collins, 2003; Leary, 1990).

 

Vision problems in children

Your child’s vision is determined by 3 things: the shape of the cornea or the covering of the eyeball over the iris, the shape of the lens and the shape of the entire globe. As your child grows and develops, her eye changes, as does her visual acuity. In metric terms, visual acuity is measured on a 6 point scale. A visual acuity of 6/6 is considered to be normal, i.e. your child can read at 6 m what the average child can read at 6 m. Similarly, if your child has a visual acuity of 6/10, she can read at 6 m what the average child can read at 10 m. Newborns have a visual acuity of approximately 6/100. A visual acuity of 6/6 is usually reached by the age of 6 but some children only reach normal visual acuity by the age of 8. By the age of 3 or 4, children are generally able to cooperate enough to undergo a visual acuity test at your doctor. It is important that the test is included in their annual physical examination because as they grow so do their eye structures and their visual acuity may therefore change anytime during childhood (Leary, 1990).

 

Some of the most common vision problems in children

 

Short-sightedness (myopia). Myopia is a refractory error that tends to increase significantly in incidence throughout the school years. It affects only 3% of 5-9 year olds, increases to 8% in 10-12 year olds and occurs in more than 17% of teenagers. A myopic child is able to see clearly up close but not in the distance. Early signs of short-sightedness include straining or squinting to see objects at a distance, like road signs or movie screens; less visual acuity at night; or constantly sitting close to the television set. Prescription lenses provide good vision but they may need to be changed periodically because the problem usually progresses during childhood and only stabilises at approximately 25 years (EyecarePlus, 2002).

 

Far-sightedness (hyperopia). Children who are far-sighted can see better at a distance than up close. This often has a significant impact on their school work. Symptoms of strain that commonly occur when trying to overcome long-sightedness include poor concentration when reading, fatigue, headaches, difficulty focusing or adjusting focus to do close work, aching or burning eyes, very close reading, nausea and irritability after sustained concentration. Prescription spectacles or lenses relieve the strain placed on the eyes due to hyperopia (EyecarePlus, 2002).

 

Astigmatism. Astigmatism is a distortion of the cornea or the shape of the eye. Usually the cornea is spherical like a marble but the affected eye is more like the shape of a grape. Astigmatism affects 2% of preschool and 3% of school-aged children. Symptoms of mild astigmatism include fatigue, headaches and discomfort. More severe cases may result in blurred or distorted vision (EyecarePlus, 2002).

 

Colour blindness. Colour blindness is usually an inherited vision deficiency that occurs primarily in males and involves the complete or partial inability to perceive certain colours. Red-green colour blindness is the most common (Leary, 1990).

 

How do you know if your child has a vision problem?

Most problems with visual acuity have a genetic basis. If one or both parents developed visual problems in childhood, it is important to make this information available to your doctor so that he can carefully monitor your child’s visual development. Signs that your child is having visual difficulties include excessive blinking or rubbing of the eyes, squinting, tearing, ‘tired eyes’, tilting the head to one side in order to see, stumbling in toddlers, constant headaches due to eye strain or at the end of the school day. Parents and teachers who are vigilant may notice that a child holds a book close to read, takes a seat close to the blackboard, or uses various visual contortions to read the writing on the board (Leary, 1990).