Astigmatism in children
The content of the article:
- Causes and risk factors
- Forms of the disease
- Degrees of astigmatism in children
- Symptoms
- Diagnostics
- Treatment of astigmatism in children
- Potential consequences and complications
- Forecast
- Prevention
Astigmatism in children is a complex violation of refraction of the eye caused by changes in the refractive properties of the lens or cornea associated with changes in their sphericity.
Translated from Latin, "astigmatism" means "lack of a single point of focus." This is an accurate description of the changes observed in this pathology - the inability of the refracted rays to focus at a single point. As a result, with astigmatism, children see the surrounding objects as blurry, with blurred outlines, and are forced to constantly strain their eyes to improve the clarity of the image.
Astigmatism in children is a frequent occurrence, but in most cases it has a small degree, no more than one diopter, so it does not have a particular effect on the quality of vision. Ophthalmic correction is only necessary in 10% of cases.
Pathogenesis of astigmatism
Causes and risk factors
With astigmatism, due to the irregular shape of the lens or cornea, the rays of light traveling along different meridians are refracted with different strengths. As a result, not one, but several foci are formed on the retina, and the observed objects look indistinct.
If astigmatism is not promptly corrected, then over time the child will develop amblyopia ("lazy eye disease").
Astigmatism in children is congenital and acquired. The congenital form of the disease is associated with violations of the sphericity of the lens or cornea, which is caused by genetic defects. Congenital astigmatism in children is often combined with other pathologies:
- fetal alcohol syndrome (fetal alcohol syndrome);
- congenital retinitis pigmentosa;
- albinism.
Acquired astigmatism in children develops as a result of damage to the structures of the organ of vision:
- subluxation of the lens with rupture of the zinc ligament;
- eyeball injuries, including surgical ones;
- cicatricial lesions of the cornea.
Another reason for acquired astigmatism in children can be a violation of the development of the dentition, leading to deformation of the walls of the orbit and, accordingly, the eyeball.
With astigmatism in children, in many cases, other ophthalmic diseases are diagnosed:
- myopia (myopia);
- congenital nystagmus;
- farsightedness (hyperopia);
- keratoconus;
- hypoplasia (underdevelopment) of the optic nerve;
- ptosis.
Forms of the disease
Astigmatism in children is both physiological and pathological. In physiological astigmatism, the difference between the refractive power along the two main meridians is less than one diopter. This condition does not require treatment, as it does not negatively affect visual function. The formation of physiological astigmatism in children is explained by the uneven growth and development of the eyeball.
According to the features of the refraction of light rays, two types of astigmatism are distinguished:
- Right. Throughout the entire meridian, the refractive power is the same. This pathology most often has a congenital nature and is often inherited.
- Wrong. The refractive power is different on different segments of the same meridian. The disease is practically not amenable to optical correction.
Correct, in turn, is subdivided into several types:
- simple myopic - one main meridian has myopic refraction, and the other has normal;
- simple hyperopic astigmatism in children - one main meridian with hyperopic refraction, and the other with normal;
- complex myopic - both main meridians have myopic refraction, but with varying degrees of severity;
- complex hyperopic astigmatism in children - both main meridians have hyperopic refraction expressed to varying degrees;
- mixed - one of the main meridians has myopic refraction, and the other has hyperopic refraction.
Degrees of astigmatism in children
By the difference in refraction of the two main meridians, the following degrees are distinguished:
- weak (the difference is less than 3 diopters);
- medium (difference from 3 to 6 diopters);
- high (the difference exceeds 6 diopters).
Symptoms
Astigmatism in young children can be suspected by the following:
- when looking at objects or images, the child narrows his eyes or tilts his head to one side;
- when walking, the baby often stumbles, falls, touches the corners of the furniture;
- the child often puts objects past the table surface;
- the child makes an effort to concentrate his gaze on a printed picture or text;
- trying to fix his gaze on any object, the child pulls the outer corner of the eye with his fingers.
How a child sees the world with astigmatism
At an older age, children with astigmatism complain of headache caused by high visual loads, diplopia, visual fatigue, distortion of the boundaries of visible objects. With astigmatism, children have poor vision of objects located at any distance from them. Prolonged eye strain causes irritation and fatigue.
Children adapt well to visual impairments, therefore, the diagnosis of astigmatism in them often occurs late, after the onset of complications (amblyopia, strabismus, delayed development of the visual system).
Diagnostics
Diagnosis of astigmatism is carried out during an ophthalmologic examination to assess visual function and eye condition. It includes the following methods:
- visometry;
- ophthalmoscopy;
- biomicroscopy;
- ultrasound examination of the eyeball.
The diagnosis of astigmatism is made during an ophthalmological examination of the child
To assess refraction, perform:
- computer keratotopography;
- keratometry (ophthalmometry);
- autorefractometry;
- skiascopy (shadow test) with cylindrical or spherical lenses.
Based on the data obtained, a conclusion is made about the presence of astigmatism in children, the form and degree of the disease, and possible complications are determined.
Treatment of astigmatism in children
Astigmatism in children is treated with conservative methods, since refractive operations (keratotomy, laser correction of astigmatism) are contraindicated until the end of the growth and development of the eyeball.
Mild astigmatism not complicated by myopia or hyperopia does not need correction. In all other cases, corrective glasses or soft contact lenses are selected.
Children with astigmatism are shown wearing corrective glasses or contact lenses
Contact lenses provide better focusing of the image on the retina. Unlike glasses, they cannot break and injure a child. However, when wearing contact lenses, you should carefully follow the rules for caring for them, since otherwise serious complications may develop that threaten the complete loss of visual function. In this regard, contact vision correction for astigmatism is usually prescribed for older children who are able to responsibly take lens care.
Orthokeratology (OK) therapy is used to treat astigmatism in children who refuse to wear corrective glasses or contact lenses. Its essence consists in wearing hard gas-permeable contact lenses, which are put on the child's eyes before going to bed and removed in the morning after waking up. This leads to a gradual correction of the corneal shape and improved vision. OK-therapy is effective only with mild astigmatism in children (no more than 2 diopters).
Wearing glasses and contact lenses only eliminates the existing refractive error and improves visual acuity and quality, but does not lead to the cure of astigmatism. It is possible to completely get rid of this pathology only with the help of surgical intervention, but it cannot be performed before 18 years of age.
Potential consequences and complications
In the absence of timely treatment of astigmatism in children, there is a high risk of complications:
- persistent headaches;
- dizziness;
- amblyopia;
- strabismus.
The lack of vision correction in astigmatism leads to a significant increase in visual stress. As a result, children quickly get tired, become irritable, conflicted, and their academic performance decreases.
Forecast
With congenital astigmatism in children, the manifestations of pathology decrease with age in 31.1% of cases, increase in 26.1%, and remain unchanged in 42.8%.
Children with astigmatism should be monitored by an ophthalmologist. They need to undergo an ophthalmologic examination at least twice a year. This is due to the growth and development of the eyeball, respectively, and refraction changes. Regular check-ups allow you to adjust the treatment by timely replacement of contact lenses or glasses.
Prevention
Prevention of congenital astigmatism has not been developed, since the exact cause of its development has not been established. To prevent the development of the acquired form of astigmatism, children need:
- avoid significant visual stress;
- perform special exercises for the eyes;
- lead an active, mobile lifestyle;
- eat properly.
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Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
