Pediatric ophthalmology

Good vision - the most important condition for a full life of every child.

According to the statistics of the Ministry of Health, in the last 10-15 years the number of children suffering from different diseases of the eyes (myopia, hypertropia, strabismus, astigmatism, amblyopia, etc.) has increased.

The capacity to clearly see everything around us is very important for a child. It is important for the visual system of the child to develop correctly. In adolescence, other problems may occur: difficult tasks at school can cause visual fatigue, which can lead to serious illnesses.

Ophthalmologists call out to parents to start solving the vision problems as soon as possible, thus having more chances at getting better results in the treatment of the visual system. During childhood, the visual system is much more flexible and easily influenced; it is more susceptible than in adulthood. It is important to pay attention and be ready to proceed in a timely manner. The functional development of the eyesight starts immediately after birth and lasts for 12 to 14 years. During childhood, it is much easier to get conservative treatment for most of the ocular pathologies, without needing any surgical interventions. Still, in order to get conservative treatment, it is necessary to get diagnosed and treated in useful time. Usually, it very much depends on when the detection and treatment of the illness is conducted, as the chances of success can rapidly diminish. Don’t wait for the “hidden” problem to become obvious! Consult a specialist in useful time and you can make sure that the eyesight of your child develops properly.

At “Oculus Prim” you have the possibility to get a consultation in regard to diagnosis, medical prognosis of the eyes development and treatment of existing pathologies. The treatment program at “Oculus Prim” is elaborated individually, taking into account the age, characteristics and lifestyle of the patient. Ophthalmologists with extensive experience in the field, especially in pediatric ophthalmology, work at “Oculus Prim”. They use the most modern diagnostics and treatment methods.

Development of the visual functions in children

The visual system of the child already possesses visual reflexes upon birth: direct and simultaneous reaction of the pupils to light, intermittent movement reaction of the eyeballs and head towards the source of light, the attempt to follow moving objects. Once the child grows, other visual functions develop gradually.

Light sensitivity

Sensitivity to light occurs immediately after birth. From the first days after birth, the light has a stimulating effect for the development of the visual system as a whole and this serves as a base for forming the visual functions. Because of light, newborns are not able to see a clear vision, and inadequate reactions predominantly occur. In newborns, the sensitivity to light is highly reduced, even if adapting to darkness is 100 times more acute than when adapting to light. Upon the first 6 months of life, light sensitivity increases significantly, and it corresponds to two thirds of the adult level. Only after 12 to 14 years of age the sensitivity to light becomes almost normal. Reduced sensitivity to light in newborns can be explained by the lack of proper development of the visual system, especially at the retina level. In these children, the dilation of the pupil in the dark is much slower than its constriction in the light. As a result of conditioned reflexes in the 2nd to 3rd week of life, the activity of the optic system becomes more complex.

Central vision

Central vision in children emerges only in the 2nd to 3rd month of life, after which it develops gradually – from the capacity to detect an object, up to distinguishing and recognizing it. The capacity to distinguish simple objects is ensured by the corresponding development level of the visual system, while recognizing images takes place thanks to the development of the intellect.

In the 4th month of life, the child reacts to someone’s presence, and earlier – in the 2nd to 3rd months – the child sees the mother’s breast. In the 7th to 10th months the child is capable of recognizing geometric shapes (cube, pyramid, cone, sphere) and at 2 to 3 years of age he/she can distinguish drawn images. The complete perception of objects’ shapes and the development of the normal visual acuity in children take place during school years. Visual acuity in newborns is extremely low, according to a study, it is 0,005-0,015. In the first months of life, it gradually increases to 0,01-0,03. At 2 years old, it reaches 0,2-0,3 and only at 6-7 years old (other sources say 10-11) it reaches 0,8-1,0.

Chromatic vision

At the same time as the development of visual acuity, the function for perceiving colors is formed. Different clinical studies show that the ability to recognize colors occurs for the first time in children of 2 to 6 months old. Distinguishing the colors starts with the perception of the red color, but the capacity to recognize the colors green and blue is developed later. At 4-5 years of age the function for perceiving colors is already well developed, but continues to evolve.

Visual field

The visual field in children of pre-school ages is approximately 10% narrower than in adults. During the school years, the limits of the visual field reach normal values. The blind spot investigated at 1m vertically and horizontally, is approximately 2-3cm wider than in adults.

Binocular vision

Binocular vision is developed later than the other visual functions. The main characteristic of the binocular vision is the more accurate evaluation of the stereoscopic vision. The stereoscopic vision development in children can be noticed in the following stages:

· At birth, the child doesn’t have a conscious vision. At bright light, the pupils narrow, the eyelids close, the head slightly tilts and the eyes move without any target, independently from one another.

· After 2 to 5 weeks of birth, bright light makes the child keep his/her eyes relatively still, staring at the source of light.

· By the end of the first month of life, the optic stimulation of the peripheral retina causes a reflex movement of the eyeballs. As a result, the source of light is perceived by the center of the retina. In the beginning, this central fixation takes place in a transitory manner and unilaterally only, but gradually, as a result of repeated stimuli, it becomes fixed and bilateral. The wandering movement of the eyeballs transits to a simultaneous movement. The basic physiology of the binocular vision is formed.