Medicine is nowadays unthinkable without technology, and one of the areas where great progress has been made over the last 20 years is the eye diseases in children. Detected and treated on time, ophthalmic diseases can be resolved by surgery, wearing glasses, patches, contact lenses, and orthoptics. Ophthalmologist Mürüvvet Ayten Tüzünalp from ACIBADEM Altunizade Hospital has over 20 years of experience in treating ophthalmic disorders in children and explains how small patients can benefit today from the most important advances in vision recovery.
Dr. Mürüvvet Ayten Tüzünalp: The progress is remarkable. In the process of diagnosing eye diseases in children, we resort to pupil dilation. Why are we doing this? To relax the muscles that help change the position of the lens. And when we do this, diopters change. A doctor who is not specialized in treating childhood eye problems can usually make measurements and prescribe glasses. But, typically, recommended diopters are greater than the actual needs of the child. This is because children have stronger muscles, and diopter indications may be erroneous. So often, children are mistakenly receiving an over correction. And to avoid this problem, there are special child- spectacles that protect them from over-correction. If the glasses are not fit, there is a risk that we can not control the progress of myopia any longer.
Dr. Mürüvvet Ayten Tüzünalp: Of course, things have evolved a lot over the last 20 years. They are very light, and the diameter of the lenses has decreased to perfectly match the kids’ needs. The peripheral area was very thick, now is substantially thinned; only the center of the lens is thicker. Thus, glasses are much easier to wear because the materials are much lighter. Additionally, they are more easily adapted to various problems: for example, a child with strabismus towards inside will wear thick lenses in the middle, if strabismus is outward, the center of the lens should be very thin. This type of lens helps the eyes return to their normal position.
Dr. Mürüvvet Ayten Tüzünalp: Usually they can change them before 8 years old. In the case of refraction, I evaluate the children once every 6 months. If one gets strabism or lazy eyes, then I evaluate this case more often. If we apply patching (eye occlusion), then I see them in a few weeks, depending on age: for example, if a child is 7 years old, then I see her after 7 weeks.
Dr. Mürüvvet Ayten Tüzünalp: In most cases, wearing the patch is enough. But there is also orthoptic therapy in which the patched eye has a transparent opening with some drawings. If the parents are trained by the doctor, they can do these exercises with their children at home. There are also glasses that can be patched automatically.
Dr. Mürüvvet Ayten Tüzünalp: When a child has problems in both eyes, and the difference between them is not more than two diopters, the glasses can be used. If this is greater than three diopters, the brain can not process the images correctly and neglects the problematic eye. It is no longer used, becomes lazy or gets strabismus. In these cases, we need something that causes the eyes to provide the same quality of vision. And these are the contact lenses.
Dr. Mürüvvet Ayten Tüzünalp: Children do not know how to lie. Adults can convince themselves of anything, but not the children. But if we make the right correction, after the measurements that are needed, the children will wear the glasses. In rare cases, when the child refuses, I recommend that parents use the pupil dilatation drops for a few days. And if a child will see in the fog because of the droplets, he will accept the glasses because it helps her to see better. And she will wear them after she is not given droplets anymore.