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Astigmatism in children cannot be considered a sentence for a child. Often this disorder is associated with uneven growth of the eyeball and other structures of the organs of vision that are involved in the process of light refraction. You should not panic after making such a diagnosis. This disease responds well to drug therapy. Also, you do not need to refuse to perform specialized exercises and wear corrective glasses. An integrated approach allows the brain to correctly form the picture that it receives from the organs of vision. If therapy is ignored, then after the age of 18, a person will need surgery. It will allow you to change the structure of the eye, but it will not affect vision.
Astigmatism – what is it?
Astigmatism – This is a visual impairment, which is accompanied by a loss of clarity of objects that a person looks at. This happens because the lens or cornea changes its normal curvature. Light rays are refracted incorrectly. As a result, on the back of the eye, where the image dot is formed, several dots are formed at once. Some of them are located on the retina, while others will be focused outside of it. Therefore, a person sees the object as blurry.
The structure of the organ of vision is quite complex. To understand how a person with astigmatism sees objects, you need to understand the functioning of two systems of the eye: light-refracting and perceiving. The refractive system corrects and directs light beams in such a way as to form an image of an object on the retina. The perceiving system is represented by rods and cones. One end receives the image, and the other transmits it to the optic nerve. The optic nerve, in turn, “broadcasts” the image to the brain.
In order for a person to be able to see the image of an object normally, the perceiving and light-refracting systems must work correctly.
All structures through which light beams pass must be transparent. Cataracts, clouding of the cornea, hemorrhage into the vitreous body, or some kind of inflammation of the organ of vision can cause a violation of their transparency.
Rods and cones must perform their function correctly.
The light that hits the eye structures must be refracted at the right angle. This is ensured by the refractive index, which differs for different structures of the eye: for the cornea it is 1,37, for the lens – 1,38, and for the lens nucleus – 1,4.
Astigmatism develops when light is refracted at the wrong angle. As a result of this violation, the so-called “false mirror effect” is created. Light rays sequentially pass through several structures. They first enter the cornea, then the lens, and then the retina. The cornea of the eyeball has the shape of a hemisphere and resembles a dome. The lens is represented by a lens convex on both sides. The lens is held on by ligaments that stretch when necessary. Thus, the organ of vision reacts to changes in illumination and directs a beam of rays to the retina, to the central visual spot.
In normal vision, light rays are refracted in the same way and hit the retina. If a person has myopia, then the rays fall on the area in front of the retina, and if a person is farsighted, then they are focused behind the retina. When the curvature of the lens or cornea is disturbed, the focus changes. Instead of a dot, a spot is formed on the retina. This condition is called astigmatism. Moreover, it is impossible to exclude nearsightedness or farsightedness.
With astigmatism, 4 main meridians suffer, which are located at points 3, 6, 9 and 12 (if we consider the structures of the eyeball as a clock face). In this case, the patient receives such an image as if he is looking through the water column.
If the disease develops in children under the age of one, then they get used to seeing objects blurry and do not present any complaints to adults. The disease is often learned when the child begins to learn to write and read. He does not see the letters, as they blur before him. While early diagnosis of the disease allows you to start treatment in a timely manner and cope with the existing problem.
Varieties of astigmatism
Depending on the cause of astigmatism, it can be congenital or acquired.
Depending on the refraction of the main meridians (perpendicular to the plane of the eye), astigmatism can be of the following types:
Direct astigmatismwhen the vertical meridians refract light rays the most.
Reverse astigmatismwhen the horizontal meridian has the maximum refractive power.
Astigmatism with oblique axes, in which the main meridians are located away from the vertical and horizontal axes of the cornea.
There is also a distinction between right and wrong astigmatism. With correct astigmatism, the main meridians run at an angle of 90 ° C with respect to each other.
Correct astigmatism is most often a congenital pathology and is divided into simple, complex and mixed:
With a simple correct astigmatism, pathological refraction of rays occurs in 1 main meridian, while the other functions normally. Hypermetropic astigmatism causes a person to see an object as farsighted, but also blurry. Myopic simple astigmatism causes the person to see the image as a nearsighted patient, but also blurry.
Complex astigmatism characterized by the fact that the two main meridians distort the light rays abnormally. At the same time, complex hyperopic and complex myopic astigmatism are also distinguished.
With mixed astigmatism one meridian forms farsightedness, and the second – myopia.
Separately, irregular astigmatism is distinguished, in which the main meridians superimpose light rays on each other. This kind of astigmatism is most often acquired. If the disorder is acquired, then vision will suffer more.
There are several degrees of astigmatism:
Less than 3 dpt is a weak degree.
From 3 to 6 dpt – the average degree.
More than 6 dpt – high degree.
If corneal defects occur during the disease, then they speak of corneal astigmatism. When the disease develops due to pathologies of the lens, then they indicate lens astigmatism.
Causes of Astigmatism
In childhood, astigmatism, which does not lead to visual impairment, is a variant of the norm. It develops due to the fact that the cornea and lens develop unevenly. In this case, it is necessary to ensure that visual acuity does not decrease by less than 1 diopter.
No more than 10% of children need treatment. In this case, the disease most often has a congenital character and one of the parents suffers from astigmatism.
The likelihood of developing pathology increases in the following cases:
The person is an albino.
A person has retinitis pigmentosa.
The child was born with alcohol syndrome.
The human cornea is cone-shaped, not hemispherical.
In humans, the optic nerve is underdeveloped.
The patient has a congenital deformity of the jaws and teeth, which affects the wall of the orbit and the eyeball.
All of these pathologies are congenital. In this case, the child will suffer from both eyes with varying degrees of intensity.
Acquired astigmatism can develop in the following cases:
The resulting injuries of the cornea due to which scars formed on its surface.
Postponed surgical interventions on the organs of vision.
Subluxation of the lens due to rupture of the ligament of Zinn.
Vitamin A deficiency.
Keratitis and conjunctivitis
Diseases of an infectious nature that can lead to inflammation of the eyes.
Symptoms of astigmatism
If a child is younger than 2-3 years old, then it is rather problematic to understand that he develops astigmatism. This is especially true for those babies in whom the disorder is not developed too much.
The following symptoms can indicate moderate and severe astigmatism:
The child comes very close to the TV screen while watching a cartoon.
To examine the toy, the child tilts his head, squints his eyes, or stretches the corners of his eyes with his fingers.
When you try to put an object on the surface, it will miss.
The child’s eyes get tired quickly, he rubs them with his hands or often closes his eyes to relieve tension.
During the game, the child encounters foreign objects.
When a child experiences visual stress, for example, when doing homework, he makes the following complaints:
For a headache that will be concentrated in the back of the head and in the eyebrow area.
Fatigue, which sets in quickly.
The inability to see objects that are far away.
For double vision.
On the sand in the eyes.
Redness and burning sensation in the eyes.
In elementary school, the child will lag behind his peers in school, as the written doubles in his eyes. This affects reading, counting, etc.
Diagnosis of astigmatism
Astigmatism is diagnosed by an ophthalmologist. The doctor is able to detect pathology even in an infant, which is possible using the skiascopy method (test in a dark room). Thanks to the study, it is possible to determine not only the presence of astigmatism in a child, but also to establish the type and degree of refraction.
Visual acuity is determined after the child reaches the age of three and can verbally interact with the doctor.
If visual impairment is suspected, the child may be shown such studies as:
Computer refractometry, which allows you to find out the type of disease and the degree of its development. This technique is more accurate than skiascopy.
Visometry, which is carried out without the use of lenses and with their use.
Slit lamp examination. The structures of the eye are viewed under multiple magnification. This technique is aimed at clarifying the etiological factor that led to the development of astigmatism.
Keratometry. This study allows you to measure the curvature of the cornea using a special device and computer technology. Thanks to this technique, it is possible to diagnose keratoconus and keratoglobus.
Ophthalmoscopy. This procedure allows you to examine the patient’s fundus and visualize certain pathological changes on it.
Less often, an ultrasound examination of the eyeball is performed. This method provides information about the state of the retina (allows you to visualize cicatricial changes, hemorrhages or its detachment on it).
Astigmatism treatment
Until a child diagnosed with astigmatism is under 18 years of age, he may be prescribed conservative therapy. The operation is not carried out before this age. Directions of treatment:
vision correction performed using glasses. Cylindrical lenses should be inserted into them. They allow you to correctly focus the beams of light on the retina. In the initial stages of using glasses, the child will experience some discomfort. They can prevent him from watching 3D movies, as well as from playing active sports. However, lenses under the age of 10 years are not recommended.
If a child is diagnosed with a corneal form of the disease, then he is shown wearing orthokeratological lenses. They are uncomfortable and hard, so they are worn only during the night rest. Lenses allow you to normalize the curvature of the lens. If the visual acuity of the child exceeds 1,5 dpt, then such lenses are not worn.
Treatment of amblyopia and asthenopia. To cope with amblyopia, that is, a drop in vision against the background of a lazy eye (the diseased organ of vision is simply turned off by the brain, since it is inconvenient for it to see a blurry image), treatment should be started as early as possible. It is desirable that therapy starts before the child reaches 6 years of age. At age 11 and older, treatment will be ineffective. Even surgery will not help to cope with the problem.
Amblyopia does not always present with any obvious symptoms. Sometimes the baby has impaired color perception, or visual acuity in one eye may decrease. However, amblyopia is a complication of astigmatism and therefore requires treatment. For this purpose, pleopic therapy is carried out. A healthy eye is sealed and the child is seated behind a special apparatus called Amblyocor. With its help, the diseased eye is stimulated with a laser beam, color, light, electromagnetic waves. Also, patients are shown physiotherapy, for example, drug electrophoresis.
Asthenopia is another complication of astigmatism and is expressed in the rapid fatigue of the visual apparatus, in low visual acuity and blurred perception of objects. To cope with the violation, the use of drugs such as Atropine is indicated. They do not last long, but they allow you to remove the spasm of accommodation. Also, the child should be engaged on special devices on the synaptophore and on the accomodation trainer.
Creation of conditions for normal nutrition of the organ of vision. To improve the nutrition of eye structures, medicines and gymnastics are used.
Drops that are used to improve eye nutrition:
Quinax. They prevent clouding of the lens.
Emoxipine. These drops are antioxidants, help to reduce the permeability of the vessels of the eyeball, do not allow microscopic blood clots to form in them, and improve the condition of the cell membrane.
Udzha. These drops improve the transparency of the lens of the eye.
Preparations for instillation into the eyes should be prescribed by a doctor. Treatment is carried out in courses 2-3 times a year.
Gymnastics for the eyes is carried out with high-quality lighting. Exercises to improve eye nutrition:
Rotation of the eyeballs clockwise and counterclockwise.
Rotation of the eyes along a trajectory resembling the number 8.
Eye movement up, down, left and right. In each position, you need to linger for 10 seconds.
Bringing the finger to the tip of the nose. At the same time, you need to keep a close eye on it.
Examining objects that are nearby, and then shifting your gaze to the horizon line. You need to hold your gaze for 30 seconds.
Squinting of the eyes. In this case, the other person should name the colors, and the patient himself should imagine them before his eyes.
Operation
Most often, astigmatism is treated with lenses. The operation can be performed after the structures of the eye stop growing (not earlier than 16 years).
Types of surgical intervention:
Kerotomy. In this case, notches are applied to the cornea, which leads to its divergence and a change in the angle of refraction. This procedure allows you to cope with mixed astigmatism and with myopic astigmatism.
Thermokeratocoagulation. The cornea is raised using a special hot needle. This method allows you to cope with far-sighted astigmatism.
Thermokeratoplasty using a laser. During the procedure, burn areas are created on the cornea, which makes it more convex.
Conductive keratoplasty. In this case, the cornea is affected not by a laser, but by radio frequency radiation.
Photorefractive keratectomy. The cornea has a high-precision effect, which allows you to change its shape.
LASIK method. Correction of the shape of the cornea is carried out by cutting off its thinnest layer in the affected area. The procedure takes no more than a quarter of an hour. It is performed on people whose vision exceeds 4 dpt. The operation does not require general anesthesia.
Implantation of phakic lenses. This procedure is carried out only when the astigmatism is severe and it is not possible to perform the procedure using a laser.
Keratoplasty. During the procedure, your own cornea is removed, replacing it with a donor or artificially created one.
After any operation, vision should be restored within 2 hours. However, for about 6 months, a person may suffer from photophobia and lacrimation, he may experience a sensation of a foreign body in the eye. Until the tissues are fully restored, it is necessary not to be near the fire, not to visit the sauna and bath, not to perform heavy physical exertion. About 2 patients out of 10 experience that the myopia or hyperopia that existed before the procedure returns.
Can astigmatism be cured?
To say for sure whether it is possible to cure a particular child from astigmatism can only be a doctor, after the diagnosis. Some forms of the disorder do not require treatment and go away on their own. Curvature may return to normal as the child grows. Until the age of 18, some patients require conservative therapy. It will help prevent vision loss and asthenopia. In other cases, surgery is required.
Forecast
If a child has congenital astigmatism, then by the year it either disappears completely or becomes less intense. By the age of 7 years, the degree of visual impairment stabilizes, but may gradually continue to decrease. A high degree of astigmatism without treatment leads to strabismus and amblyopia.
Prevention
Measures to prevent astigmatism:
After the child reaches six months, you need to regularly take him to an ophthalmologist for examination.
The child should be able to perform gymnastics for the eyes.
It is important that the workplace is well lit.
It is necessary to massage the collar zone, swim, take a contrast shower.
The child must eat right.