Strabismus represents any misalignment of the eyes. Crossed eyes, also called esotropia, occurs when either eye looks straight ahead and the other eye turns inward toward the nose. "It is the act of focusing that is causing the eyes to cross," says Granet. Generally, this condition develops in early infancy or childhood.
Parents should consult an eye specialist if their child's eye is consistently crossed beyond the age of four to six months. If not properly treated, crossed eyes can lead to permanent loss of vision. "If glasses are not indicated, there is a high likelihood that surgery will be needed to align the muscles," Granet explains.
A few specialists will use Botox to treat strabismus; however, most ophthalmologists will intervene with surgery in children. The best results for congenital crossing of the eyes are at one year of life or younger, he adds. If a child becomes cross-eyed between the ages of two and five, glasses are usually indicated.
A more serious underlying condition, such as a tumor or neurological problem, may be the cause for eye crossing in a very small percentage of children.
Amblyopia (Lazy Eye)
Amblyopia, or "lazy eye," results in poor vision without any obvious injury or disease to the eyeball. "Amblyopia can result from an eye that is turned, or an eye that has a different need for glasses, or if an eye is blocked by an eyelid or cataract," explains Granet.
In some cases glasses may be prescribed. In other cases, one eye needs to be forced to see better with a patch or other method. Says Granet: "I frequently use a method known as Atropine penalization. A drop is instilled in the "good" eye on a regular basis that blurs the vision and makes it slightly worse that in the other eye. This forces the child to use the other (weaker) eye without the use of a patch."
Recently, a study compared the use of a patch to the drop and found that both yield virtually equal results. Another study compared two hours and six hours of patching in children who have mild amblyopia, and found that in that case also, essentially equal results were achieved.
Physicians individualize treatment to best fit each family and child's needs. "I use the drops while the child is in school and recommend the patch for at home," says Dr. Granet. "The treatments are extremely powerful and can literally restore sight to a blind eye."
Untreated amblyopia will result in a permanent decrease in vision, to the extent of causing functional blindness.
Conjunctivitis, or pink eye, is an inflammation of the conjunctiva, the thin, transparent membrane lining the eyelids and front of the eyeball. Allergies, environmental irritants, or an infection can cause pink eye. Symptoms may include eye swelling, redness, irritation, and a yellow, sticky discharge that causes the eyelids to stick together.
If the conjunctivitis is viral or bacterial, it can be highly contagious. Special precautions, such as washing hands frequently and keeping fingers away from the eyes, should be taken. In addition, the bacterial infection is usually treated with prescription antibiotic drops or ointment.