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Eyelid Problems - HealthyChildren.org

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Droopy eyelid (ptosis) may appear as an enlarged or heavy upper lid; or, if it is very slight, it may be noticed only because the affected eye appears somewhat smaller than the other eye. Ptosis usually involves only one eyelid, but both may be affected. Your baby may be born with a ptosis, or it may develop later. The ptosis may be partial, causing your baby’s eyes to appear slightly asymmetrical; or it may be total, causing the affected lid to cover the eye completely. If the ptotic eyelid covers the entire pupillary opening of your child’s eye, or if the weight of the lid causes the cornea to assume an irregular shape (astigmatism), it will threaten normal vision development and must be corrected as early as possible. If vision is not threatened, surgical intervention, if necessary, is usually delayed until the child is four or five years of age or older, when the eyelid and surrounding tissue are more fully developed and a better cosmetic result can be obtained.

Most birthmarks and growths involving the eyelids of the newborn or young child are benign; however, because they may increase in size during the first year of life, they sometimes cause parents to become concerned. Most of these birthmarks and growths are not serious and will not affect your child’s vision. Many decrease in size after the first year of life and eventually disappear entirely without treatment. However, any irregularity should be brought to the attention of your child’s pediatrician so that it can be evaluated and monitored.

Some children will develop lumps and bumps on their lids that can impair development of good eyesight. In particular, a blood vessel tumor called a capillary or strawberry hemangioma can start out as a small swelling, and rapidly enlarge. They will enlarge over the first year of life, and then start to spontaneously resolve over the next few years of life. If they become large enough, they can interfere with your baby’s development of good vision in the affected eye and will need to be treated. Because of their potential to cause vision problems, any child who starts to show any lumps or bumps around either eye should be examined by an ophthalmologist.

A child might also be born with a flat, purple colored lesion on their face called a port wine stain, because of its resemblance to a dark red wine. If this birthmark involves the eye, especially the upper lid, the child may be at risk for development of glaucoma (a condition where pressure increases inside the eyeball) or amblyopia (a weak eye muscle). Any child born with this birthmark needs to be examined by an ophthalmologist shortly after birth.

Small dark moles, called nevi, on the eyelids or on the white part of the eye itself rarely cause any problems or need to be removed. Once they have been evaluated by your pediatrician, these marks should cause concern only if they change in size, shape, or color.

Small, firm, flesh-colored bulges on your child’s eyelids or underneath the eyebrows are usually dermoid cysts. These are noncancerous tumors that usually are present from birth. Dermoids will not become cancerous if not removed; however, because they tend to increase in size during puberty, their removal during preschool years is preferred in most cases.

Two other eyelid problems—chalazia and hordeola or sties—are common, but not serious. A chalazion is a cyst resulting from a blockage of an oil gland. A sty, or hordeolum, is a bacterial infection of the cells surrounding the sweat glands or hair follicles on the edge of the lid. Call your pediatrician regarding treatment of these conditions. He probably will tell you to apply warm compresses directly to the eyelid for twenty or thirty minutes three or four times a day until the chalazion or sty clears. The doctor may want to examine your child before prescribing additional treatment, such as an antibiotic ointment or drops.

Once your child has had a sty or chalazion, she may be more likely to get them again. When chalazia occur repeatedly, it’s sometimes necessary to perform lid scrubs to reduce the bacterial colonization of the eyelids and open the oil gland pores.

Impetigo is a very contagious bacterial infection that may occur on the eyelid. Your pediatrician will advise you on how to remove the crust from the lid and then prescribe an eye ointment and oral antibiotics.

Last Updated
11/21/2015
Source
Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

infants and children: MedlinePlus Medical Encyclopedia

URL of this page: //medlineplus.gov/ency/article/003035.htm

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Ptosis (eyelid drooping) in infants and children is when the upper eyelid is lower than it should be. This may occur in one or both eyes. Eyelid drooping that occurs at birth or within the first year is called congenital ptosis.

Ptosis in infants and children is often due to a problem with the muscle that raises the eyelid. A nerve problem in the eyelid can also cause it to droop.

Ptosis may also occur due to other conditions. Some of these include:

  • Trauma at birth (such as from the use of forceps)
  • Eye movement disorders
  • Brain and nervous system problems
  • Eyelid tumors or growths

Eyelid drooping that occurs later in childhood or adulthood may have other causes.

SYMPTOMS

Children with ptosis may tip their head back to see. They may raise their eyebrows to try to move the eyelid up. You may notice:

  • Drooping of one or both eyelids
  • Increased tearing
  • Blocked vision (from severe eyelid drooping)

EXAMS AND TESTS

The health care provider will do a physical exam to determine the cause.

The provider also may do certain tests:

  • Slit-lamp examination
  • Ocular motility (eye movement) test
  • Visual field testing

Other tests may be done to check for diseases or illnesses that may be causing ptosis.

TREATMENT

Eyelid lift surgery can repair drooping upper eyelids.

  • If vision is not affected, surgery can wait until age 3 to 4 when the child has grown a little bigger.
  • In severe cases, surgery is needed right away to prevent "lazy eye" (amblyopia).

The provider will also treat any eye problems from ptosis. Your child may need to:

  • Wear an eye patch to strengthen vision in the weaker eye.
  • Wear special glasses to correct an uneven curve of the cornea that causes blurred vision (astigmatism).

Children with mild ptosis should have regular eye exams to make sure amblyopia does not develop.

Surgery often works well to improve the look and function of the eye. Some children need more than one surgery.

Contact your provider if:

  • You notice your child has a drooping eyelid
  • One eyelid suddenly droops or closes

Blepharoptosis - children; Congenital ptosis; Eyelid drooping - children; Eyelid drooping - amblyopia; Eyelid drooping - astigmatism

  • Ptosis - drooping of the eyelid

Bass N. Hypotonia and neuromuscular disease in the neonate. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 56.

Olitsky SE, Marsh JD. Abnormalities of the lids. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 642.

Pavone P, Cho SY, Praticò AD, Falsaperla R, Ruggieri M, Jin DK. Ptosis in childhood: A clinical sign of several disorders: Case series reports and literature review. Medicine (Baltimore). 2018;97(36):e12124. PMID: 30200099 pubmed.ncbi.nlm.nih.gov/30200099/.

Updated by: Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Vision in infants: the formation of the visual system after birth.

From Gary Heiting, OD, and Adam Debrowski

Your heart skips a beat when your newborn baby opens its eyes for the first time and looks at you.

Don't worry if it doesn't happen right away. In newborns, the visual system develops gradually.

In the very first week of life, a child sees the world differently: indistinctly and in shades of gray.

Only a few months after birth, the baby's visual system will work to its full potential. Knowing the key milestones in the development of the eyes of a newborn baby (and how to help them along) will help you understand that your baby is developing normally and enjoying life.

Baby's eye development begins during pregnancy

Your baby's visual system begins to develop even before birth. Therefore, how you take care of yourself and your body during pregnancy is important and affects the development of the body and mental abilities of the child, including the eyes and visual centers in the brain.

Be sure to follow the nutritional advice your doctor gives you. Be sure to take your prescribed supplements and vitamins, and get enough rest.

Do not smoke or drink alcohol during pregnancy, as toxins can cause many health problems for the baby, in particular vision problems.

Smoking is especially dangerous during pregnancy. Cigarette smoke contains about 3,000 different chemicals (such as carbon monoxide or carbon monoxide) that can harm a person.

Even regular aspirin can be dangerous: it increases the risk of having a low birth weight baby and complications during childbirth. Low body weight, in turn, can contribute to vision problems.

Always check with your doctor before taking any medication during pregnancy. This also applies to over-the-counter drugs, herbal supplements, and other over-the-counter medications.

Eye Condition at Birth

Shortly after birth, your pediatrician or neonatologist will examine your baby's eyes for congenital cataracts or other serious neonatal eye problems in newborns.

Although such diseases are rather an exception, it is better to detect and treat them at an early stage in order to reduce the pathological impact on the development of the infant's visual system.

To protect the child's eyes from pathogenic bacteria and microorganisms that could enter them during the passage through the birth canal and cause eye infection , an antibiotic ointment is placed in them. Early prevention of possible eye infections is very important for the normal development of the visual system.

ARE YOU CONCERNED WITH YOUR BABY'S VISION? Find an optometrist nearby .

At birth, your baby sees objects only in black and white and in shades of gray. This is due to the fact that the nerve cells in the retina and brain that are responsible for color perception are not yet fully developed.

A newborn baby is not yet able to focus on nearby objects (disturbance of accommodation). Don't worry if you notice that your baby is unable to "focus" on objects or on your face. It will take time for him to acquire this ability.

Despite all these features, studies have shown that just a few days after birth, the baby is able to distinguish the mother's face from the face of a stranger.

Scientists believe that the baby recognizes the mother's face thanks to the contrasting hairline. (During the study, women covered their hair with a scarf or swimming cap, and the baby could not tell the mother's face from that of a stranger. )

Therefore, to encourage eye contact, during the first weeks of a child's life, do not change the hairstyle or appearance.

You may also notice that babies have rather large eyes. This is because usually a child's head grows first, and then the rest of the body. At birth, a baby's eyes are 65% the size of an adult's eyes!

Baby's eyes in the first month of life

In the first month of life, the baby's eyes are not highly sensitive to light. By the way, in order for a child who is 1 month old to understand that there is light in the room (the threshold of sensitivity to light), the light must be 50 times brighter than normal.

Don't be afraid to leave a light on in the nursery, because it won't disturb the baby's sleep and you won't trip over the furniture when you go to visit him at night!

Very quickly the baby acquires the ability to distinguish colors. A week after birth, the baby can see red, orange, yellow and green. A little later, he will be able to distinguish between blue and purple. This is because blue light is the shortest wavelength, and there is only one type of receptor in the retina that can "see" blue light.

Don't worry if you notice that your baby's eyes are looking in different directions. One eye may sometimes be slightly averted to one side or the other. This is fine. But if the baby's eyes squint to the side, consult an optometrist immediately.

Tips: Paint your baby's room in bright, cheerful colors to stimulate his eyesight. Furniture or interior details should be of contrasting colors and shapes. Hang a bright, colorful hanging piece above or next to your crib. It is important that it be multi-colored and consist of different geometric shapes.

Development of the organs of vision: 2nd and 3rd month of life

Significant changes occur in the baby's visual system during the second and third months of life. During this period, visual acuity increases , functional strabismus (if it was) disappears. Now your child is able to follow moving objects and tries to fix his eyes on them.

A bright, bright room with lots of colors and shapes to help stimulate your baby's vision development.

Moreover, the baby learns to look from one object to another only with his eyes, without moving his head. Also, the child's eyes become more sensitive to light: at the age of 3 months, the threshold of sensitivity to light decreases. Therefore, during sleep, the light should be dimmed.

Tips: To stimulate the eyesight of a 2-3 month old baby:

  • Add new objects to the room or change their position frequently to enrich the baby's experience.

  • Leave a night light on to stimulate vision when your baby is awake in the crib.

  • Place the baby on its back during sleep to reduce the risk of sudden infant death syndrome (SIDS). However, when the baby is awake and under supervision, put it on the tummy. This posture stimulates the development of visual perception and motor skills.

Development of the organs of vision: Months 4-6

By 6 months, the visual centers of the baby's brain are quite well developed. The child sees more clearly and can follow moving objects with quick and precise eye movements.

Visual acuity improves from about 20/400 (6/120) at birth to 20/25 (6/7.5) at 6 months. Color perception reaches the level of an adult; the child can distinguish all the colors of the rainbow.

At the age of 4-6 months, the child's hand-eye coordination becomes more perfect, which allows him to quickly find and pick up objects with his hands, as well as accurately guide the bottle (and more!) into his mouth.

Six months is an important milestone in life, as this is when you should have your baby's first eye exam.

If necessary, a qualified eye specialist will examine a child at 6 months of age. But routine eye exams are usually recommended after kindergarten age (3-4 years and older).

If you have any concerns, you can also consult your doctor for further advice.

For a thorough examination of your six-month-old baby's eyes, see an optometrist who specializes in children's vision and eye development.

Eye Development: Months 7-12

Your baby is now moving around a lot, crawling and covering distances you never dreamed possible. He is getting better at estimating the distance to objects, more precisely grabbing and throwing them. (Beware!)

This is an important period in your child's development. At this stage, the baby feels his whole body better and learns to coordinate vision and movement.

Now you have to pay more attention to the baby to keep him out of harm's way. It is not uncommon for bumps, bruises, eye injuries and other serious injuries when the baby explores the world around him.

Close cabinets with household chemicals with a padlock, place special railings in front of stairs.

Don't worry if your child's eyes start to change color. Most babies are born with blue eyes because at birth there are not enough dark pigments in the iris. Over time, there will be many more of them, so your baby's eyes may change color from blue to brown, green, gray or swampy.

Tips: To stimulate your child's hand-eye coordination, you can lie on the floor with him and invite him to crawl to an object. Put your baby's favorite toy away and invite him to get to it. You can also offer to disassemble and assemble various objects and toys.

Strabismus problems

Pay close attention to how your child's eyes move, either together or separately. Strabismus is a term for a misalignment of the eyes. It is very important to detect and treat it at an early stage so that the child's vision develops properly.

Left untreated, strabismus can lead to amblyopia or "lazy eye."

It may take months for a child to achieve joint eye movement. But if you notice that one of the baby's eyes is squinting or moving separately from the other, contact an optometrist immediately.

Vision problems in premature babies

The average duration of a normal pregnancy is approximately 40 weeks (280 days). According to the WHO, a baby born before 37 weeks is considered premature.

Compared to full-term babies, premature babies are at greater risk of developing eye problems. And the shorter the period, the more serious the complication.

The following visual problems associated with preterm birth are characteristic:

Retinopathy of prematurity (RP)

This is a disease in which fibrous changes and blood vessels develop in the thickness and on the surface of the retina. ROP is often accompanied by retinal scarring, poor vision and retinal detachment . In severe cases, retinopathy of prematurity can lead to blindness.

All premature babies are at risk of ROP. Extremely low birth weight is an additional risk factor, especially when the baby is placed in a high oxygen incubator immediately after birth.

If your baby was born prematurely, ask your obstetrician for a referral to a pediatric ophthalmologist for an eye exam to rule out ROP.

Nystagmus

These are involuntary oscillatory eye movements.

In most cases, nystagmus manifests itself in the form of involuntary eye movements in various directions, with different frequencies and amplitudes of "oscillation". Eye oscillations are pendulum in nature, horizontal, diagonal and rotational movements are observed.

Nystagmus may be congenital or may develop over several weeks or months. Risk factors include optic nerve hypoplasia, albinism, and congenital cataracts. By the amplitude of eye oscillations, you can determine how badly the baby's visual system is damaged.

If the child shows signs of nystagmus, consult an optometrist immediately.

Remember that smoking during pregnancy greatly increases the chance of preterm labor.

Page published on Monday, November 16, 2020

The child's eye is festering, what to treat, medicines, washing, professional ophthalmological advice

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Upcoming events

March 10, 2023 A meeting dedicated to the fight against glaucoma will be held at the School of Good Vision

To help the elderly and their loved ones learn more about diseases that often appear with age, the Optic Center conducts free classes of the School of Good Vision. One of them, dedicated to the fight against glaucoma, will be held on Friday, March 10th.

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Children's vision

Sometimes in the first weeks of life, a newborn has purulent discharge from one or both eyes, eyelashes stick together or watery eyes. These signs indicate the presence of a disease in an infant. The most common reasons may be:

Allergy
The baby may have an allergic reaction, for example, to milk or medicines. In this case, there is an abundant release of tears, which causes redness of the eyes and the appearance of pus.

Blepharitis
A disease that affects the edges of the eyelids, accompanied by the appearance of purulent crusts on the eyelashes, gluing of the eyelashes, swelling and redness of the edges of the eyelids. Improper hygiene of the child's eyes can lead to the appearance of pus on the eyelashes.

Conjunctivitis
Inflammation of the mucous membrane of the eyeball and eyelids occurs against the background of the presence of chlamydia (possibly when infected through the birth canal), staphylococcus aureus, SARS, influenza and other infectious diseases. The main signs of inflammation are redness of the eyes, accumulation of pus in the corners of the eyes, itching, tearing, pain in the eyelids. Read more about conjunctivitis here.

Dacryocystitis
The cause of the appearance of pus in the eyes of a newborn child may be a violation of the patency of the lacrimal ducts.

The main symptoms of the presence of the disease

  • A large number of purulent crusts
  • Persistent, copious greenish or yellow discharge
  • Swollen or red eyes.

Usually these symptoms are not dangerous for the health of the child, but if the first symptoms appear, you should not treat yourself at home and put drops or ointment in your eyes. It is important to immediately contact an ophthalmologist for a consultation. The doctor will be able to accurately diagnose and prescribe the necessary course of treatment.

Hygiene and treatment

For hygienic purposes, eyewash with antiseptic solutions is used. It is possible to use a solution of potassium permanganate. Washing with ordinary boiled water and regular compresses help. The main thing is not to forget the basic rules of eye hygiene: