Eye and Vision Problems (Common Problems of Former Preemies)

Eye and Vision Problems

What are some of the more common eye problems of former preemies?

The most common eye problems to appear after discharge are:

• Poor vision (either near sighted or far sighted)
• Strabismus (inward or outward turning of one or both eyes)
• Amblyopia (lazy eye due to unequal vision)
• Nystagmus (constant or frequent jerking movements of the eye)
• Decreased color vision (some colors look alike, for example purple,blue,green)
• Smaller field of vision

Although the above listed problems are more common in infants who have had Retinopathy of Prematurity, they can occur in other preemies as well.

• Hemangiomas are small networks of tiny blood vessels. They can appear anywhere on the skin and grow rapidly for several months. If they are on the eyelid or skin surrounding the eye, they may interfere with vision. Hemangiomas are more common in premature infants.
• Former preemies can have eye problems common in all children, these include:
  • Conjunctivitis - inflamation or infection of the surface of the eye
  • Blocked tear duct

How will I know if my child has an eye problem?

If your child develops any of the following, bring these to the attention of your child's doctor. Your infant may need to see an ophthalmologist (eye doctor) very soon; s/he might have a serious vision problem.

• Infant frequently pokes at his/her eye
• Lazy eye, slow to move
• Constant movement of eyes, even when trying to look at something
• Frequent crossing of eyes, beyond three months of age correcting for prematurity
• One eye that stays out or in most of the time
• Frequent or constant jerking of eyes especially when looking straight ahead. A few jerks when looking to the far left or far right is normal.
• The infant fails to blink to a camera flash just in front of the face
• The surface of the eye or the pupil (black circle in the center of the eye) appears cloudy or white
• In a photo, the center of one eye appears red while the other eye does not
• Abnormal head turn or head tilt
• The infant (beyond 6 weeks of age correcting for the weeks of prematurity) cannot fix his/her eyes on an object or a face, or follow it as it moves
• The infant's eyelid droops so much that it completely covers the pupil (black center) of the eye when he/she is awake
• Normal lighting seems to hurt the baby's eyes and make him/her cry or turn away

Common problems can often be handled by your baby's regular doctor. These include:

• Frequent tearing (blocked tear duct)
• Redness to the eyes with cloudy or yellow drainage (may indicate a conjunctivitis or infection on the surface of the eye)

If you have a question about your baby's sight or think your child may not see well, call your baby's physician or an eye doctor.

It is important to keep any eye appointment that was arranged at your baby's discharge, even if you do not think there is an eye problem.

How are eye problems treated?

Infants who have poor vision can be fitted with glasses. If the correction of vision would require very heavy or thick lens, soft contact lens may be prescribed. Other conditions, such as wondering eye and crossed eye, are treated with patching of one eye to encourage the use of the other eye. Early treatment is important for best visual outcome later on.

Why is early treatment so important?

When infants see much better out of one eye, or if using both eyes causes double vision, they will gradually stop using (seeing out of) the weaker eye. Visual pathways are still being established in the first few months and years of life. Making and keeping these connections requires regular use of the eye. If a child "blocks out" vision in one eye during this critical period in eye development, these connections are not established and cannot be made at a later age. Sight from two eyes is necessary for determining what is close and far away (depth perception). Poor vision may slow mental development and physical progress in many areas such as recognition of objects, learning symbols such as letters or pictures, and motor activities such as walking or climbing.