Focusing on eye health

Jordan Wong was just 10 when her vision started to blur. Her mother dismissed her complaints, assuming that her daughter just wanted attention.

However, Wong’s uncle realised her plight and brought her to the optician’s, where she was prescribed reading spectacles for myopia (short-sightedness).

However, the refractive error squint of her eyes increased over the years.

Now, age 30, she wears contact lenses for an optical power of minus 700 diopters. If you were to hold an apple 10cm from her face, all she will see without wearing glasses is a fist-sized mass of red.

Many parents have expressed their concern about their children’s progressive myopia, where, like Wong, their vision deteriorates to the point that they are totally dependent on visual aids.

“Start with taking note of tell-tale signs in children such as their going very close to the TV or tipping their head and squinting very hard and long, ” Dr Yen Siew Siang, a consultant ophthalmologist who runs a private practice in Kuala Lumpur, urges parents.

Reading while lying down, under poor lighting, or holding the book too close to the face – we know to avoid these habits; yet they don’t account for concrete proof as cause of progressive short-sightedness. Nor will curbing these habits promise to limit myopia.

Dr Yen says according to a local study, myopia increases consistently with age; approximately 10% in seven-year-olds and 34% in mid-teenagers.

“Children who lean in very closely to their work, books or computers tend to be associated with myopia more than others,” explains Dr Yen. “But apart from that, there is no conclusive link between genetics and environmental factors with deteriorating eyesight.

“Furthermore, young children are often unlikely to express their needs. Thus, it’s important for parents to be sensitive to what their children are saying,” she adds.

Severe squint

Refractive error squint (esotropia) is a relatively common problem. It is essentially a condition caused by a misalignment of both eyes, making the person unable to look in the same direction. The misalignment may present itself sporadically or throughout the day.

Susan Lee, of Kuala Lumpur, was perplexed when she found her two-year-old daughter Faye struggling with the condition.

Her eyes would roll apart and appear unfocused most of the time.

“We consulted an ophthalmologist, who confirmed that Faye had congenital squint, and prescribed her corrective prism lenses,” Lee, in her 40s, says. “We were informed that surgery would be necessary if the glasses didn’t ‘fix’ her problem.”

Keeping glasses on a reluctant toddler was a big challenge for both working parents, but the family worked together to help the child. By age six, Faye’s vision hadn’t improved to a satisfactory level. She needed surgery, followed by intensive therapy.

“She was seven by then and we spent the year shuttling between home and eye therapy in the heart of Kuala Lumpur. It was stressful for us but we were able to stop after a year,” Lee recalls. (The sessions comprised eye exercises to help recuperating squint sufferers use their eyes better.)

Today, nine-year-old Faye wears ordinary myopia spectacles to school (for reading, mostly) and corrective prism lenses at home. If you were to look at her directly, you’d hardly be able to tell that she’d once had severe squint.

“She’s cheerful and confident. Nothing in the past with her visual problems has fazed her. We’ve taught her what to say to strangers and friends who express their curiosity over her prism glasses,” Lee says. “So when people ask, she simply replies that she sees better with them.”

Dr Yen emphasises the need for early detection. “If the problem goes untreated, the disorder digresses into amblyopia, otherwise known as the lazy eye syndrome.” (Lazy eye is a visual disorder in which the brain partially or wholly ignores input from one eye; it can be a congenital condition.) Since the disorder is caused by overstretched muscles in the sockets, the patient’s eyes would have adapted to the inborn flaw.

“Untreated, it becomes permanent. It’s difficult to treat once the child reaches seven years of age,” Dr Yen warns.

Lazy eye

Fortunately for Selangor local James Qin Chitty, his congenital “lazy eye” condition was detected early.

The four-year-old (then) was at the clinic with his mother when the paediatrician noticed an oddity in the child’s visual response to his environment. Instead of looking directly at the object, the young boy would tilt his head slightly to one side and peer through the corner of his eye.

“Have you considered bringing him to an eye specialist?” the paediatrician enquired.

It hadn’t occurred to 44-year-old Jacky Ong, owner of a consulting firm, that her son might have a problem with his eyes. After all, he was healthy and the newfound “problem” was barely noticeable.

A trip to the ophthalmologist’s confirmed James’ problem - long-sightedness and amblyopia.

“It was only after James was diagnosed that we realised that amblyopia runs in our family. My sister-in-law and nieces have it too,” Ong says.

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