Money Today Reporter Park Jeong-ryeol | 2024.01.18 16:31
[박정렬의 신의료인]
There is a proverb that says: “If a body is worth a thousand nyang, an eye is worth 900”. Most of the information the brain receives comes through the eyes, but eye health is something that is easily overlooked. In particular, young children have difficulty monitoring eye development with the naked eye and are not able to express abnormal symptoms like adults, so they often discover eye diseases late.
A typical eye disease that requires attention in children and adolescents is “strabismus,” in which the alignment of both eyes is misaligned. According to the Health Insurance Review and Evaluation Service, of the 176,561 patients who received hospital treatment for strabismus in 2022, 874,697 were younger than 9 years old, or 6 in 10 (61%).
Kim Dae-hee, a specialist at the Pediatric Ophthalmology Center for Strabismus at Kim Eye Hospital, said: “Unlike other parts of the body, vision develops intensively in childhood and is almost complete by the age of 7 -8 years,” adding: “If strabismus is If not treated in time, it can have a negative impact on the development of vision.” “Careful observation and regular checks by guardians are very important,” he stressed.
Ratio of patients with strabismus by age in 2020./Photo = Health Insurance Review and Evaluation Service
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It must be detected and treated before vision is complete
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Strabismus is caused by an imbalance in the muscles that move the eyes. Most cases occur without a clear cause, but if an eye disease such as a refractive error, congenital cataract, or retinal abnormality is present, the ability to move the eyes is reduced and the pupil is tilted on the one hand, causing strabismus. Large external shocks, brain diseases such as cerebral palsy or eye-related muscle abnormalities also influence the onset. Recently, it is not uncommon for people to look at smartphones, computers or TV monitors for long periods of time causing eye dilation and increased fatigue, leading to strabismus. Kim Wook-gyeom, director of B&Bit Gangnam Bright World ophthalmology clinic, said: “Especially before going to sleep, if you look at the bright screen of a smartphone for a long time while lying on your side with the lights off, one eye will be blocked .and the visual and brain signals do not match, which can cause strabismus, so be careful.
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“Intermittent esotropia” is the most common
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In Korea, about 2% of children suffer from strabismus. Depending on the symptoms it is divided into “esotropia”, in which the eyes are turned inward, and “exotropia”, in which the eyes are turned outward, but the detailed types and treatment methods differ depending on the onset and duration.
First. Intermittent esotropia is the most common pediatric strabismus in Korea. It is an eye disease in which the symptom of esotropia, in which one eye turns outward, temporarily occurs. Normally the pupils are exactly in the center, but when you are tired, sleepy, have a bruise or take a photo, the pupils rotate. Specialist Kim Dae-hee said: “Symptoms do not always appear, and there are many cases where parents are unaware of them.”
The second is infantile esotropia which appears within 6 months of birth. This is a case where one eye is severely turned inward and recovery of vision can only be expected if the surgery is performed by 2 years of age at the latest.
Types of strabismus./Photo = Ministry of Health and Welfare, Korean Medical Association The third type is accommodative esotropia. If you have severe farsightedness, which makes it difficult to see nearby objects, you open your eyes too much and turn them inward to see things clearly. In this case, if you wear glasses (convex lenses) to correct hyperopia outside of sleep hours, the strabismus will disappear. Even if the vision is too weak, strabismus can appear and in this case “obscuring therapy” can be useful, which covers the healthy eye and forces the use of amblyopia. Specialist Kim added: “Since hyperopia decreases as the child grows, strabismus disappears and the child can take off his glasses, but if the symptoms persist and it is believed that they cannot be corrected with glasses, a surgery”.
Finally, there is also “pseudostrabismus”, which is not a real strabismus, but seems to be one. Asian children, including Koreans, have a low nose bridge and a gap between the eyes, so the skin of the nose covers the whites of the eyes, making them appear cross-eyed. It looks like esotropia, but in reality there is no strabismus. This disappears naturally as it grows and requires no special treatment.
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If you squint in a bright place, you may become suspicious.
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When strabismus occurs, the pupil turns to one side, movement is limited, and symptoms include turning the head in the direction away from the eye. Raising the chin or tilting the head to one side are also signs of strabismus. It’s also a good idea to get an eye exam if one eye seems blurry or if you react sensitively, such as squinting when looking at sunlight.
Strabismus is a disease caused by an imbalance between the two eyes, and the use of glasses to correct vision is the basic treatment. If nonsurgical treatments such as glasses or masking treatments don’t have a significant effect, consider surgery to find the muscles that move the eyes and reposition them, or cut and reattach part of them. It is performed under general anesthesia, leaves no scars and is practically painless, so the exam can be performed on the same day as the surgery.
For at least 3 weeks after strabismus surgery, you must be very careful not to touch your eyes with your hands or get water in them to prevent infection. Even with surgery, 20-30% of cases of intermittent esotropia are ineffective, but if the strabismus recurs, re-operation may be necessary in more severe cases. Director Kim Wook-gyeom stressed: “To prevent recurrence, it is advisable to take care of your vision by avoiding close work and getting enough rest, and consistently follow your doctor’s instructions, including wearing glasses and eye protection.” Specialist Kim Dae-hee said: “If regular checkups are difficult, it is best to have eye exams at the ages of 1, 3 and 6. The earlier pediatric eye diseases are treated, the better the impact on development vision, so check them.” if possible at an early age.” “If possible, we recommend having an eye exam at least once a year,” she added.
[저작권자 @머니투데이, 무단전재 및 재배포 금지]
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