Managing eye health in young children

In The CLInIC Managing eye health in young childrenChildren are brought to us with a range of conditions, usually when their parents or carers notice something is wrong.This article focuses on the more challenging complaints in babies and young children, who are the most difficult to assess.This is not an exhaustive list of presenting complaints or examination techniques, but it will give a starting point. General principlesWhen your patient is a young child:• Do the best you can, and start treatment or refer the child as quickly as possible.The earlier the treatment starts, the better a child's vision is likely to be after treatment.Even if there is no treatment, a blind baby or child still needs help to develop as normally as possible and should also be referred.• Believe the parents.Most things parents notice and mention to you are real and relevant.Parents are usually right!They spend a great deal of time with their children, and will observe how children behave and what their eyes look like.• listen more than you speak.Usually the parent will help you towards the diagnosis.• Don't take any chances -play it safe.If in doubt, ask a colleague or refer the child to a specialist.• Be patient.It takes time to let the parents tell their story and to examine a child properly, especially one who cannot or will not cooperate.• Plan ahead.If you have a busy clinic, see any young children first.If you don't, they may get tired and irritable, which will cause stress for their parents or carers; it also makes children difficult to examine.