As pediatric eye care continues to improve, many eye diseases can be detected earlier. For example, low vision in children due to refractive error amblyopia; strabismus caused by eye position error, etc.. Young parents are often at a loss when it comes to these yes/no questions, such as farsightedness, myopia, astigmatism, amblyopia, strabismus, and so on. I don’t know what these terms really stand for. Now let’s talk about what to do if a child has strabismus and amblyopia. First, what is refractive error, strabismus, amblyopia People often compare the eye to a camera, the refractive system of the eye is equivalent to the focus lens of the camera. That is, light passes through some transparent refractive media inside the eye, such as cornea, atrial fluid, crystal, vitreous humor, etc., and converges the light on the retina to form a clear image. This system is called the refractive system. If the properties of some of the refractive media in this system are altered so that light cannot converge on the retina, this is an abnormality that we medically call refractive error. Usually refractive errors include farsightedness, myopia, astigmatism, etc. Amblyopia is the absence of organic disease in the eye, the best corrected visual acuity is less than 0.8, that is, no matter how much glasses can be worn, the visual acuity can not be improved to 0.8. Strabismus is the two eyes are not parallel, can not look at the same target at the same time. The clinical manifestations are internal strabismus, external strabismus, vertical strabismus, etc. What should I do if I have abnormal vision? From the above, it is clear that abnormal vision does not necessarily mean that a child is myopic. Generally, most of the children aged 3-7 years with refractive errors are farsighted or with astigmatism, but of course, with the popularization of TV and computer, children’s eye time is significantly more than before, and the age of onset of myopia is younger than before. Once parents find that their child’s vision is abnormal, they should go to a professional pediatric ophthalmology department for an eye referral examination. It is important to emphasize that because the ciliary muscle is so strong in children, a normal small-aperture optometry does not objectively reflect the true refractive status, and pediatric optometry must be performed with ciliary muscle paralysis, also known as dilated optometry. Through optometry can be found various types of refractive error, if it is mild refractive error, no obvious eye discomfort, naked eye vision does not significantly affect the use of eyes such as class, etc. can not wear glasses. If you have a mild refractive error, no significant eye discomfort, and your bare eye vision does not significantly affect your ability to use your eyes, such as in class, you may not need glasses. It should be noted that glasses are only a tool for vision correction and do not have a therapeutic effect on refractive error, so you should pay attention to your eyes after wearing glasses and follow up with your eye doctor regularly. For those who can’t reach 0.8 or above after wearing glasses and have no other abnormalities in eye examination, they are amblyopic. In addition to glasses, amblyopia also requires masking therapy, fine vision training and medication for different types of amblyopia. As a parent, you should understand that amblyopia treatment has a time limit. Because the sensitive period of amblyopia treatment is around 6 years old, after 10 years old, the effect of amblyopia treatment will be very poor, which will affect the child’s future study, work and further education. Therefore, parents should actively cooperate with the doctor for treatment. So once myopia is diagnosed, what should be done? What is pseudomyopia and true myopia? Pseudomyopia refers to poor vision in the naked eye, but after ciliary muscle paralysis the vision improves significantly, even to 0.8 or more. This is due to excessive near eye use, the patient’s ciliary muscle is over-regulated, producing regulated myopia, which has not yet caused abnormalities in corneal refractive power and elongation of the eye axis, and when the ciliary muscle regulation is removed, it returns to a normal refractive state, called pseudomyopia. The main clinical manifestation is that the vision is sometimes good and sometimes bad, often in inverse proportion to the intensity of eye use. At this time, if we can control the frequency and intensity of eye use, reduce the time spent watching TV and computer and playing video games, read and write for an hour or so and look into the distance for a while, do eye exercises, etc., we can prevent the further development of myopia. In addition, you can also take tropicamide eye drops at night before going to bed to relax the ciliary muscle. True myopia is the degree of myopia obtained through ciliary muscle paralysis optometry, which is true myopia, in fact, what we usually call myopia is often referred to as true myopia. For the treatment of true myopia, scientists from various countries are constantly researching, but there is no clear and effective method yet. The main approach now is through correction of myopia. There are traditional frames, corneal contact lenses and refractive surgery for myopia, among others. For our 3-7 year olds, the main thing is to wear proper frames. So when is it time to get glasses? This depends on the patient’s naked eye vision and the degree of myopia. If the naked eye vision is okay, 0.6-0.7, myopia is around -1.00, it does not affect the normal use of the eyes, such as the normal classroom study can be carried out, you can not wear glasses. On the contrary, you should wear glasses. It is also important to note that myopia is an eye disease that grows gradually with the growth and development of children and is associated with congenital genetic factors, such as a high prevalence of myopia in premature children, a high prevalence of myopia in children whose parents are both myopic, or in children whose parents are highly myopic. At the same time, myopia is related to the balance of eye use and nutrient intake later in life. The stressful pace of life, excessive eye use, and poor food structure are all factors that contribute to myopia. Therefore, to prevent the occurrence and development of myopia, it is necessary to start from all aspects, reduce the study burden of children, and do not let children enter the hurried and stressful adult life too early. Eat more food containing phosphorus and calcium, and do more outdoor exercises. It is necessary to follow up with the hospital regularly, usually once a year or half a year or so need to dilate the pupil optometry, timely detection of problems, timely correction. The first thing you need to do is to go to the hospital and find out that your child’s eye position is not right, while others go to the hospital and find out that your child has poor vision or an abnormal head position when looking at things. Strabismus is usually accompanied by abnormal vision or even amblyopia. Therefore, strabismus not only affects the cosmetic appearance of the child, but also affects the development of visual function of both eyes, which directly affects the physical and mental health development of the child in the future. Therefore, early detection and timely treatment are crucial issues. The easiest way to detect strabismus is to observe whether the reflection point in the center of the child’s eye is located in the center under the light. In a normal eye position, a bright spot can be seen in the center of both eyes under the light. If it is found that the reflective point of the corner touch of one eye is in the center, while the reflective point of the corner touch of the other eye is off-center, it suggests that the eye that is off-center is a strabismus eye. This can usually be detected in a close up photograph. Once abnormal visual acuity or eye position is detected, you should visit a specialized pediatric strabismus and amblyopia hospital. Strabismus can be examined not only by the simple corneal reflection method mentioned above, but also by alternate masking test, trigeminal combined with masking test, synoptic examination, Maddox examination, fundus photography, and a series of other tests. The nature of the strabismus, the degree of strabismus, and the visual function of both eyes are determined. If the diagnosis of strabismus is confirmed, different methods should be adopted according to the different types of strabismus, which are briefly described here: Adjusted internal strabismus: this type of strabismus can be completely corrected after wearing glasses. The best and only way to correct this type of strabismus is to wear appropriate glasses. Non-modulated internal strabismus and constant exotropia: strabismus greater than 20△-25△ should be corrected surgically. Because these types of strabismus significantly disrupt binocular vision, surgery should be performed as early as possible with as clear an examination as possible. Intermittent exotropia: This type of strabismus is mainly manifested as sometimes the eye position is orthotropic, as normal, especially when concentrating, but also sometimes exotropia is presented, especially when wandering, inattentive diseases, etc. This is why it is called intermittent exotropia. Since this type of exotropia can still preserve some binocular vision, it is currently advocated that surgery can be deferred and that prolonged coverage of one eye be avoided. If there is persistent exotropia or if the interval of exotropia is significantly reduced, surgery should be considered. In addition, there is a more specific type of strabismus that manifests as a tilted head with the affected eye turned upward. This is medically known as superior oblique palsy. Some cases are often misdiagnosed as cervical muscle spasm and cervical muscle release is performed. In fact, this is a generally complex vertical strabismus, often involving several extraocular muscles, and the examination is tedious and complicated, requiring measurement of strabismus in various eye positions, as well as assessment of binocular visual function, and most require surgical treatment after the examination has been perfected.