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01/Feb/2018

According to ophthalmologists, the visual acuity of a newborn is extremely low (0.005 – 0.015). In the first months of life it gradually increases to 0.01 to 0.03, at the age of 2 years it rises up to 0.2 – 0.3 and only at 6-7 years it reaches 1.0.

Regular visits to an ophthalmologist are very important. In order to identify congenital diseases (cataracts, retinal tumours – retinoblastoma, glaucoma) and inflammatory diseases the first examination of the child should be done in maternity. It is mandatory to examine premature born babies to exclude retinopathy of prematurity and optic nerve atrophy. The first year of life is a period of intense development, so visits to the ophthalmologist should be done at six months and at one year.

The novel device available at Optisan Clinic offers real-time following information:

  • Measurement of eye refraction;
  • Corneal reflex analysis (symmetrical or asymmetrical);
  • Measurement of pupil diameter in both eyes and pupil distance;
  • Build up the eye-fixing image.

A unique feature of this autorefractometer is the ability to obtain accurate refractive binocular measurements at a distance of 1 meter without pupil dilation. Measurements are performed simultaneously in both eyes. The device can be used in children of all ages, including children with nystagmus and in non-cooperating patients.

The technique of measurement of the autorefractometer is based on dynamic photoskiascopy (infrared radiation). Infrared radiation is harmless to the child’s eyes; it is present in the day light and is invisible to a human eye.

During the examination, the infrared rays are projected onto the retina through the pupil. Depending on the refractive error, the reflected light generates a bright image inside the pupil.

A medical exam resembling a game!

Diagnosis in children, especially young children, has always been more difficult. Unlike an adult, a kid cannot meet all the doctor’s requirements. He revolves his head, rarely stays quiet, and cannot focus his sight for a long time.

All measurements completed with the new generation autorefractometer are performed in an interactive way, resembling a game: the camera generates a special sound, catching the attention of the child, and the screen displays a smiling face. The procedure lasts just a few seconds, it is non-contact, so that the child does not get tired and does not feel any discomfort.

Photo: goo.gl/pYQhMS

 


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01/Feb/2018

Regular visits to the ophthalmologist are as important as regular vaccinations and visits to the pediatrician. Unfortunately, the brief examination of the ophthalmologist at the polyclinic, kindergarten or school is not always able to provide a complete idea about the child’s eye health. The fact that you do not have vision problems does not guarantee that your child will have a good vision. Opposite, myopia in one of the parents may not affect the child’s vision. However, it is advisable to consult a specialist.

Outdated technologies for testing visual acuity by means of wall chart are still used in hospitals, kindergartens and schools. Such a test does not provide a satisfactorily complete condition of visual health, as sometimes a latent myopia or a hypermetropia, which in several cases requires optical correction, may be overlooked.

The Optisan Clinic offers a comprehensive diagnosis of the visual system, a consultation of an ophthalmologist with experience in pediatric ophthalmology, able to properly assess the condition of the child and, if necessary, initiate an effective, individualized treatment. New Generation Computerized Diagnostic Devices used in the Optisan Clinic for examining children provide a very high accuracy of the data obtained.

Diagnosis in children, especially young children, has always been more difficult. Unlike an adult, a kid cannot always meet all the doctor’s requirements, often cannot accurately assess his perception and may give unclear answers. Therefore, the devices used in diagnosing children are designed in such a way that the test results do not depend on the precision of the child’s actions.

It is important to note that methods of investigation and diagnosis for children, used at Optisan Clinic are based on modern non-contact equipment. If during the exam the doctor reveals some vision problems, the child will receive the indispensable treatments and will be closely monitored.

Measurement of refraction is performed with autorefracto / keratometer. Currently there are special autorefracto / keratometers for children; these do not require exact eye fixation and even follow the movements of the eye. These devices measure both the refraction of the entire optical system and the cornea (one of the natural lenses of the eye) separately, which is very important in case of astigmatism.

Modern diagnosis entails examination of the eye fundus with pupil dilated. New generation drugs, harmless and easily tolerated, are used for the dilation of the pupil.

The Optisan Clinic offers an early diagnosis of eye disease, providing the opportunity to start treatment as early as possible when the disease has not yet had a significant impact on eye function.

Photo: goo.gl/CEM5nS

 

 


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01/Feb/2018

Vision is important at any age. Children explore the world by means of their eyes, adults make visual efforts at their workplace, the elderly preserve their vision for evenings spent with grandchildren.

We accept clear vision like something natural and notice changes only after the age of 40 years. Some people attend an ophthalmologist for the first time at this age.

In my career as an ophthalmologist, with many years of professional experience, I have encountered numerous cases of late established eye disorders. I strongly support the presumtion that there is an imperative must for early prevention and screening of ophthalmic disorders and refractive errors, in order to give my patients a real chance of having a good vision.

For several years I have focused on pediatric ophthalmology, for the reason that I consider children being a vulnerable category. Contemporary diagnostic devices allow assesment of refraction at a very young age, even under the age of one year. That’s why I encourage you to attend an ophthalmologist in the first year of your child’s life. If there are no concerns or family history of eye conditions, the first visit can be postponed until the age of 3 years.

A correct and personalized therapeutic approach at a young age greatly increases the chances of recovery of the child’s vision and, unreservedly, his / her optimal intellectual development, as well as his / her school performance.

I’m waiting for you at the Optisan Clinic to answer all your questions regarding the health of your eyes.

With kind regards,

Dr. Alexandru Dimitriu

Ophthalmologist


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01/Feb/2018

The child receives more than 90% of the information through vision. Therefore, if the vision is poor, this may affect the child’s development in the future. Subsequently, in order to detect possible diseases at early stages, it is important to consult an ophthalmologist once a year, even if no complaints.

Glasses: to wear or not to wear?

The most common conditions that require wearing glasses from childhood are astigmatism, myopia and hypermetropia. Wearing glasses cannot be neglected in any case, as it is an important part of the treatment. However, it should be stressed that the outcome of the treatment, namely a good vision of the child in the future, depends largely on choosing the proper correction!

Usually, in hypermetropia, glasses are prescribed for permanent wearing. In childhood, uncorrected hypermetropia may lead to the development of amblyopia (lazy eye) and convergent strabismus. Early detection of hypermetropia (2-3 years) and its proper treatment can prevent the development of these conditions.

As for myopia, most children need glasses for vision at distance, and some of them – also for reading (when myopia exceeds 5-6 diopters). Unfortunately, due to the association of degenerative changes in the layers of an eye with myopia, glasses cannot always correct the vision good enough.

In astigmatism glasses are with cylindrical lenses, and are worn in the way prescribed by the doctor (either permanently or just for activities at near).

Regardless of the diagnosis, at Optisan Clinic physicians have an individualized approach to prescribing optic correction and always assess the patient’s tolerability of glasses.

There is an alternative!

If your child definitely refuses to wear glasses, the ophthalmologist at the Optisan Clinic can offer you an alternative method of correction – contact lenses. The doctor always considers both child’s age and psychic characteristics. Choosing contact lenses of any complexity is done from a young child’s age. Contact lenses are a modern, excellent correction method and can be prescribed even to very young patients.

However, in order to preserve the health of children’s eyes, it is necessary to observe some rules, and namely:

  • Contact lenses for your child must be selected by a physician based on the results of diagnostic tests performed with modern equipment;
  • Buy only lenses of good quality and only in a specialized clinic.
  • Keep and maintain the contact lenses properly, do not wear them longer than the indicated wearing time.
  • Also, remember that the lens is a foreign body in the eye, so it is necessary to consult an ophthalmologist regularly.

Photo: goo.gl/mVE9FR


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01/Feb/2018

Diagnosing and initiating an early treatment of strabismus should be the goal of parents and ophthalmologists, because the most important period for developing of a normal vision of both eyes and binocular vision (space vision) is the period of up to 2 years.

Any imbalance unsettled during this period may lead to lack of development, impossible to solve later, even if the position of the eyes can be corrected. Strabismus can cause a delay in the child’s mental development.

Dr. Alexandru Dimitriu is answering the questions of the viewers.


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01/Feb/2018

Generally, the treatment of strabismus is a complex one. The treatment choice depends on many factors: the age of the patient, the causes of strabismus and the direction of deviation.

Treatment methods include: wearing eyeglasses, therapeutic treatment and surgery (if necessary).

Dr. Alexandru Dimitriu presents the treatment after establishing the diagnosis of strabismus and, also, the importance of optical correction.


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01/Feb/2018

Generally, parents observe carefully the growth and development of their children, especially if this is the first child. In the last period parents have become aware of the importance of preventive consultation. At the Optisan Clinic, Dr. Alexandru Dimitriu consults children from the youngest ages and recommends a first attendance to an ophthalmologist around the age of 6 months. What do parents have to follow in children to discover in useful time a strabismus?

First of all, they need to understand how good their child sees. Find more from the video.


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01/Feb/2018

Strabismus is a visual problem in which the eyes are not aligned properly and point in different directions. About 4-5% of new-borns have strabismus and, over time, 50% of them develop amblyopia (lazy eye). The causes of strabismus are multiple, heredity has a crucial role, but there are children who have strabismus without a known cause.

What is strabismus and how does it manifest itself? Dr. Alexandru Dimitriu explains what congenital strabismus is.


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01/Feb/2018

Strabismus is a visual problem in which the eyes are not aligned properly and point in different directions. The condition may be present occasionally or constantly, in one eye or, more commonly, in both eyes.

 

How often does it appear?

– 4-5% of new-borns in one year have strabismus

– 50% develops amblyopia (lazy eye)

 

What are the causes?

– Heredity – especially a family history of refractive errors (myopia, hypermetropia, astigmatism) – in 60-80% of cases;

– Nervous system disorders: neonatal neurological history – prematurity, dysmaturity, cerebral motor disability, meningitis;

– Trauma of the skull, orbits;

– Refraction errors, differences in refraction between the two eyes;

Hypermetropia is commonly associated with convergent strabismus;

– Congenital changes in orbital bones;

– Unilateral ptosis (fallen eyelid);

Unilateral congenital cataract;

The vast majority of children with strabismus, however, have none of these problems.

Some tend to think that the baby has a period of physiological instability in which it is “normal” for the eyes to exhibit some instability. Deviations (strabismus) can be considered “normal” if they are intermittent, usually divergent (i.e. outward) and disappear after 6 months of age, with a stable and parallel position of the eyes. Those which are constant, ample, visible and not disappearing after this age hide big imbalances and, as a rule, the treatment should be started early.

There is a so-called “strabismus from birth”, that is, the one noticed from the first days of life and which continue to be present after the age of 6 months. Specialists call this “infantile or congenital strabismus” and the recommendation is that the child should be examined as soon as possible by a paediatric ophthalmologist. Examination of a child less than one year of age requires a child specialist and not a general ophthalmologist because the protocol, means of examination and experience are completely different. One should not forget that the appearance of a “running” eye can hide serious medical conditions: congenital cataract, malformations, nerves and retinal disorders, sometimes tumours.

When should a baby be examined by an eye specialist?

  1. If it is born prematurely or suffered at birth (low APGAR score) – from the first days, as soon as its examination is possible. In large cities, there is a program for examination and treatment of premature babies in hospital just after birth. There are specialists in Romania who deal with this successfully.
  2. If it was born in term, with normal weight, but with obvious deficiencies at eye level – marked asymmetry, white pupil, nystagmus, different size of cornea or eye ball, deviation of both eyes inward or outward, lack of reaction to visual images or visual stimuli . Such a child should be examined under the age of 6 weeks.
  3. If within first 6 months the child has intermittent or permanent strabismus of one eye and this persists after the age of 6 months, it is advisable for the child to be examined by the paediatric ophthalmologist.
  4. If the child has no disorders for up to 6 months, but then a permanent or intermittent strabismus is installed, the child should be examined by the paediatric ophthalmologist.

Diagnosing and initiating an early treatment of strabismus should be the goal of parents and ophthalmologists, because the most important period for developing of a normal vision of both eyes and binocular vision (space vision) is the period of up to 2 years.

Any imbalance unsettled during this period may lead to lack of development, impossible to solve later, even if the position of the eyes can be corrected. Strabismus can cause a delay in the child’s mental development.

This is why strabismus that occurs after two years of age is somewhat easier to treat and is associated with better functional results.

Chances of success are greater if the treatment starts early.

Treatment of infantile strabismus

Sometimes such treatments as the prescription of special glasses or contact lenses, eye exercises, etc., may be enough to treat strabismus. Other treatments may involve surgery to correct the unbalanced eye muscles or to remove a cataract. Surgery for strabismus provides a good cosmetic effect as it works to straighten the eyes, but it does not restore binocular (two-eyed) vision.

Therefore, patients need a postoperative recovery therapeutic course (offered at the Optisan Clinic) to help them adjust to the new eye conditions and gets the best results.

 

The therapeutic treatment of strabismus

Strabismus is a visual problem in which the eyes are not aligned properly and point in different directions. In strabismus, doctors strongly recommend starting treatment as soon as possible to prevent the development of complications and to enable early functional rehabilitation.

Generally, the treatment of strabismus is a complex one. The treatment choice depends on many factors: the age of the patient, the causes of strabismus and the direction of deviation.

Treatment methods include: wearing eyeglasses, therapeutic treatment and surgery (if necessary).

In some cases optical correction and therapeutic treatments may be enough to normalize the visual function. For accommodative esotropia, glasses reduce the focusing effort and often straighten the eyes. Sometimes bifocals are needed for close work.

These are also necessary to eliminate amblyopia (which often accompanies strabismus) and to restore the connection between the two eyes. The patient’s brain is trained to combine the two pictures into a single, three-dimensional image. This three-dimensional image gives us depth perception.  If necessary, the lenses can have a prismatic effect, which makes it possible to approach the images obtained by each eye.

At Optisan Clinic, ophthalmologists deal with this problem quickly and effectively by complex vision stimulation with special equipment. The cure of therapeutic treatment makes it possible to significantly improve vision. For more details, contact us at office@optisan.ro.

 

 


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31/Jan/2018

During pregnancy, the main threat to the visual system is the condition of the retina. The retina is a thin layer of nervous tissue located on the inside of the back of the eyeball.

It is responsible for the perception of the image projected on it through the cornea and the lens; it transforms the image into nerve impulses that are then transmitted to the brain.

The main problems that may appear in the retina are: retinal degeneration, retinal rupture, and retinal detachment.

The main concern of all pregnant women is to keep their vision.

In order to prevent possible complications of the eye during pregnancy and childbirth, it is necessary to determine in advance the condition of the visual system of the future mother and to check the integrity of the retina.

Regardless of how you see and the presence or absence of visual complaints, ophthalmologists recommend that you take an eye exam at 10-14 weeks of pregnancy.

In addition to the general examination of the visual system, it is necessary to perform a diagnosis of the eye fundus with the dilated pupil.

If the ophthalmologic examination does not reveal anomalies, it is recommended to repeat it at 32-36 weeks of pregnancy. However, if you have myopia, ophthalmologists recommend making a monthly exam. During pregnancy, the entire body of the woman is subject to change, including the visual system; therefore the eyes require particular attention from the future mother.

How will the delivery be?

Any woman who has some vision problems may ask herself at some point weather she can have a natural delivery or a caesarean section will be needed. The answer to this question is not a simple one because the decision on how the delivery will take place depends on several factors such as the condition of the retina and the eye, the general condition of the patient, the age, etc.

Cesarean is a surgical procedure which is performed only under absolute indications, i.e. in cases where natural birth is impossible or implies risks for the life of mother or fetus. Unfortunately, one of the most common indications for caesarean section is degenerative changes of the retina.

If you have myopia

As a result of pressure oscillations during natural birth, the risk of retinal detachment increases in women with myopia and other changes in the eye. In order to prevent the spread of degenerative changes of retina and to reduce the risk of retinal detachment, prophylactic laser photocoagulation could be used. During this procedure, the laser makes burns around the retinal tear, creating scarring that usually “welds” the retina to underlying tissue. Prophylactic peripheral laser photocoagulation can be applied at any time before pregnancy or during pregnancy up to 35 weeks.

The condition of the retina is not always related to the degree of myopia. Sometimes in a patient with a high degree of myopia, the condition of the retina is satisfactory, with no cracks and progressive degenerative changes. Conversely, people with slight myopia, not exceeding 1-3 diopters, may have dystrophic changes on the eye fundus.

If you are planning a pregnancy or are already pregnant, you should consult an ophthalmologist for eye examination. Keep in mind that a simple procedure reinforcing retina, done on time, can eliminate the need for a cesarean delivery.

Photo: goo.gl/rntGcr


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