Money Today Reporter Park Jeong-ryeol | 2024.01.18 16:31
[박정렬의 신의료인]
There is a proverb that goes, “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, it is difficult for young children to check their eye development with the naked eye, and they are unable to express abnormal symptoms as well as adults, so they often discover eye diseases late.
A typical eye disease that requires attention in children and adolescents is ‘strabismus’, where the alignment of both eyes is misaligned. According to the Health Insurance Review and Assessment Service, of the 176,561 patients who received hospital treatment for strabismus in 2022, 874,697 were under the age of 9, or 6 out of 10 (61%).
Kim Dae-hee, a specialist at the Strabismus Pediatric Ophthalmology Center at Kim Eye Hospital, said, “Unlike other body parts, vision develops intensively during infancy and is almost complete by the age of 7 to 8,” adding, “If strabismus is not treated in time, it can have a negative impact on vision development.” “Careful observation and regular checkups by guardians are very important,” he emphasized.
Ratio of patients with strabismus by age in 2020./Photo = Health Insurance Review and Assessment Service
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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 there is an eye disease such as refractive error, congenital cataract, or retinal abnormality, eye movement ability is reduced and the pupil is tilted to one side, causing strabismus. Large external shocks, brain diseases such as cerebral palsy, or eye-related muscle abnormalities also affect the onset. Recently, it is not uncommon for people to look at smartphones, computers, or TV monitors for long periods of time, causing their eyes to become dilated and causing 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 a bright smartphone screen for a long time while lying on your side with the lights off, one eye will be blocked and the visual and brain signals will not match, which can cause strabismus, so be careful. “Do it,” he urged.
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‘Intermittent exotropia’ is the most common
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In Korea, approximately 2% of children are reported to experience 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 exotropia is the most common pediatric strabismus in Korea. It is an eye disease in which the symptom of exotropia, in which one eye turns outward, occurs temporarily. Normally, the pupils are in the exact center, but when you are tired, sleepy, bruised, or take a picture, 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 that appears within 6 months of birth. This is a case where one eye is severely turned inward, and vision recovery can only be expected if surgery is performed by the age of 2 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 hyperopia, which makes it difficult to see close objects, you open your eyes excessively and turn them inward to see things clearly. In this case, if you wear glasses (convex lenses) to correct hyperopia outside of sleeping hours, the strabismus will disappear. Even if your eyesight is too weak, strabismus can appear, and in this case, ‘obscuration therapy’, which covers the healthy eye and forces the use of amblyopia, can be helpful. Specialist Kim added, “As the hyperopia decreases as the child grows, the strabismus disappears and the child can take off the glasses, but if the symptoms remain and are judged not to be corrected with glasses, surgery is required.”
Lastly, there is also ‘pseudostrabismus,’ which is not actual strabismus, but appears to be strabismus. Asian children, including Koreans, have low nose bridges and a distance between the eyes, so the skin on the nose covers the whites of the eyes, causing them to look cross-eyed. It looks like esotropia, but in reality there is no strabismus. This disappears naturally as it grows and does not require special treatment.
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If you squint one eye in a bright place, you may become suspicious.
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When strabismus occurs, the pupil turns to one side, movement is restricted, and symptoms include turning the head in the opposite direction of the eye. Raising your chin or tilting your head to one side are also signs of strabismus. It is a good idea to get an eye exam even if one eye seems out of focus or you react sensitively, such as squinting when looking at sunlight.
Strabismus is a disease caused by an imbalance between the two eyes, and wearing glasses to correct vision is the basic treatment. If non-surgical treatments such as glasses or masking treatments do not 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 virtually pain-free, so testing can be done on the same day as 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 to 30% of cases of intermittent exotropia are ineffective, but if the strabismus recurs, reoperation may be necessary in severe cases. Director Kim Wook-gyeom emphasized, “To prevent recurrence, it is advisable to take care of your vision by avoiding close work and getting enough rest, and to consistently follow the doctor’s instructions, including wearing glasses and eye protection.” Specialist Kim Dae-hee said, “If regular checkups are difficult, it is best to get eye exams at ages 1, 3, and 6. The sooner pediatric eye diseases are treated, the better the impact on vision development, so check them out at an early age if possible.” “If possible, we recommend getting an eye exam at least once a year,” he added.
[저작권자 @머니투데이, 무단전재 및 재배포 금지]
2024-01-18 07:31:58
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