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Paediatric ophthalmology

Children are unable to distinguish between clear and unclear vision. Even if your child can read the smallest letters on an eye chart, there may still be hidden problems. School vision tests briefly screen vision only at a distance. The majority of school tasks require that a child be able to focus and see
clearly up close to read and write. That’s why we recommend a complete eye examination for every child by age three, and sooner if problems are suspected.  A child"s vision exam includes many important tests.

Your children will feel comfortable in their own waiting area and designated exam rooms. Our
optical department has many frame styles especially for children. If your child would
benefit from contact lenses, this service is also available.

According to the World Health Organization in May 2009 more than 314 million people worldwide were visually impaired out of this 45 million were blind and 85% people had low vision & avoidable blindness, childhood blindness remains a significant problem, with an estimated 12 million blind children below age 15.

The Paediatric Ophthalmology Department at aastha hospital deals with eye problems in children. Adult patients suffering from squint and double vision are also examined and treated effectively.
Children may not complain if they do not see out of one or both eyes. Sometimes the only clue may be poor performance in School, as well viewing the blackboard at a very close distance. Hence all children need an eye exam at the time of starting Schooling.
Of the eye problems in children, the most important are refractive errors, squint and amblyopia

Refractive error or the need for glasses is the single most important cause of vision impairment in children. This may lead to permanent deficiency in vision if not detected and treated early.
Squint, also known as cross eyes, is the condition where the eyes do not work together. Treatment includes glasses, eye exercises or eye muscle surgery

Lazy eye or amblyopia is the term for poor vision in one or both eyes. It can result from refractive error, squint or several other causes. This needs to be identified and treated at an early age to recover vision.

Infants born prematurely are at risk for developing Retinopathy of pre-maturity (ROP) which may lead to permanent blindness. Early diagnosis & treatment is key to success.
Cataract (opacification of the lens) can occur in children. This may be present since birth or result from injury. The treatment involves surgical procedures but very often treatment of lazy eye.
There are several causes of double vision and squint in adults as well. These are managed by exercise, special glasses, and eye muscle surgery when required


A child with any of the following needs to have a complete eye examination
Poor performance in School

  • Viewing objects at a very close distance
  • Squint
  • Eyes shaking
  • Family history of eye problems or wearing glasses

Facilities Available

•  Vision assessment
•  Amblyopia (lazy eye)
•  Sports injuries
•  Routine eye care
•  Pediatric glaucoma
•  Retinoblastoma
•  Strabismus (eye misalignment)
•  Pediatric cataracts
•  Hereditary eye diseases
•  Referral consultation
•  Retinopathy of Prematurity

Know about Paediatric Ophthalmology

Paediatric Ophthalmology is a relatively newer branch of Ophthalmology, which focuses on children’s eyes till the age of 16 years. The eye of a child is developing till this age. A normal ophthalmologist neither has the specialized training nor the equipment to correctly assess the visual needs of a child.

Some of the most common problems in children are Refractive Errors, Strabismus (squints), Amblyopia (lazy eye syndrome) and Astigmatism (abnormal curvature of the cornea).

In the case of children, it is very necessary for early detection and intervention. If this is not done, the entire development process may be hampered, and in extreme cases, may result in irreversible blindness. It is generally recommended that on birth, the concerned Paediatrician examines the eyes of the baby under normal torchlight and refers to a Paediatric Ophthalmologist in case of any aberration. Remember, there is no lower age limit for bringing a baby for consultation. The hospital often receives babies who are just a few days old.

It is normally advised that children up till the age of 16 years should visit a Paediatric Ophthalmologist every six months. Quite often, during these routine examinations, the doctors pick up conditions which otherwise left unattended, may adversely affect the child’s eye. It is shocking but even in Delhi, 1 out of a 1000 children suffers from Childhood Blindness; Blindness brought about due to lack of detection and intervention in the childhood years


Tips for Parents

If your child displays any of the following symptoms get in touch with a Paediatric Ophthalmologist. Your child has only one pair of eyes. Don’t neglect them!

• Regularly complains of headache or watery eyes
• Blinks or squints excessively
• Rubs eyes vigorously during or after short periods of reading
• Makes frequent written mistakes even while copying
• Repeatedly bumps into or drops things
• Suffers from nausea, dizziness, motion sickness or double vision


Eye examination benchmarks for children
Internationally, a child’s comprehensive vision examination has to include the testing of a number of visual skills, namely:

• Distance Acuity
• Near Acuity
• Binocular Fusion
• Color vision
• Convergence and eye teaming skills
• Eye tracking and fixation skills
• Focusing skills
• Streopsis
• Visual form discrimination
• Visual Memory
• Visual Motor Integration.

The examination should also test for the ability to transform images from a vertical to a horizontal plane (i.e. from the blackboard to the desk surface) and for the conditions of Hypermetropia and reversal frequency.

Insist on these tests. You owe it to your child.

Know about strabismus

Strabismus or squint  is a deviation of the eyes. Strabismus is a condition in which the eyes point in different directions.
An eye turn may be constant (when the eye turns all of the time) or intermittent (turning only some of the time, such as, under stressful conditions or when ill). Whether constant or intermittent, strabismus always requires appropriate evaluation and treatment preferably before seven years of age to enable proper development of binocular vision.

Children do not outgrow strabismus!

Strabismus (misaligned eyes) in adults is often the result of progressive, untreated or unsuccessfully treated strabismus from childhood. There are also many adults who develop strabismus as the result of an injury or disease, which then frequently leads to double vision. This is often hard to tolerate and prompts evaluation and treatment by a strabismus specialist.
In the past, most eye doctors thought that adults with misaligned eyes could not be treated successfully, or that treatment was "only cosmetic". Advances in the management of misaligned eyes now provide benefits to most adults as well as children.
Treating adults with strabismus can improve depth perception, the way the two eyes work together, and the field of vision. Many patients report improved self-esteem, communication skills, job opportunities, reading and driving.
The best way to determine whether straightening of the eyes is possible and appropriate, is to undergo an examination by a strabismus surgeon.
Having straight eyes is a valuable asset that patients deserve.

In addition to affecting eye function, misaligned eyes can get in the way of normal eye-to-eye contact, communication skills and social interaction. This can lead to reduced self-confidence and many patients will often look down or away from the person to whom they are speaking to avoid eye contact. The person being spoken to may be uncertain which eye the patient is using and may be distracted from what the patient is trying to communicate. Such impairment of communication skills can lead to limited job (or job advancement) opportunities.
Straightening the eyes will lead to some binocularity (that is, the two eyes working together) in the majority of cases, even in instances where the onset of the strabismus occurred in early childhood.
Strabismus repair is not a "cosmetic" procedure but should more appropriately be considered reconstructive. After eye alignment surgery, most children and many adults improve eye function and may gain social and economic benefits.

Treatment Options

Strabismus can be treated in various ways. Depending on the individual case, treatment options include:
• Glasses
• Prisms
• Patch
• Botox injection
• Surgery

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