High Eye Pressure in Children: Causes and Solutions

Eye pain and elevated intraocular pressure?

A first-grade student sleeps a sufficient 9 hours during the daily nap, has no after-school care, does not use electronic devices, and does not watch television.
Homework takes about 2 hours at home, yet she complains of eye pain every night before bed.
After visiting an ophthalmologist, it was found that her intraocular pressure was elevated.
Is there any way to improve this situation? After her first visit for eye pain, her intraocular pressure remained high for two weeks, and the doctor recommended transferring her to a larger hospital.
After stopping the eye drops for three days and transferring to Chang Gung Memorial Hospital, her intraocular pressure was normal, but she was diagnosed with pseudomyopia.
The hospital indicated that she might be allergic to steroids and advised caution with medication.
Three months later, she again complained of eye pain and was told her intraocular pressure was elevated.
What other factors could be contributing to her intraocular pressure issues?

NINI, 30~39 year old female. Ask Date: 2017/05/26

Dr. Cai Wenyuan reply Ophthalmology

Hello, I apologize, but your question can only be answered through an actual consultation.
Wishing you peace and good health.
Sincerely, Dr.
Tsai Wen-Yuan, Director of the Ophthalmology Department, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2017/05/26

More Info

High eye pressure in children, particularly in a first-grade student who experiences eye pain and has been diagnosed with elevated intraocular pressure (IOP), can be concerning for both parents and healthcare providers. Understanding the potential causes and exploring solutions is essential for managing this condition effectively.

Possible Causes of High Eye Pressure in Children
1. Genetic Factors: Some children may have a genetic predisposition to elevated eye pressure or conditions like glaucoma. A family history of eye diseases can increase the risk.

2. Anatomical Variations: Children may have anatomical differences in their eyes, such as a narrower angle in the anterior chamber, which can lead to increased IOP.
3. Eye Conditions: Conditions such as pseudoexotropia (false strabismus) or other refractive errors can cause discomfort and may be associated with changes in eye pressure.

4. Medications: The use of corticosteroids, even in topical forms, can lead to increased IOP in susceptible individuals. If the child has a history of steroid use, this could be a contributing factor.

5. Environmental Factors: Although the child does not engage with screens or excessive reading, environmental factors such as allergens or irritants can cause eye strain and discomfort, potentially leading to elevated pressure.

6. Stress and Anxiety: Emotional factors, including stress related to school or social situations, can manifest physically, including in the eyes. This can lead to increased muscle tension around the eyes, potentially affecting IOP.

Solutions and Management Strategies
1. Regular Monitoring: Frequent eye examinations are crucial to monitor IOP levels and assess any changes. This can help in identifying patterns or triggers that may lead to elevated pressure.

2. Medication Review: If the child is on any medications, particularly corticosteroids, it is essential to discuss these with the ophthalmologist. Alternatives or adjustments may be necessary to manage eye pressure effectively.

3. Lifestyle Adjustments: Although the child has limited screen time, ensuring that they take regular breaks during homework or reading can help reduce eye strain. The 20-20-20 rule is a good practice: every 20 minutes, look at something 20 feet away for 20 seconds.

4. Hydration and Nutrition: Maintaining proper hydration and a balanced diet rich in antioxidants (found in fruits and vegetables) can support overall eye health.

5. Stress Management: If anxiety or stress is a factor, incorporating relaxation techniques such as deep breathing exercises or mindfulness can be beneficial.

6. Consulting Specialists: If the child's condition does not improve or if there are concerns about the diagnosis, seeking a second opinion from a pediatric ophthalmologist or a specialized eye care center may provide additional insights and treatment options.

7. Follow-Up Care: Regular follow-ups with the eye care provider are essential to ensure that any changes in eye pressure are addressed promptly. This includes adhering to any prescribed treatment plans and reporting any new symptoms immediately.

Conclusion
High eye pressure in children can arise from various factors, and it is crucial to approach the situation with a comprehensive understanding of potential causes and solutions. Continuous monitoring, lifestyle adjustments, and professional guidance are key to managing this condition effectively. Parents should remain vigilant and proactive in seeking care and advocating for their child's eye health.

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