Dear Doctor,

Of late, my three-year old daughter has been over scratching her eyes. She tells me they itch her all the time. What could be the cause and how can I manage this condition?

Robinah

Dear Robinah,

Ideally, a three- year old child is too young to have eye strain. The most common cause is a convergence defect.

Good coordination of the two eyes is needed to get a clear and sharp image of objects seen. In a child with convergence defect, due to weakness of eye muscles, he/she is not able to see very clearly. This spontaneously leads to rubbing of eyes. This problem can be detected by simple visual tests.

It is curable by means of a set of exercises of the eye muscles. As the child grows, the muscles get strengthened due to exercises and coordination improves, thus improving clarity of vision. Severe resistant cases need surgical intervention. A nutritious diet containing vitamins A and B complex is also useful in this matter.

Allergy to pollens/spores or anything in the environment can cause some itching, causing a small child to rub his eyes. Dryness of the scalp or seborrhoiec dermatitis over the scalp, can cause some dry flakes from the scalp to fall over eyes, causing itching, making a child rub its eyes. This just needs regular washing of the eyes with cool, clean water which removes potential allergy-causing substances and any dust or other particles settled there. If the itching is severe, use of some anti allergy eye drops or syrup given for some days can help the child.

Chronic infections of eyes like trachoma and blepharitis can also cause itching.

But whatever may be the reason for the itching, rubbing the eyes frequently can introduce infection. This can augment itching and cause redness and pain of eyes. Hence a child should be instructed not to touch the eyes. If it is unavoidable, he can be given soft tissue to rub the eyes with softly. It is also important to keep the finger nails of the child trimmed and clean so that he does not injure the eyes while rubbing them.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital