Are eye diseases hereditary? How to prevent vision problems 

Eyes are one of the most important sense organs of a person. Through them we learn about the world, read, and develop. Children with visual impairments experience developmental delays. They also have a harder time at school, particularly in terms of socialization. That is why genetics plays an important role, because many diseases are inherited, including eye diseases. 

If we know about the ailments that bother us, we often have no idea that we can be carriers of diseases. As well as the probability of their manifestation in descendants. So today we will touch on the topic of hereditary eye diseases. Tetyana Levitska, a pediatric ophthalmologist at the “Novy Zir” medical center, shared her expert opinion.

Levitska Tetyana Igorevna

Pediatric ophthalmologist, ophthalmology center "New Vision"

Cataract

There are eye diseases that children are born with. For example, children from parents with congenital cataracts often inherit the same pathology. Moreover, this gene can be passed on by grandparents, since the parents will be carriers. Therefore, if there were congenital cataracts in the family, the baby should be immediately tested for this disease. And you can also see or suspect clouding of the lens in utero during a screening ultrasound. 

Unfortunately, cataracts that are not diagnosed and operated on in time can lead to disability. In this regard, the situation in Ukraine is not the best: the country has problems with preventive measures, in simple words - with prevention. 

On the other hand, this disease is quite rare – one case per 10. It mostly affects one eye. The pathology can only be detected after a special ophthalmological examination.

Source: freepik

Myopia

Poor eyesight is now a very common phenomenon. Adults care little about their health, believing that not seeing clearly is normal. So it is not surprising that they do not pay attention to vision problems in children. 

Myopia is a global problem today. It can be congenital, meaning that a child is born with negative refraction and poor vision. However, there are few such cases, approximately 2%. Usually, myopia appears at school age and progresses until the age of 18, less often 24. There is also pathological myopia, which can progress throughout life. 

However, heredity plays a significant role here. If one of the parents has myopia, the risk of its development in the child is three times higher than in the others. If two parents have it, it is 8 times higher! So, genetically we transmit myopia. In any case, the child can be either a carrier or suffer from myopia. 

The fact that a baby is born without signs of myopia does not mean that the disease will not develop at school age, during a period of active growth. Our children have been studying remotely for 3 years in a row, constantly sitting at computers and almost not walking in the fresh air. And these are all factors that provoke a decrease in vision. 

Thus, the Novy Zir clinic has noted a significant spread of myopia in children. The situation worsened in the first year of the Covid pandemic. In March 2020, children were sent to quarantine, and in January 2021, the medical facility saw a peak in myopia examinations.

Fortunately, there are now various ways to correct vision. The first and easiest is to wear glasses. A good alternative is contact lenses. The most effective in the world are considered rigid (orthokeratological) night lenses, which change the shape of the cornea during 7-8 hours of sleep, which provides a clear image during the day. A convenient method of correction, which also stops the progression of myopia, are soft contact lenses. However, it should be remembered that during periods of active growth of the child, myopia may increase.

Source: freepik

Farsightedness

Babies are born with hyperopia, and this is the norm. However, by the age of 6-7 it should disappear or a very small percentage of it may remain. The thing is that children are born with a reduced size of the eyeball, so the light beam focuses not on the retina, but behind it. This is how farsightedness manifests itself. 

This is why you shouldn't hold small objects in front of a child's face so they can focus their gaze on them. This is why students start school at the age of 6 – not because of mental development, but because the body has to adapt to certain stresses and demands. 

Farsightedness is often accompanied by strabismus. Previously, it was diagnosed at the age of three. The child began to study small objects, become interested in books, Lego, and the visual analyzer could not withstand the load due to the large positive refraction - this is how the eyes squinted. Now it is detected more often and earlier, because kids sit in gadgets that are held at a close distance. 

Farsightedness is hereditary. As for strabismus, experts have differing opinions.

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Glaucoma

Ophthalmologists fear this disease even more than cataracts. After all, impaired outflow of intraocular fluid leads to irreversible changes. Due to increased intraocular pressure, the child may lose vision, and it will no longer be possible to restore it. 

One of the signs of the disease is an increased diameter of the cornea and the size of the eyes. These parameters should alert a pediatrician or ophthalmologist during an examination of a small patient. Children usually do not feel pain - due to increased intraocular pressure, the eyeballs are overstretched, the structures are deformed, and the optic nerve suffers. 

Congenital glaucoma, unfortunately, is hereditary. In addition, it can be one of the symptoms of certain syndromes that are inherited. 

Source: freepik

Nystagmus

Due to involuntary movements of the eyeballs, the child cannot focus his gaze. There are different types of the disease - horizontal, vertical, rotatory nystagmus, but the result is the same - the baby has a wandering gaze. Congenital nystagmus is often hereditary due to a defective gene, other causes may be impaired intrauterine development, damage to the central nervous system. If a newborn does not focus his gaze on objects after 4 weeks, be sure to inform your pediatrician or ophthalmologist.

Retinal pathology

One of the congenital pathologies is retinoblastoma. This is an oncological disease of young children. It is most often detected before the age of 3, less often before the age of 6, and extremely rarely in older age. If the disease is diagnosed in time and treated, it is possible to save both the baby's life and the eye as an organ, and even fight for visual acuity. 

The pathology can occur in one or both eyes – it is genetically determined. So, if one of the parents has retinoblastoma, then the child has a high risk of having the same disease. Another cause may be a breakdown of the RB1 gene, located on the long arm of chromosome 13. 

To detect the disease, a “Red Eye” screening is performed. When we photograph a child, during a flash, the pupil area becomes red. This is normal. But if the reflex is not red, but white, be sure to visit an ophthalmologist for a thorough diagnosis. Also, today this is a screening test at a pediatrician or family doctor.

Retinal pathologies include many diseases, for example, Stargardt, Coats' retinitis, retinal abiotrophy. They are mostly present from birth, but appear or progress at school age or during hormonal changes, puberty. They are difficult to identify in infants, because the child cannot yet explain how he sees or does not see. 

The importance of genetic counseling

When a woman is pregnant, it is no longer possible to prevent the pathology. However, if the parents know that they have a serious ophthalmological disease, at the stage of family planning they should contact a geneticist. The specialist will tell you about the ways to solve the problem and whether he can help. For example, in the case of retinoblastoma, the doctor may suggest artificial insemination, and the embryo will be without the defective gene.

Unfortunately, we cannot eliminate eye pathology in an unborn child naturally. 

Source: freepik

Forewarned, therefore armed

There are people who don't realize they have eye problems. They were born with a pathology, so they are sure it's normal, because they don't know how it could be otherwise. Therefore, an examination by an ophthalmologist before planning children is mandatory.

Future parents should be as open as possible and inform their partner about all the nuances of their health. Only then can you decide together whether you are ready for certain difficulties.

Preventive examinations of children are very important. The first visit to an ophthalmologist is best done at the age of 3–6 months. Then at the age of one year. If there are no complaints, then at 3 and 6 years, before school. If pathology is suspected, the doctor will recommend visiting him once a year or every six months for observation or to make a decision on treatment.

Surgical intervention

There are pathologies that require immediate intervention, practically from birth. These are pathologies of the retina and lens - it all depends on how much the disease will affect the quality of vision or life. 

So, if the lens is not diffusely cloudy with cataracts and there is sufficient visual acuity, the operation can be postponed to better calculate the artificial lens for the future. However, one should not delay for a long time: the pathology interferes with the passage of light rays, which can lead to the development of amblyopia, a “lazy eye” syndrome. And when the brain does not receive information from the affected eye, it excludes it from the process of vision, because it cannot and does not learn to see with it.

In the case of retinoblastoma, there is a practice of premature birth abroad. Often this disease is detected in utero, and the tumor grows all the time. The larger it becomes, the less chance there is of preserving the eye as an organ. Therefore, a decision is made to deliver prematurely in order to provide treatment more quickly.

But vision defects in children: myopia, farsightedness, astigmatism - are treated or their progression is stopped conservatively, with the help of glasses or contact lenses.

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