This fortnight, on Ask the Expert, we ‘meet’ Dr. Mithila Gaitonde-Negalur who is here to tell us all about caring for those beautiful, curious, little eyes.

Mithila hails from Maharashtra and has completed her post-graduation DNB in Ophthalmology, followed by FICO (Fellow of the International Council of Ophthalmology), UK  and is now pursuing a Fellowship in Pediatric Ophthalmology, Strabismus & Neuro-ophthalmology as a Clinical Adjunct at LV Prasad Eye Institute, Hyderabad.

She has been a part of various school screening & newborn ICU screening programmes across Andhra Pradesh & Telangana and has participated in teaching programmes at her institute as well as state conferences.

Academics apart, she has completed her graduation in Kathak and she absolutely adore animals.

Here’s my Q&A session with her:


  1. Could you tell us about the common eye problems/issues that children may face between the ages of 1 to 5 years?

The most common eye problem in children across all ages is refractive error, especially myopia commonly called as short sightedness.

We also frequently see infective conditions like “red eye” or conjunctivitis, eyelid swellings like stye or chalazion, amblyopia also called a lazy eye and squinting of eyes which usually presents between 1-5 years. Very rarely do they even develop cataracts or eye tumours at this age. Infants i.e. children less than 1 year of age may also have eye conditions unique to them. Though not very common, they need to be seen for any watering of eyes which could be a nasolacrimal duct obstruction or any signs of pre-maturity or congenital anomalies in the eyes.

  1. How can a parent know if their child is having an eye problem? Especially for kids who can’t speak or express themselves yet, what is it that they should look out for?

While assessing pre-verbal children, what we check & what we ask the parents to look for is the expected visual behaviour of the child at each age.

For example, by 2-4 months of age, a baby should start making eye contact with the parents & smile at them, if this is not happening we know there may be something wrong. We also assess the overall development of the child to look for delay in any other milestones like sitting, walking, speaking etc. Many a times parents may notice indirect signs of eye problems like child keeps bumping into objects, does not see well if it becomes dark, child’s eyes keep shaking continuously, child keeps rubbing the eyes, watches TV from very close distance etc.

Parents should look out for any such abnormal visual behaviour & consult an eye doctor. For children 6-7 months & above we have special eye charts for vision assessment and some electrophysiological tests for even younger infants to estimate their vision.

  1. What is your take on screen time for children? Is there really a ‘good time’ to introduce the screen to children?

I really don’t think there is any ‘good time’ to introduce screen to children. I know in today’s busy world, it’s a matter of convenience for all parents but studies are showing that children who spend a lot of time with these gadgets have an increased risk of developing myopia. So I would not recommend more than 1 or 1 and half hours of total screen time including TV, Ipads, mobiles, video games and maybe another hour extra or so on a holiday.

  1. At least 6-8 out of every 10 children are hooked on to some form of screen in the current world. If screen time really does affect the eyes, what are some precautions that parents must take?

Like I said it does really affect eyes, so it is important to limit screen time for children. Parents instead should encourage children to go out and play as outdoor activities have been found to have beneficial effects against development or progression of refractive errors.

  1. Could you give some general guidelines to be followed to reduce eye problems in adults and children?


  • Start with keeping eyes and eye lids clean. Clean them everyday with cool, clean water.
  • Wear protective eye wear while travelling especially while on a two wheeler.
  • Wear glasses regularly as instructed by your doctor.
  • Immunization must be up to date for all children as per age.
  • While studying or reading ensure you are sitting with a good posture and in a well illuminated room.
  • Have a healthy diet and a good night’s sleep everyday so your eyes are well rested.


  • Do not rub your eyes.
  • Do not touch your eyes with unclean hands eg: while playing or while eating.
  • Do not self medicate children ever even if you are almost sure what the problem is, it could be dangerous.
  • Avoid kajal/ surma in eyes for new born babies.
  • For older children/adults – Avoid eye make-up in case of eye irritation/ red eyes and it’s best not to share eye cosmetics with others.
  1. Like taking a child to a dentist, is it required to take a child to an ophthalmologist from time to time for a general check-up?

Neonatal screening is practiced nowadays, so the first eye check-up is recommended within the first week of life in the hospital so we can pick up any abnormalities, if present and treat it early.

Following this, an annual eye examination is recommended for everyone, not just children and an even shorter follow-up in children with eye problems may be needed depending on the condition.

Remember, your eyes reflect your health and sometimes your eye doctor may be the first one to pick up an eye problem which is actually a sign of an underlying systemic health issue.

  1. A balanced meal helps the eyes just as much as it helps the rest of the body – but is there something specific that can be/should be consumed to maintain good eye health?

It is very true that a balanced meal helps the eyes just as much as it helps the rest of the body. Your eyes can have various problems if your Vitamin A levels are inadequate, especially if a child has had an attack of measles or very severe diarrhoea. So, Vitamin A rich foods like green leafy vegetables – spinach, broccoli, lettuce etc., all the ‘red’ coloured food items like carrots, papaya, melon, mango etc., nuts, fish, eggs should be consumed regularly.

In families with a purely vegetarian diet or those who do not eat eggs, Vitamin B levels may be low which is essential for optic nerve function. We must ensure these children have adequate milk every day and may need further supplementation, if necessary.


Thank you so much, Mithila, for agreeing to do this. We appreciate the help.

Have more questions you’d like to get answers to? Email me and I’ll try and get it answered for you.


Posted by:Madhumitha

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