Eye Care:

There are greater incidences of eye problems in children with FACS. For this reason it is important that health care professionals should take added precautions when assessing these children. The epicanthic folds in Fetal Anti Convulsant Syndrome are similar to those in Downs Syndrome, so it is not surprising that many of the challenges presented in the child with downs syndrome are similar to those of the FACS child. It is because of this that the information on this page is drawn from not only reports from parents, but from those with Downs Syndrome.

 

This is an area that needs much more research on the effects on the developing eye in children with Fetal Valproate syndrome.  It appears that the dysmorphic features in Down Syndrome create similar eye problems in a child with Fetal Anti-Convulsant Syndrome. 

Refractive errors such as Hyperopia (farsightedness), astigmatism (lazy eye), or myopia (near-sightedness) are not uncommon in these children. Other problems include weak accommodation (difficulty changing the focusing power of the eye from distance to near). 

 

Other conditions such as Strabismus (eye misalignment) the eyes are misaligned; do not line up well with each other, fortunately strabismus can be subtle, even to the paediatrician. This is because of the folds of skin also cover up the underlying strabismus, which can sometimes  make the eyes appear as if they are crossing even if they are not.

 

Amblyopia (commonly called “lazy eye” which includes decreased vision) can be caused by multiple different eye problems such as strabismus, severe ptosis (eyelid droop). 

 

Other more rare problems which can occur with the optic nerve or retina of the eye which can sometimes cause vision loss and unfortunately are generally not treatable. Nystagmus (a rhythmic shaking of the eyes) has also been reported in these chldren.

 

If your child has eye problems he will likely see a paediatric ophthalmologist, and may see one who specialises in those children with special needs. Many children with Fetal Anti Convulsant Syndrome wear glasses for both far and near sightedness.

Squint:

Many FACS children have a squint. A squint is when the eyes are pointing in slightly different directions. Squints can be intermittent especially when they first appear; others are constant. In some cases the child alternates between squinting with the right eye and the left eye; in others, the child squints constantly with the same eye. When one eye moves out of alignment the brain receives two separate images so the one from the squinting eye is suppressed. The vision in a constantly squinting eye tends to be reduced.

Many children squint because they are long-sighted or short-sighted and consequently need glasses. Many children with a convergent squint, where one eye turns inwards towards the nose, are long-sighted (hypermetropic) and often, if such a child is given glasses to correct this the squint can become less noticeable or even disappear completely while the child is wearing the glasses. Children who are short-sighted, or who are likely to become short-sighted when they grow older, may have a tendency for one eye to drift outwards which can be controlled.

 

If any child is suspected of having a squint or any visual problem, it is important to arrange referral to someone who can establish a diagnosis and arrange treatment. Usually, children see an orthoptist, who always works closely with an ophthalmologist and possibly an optometrist.

Blocked Tear Duct:

About one in five children are born with a tear duct that is not fully developed.  In some FACS children this can be more common as  children with FACS are born with narrow tear ducts which promote blockages.     

 

In most children this will improve, as the eye will continue to and finish developing.  Wiping the eyes regularly with a saline solution and a sterile wipe will reduce the chances of     infection.  This process will often take a few days to a several months.  The baby is     monitored to see if this goes.  If this does not seem to be improving after six months, make sure that your doctor is aware of potential problems associated with FACS. 

 

If it has not improved by 12 months he should be referred to an eye specialist if your baby has not already been so. This is not often a serious problem.  The tear production in a baby may take up to a week to start.  You may notice watery eyes, sometimes, after sleep, it will appear sticky.  You will need to wipe this away with a sterile wipe and saline solution, or water that has been boiled and cooled down.  Even after this seems to have gone a cold can cause the eyes to become sticky during the cold as the newly opened tear duct may become blocked by mucus.

 

It can help if you massage the tear duct up to six times a day. This is done by putting gentle pressure on the top of the nose.  This will not only remove some of the blocked liquid, but it can also encourage the tear duct to develop.

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