Surgery, involving dividing and then reattaching some of the eye muscles, may sometimes be an option. The main treatments for squints are glasses, eye exercises, surgery and injections into the eye muscles.
If your child has developed a lazy eye, they may benefit from wearing a patch over their "good" eye to encourage their other eye to work harder. Read more about treatments for squints. Because people with albinism lack melanin in their skin, they're at increased risk of getting sunburn and skin cancer. If you have albinism, you should wear sunscreen with a high sun-protection factor SPF. An SPF of 30 or more will provide the best protection.
Report these to a doctor as soon as possible. Skin cancer is much easier to treat if it's found early. Read more about protecting your skin and eyes from the sun. There's usually no reason why someone with albinism cannot do well in normal schooling, further education and employment.
You might like to talk to other people with albinism. The Albinism Fellowship has a contact person network that can provide advice and support locally. You can opt out of the register at any time. Page last reviewed: 30 November Next review due: 30 November Eye problems The reduced amount of melanin can cause eye problems. Possible eye problems linked to albinism include: poor eyesight — either short-sightedness or long-sightedness , and low vision sight loss that cannot be corrected astigmatism — where the cornea clear layer at the front of the eye is not perfectly curved or the lens is an abnormal shape, causing blurred vision photophobia — where the eyes are sensitive to light nystagmus — where the eyes move involuntarily from side to side, causing reduced vision; you do not see the world as "wobbling" because your brain adapts to your eye movement squint — where the eyes point in different directions Some young children with albinism may appear clumsy.
How albinism is passed on The 2 main types of albinism are: oculocutaneous albinism OCA — the most common type, affecting the skin, hair and eyes ocular albinism OA — a rarer type that mainly affects the eyes Autosomal recessive inheritance In all types of OCA and some types of OA, albinism is passed on in an autosomal recessive inheritance pattern.
X-linked inheritance Some types of OA are passed on in an X-linked inheritance pattern. Genetic counselling If you have a history of albinism in your family or you have a child with the condition, you may want to talk to a GP about getting a referral for genetic counselling. Read more about genetic testing and counselling Diagnosing albinism Albinism is usually obvious from a baby's appearance when they're born.
Treatments for eye problems due to albinism Although there's no cure for the eye problems caused by albinism, there are a number of treatments, such as glasses and contact lenses, that can improve vision.
A child with albinism may also need extra help and support at school. Most likely only the eye doctor will be able to tell if your child has iris transillumination. Nystagmus say: na-STAG-mass causes the eyes to "shake" or move rapidly.
The eyes may move side to side, up and down or in a circle. Most children with albinism have some form of nystagmus. The shaking decreases with age and will usually stop by the time your child is seven. In the eyes of a person without albinism, the optic nerve leaves each eye and goes to the centre of the brain.
This is where the pathways from each eye meet in a structure called the optic chiasm. At the chiasm, about half of the nerve fibres travel to the opposite side of the brain from where they started.
The other half travel to the same side of the brain as they started. The crossing of the nerves helps us see properly and transmit images from the eye to the brain. For a person affected with albinism, the nerves split unevenly.
For example, instead of half going to each side of the brain, 30 per cent may go to one side and 70 per cent to the other. This is called chiasmal misrouting. Most people with albinism have chiasmal misrouting. It is uncommon in people who do not have a form of albinism. To find out if your child has chiasmal misrouting the eye doctor will do a test called a visual evoked potential VEP.
Most people with albinism are sensitive to bright lights as they lack pigment in the ocular structures to absorb light. This can be uncomfortable but is usually not painful. Your child may want to wear sunglasses or a peaked cap both inside and outside to protect the eyes from bright lights.
OA is an X-linked disorder, which means it affects mainly boys. Boys with ocular albinism have an alteration in their only copy of the GPR gene. Genes are instructions for how the body develops or functions.
Girls can be carriers of ocular albinism. Carriers are typically unaffected by ocular albinism, although some may have mild iris transillumination, which can be detected on an eye exam. Rarely, girls can develop symptoms of ocular albinism, although typically the symptoms are milder than those found in boys.
In contrast, oculocutaneous albinism OCA is most commonly inherited in an autosomal recessive manner. In autosomal recessive conditions, there are two copies of the gene, and both copies are not working. Girls and boys are equally affected. Carriers of OCA have one working copy and one non-working copy of the gene.
Carriers can be girls or boys and are typically unaffected. Your child with albinism should visit the eye doctor at least once per year to have their eyes tested.
Ask your eye doctor about your child's visual acuity VA before they start kindergarten. Your child will probably sit very close to the television and will hold books very close to their face. This is normal for children with albinism and will not hurt their eyes or worsen their vision.
Your child may need assistive devices to see better. Ask your eye doctor for a referral for a low-vision assessment. This type of service can show you different devices available to help your child. If your child has low vision, make sure your child has an itinerant teacher. Females have two copies of the X chromosome while males have only one copy and a Y chromosome that makes them male. To have ocular albinism, a male only needs to inherit one changed copy of the gene for ocular albinism from his carrier mother.
Therefore almost all of the people with OA1 are males. Parents should be suspicious if a female child is said to have ocular albinism. While possible if the mother is a carrier of ocular albinism and the father has ocular albinism, it is extremely rare. For couples who have not had a child with albinism, there is no simple test to determine whether a person carries a gene for albinism. Researchers have analyzed the DNA of many people with albinism and found the changes that cause albinism, but these changes are not always in exactly the same place, even for a given type of albinism.
Moreover, many of the tests do not find all possible changes. Therefore, the tests for the albinism gene may be inconclusive. If parents have had a child with albinism previously, and if that affected child has had a confirmed diagnosis by DNA analysis, there is a way to test in subsequent pregnancies to see if the fetus has albinism.
The test uses either amniocentesis placing a needle into the uterus to draw off fluid or chorionic villous sampling CVS. Cells in the fluid are examined to see if they have an albinism gene from each parent. For specific information and genetic testing, seek the advice of a qualified geneticist or genetic counselor. Those considering prenatal testing should be made aware that people with albinism usually adapt quite well to their disabilities and lead very fulfilling lives.
Eye problems in albinism result from the abnormal development of the eye because of a lack of pigment and often include:. The iris, the colored area in the center of the eye, has very little or no pigment to screen out stray light coming into the eye. Light normally enters the eye only through the pupil, the dark opening in the center of the iris, but in albinism light can pass through the iris as well.
For the most part, treatment consists of visual rehabilitation. Surgery to correct strabismus may improve the appearance of the eyes. However, since surgery will not correct the misrouting of nerves from the eyes to the brain, surgery will not improve eyesight or fine binocular vision. Surgical intervention is also available to minimize nystagmus. People with albinism are sensitive to glare, but they do not prefer to be in the dark, and they need light to see just like anyone else.
Sunglasses or tinted contact lenses may help outdoors. Indoors, it is important to place lights for reading or close work over a shoulder rather than in front. Various optical aids are helpful to people with albinism, and the choice of an optical aid depends on how a person uses his or her eyes in jobs, hobbies or other usual activities. Some people do well using bifocals which have a strong reading lens, prescription reading glasses or contact lenses.
Others use handheld magnifiers or special small telescopes, and some prefer to use screen magnification products on computers.
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