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Eye or Ear Problems

Baby having a hearing test
Eye abnormalities

Some babies are born with eye abnormalities. They form as the result of something going wrong with the development of baby’s eyes during pregnancy. It is important to keep in mind that these abnormalities are rare. A few examples are:

  • Aniridia: This is an absence of the iris. As the iris regulates the amount of light entering the eye, aniridia makes it difficult to see because of glare and bright light conditions. Sometimes there is only a partial absence of the iris. Some people with aniridia can obtain contact lenses containing an artificial iris.
  • Anophthalmia: This is the absence of an eyeball. Newborn babies who have this condition should receive special plastic conformers to put into the eye socket. This maintains the shape of the eye socket as the bones in the face grow. When the child is older, an artificial eye can be made for her.
  • Coloboma iridis: This common eye abnormality is a keyhole-shaped notch in the bottom of the iris. It frequently occurs with other eye abnormalities.
  • Congenital aphakia: This is when a baby is born without a lens. Congenital aphakia can be treated with glasses or contact lenses that have a strong convex prescription.
  • Congenital cataracts: This is a condition where the lens becomes opaque, and vision may be blurry. If left untreated, permanent vision loss can occur. In some cases, congenital cataract can lead to lazy eye or underdevelopment of the visual system. The most effective way to treat cataracts is to remove the lens surgically. Optical correction with contact lenses or glasses is usually required after the surgery.
  • Microphthalmia: This is when the eyeball is too small. Chronic infections during pregnancy, especially viral infections such as rubella, are a common cause of microphthalmia. Babies with very mild forms of microphthalmia may benefit from medical or surgical treatment.

Ear abnormalities

Some babies are born with abnormalities of the ear. They form as the result of something going wrong with the development of the baby’s ear during pregnancy. The main examples are:

Outer ear malformations

These are common, usually minor but sometimes severe abnormalities of the outer ear. Outer ear abnormalities can include shallow depressions or bumps called skin tags in or around the outer ear. Many chromosomal abnormalities have ear malformations as one of their features. If necessary, some outer ear abnormalities can be corrected with surgery.

Congenital hearing loss

Some newborn babies are at risk of being born with hearing loss. These include babies with a family history of hearing loss, babies who have certain facial birth defects, and those who were affected by certain infections during pregnancy. Your baby’s health care provider will check to make sure she can hear properly, by clinically assessing her hearing. Many jurisdictions offer newborn screening for hearing.

Congenital deafness or hearing loss is a partial or complete loss of hearing in one or both ears, due to abnormal development of the ears in pregnancy. Most cases of congenital hearing loss have genetic causes. Therefore, if you or your partner has a family history of congenital hearing loss, there is a chance that your baby could also develop this condition. Congenital hearing loss can also be caused by certain infections during pregnancy, such as rubella and toxoplasmosis.

A child's early years are very important for learning and the development of speech and language. Treating hearing impairment early makes a big difference in how well a child functions later in life. A health care provider called an audiologist will try to provide the best use of a child's remaining hearing. The audiologist will develop a treatment plan for your child. This plan consists not only of making sound louder with hearing aids, but also speech and language training and parent support and training.

Hearing aids, which are loudspeakers that amplify sound, can benefit children of all ages, even young infants. Hearing aids do not make sounds more clear; in fact, they can sometimes distort sound. Therefore, as a baby becomes older, she needs to learn how to distinguish which sounds are important and which can be ignored. An audiologist can help a child to make these distinctions more easily. Children older than 12 months may sometimes benefit from having a cochlear implant, which can help improve their hearing and oral language abilities.

Hearing impaired children can be offered speech and language training programs as early as infancy. If the baby has only limited hearing loss, she can be taught to make the most of her speech and hearing abilities. If she has more severe hearing loss, she can learn a variety of ways to communicate, including speech, lip reading, finger spelling, reading, writing, and sign language.

If you have a baby with hearing loss, always make sure to speak directly to her, on her level. Use short, simple phrases. Speak clearly and not too fast. Repeat words and phrases often. Use a lot of facial expressions when you speak.

Andrew James, MBChB, MBI, FRACP, FRCPC