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Pediatric Eye Disorders

Pediatric Eye Disorders

There are numerous conditions and diseases that can affect a child's vision. Early diagnosis and treatment are critical to maintain the child's eye heath.

Amblyopia

  • Also known as Lazy Eyes

  • Reduced vision in an eyethat results from misalignment of the eyes(strabsiums),need for glass (refractive errors, or disruption of light passing through the eye (e.g. pediatric cataract)

  • if recognized early, Amblyopia responds well to the treatment

  • if recognized later, amblyopia is much more difficult to treat and the child may have permanent vision loss.

  • Signs and symptoms to watch for include misaligned eyes, squinting one eye, bumping into objects or other signs of poor depth perception, head tilting, and double vision.

  • Therapy can include glasses, patching, eye drops, and sometimes surgery

Astigmatism

    Refractive Errors
  • It is a condition in which objects at both distance and near appear blurred

  • It results from uneven curvature of the cornea and/or lens which prevents light rays entering the eye from focusing to a single point on the retina, thereby causing blur

  • It can often occurs with myopia (nearsightedness) or hyperopia (farsightedness)

  • It can be corrected with glasses having cylindrical power

  • Hyperopia or Farsightedness
  • It is a condition where a person can see distant objects more clearly than near objects

  • Typically the farsighted eye is smaller than normal. As a result, light rays do not focus properly on the retina at the back of the eye and causes blur

  • Hyperopia can be inherited

  • Infants and young children are typically somewhat farsighted, but this lessens as the eye grows

  • Infants and young children are typically somewhat farsighted, but this lessens as the eye grows

  • Some children can have higher amounts of hyperopia which can cause a constant blurry image in one or both eyes and prevent normal visual development

  • If not recognized early, this can result in permanent visual loss

  • Also, higher than normal amounts of hyperopia in children can cause inward crossing of the eyes (typically between 2 – 7 years of age) and treatment with eyeglasses can correct the eye misalignment (strabismus)

  • Myopia or Nearsightedness
  • It is a condition where a person can see near objects more clearly than distant objects

  • A myopic eye causes light from distant objects to be focused before they reach the retina and results in blurred vision for distant objects

  • Excessive myopia in children can result in lazy eye (amblyopia)

  • Holding objects very close and squinting may indicate significant myopia

Cataract

  • A cataract is a cloudiness or opacification of the normally clear lens of the eye

  • Depending on the size and location, the cataract can interfere with light passing to the retina and cause blurred vision

  • Cataracts are typically associated with older adults, but cataracts can occur at birth or during childhood

  • Early detection and treatment of cataracts are critical in infants and young children in order to restore normal visual development

  • A white area in the pupil and misalignment of the eye can be a sign of cataract Pediatric cataracts that significantly obstruct vision require surgery

  • Patients subsequently require treatment with eyeglasses, bifocals, or contact lenses, and eye-patching

  • Often, pediatric cataracts result in some degree of lazy eye (amblyopia)

Childhood Tearing

  • Epiphora is the term for excessive tearing.

  • Childhood epiphora is often noted soon after birth, but can be acquired later.

  • When noted during infancy, it is usually due to blockage of the tear drainage system.

  • This type of tearing often improves spontaneously by 6-12 months of age.

  • Medical treatment includes tear sac massage and eye drops, but if tearing persists, surgical probing of the drainage system may be required.

  • Other rare causes of childhood tearing include pediatric glaucoma and ocular surface disease.

Childhood Tearing

  • Epiphora is the term for excessive tearing.

  • Childhood epiphora is often noted soon after birth, but can be acquired later.

  • When noted during infancy, it is usually due to blockage of the tear drainage system.

  • This type of tearing often improves spontaneously by 6-12 months of age.

  • Medical treatment includes tear sac massage and eye drops, but if tearing persists, surgical probing of the drainage system may be required.

  • Other rare causes of childhood tearing include pediatric glaucoma and ocular surface disease.

Double vision (diplopia)

  • It is typically caused by misalignment of the eyes (strabismus)

  • It causes one to see an object in two different places at the same time

  • The object can be displaced in a horizontal, vertical, or diagonal fashion

  • Double vision can result from many conditions and should be evaluated at the time of onset

  • Treatment for double vision can include prism glasses, strabismus surgery, and Botox injection

Double vision (diplopia)

  • It is typically caused by misalignment of the eyes (strabismus)

  • It causes one to see an object in two different places at the same time

  • The object can be displaced in a horizontal, vertical, or diagonal fashion

  • Double vision can result from many conditions and should be evaluated at the time of onset

  • Treatment for double vision can include prism glasses, strabismus surgery, and Botox injection

Developmental Abnormalities

  • During development of the fetus, abnormalities in the visual system can occur

  • Some developmental abnormalities include coloboma, microphthalmia (small eye), and optic nerve hypoplasia

  • These abnormalities often result in vision loss

Genetic Eye Disease

  • Many eye diseases have a known genetic abnormality

  • These diseases are often inherited and frequently there are other family members who have had the disease

  • In cases of known inherited eye disease in the family, early evaluation is important.

Pediatric Glaucoma

  • Glaucoma is a condition that is associated with the high pressure within the eye

  • This pressure can damage the optic nerve, which is critical for vision, resulting in permanent vision loss

  • It is a rare condition that can present in the newborn or during childhood

  • Signs and symptoms of pediatric glaucoma include cloudy cornea, tearing, frequent blinking, light sensitivity, and redness of the eye.

Nystagmus

  • It is an involuntary, rhythmic oscillation of the eyes

  • The eye movements can be side-to-side, up and down, or rotary

  • Nystagmus may be present at birth or acquired later in life

  • It may result from abnormal binocular fixation early in life

  • It also may accompany a number of eye disorders and neurological disorders

Pediatric Glaucoma

  • Glaucoma is a condition that is associated with the high pressure within the eye

  • This pressure can damage the optic nerve, which is critical for vision, resulting in permanent vision loss

  • It is a rare condition that can present in the newborn or during childhood

  • Signs and symptoms of pediatric glaucoma include cloudy cornea, tearing, frequent blinking, light sensitivity, and redness of the eye.

Retinopathy of prematurity (ROP)

  • It is an eye disease that occurs in some premature infants

  • It results from abnormal development of the blood vessels in the retina

  • ROP is progessive, starting with mild changes and sometimes progressing to severe, sight-threatening changes

  • Most infants with ROP improve spontaneously, but some develop severe changes that require treatment with a laser

  • Complications of ROP can include strabismus (eye misalignment), myopia (nearsightedness), cataract, and, in severe cases, blindness from retinal detachment

  • Premature infants at risk of ROP are identified in the hospital and enrolled in a routine screening protocol

Ptosis (drooping of the upper eyelid)

  • It occurs in both children and adults

  • Children can be born with ptosis (congenital) or acquire it during childhood

  • It is caused by weakness in the muscle that elevates the eyelid

  • A droopy eyelid can block light passing to the retina in the back of the eye and/or create significant astigmatism that produces a blurry image in the affected eye

  • These situations cause lazy eye (amblyopia) and, if untreated, can result in permanent loss of vision

  • Also, children may develop a chin-up head position due to the droopy eyelid

  • If the ptosis is significant, surgical correction may be necessary

Cortical visual impairment (CVI)

  • It is vision loss due to any abnormality of the visual center in the brain

  • The eyes are normal, but the visual interpretation center in the brain does not function properly and prevents normal vision.