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Treating Vision Problems in Children
- Amblyopia is decreased vision in an eye that occurs in childhood secondary to misalignment of the eyes, refractive error or a structural abnormality of the eye. In childhood when there is an abnormality with one eye, the brain can ignore the eye with the problem and only use the other eye. Often glasses and or patching of the good eye are used to treat amblyopia. Amblyopia is best treated early in childhood. This is the most common abnormality detected by the pediatrician when vision screening is performed in early childhood. Amblyopia is sometimes referred to as a “lazy eye.” Unless amblyopia is treated early in life, the brain will never learn how the use the eye properly.
- Strabismus is misalignment of the eye. Strabismus is sometime referred to as a lazy eye, crossed eyes and wandering eye. Strabismus occurs when one or both eyes turn in or out and up or down. When the eye turns in the condition is called esotropia and when the eye turns out the condition is called exotropia. Strabsimus is caused by the brain's inability to coordinate both eyes simultaneously. Various types of strabismic conditions are treated differently in children. Sometimes glasses or patching can be used to treat strabismus. In other instances, eye muscle surgery is required to correct the strabismus. Although most adults with strabismus complain about double vision or diplopia, children often ignore the second image that occurs when the eyes are not straight.
- Retinopathy of Prematurity (ROP) is caused by abnormal growth of the blood vessels in the retina which is the back of the eye. When a baby is born prematurely, the retina is not fully developed. The blood vessels in the retina grow until the mother’s due date. When the blood vessels grow abnormally the result is ROP. Most types of ROP are mild and resolve spontaneously. However, some types are severe and could cause loss of vision if not treated with laser therapy.
- Disorders of the tear drainage system include conditions that do not allow the tears to drain normally from the eyes to the nose. The most common disorder is congenital blockage of the nasolacrimal duct, also known as the tear duct. The nasolacrimal duct connects the eye to the nose. In infants this duct is often not fully developed. When this occurs, the child has excessive pus and tearing from the involved eye. Most often this resolves by itself in the first year of life. If this does not resolve spontaneously, a procedure can be done called a probing which opens up the tear duct.
- Ptosis, or drooping eye, in children most often presents at birth with the inability of the child to fully open the eye. The cause is abnormal development of the eye muscle responsible for elevating the lid. Often these children require glasses in the eye that has the ptosis. Eyelid surgery is available to improve the cosmetic appearance of the child.
- Tumors of the eye and orbit include diseases such as dermoid cysts, capillary hemangiomas, and retinoblastoma. Hemangiomas which are benign vascular neoplasms or tumors that grow rapidly in childhood and affect vision by preventing light from reaching the eye or by causing a severe refractive error. If the tumor is affecting the development of vision, it must be treated early to allow for normal vision to develop. Retinoblastoma is a rare tumor of the retina that most often occurs in the first two to three years of life and presents with a white spot in the pupil. Many different therapies are available to treat this childhood cancer.
- Optic Nerve Disorders - The optic nerve transmits visual information from the retina to the brain. Children can have many disorders of the optic nerve, some disorders they are born with and others can be acquired during childhood. These diseases include atrophy of the optic nerve, hypoplasia of the optic nerve and swelling of the optic nerve.
- Cataracts are cloudiness of the lens of the eye. Cataracts are much rarer in children than adults and much more difficult to treat. Once a cataract is removed in an adult, an intraocular lens is placed in the eye to replace the diseased lens. Not all children have intraocular lens or implants placed into the growing eye.
- Glaucoma is a group of diseases characterized by damage to the optic nerve that often occur when the eye pressure is elevated and can result in severe vision loss. Glaucoma is more common in the elderly but can develop at any age. Infants and children with glaucoma typically have different signs and symptoms than adults. Pediatric glaucoma is treated by lowering the intraocular pressure by medical and/or surgical means. Most cases of pediatric glaucoma are treated with surgery