Common Pediatric Eye Problems

Amblyopia (Lazy Eye)

Amblyopia, also known as lazy eye, is a condition in which one or both eyes do not develop normal vision due to various factors that cause the visual part of the brain to function abnormally. This weakens the eye and can lead to long-term vision problems. If recognized early, amblyopia generally responds well to treatment. Amblyopia therapy can include glasses, patching, eye drops, and sometimes surgery. Click here to learn more about amblyopia.

Astigmatism-Farsightedness-Nearsightedness

These three conditions, or refractive errors, are the most common eye problems in children and adults and are most often caused by abnormalities in the surface of the eye that prevent light from properly being focused on the retina. Click here to learn more about these refractive errors.

Childhood Tearing/Epiphora

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 to 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 diseases.

Cortical Visual Impairment

Cortical visual impairment (CVI) 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.

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.

Double Vision

Double vision (diplopia) is typically caused by misalignment of the eyes (strabismus), which 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, or Botox injections.

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. The Dean McGee Eye Institute has an ophthalmic genetic counselor who routinely sees patients in the clinic.

Nystagmus

Nystagmus 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, and may also accompany a number of eye disorders and neurological diseases.

Pediatric 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) and strabismus as well.

Pediatric Glaucoma

Glaucoma is a condition that is associated with high pressure within the eye. This pressure can damage the optic nerve, which is critical for vision, resulting in permanent vision loss. Pediatric glaucoma is a rare condition that can present in the newborn or during childhood. Signs and symptoms of pediatric glaucoma include cloudy corneas, tearing, frequent blinking, light sensitivity, and redness of the eye.

Pediatric Ptosis (Drooping Eyelid)

Ptosis, or drooping of the upper eyelid, occurs in both children and adults. Children can be born with ptosis (congenital) or acquire it during childhood. Neurological diseases can also trigger it.

Ptosis 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. In addition, children may develop a chin-up head position due to the droopy eyelid. If the ptosis is significant, surgical correction may be necessary.

Retinopathy of Prematurity (ROP)

Retinopathy of prematurity (ROP) is an eye disease that occurs in some premature infants. It results from abnormal development of the blood vessels in the retina. ROP is progressive, 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 laser treatment or injections of medicine into the eye.

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.

Strabismus (Crossed Eyes)

Strabismus is the term for misalignment of the eyes in which an eye may be turned inward, outward, upward, or downward. Strabismus in children can result in lazy eye (amblyopia) and cause permanent loss of vision if treatment is delayed. Adults and older children often experience double vision (diplopia). Depending on the type and cause of the strabismus, treatment may include eyeglasses, prisms, surgery, Botox injection, or eye-patching therapy. Click here to learn more about strabismus.