Many common eye disorders – nearsightedness, farsightedness, astigmatism – are first diagnosed and treated in childhood. Other less common disorders affecting children's eye sight often go untreated or undiagnosed, including strabismus (misaligned eyes) and amblyopia (poor vision development in the brain). Virginia Mason Franciscan Health's pediatric ophthalmologist specializes in treating these and other childhood ophthalmic disorders. For more information about Virginia Mason's ophthalmologists or to schedule an appointment regarding pediatric ophthalmology, call 206-223-6840.
Strabismus is a general term that indicates any misalignment of the eyes.
Symptoms of strabismus
Most children do not complain of or experience double vision. They may have double vision, or may close one eye, or someone may see an eye misalignment. Most often, there are no symptoms of strabismus in children. Adults more often have double vision.
The only way to diagnose strabismus reliably is with a complete eye exam that includes measurements of the eye alignment.
Strabismus is often treated with glasses, prisms in glasses, or surgery to move eye muscles and bring the eyes back into alignment. Sometimes a combination of all of these treatments is required.
Amblyopia is a term for poor vision development in the brain that stems from some underlying problem in the eye getting a clear, focused image sent to the brain.
Symptoms of amblyopia
There are, generally, no symptoms associated with amblyopia. Children, especially, are unaware that they don't see well out of one eye.
Vision screenings in children are aimed at detecting amblyopia at a young age while treatment is effective. Pediatricians and public schools screen vision regularly. Any suspicion of poor vision in a child should be investigated with a comprehensive eye exam by someone who has extra training in pediatric ophthalmology. Any child with a family history of amblyopia in a close relative (parent or sibling) should also be examined thoroughly at least once.
Treatment of amblyopia
Treatment of amblyopia depends on the underlying cause. Glasses may be given or surgery may be recommended for some special cases. Generally, drops to blur the good eye are given, or the good eye can be patched to help the worse-seeing eye improve. Treatment takes months to years, and involves the brain learning better vision from the eye with amblyopia. Because it is a disorder of brain development, there is a period after which detection and treatment of amblyopia is not helpful. This age may be different for different people. Treatment is most effective at a young age, so early detection is critical.
Glaucoma is a disease of high eye pressure, which damages the optic nerve. Glaucoma in children is rare. It can be congenital or result from injury or surgery on the eyes. There are also some diseases associated with the development of glaucoma in children.
Symptoms of pediatric glaucoma
There are no symptoms of glaucoma, generally. In some serious cases of infant glaucoma, the baby may be very light sensitive, tear quite often, and the eye actually enlarges. Generally, glaucoma is without symptoms.
Diagnosing pediatric glaucoma
Pediatricians look at the eyes during well-child check ups. If they see anything abnormal, they refer for further evaluation. Any excessive tearing or possible eye pain/light sensitivity in a young child should be brought to the pediatrician's attention. Diagnosis can only be made by an ophthalmologist trained in glaucoma or pediatric eye care.
Treating pediatric glaucoma
Treating glaucoma in children is performed with drops or surgery, depending on the situation. Sometimes multiple medications and multiple surgeries may be required to control the eye pressure.
Cataracts are rare in children. They can be congenital or develop as an effect of an eye injury or disease. A cataract is a clouding of the normally clear lens in the eye.
Diagnosing pediatric cataracts
Pediatricians check for the red reflex on infant and toddler well-child check ups. This is one way of detecting a lens that isn't clear. Vision screenings by pediatricians and school systems also help detect eye problems such as cataracts. A diagnosis of a cataract can be made during a comprehensive eye examination by a qualified ophthalmologist.
Treating pediatric cataracts
Treatment is often surgery, and can take place in infants as young as a few weeks old in some cases. Some cataracts in children are mild and don't require surgery. Very mild cataracts can be followed without surgery to be sure good vision development takes place. If surgery is needed, there may be an artificial lens used, as in adults, or there may be no artificial lens placed at the time of surgery. Glasses or contact lenses are generally needed in all children who have cataract surgery. A cataract in a child requires close follow up to help ensure good vision development, regardless of whether surgery has been performed.