Pediatric Disorders and Treatments

When it comes to eyes, children have many different challenges than adults. Sadly a large number of children are screened at school and pass with flying colors only to find out later that underlying problems could be robbing them of their vision. Typical school screenings test only for distance vision which can miss farsightedness or neurological vision problems such as strabismus and amblyopia. Students who are farsighted are often able to see distance, but seeing objects up close can be very difficult. As a result, many farsighted students don’t like to read because they can’t see very well. Following is a list of vision disorders that your child may be experiencing. The only way to know for certain is to get them in for an exam early. The earlier a disorder is detected, the better the chance for vision improvement. Children should have their vision checked by their pediatrician, family physician or ophthalmologist by three years of age. If there is a family history of vision problems, babies from six months to one year should be tested. Fortunately, Dr. Aouchiche can perform a complete eye exam on children of any age.

Nearsightedness (Myopia):

Myopia refers to the way light enters the eye.  If a patient has perfect vision, light reaches all the way to the retina and macula allowing for sharp vision at 20 feet. However, if the cornea (clear part of the eye) is steep, light doesn’t make it all the way to the retina and focuses somewhere in front of the macula. Patients with nearsightedness usually have a difficult time seeing in the distance but can see things brought close to their eyes clearer.  Nearsightedness is treated with eyeglasses, contact lenses or refractive surgery. Refractive surgery is not recommended for children under the age of 18 because eyes are still growing and changing.

Farsightedness (Hyperopia):

Patients with hyperopia usually have a shallow or flatter cornea allowing light to focus somewhere behind the retina. Mildly farsighted patients can usually see relatively clearly in the distance and may need no correction to see items far away. However, the closer they come to an object, the blurrier it becomes. Patients with more advanced farsightedness have difficulty seeing both far and near. Hyperopia also is corrected with eyeglasses, contact lenses and after 18 years of age, refractive surgery.

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Strabismus (misaligned eyes):

When babies are born, it sometimes takes a while for their brain to teach their eyes to work together. Often newborns tend to appear cross-eyed as they adjust to their newly discovered vision. Although this is a normal occurrence, frequent eye crossing should be brought to the attention of a pediatrician who may refer you to an ophthalmologist or orthoptist.

Strabismus refers to eyes that point in different directions – in or out, up or down. Eyes that turn in are called esotropic and those that turn out are called exotropic. This disorder can be present all of the time or just some times. Children with strabismus are usually unaware of the problem but with a thorough eye exam, the disorder can be identified and treated with special lenses called prisms or in some cases, muscle surgery will be used to correct the problem.

Amblyopia (lazy eye):

Infants and young children may develop poor vision in one or both eyes which is a condition called amblyopia. Usually, one eye is stronger which causes further weakening of the other eye. Eventually, if not treated, the eye that doesn’t have to work as hard becomes useless. It is best to catch amblyopia as early as possible because the threat of losing vision is most common in young children during their early period of visual development. During later childhood years, further decline in vision is no longer a substantial threat.

Treatments for amblyopia include finding the underlying cause as well as treating the amblyopia itself.  Misalignment of the eye and focusing problems may be treated with special prism lenses or surgery or sometimes both. Once the source of the problem is addressed, patching or using blurring drops in the good eye forces the weak eye to step up and start pulling its weight. Under the supervision of a pediatric ophthalmologist or a certified orthoptist, patching and other interventions force the brain to develop vision in the lazy eye.

Adults with Amblyopia and Strabismus

Many adults with amblyopia and strabismus have struggled through the discomfort of having misaligned eyes. Studies have shown that often applicants are passed over for jobs or promotions because of the appearance of their eyes. Others find that customers or clients have difficulty trusting them if their eye wanders. Misaligned eyes can be corrected at any age. Although surgery to align eyes will not restore lost vision, straightening eye muscles for cosmetic purposes is common.