Pediatric Ophthalmology

Lazy eye, or amblyopia, is poor vision in an eye that did not develop normal sight during early childhood. Although it is preventable, it can only be corrected if it is treated during childhood. If not treated early, amblyopia can lead to permanent vision loss in adulthood. Children with a family history of lazy eye should be checked as early as possible.

The main causes of lazy eye are: strabismus (eye misalignment), unequal focus (need for glasses), or cloudiness in eye tissues that are normally clear (such as cataract). To correct lazy eye, the child must be forced to use the poor-seeing eye. Treatment typically involves patching or placing drops in the good eye and, in severe cases, strabismus surgery.

A blocked tear duct in an infant can cause excessive tearing and mucus buildup on the eyelids and eyelashes. This occurs when a thin tissue in the nose does not open before birth, blocking the drainage of tears from the eyes into the back of the nose and throat. Many cases resolve within 6-12 months after birth. If unresolved, it can be treated with a brief outpatient surgical procedure. During this surgery, a thin, blunt metal probe is passed through the tear drainage system to open the obstruction. Following the procedure, infants and children do not experience pain, however blood-tinged tears or nasal secretions are common.

A drooping eyelid, or ptosis, in children may be present at birth, or it may develop during childhood. It can become worse as the child grows and potentially cause a lazy eye, so it needs to be closely monitored by an ophthalmologist to ensure that normal vision is developing in the eye. If the droopy eyelid is causing loss of vision, an outpatient surgical procedure can be performed to raise the eyelid height.

A stye is a small, red area of swelling on the eyelid that may or may not be painful to touch. Many children get one or more styes during their childhood. Generally, home therapy is tried first. If it does not get better, a procedure can be performed to open up the stye so that it drains and resolves.

A white pupil, or a difference between the pupils in the eyes, needs to be evaluated as soon as possible. There are many causes for a white pupil. One of the more common causes is a cataract in children. If not treated properly, a cataract in one eye can cause blindness and a severe lazy eye.

Congenital ocular disorders are vision problems present at birth. Our Specialists are proud to offer early treatment for congenital ocular disorders for children. Through these early treatments, we can ensure that children are given the best chance of having the healthiest possible vision.

Yes. Our pediatric ophthalmologist has special instruments, tools and techniques to assess and diagnose the visual problems for an infant who does not communicate yet.

Yes. Dilation of the eyes is an essential part of a comprehensive eye examination in children. The pupils will remain large for several hours after the exam, and sometimes until the next day. While the drops do not cause pain, they can have a slight burning or stinging sensation.

We ask that parents set aside approximately one and a half to two hours for your child’s eye exam. While we understand that children require timely care to avoid any disturbances, we coincide this with the need to thoroughly evaluate and assess each child.

Dilation can last up to 24 hours. Patients with lighter eyes (blue) may stay dilated longer. Patients with darker eyes are sometimes difficult to dilate and may need up to 3 dilation drops in the office. Dilation drops can cause light sensitivity and blurry vision that will resolve once the eyes are no longer dilated.

If a patient is farsighted, they may grow out of their glasses depending on how strong their glasses prescription is. If a patient is nearsighted, they will likely need glasses for life. If a patient has astigmatism, which is when the eye is shaped like a football, they will likely need glasses for life.

Amblyopia is when one eye is not seeing as well and the other because the brain shuts off use of an eye. This can happen for a variety of reasons. Amblyopia can often be corrected with patching or drops, but it does have a limited timeframe for correction. Amblyopia is treatable until about the age of 10 years old. After age 10, amblyopia is not treatable and cannot be corrected with glasses, surgery, or other therapies. Early intervention is key in treating amblyopia.

If a patient has strabismus (esotropia, exotropia, or one eye higher than the other), the patient will typically not outgrow the condition with a few exceptions. Control is key and if glasses or patching do not improve control, patients may need surgical correction.

Dilated appointments can take up to 2.5 hours and Recheck appointments can take up to 1.5 hours. Appointment times vary based on cooperation of the patient, questions parents/guardians may have, or other extenuating circumstances. Please know we are trying to keep within the timeframes, but emergencies and other factors may cause delays.

During a dilated exam the patient will be assessed by the technician through testing including visual acuity, depth perception, binocular function, eye pressure, and pupils. Then dilation drops will be instilled. After the drops have been instilled and pupils are dilated, the patient will be assessed by the doctor. During this part of the assessment, the doctor will check the refractive error and see if the patient needs glasses. The doctor will also view the back of the eye to make sure everything is healthy or there are no new changes. After all information is collected, the doctor will review results with the patient and parent/guardian. All questions will be answered. For a recheck appointment, the patient will have the technician workup repeated and then will see the doctor. Rechecks are visits to assess any progress or changes that need to be monitored more frequently than yearly.

No. Glasses are used to correct refractive error and clear any blur in vision. Glasses can also be used to relax over focusing causing crossing of the eyes or improve control of drifting.

Unless specified by the doctor, all patients should wear their glasses full time to properly adjust to and benefit from glasses.

Patching is used for different diagnoses. If a patient is patching to improve alignment control, the patient will need to patch until good control is achieved and may need to be restarted if control worsens. If a patient is patching to improve amblyopia, the patient will need to patch until vision is 20/20 in the poorer seeing eye or until visual acuity is equal in both eyes. Patching may be discontinued if the patient is not cooperative, not tolerating patching, or if the patient has reached the age occlusion therapy is no longer beneficial.

If a patient is refusing glasses, we can often send in a drop that is used for 1 week to help patients relax into glasses. If a patient is refusing to patch, the patient may be able to switch to a drop that will blur the vision in the good eye. Not all patients are candidates for the drop instead of patching. Please speak with your child’s doctor to assess other options. Other ways to promote patching are to allow the patient to watch tv, play video games, or perform near tasks (coloring, reading, tracing activities etc.) during the patching time may improve cooperation. Offering rewards for patching is also a good motivator for patients.

Atropine causes the pupil (dark circle in the middle of the eye) to dilate (get big). This is supposed to happen, so DO NOT STOP using the drop. One atropine drop may dilate the pupil for up to one week. Although the pupil remains dilated, the blurring effect of atropine wears off in less than 1 day. Administer the drop as directed by the doctor.