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Pediatric
Ophthalmology
Paediatric Ophthalmology is a branch of Ophthalmology that deals with the treatment of eye diseases in children.
The type of eye diseases that affect children are different from those affecting adults and treatment methods required in children are also quite different. Moreover, the eye doctors for children are distinctive and trained differently.
Our comprehensive service manages all childhood eye and visual development problems. We screen and treat neonates for retinopathy of prematurity and assess inpatients for eye problems.
We treat all childhood eye and visual development disorders such as:
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squints
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double vision
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blocked tear ducks
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amblyopia (lazy eye)
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watery eyes
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red eyes
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lumps and bumps
Many people think cataracts only happen to older people. Children can get cataracts too. At any age, cataracts are a clouding of the eye's lens. An eye’s lens must be clear to focus the images it sees onto the retina, which then sends the images to the brain. A cataract can prevent light from reaching the retina. It can also cause light rays to scatter as they pass through the cloudiness. This distorts the image and can cause blurry vision or blindness.
Children's eyes and brains are still developing until they're 8 or 10 years old. That's why untreated cataracts can have serious, permanent effects on their vision.
The cause of glaucoma can vary from child to child. Sometimes a child inherits it from a parent. Other times doctors don't know the cause. Other causes include, a change (mutation) in a child's DNA. a medical condition, disease, or eye injury, eye surgery or other surgery, medicine (like a steroid). A child also can have glaucoma with no symptoms.
That's why it's important for kids to have regular eye exams as they grow up.
Amblyopia refers to poor vision in an eye when all other causes are discounted. Often it is confused with a squint, but amblyopia can occur even if the eyes are straight.
In amblyopia, it is important to check if glasses will sort the problem out before using occlusion. This is called Refractive Adaptation. This can take 4 months to work as unlike adults it takes some time for the brain to adapt to glasses. We only treat with Occlusion when we have the best vision from glasses.
This is also useful as the child will be able to see something rather than very little in the bad eye with occlusion and may want to continue rather than fighting with the parents.
There have been a large number of studies trying to look at the factors responsible for progressive myopia. There are genetic and environmental factors. Certain races appear to be genetically predisposed to myopia in certain environments eg Chinese and Indian. The evidence seems to point to more time outdoors being more effective.
At present, medication (low dose atropine drops) and special types of contact lenses (orthokeratography or progressive contact lenses) are able to reduce the progression of myopia.
Nystagmus is an involuntary movement of the eyes – usually from side to side, but sometimes the eyes oscillate up and down or even in a circular motion.
Most people with nystagmus have vision which is much worse than average – well below what is considered to be short-sighted. Many people can register as partially sighted and a small number can register as blind.
Babies often have broad noses and as a result, the amount of white (conjunctiva) seen on the inner aspect of the iris can be asymmetrical. Therefore, parents can feel the eyes are misaligned.
Our job is to assess the baby thoroughly to ensure that he/she does not have a squint. We also assess for features that can cause a squint such as need for glasses or abnormalities at the back of the eye.
We only see the baby for a short period of time so it is possible that the baby was straight during our examination and squinting at other times (eg when tired). This is called an intermittent squint.
As 10% can still develop a squint, despite being given the all clear by us, a follow-up appointment is essential.