Early diagnosis and treatment of pediatric eye disease are critical to preserving your child’s vision. Dr. Ann Ranelle, a pediatric ophthalmologist, explains some common eye problems diagnosed in children.
Pediatric Eye Disease Medical Treatment
Pediatric eye specialists diagnose, treat and manage all manner of eye problems experienced by children. Common vision and medical eye treatments for pediatric eye disease provided by Fort Worth Eye Associates include:
- Childhood Eye Exams – Vision Screening Recommendations: Prescriptions for eyeglasses and/or contact lenses
- Lazy Eye (Amblyopia) Therapy: Includes glasses, patching and pharmacologic treatment
- Glaucoma (Congenital Glaucoma) Treatment
- Retinopathy of Prematurity (ROP): Retinal examination and laser treatment
- Corneal Abrasion: Scratch on the surface of the cornea
Topical (Eye Drops) and/or Systemic (Oral) Therapy for Pedaitric Eye Disease
Topical therapy (eye drops) can be used by ophthalmologists to treat a number of eye problems in pediatric patients. Some common conditions that topical or systemic therapy can be used to treat:
- Pinkeye (Bacterial or Viral Conjunctivitis)
- Ocular Allergies (Allergic Conjunctivitis)
- Eyelid Inflammation (Blepharitis)
- Eyelid Cysts (Chalazion or Stye)
- Tearing from Blocked Tear Ducts (Nasolacrimal Duct Obstruction)
Eye drops in the form or antibiotics or antimicrobial medications are used to attack the bacteria or the microorganisms that form in the cases of these conditions.
Pediatric Eye Disease Surgical Procedures
Surgical procedures performed by pediatric ophthalmologists from Fort Worth Eye Associates:
- Strabismus Surgery: Eye muscle surgery to correct misaligned eyes, crossed eyes, or wall eyes
- Blocked Tear Duct Surgery : Outpatient procedure performed to address blocked tear ducts in children
- Pediatric Cataracts (Cataract is either Congenital/Infantile and Acquired/Juvenile)
- Glaucoma Cataract Extraction: Pediatric cataract extraction and replacement with intraocular lenses (IOLs) in patietns with glaucoma
- Chalazion (Eyelid Cysts) Excision: Excision of chalazion (eyelid cyst) and stye (eyelid margin cyst)
- Congenital Ptosis (Drooping Eyelids) Surgery
Amblyopia is a condition in which decreased vision in one or both eyes occurs as a result of abnormal development of vision in infancy or childhood. Amblyopia is not always obvious prior to examination by an ophthalmologist. Loss of vision in one or both eyes occurs when the nerve pathways that connect the brain and the eye are not sufficiently stimulated. The brain then adjusts itself to the blurry images and over time will favor one eye over the other, whichever has the strongest vision. This condition, although easy to miss, is the number one cause of vision loss in children. Types of amblyopia include:
Strabismic amblyopia is caused when the eyes are not aligned correctly. One eye may turn in or out instead of facing straight, causing the brain to ignore this eye, and over time causing vision loss in this eye. Treatment for strabismic amblyopia can include monitoring a child for a period of time to better understand the condition, and hopefully treat it before surgery must take place. Surgery can however be used to straighten the misaligned eyes to ensure that the eyes begin to work as a team. The surgery in and of itself will not improve vision.
This form of amblyopia involves the development of cataracts or related conditions that limit the visual experience of children’s eyes. If left untreated for even a short amount of time, children suffering will most likely struggle with poor vision for the rest of their lives. It is also possible for both eyes to be affected by this type of amblyopia. Treatment for deprivation amblyopia is to perform surgery to remove cataracts, clearing up the child’s vision and allowing both eyes to recover together.
Refractive Amblyopia (Anisometropia):
Type of amblyopia presents as a large difference in refractive error (glasses strength) in each of a child’s eyes. When this occurs, the brain learns to depend on the eye with great visual strength and neglect the usage of the weaker eye. Even on inspection of the eyes, a parent or ophthalmologist may not see a difference between the eyes, so without a vision test, it is hard to detect. This problem is best helped if found and treated early.
Treatment for refractive amblyopia is to use eye drops or an eye patch over the normal eye to give the weaker eye an opportunity to be used more and strengthen. Glasses may be helpful, as well. For children’s prescription eyeglasses and contact lenses visit our full-service optical shop, Camp Bowie Optique (817-732-9307), which is conveniently located in the Fort Worth office building of Fort Worth Eye Associates.
A bacterial eye infection that requires antibiotic medication to heal comes in two forms:
- Anterior blepharitis: Affecting the outside of the eyelid where the eyelashes are located
- Posterior blepharitis: Affecting the glands within the eyelid
Blepharitis can often reoccur, so a doctor will advise a revision of eye hygiene by the patient, suggesting over-the-counter scrubs or ointments that can be used on a regular basis. Both topical eye drops and antibiotic oral medication can be recommended to reduce swelling and relieve pain and other symptoms.
Eye Infections and Mucopurulent Discharge
Many different kinds of eye infections show very similar symptoms, so it is important to be seen by a doctor for the correct diagnosis, and specifically, the right medication or treatment for the corresponding eye condition. Many of these infections have serious consequences if left untreated, or can develop into more serious infections, so immediate medical attention is advised.
Despite the risk of complications, most bacterial eye infections can be treated with antibiotic eye drops. Viral eye infections usually clear up without much intervention, but if severe, can be treated with antiviral eye drops.
The doctor will also assess the underlying cause of the eye infection, and in certain cases, will prescribe oral medication in addition to combat the infection.
Corneal abrasions are, simply put, scratches to the surface of the eye, common in children and caused by one of several things. These corneal abrasions occur when something gets into the eye, such as sand, dirt, or another similar object. The injury itself can be painful, but in most cases, corneal abrasions heal within a few days without major complications or severity.
The cornea is the outer part of the eye, what we can see as the clear, transparent tissue covering the eyeball. The cornea is the protective layer between outside objects and the iris (the colored part) and the pupil (the black part). An abrasion occurs when something brushes up, scratches, or cuts the cornea. In some rare cases, a corneal abrasion can lead to something more serious like a corneal ulcer, which is rare, but serious, which is why it’s necessary for a doctor to examine a corneal abrasion to ensure no further damage is done.
Symptoms of a corneal abrasion are:
- Stinging or burning in the eye
- Blurry vision
- Sensitivity to light
- Red or bloodshot eyes
- Swollen eyelids
- Watery eyes or increased tears
- The feeling of something being in the eye
Diagnosis and Treatment of a Corneal Abrasion
A doctor will diagnose a corneal abrasion by examining the eye and testing it by placing a fluid called fluorescein on the surface of the eye. The doctor will then examine the eye under a filtered light, and the fluorescein will show any abrasions clearly. Upon diagnosis of a corneal abrasion, a doctor may prescribe eye drops or ointment to assist the healing process, and pain medications are sometimes recommended if the child is experiencing a lot of discomfort.
Ptosis (Drooping Eyelids)
Ptosis is the medical term for the drooping of the upper eyelid, where the eyelid may droop partially or severely to an extent where it covers the pupil and restricts vision in a patient. Ptosis is sometimes inherited and can affect one or both of the eyelids. Ptosis can be present at birth or can occur later in life, however, infants with ptosis suffer with a form of the condition called congenital ptosis.
If you would like to learn more about treatment for pediatric eye disease by our pediatric eye specialists, please call our Fort Worth office at 817-732-5593.