Early detection of pediatric visual disorders can improve vision for life. Amblyopia and strabismus, two common pediatric disorders, can be treated and possibly prevented when managed at a young age. Vision screening, with appropriate referral to a pediatric ophthalmologist, is an effective tool done by schools and pediatricians for detection of these and other diseases.
It is important to see a pediatric ophthalmologist when strabismus and/or amblyopia are suspected; if there is a family history of ocular disorders; or parents are noticing symptoms such as excessive blinking, squinting, and head tilting.
What we do during the exam:
Assess the vision and depth perception
Evaluate ocular motility
Monitor for diseases such as cataracts, glaucoma and retinal diseases with a full dilated examination
Check the need for glasses. It is not necessary children be able to communicate for refraction, which is the test the doctor uses to determine the prescription for eyeglasses. We use a technique called retinoscopy in which your pediatric ophthalmologist will refract your child objectively without any need for input from your child. This process does require dilation with eye drops in the clinic. The dilation will last for a few hours but rarely bothers young children.
Amblyopia is when the vision does not develop properly in the brain. The vision develops approximately over the first decade of life and any misalignment of the eyes, difference in refractive error or anything blocking the vision can cause amblyopia. The earlier the treatment is initiated, the better outlook for permanent visual development.
Treatment can be via a combination of glasses, patching and/or eye drops (atropine.) Patching involves occluding the "stronger" eye to ensure the brain recognizes the amblyopia (weaker) eye to improve its vision. Progress is followed closely every few months until optimal vision is obtained.
Strabismus is when the eyes are not properly aligned. When the eyes are not aligned, adults may develop diplopia (double vision) and kids may suppress an eye, causing amblyopia. A full dilated ocular examination is necessary to identify the underlying cause and possible treatments. Based on the examination, treatments may include a combination of glasses, patching therapy and/or surgical intervention.
Strabismus surgery for both adults and children involves repositioning of the ocular muscles, which lie on the surface of the eye. A combination of loosing or tightening of one or more muscles can improve the ocular alignment in most cases. The surgery is done on an outpatient basis under general anesthesia.