Pediatric Problems

Amblyopia

Amblyopia is poor vision in an eye that did not develop normal sight during early childhood. It is sometimes called a lazy eye. Usually only one eye is affected by amblyopia, but it is possible for both eyes to be lazy. The best time to correct this problem is during infancy or early childhood.

Amblyopia is caused by any condition that affects normal use of the eyes and visual development. In many cases, the conditions associated with amblyopia may be inherited. Amblyopia is one of the most common causes of visual impairment in childhood, and can affect approximately 2 to 3 out of every 100 children.

Blocked Tear Duct

Most children are actually born with a blocked tear duct, however, it usually resolves within the first two weeks of life. Since infants do not make tears for the first few weeks of life, this obstruction generally goes unnoticed, except in special circumstances.

The usual symptoms are simple tearing, mild to severe mattering, and chapped skin underneath the eye. Some children can develop a severe infection of the skin and soft tissue of the eyelids, or a serious collection of pus in the tear sac. (These last two symptoms may require immediate attention by the pediatrician and/or ophthalmologist.) Fortunately, the serious infections are uncommon, allowing conservative observation of most children with this condition.

Conservative management usually involves the use of antibiotic ointment or drops, and massaging of the tear sac. The antibiotics do not act like "DRAINO" to unstop the blockage. They simply are aimed at treating or preventing infection, which helps avoid potential scarring that can occur while waiting on the tear duct to open up. Some believe that massaging the tear sac with the index finger help.

Most pediatric ophthalmologists like to give the blockage at least six months to clear up on its own. If the obstruction has not cleared by a year, the chances of spontaneous resolution are much less, and surgical intervention is usually offered.

Surgery involves probing the tear duct or placing a temporary tube in the tear duct to hold it open. This decision is usually made at the time of surgery. The decision to place a tube is dependent on how the probing goes. If the probing allows successful irrigation of the tear duct, then the tubing may not be necessary. However, if the tear duct cannot be irrigated at the time of surgery, the tube may be placed.

Retinopathy of Prematurity

Retinopathy of Prematurity (ROP) is a retinal problem that affects premature infants. Between sixteen weeks gestation and birth, retinal blood vessels begin to grow out from the optic nerve towards the peripheral retina. When a child is born prematurely, (under thirty-two weeks gestation) the normal growth of these retinal blood vessels stops. Abnormal blood vessels can grow in the retina in areas that the normal blood vessels have not yet grown. This can cause serious vision problems or vision loss. A pediatric ophthalmologist or a retina specialist will usually want to see a premature infant shortly after birth.

In a normal forty week pregnancy, the last twelve weeks are the most vital in the development of fetal eyes. Therefore, any child that is born prematurely is at a higher risk than a full term baby for other eye and vision problems. Regular eye examinations are recommended for all infants born under thirty-two weeks.