At Children's Hospital Colorado, pediatric ophthalmologists treat a wide range of common and complex childhood eye conditions, including the ones listed below.
Amblyopia, "Lazy Eye"
Amblyopia, or lazy eye, is reduced vision in an eye that has not received adequate use during early childhood. This condition has many causes. It can result from a misalignment of a child's eyes, such as crossed eyes, or a difference in visual acuity between the two eyes. One eye becomes stronger, suppressing the development of vision of the other eye. If uncorrected at the right time in childhood, amblyopia can result in permanent vision loss.
Astigmatism is blurred vision caused by an irregularly shaped cornea (corneal astigmatism) or lens (lenticular astigmatism). The irregular shaped cornea or lens causes light to focus on more than one point in the eye, blurring vision. Astigmatism can usually be corrected with eyeglasses, contact lenses or surgery. Depending on the degree of astigmatism, glasses or contacts may be needed at an early age to ensure that normal vision development takes place, and amblyopia (lazy eye) is avoided.
A cataract is a cloudy area in the lens. The lens is made up of mostly water and protein. Protein can sometimes clump together to cloud an area of the lens and blur vision. In very young children, surgical removal of the cataract offers the best solution for preserving vision. Because of the size of the lens and an increased inflammatory response in kids, children with cataracts are best treated by a pediatric eye specialist.
Styes are acute inflammation from clogged oil glands in the eyelids caused by the oil backing up into the eyelid skin. In rare cases, this can also cause a more serious infection. Styes usually develop over a few days and may drain spontaneously and heal. But, the leftover oil and white blood cells may leave behind a chronic lipogranuloma, called a chalazion.
Esotropia, "Crossed Eyes"
Esotropia is a condition in which one or both eyes turn inward. Young children with esotropia do not use their eyes together. In most cases, early surgery is needed to correct the misalignment and prevent vision loss, and many children will require glasses and eye patching. Esotropia is not normal after about 3 or 4 months of age, and needs to be treated by a pediatric eye specialist.
Exotropia is a condition in which one or both eyes turn outward. Although glasses or eye muscle exercises may help control or reduce the outward turning eye, surgery is often needed to correct exotropia and prevent permanent vision loss.
Although glaucoma is commonly associated with older adults, in children it is much more serious and more difficult to treat. Glaucoma, which occurs in one in 10,000 children, is caused by an elevation in pressure inside the eye that results from a buildup of excess fluid. Most adults develop the condition as their eyes change with age or as a response to trauma, but glaucoma in children occurs because their eyes did not form normally in their mother’s womb. Nearly all children need surgery for this condition. Recently a new procedure – called endolaser – has shown promise for treating some children with glaucoma. In late 2004, Children’s performed the first pediatric endolaser procedure in Colorado. This type of laser is only available for kids at a few centers in the country.
Genetic Diseases of the Eye
Genetic diseases are inherited. Many eye diseases have a genetic component and many genetic diseases and birth defects can affect vision. Congenital cataracts (cataracts present at birth,) pediatric glaucoma and retinal degenerations, such as retinitis pigmentosa, are common eye diseases with a genetic link.
Hyperopia, or farsightedness, is a common vision problem. People with hyperopia can see distant objects very well, but have difficulty seeing objects that are up close. The eyeball of a farsighted person is shorter than normal. Many children are born with hyperopia, and some of them outgrow it as the eyeball lengthens with normal growth. Childhood hyperopia is a common cause of crossed eyes (estropia). Depending on the degree of hyperopia, glasses or contacts may be needed at an early age to ensure that normal vision development takes place, and amblyopia is avoided.
Nearsightedness, or myopia, is a common vision problem. Nearsighted people can see close objects very well, but have difficulty seeing objects at a distance. The eyeball of a nearsighted person is slightly longer than usual from front to back. Depending on the degree of myopia, glasses or contacts may be needed at an early age to ensure that normal vision development takes place, and amblyopia is avoided.
Nasolacrimal Duct Obstruction, "Teary Eyes"
Nasolacrimal Duct Obstruction is a common condition in which tear drainage to the nasolacrimal duct is partially or fully blocked from birth. Tears, mucous, and bacteria are not cleared from the eye. This may require a simple surgical procedure to correct, and a few children need more than one surgery.
Ptosis, "Drooping Eyelids"
Ptosis (pronounced toe-sis) is the medical term for drooping eyelids. In some cases, the sagging upper eyelid can result in a loss of vision. Many children with ptosis will need glasses, patching, or surgery, to treat and prevent amblyopia from the ptosis.
Retinopathy of Prematurity
Retinopathy of Prematurity, or ROP, is the abnormal growth of blood vessels within the retina and vitreous that occurs in some premature infants. Typically, the smallest and earliest premature babies are at the highest risk for developing ROP. The severity of ROP varies, ranging from nearly normal vision to total blindness. This condition always requires monitoring, and sometimes requires surgery.
Strabismus involves deviation of the alignment of one eye in relation to the other. Strabismus is caused by a lack of coordination between the eyes. As a result, the eyes look in different directions and do not focus simultaneously on a single point. In children, the brain may learn to ignore the input from the misaligned eye. If this is allowed to continue, the eye that the brain ignores will never see well. This loss of vision is called amblyopia, and it is frequently associated with strabismus.
Adults can have misaligned eyes as well. Sometimes it has been present from childhood, and other times it can start suddenly. Sudden double vision should be evaluated by your primary care provider, because it may be caused by a serious condition in the brain, and require quick evaluation and treatment. Your Ophthalmologist should also evaluate this, and may recommend an evaluation by a Pediatric Ophthalmologist at Children’s Hospital Colorado for prism treatment or surgery. Many adults can be helped with their double vision and with their eye appearance by strabismus surgery.
Trauma to the Eye
Eye trauma refers to any injury to the eye. It is a regular event in children and a common cause of loss of vision. Trauma from sports is common. Other common causes of trauma to the eye include chemicals, sharp toys or fingernails. Any trauma to the eye should be considered a medical emergency and immediate medical care is necessary.