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Infant and Pediatric Ophthalmology

When should my baby’s eyes be examined?

At birth. Your pediatrician or family physician will look carefully at your newborn’s eyes. Most children are born with normal, healthy eyes. However, a few children are born with serious eye problems. Fortunately, when these diseases or disorders are identified, treatment can be immediately initiated.

After birth, your child’s eyes are checked during regular well baby visits. If there is a family history of misaligned eyes, childhood cataracts or a serious eye disease or disorder, an examination by a pediatric ophthalmologist during infancy is highly recommended.

What should I look for in my baby’s eyes?

First and foremost, are your baby’s eyes focused on you? You are the most important visual object in your newborn’s universe. Your baby instinctively seeks you out and should look directly at you. Rotating or jiggling eyes may be a nerve problem in the eye or the brain or the optical pathway. If your infant’s eyes do not appear to be looking straight ahead most of the time by the age of 3 months, an examination by a pediatric ophthalmologist is recommended.

If there is no family history of eye problems and no eyesight problems develop during infancy, when should a child have an eye examination?

Every child should have a visual assessment by 4 years of age. Most physicians test vision as an element of an annual medical examination. Children who fail this visual screening should have an examination by an ophthalmologist, preferably a pediatric ophthalmologist.

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Why are these routine check-ups and screenings important?

Critical visual functions develop early in life. Good vision is essential for learning about the world in which we live. Untreated eye conditions affect a child’s physical and emotional health as well as their academic and athletic performance. A child with amblyopia may suffer serious vision loss. Early examinations represent an important first step in a lifetime of healthy vision.

What is amblyopia?

Amblyopia refers to any condition that interferes with a child’s normal visual development. Usually one eye is affected by amblyopia and the other eye has normal vision.

How does that occur?

Amblyopia usually occurs when there is strabismus or misalignment of the eyes. The eye that is not straight turns off to avoid seeing the double image. The child only uses the straight eye and, as a result, the misaligned eye develops amblyopia.

Eyes that do not focus equally, referred to as refractive error, causes one eye to turn off to avoid seeing a blurry image.

A third cause of amblyopia is a clouded cornea, lens or any other part of the eye that should be clear.

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How is amblyopia treated?

The treatment focuses on improving vision in the weak eye. This is usually accomplished by patching the strong eye several hours a day for months. Once the vision in the weak eye becomes normal, patch time is reduced.

What if the child resists, continually removing the patch when no one’s looking?

In that case, dilating eye drops are used to blur near vision in the strong eye forcing the child to use the weak eye for near vision.

How does an eye become misaligned?

About 4% of children in the U.S. have misaligned eyes. There are six muscles that position the eye to clearly see and follow objects of visual interest. If these muscle movements are not coordinated by the brain, a child will not be able to see a detailed, three-dimensional image with clarity. This condition is referred to as strabismus.

Children with cerebral palsy, Down Syndrome and brain tumors are more likely to have strabismus.

How is strabismus treated?

It is individualized. In some cases, eyeglasses can be prescribed to straighten the child’s eyes. In other cases, surgery may be required to reposition eye muscles.

How are cloudy corneas and lenses treated?

They are surgically replaced with clear replicas.

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