Signs Your Child Needs To See a Pediatric Ophthalmologist

Your little one’s eyes are his or her windows to the world. Many potentially serious eye problems begin in infancy, but can go undetected.  Your pediatrician or family doctor will screen your child’s eyes at birth and at regular checkups.

But there are times when a trip to the specialist – the pediatric ophthalmologist – is the best option. Pediatric ophthalmologists are trained to diagnose, treat and manage all children’s eye problems, as well as prescribe eyeglasses and contact lenses. They are also skilled at recognizing the sometimes subtle signs of an eye problem that a baby or young child cannot describe.

Common Eye Problems in Children

Blocked tear ducts: This relatively common condition occurs in infancy when a membrane in the tear duct that drains to the nose does not open after birth,” says Faruk Orge, MD, Chief of Pediatric Ophthalmology at UH Rainbow Babies & Children’s Hospital. “Tears cannot drain, so they back up, causing perpetual watery eyes and mucous discharge."

Most cases resolve without treatment. But some babies need gentle massage or a surgical procedure to open the membrane.

Pediatric cataracts: Most cataracts develop in older people. But some children are born with them or develop them in childhood as a result of other diseases, such as metabolic or genetic conditions. “A cataract is a clouding of the eye’s lens that can cause blurred vision or severe amblyopia and need immediate attention,” says Dr. Orge.

Amblyopia, or “lazy eye”: Amblyopia is a condition in which vision in one eye is reduced because the eye and brain are not working together properly. The eye may look normal, but the brain is favoring the “good” eye. Left untreated, vision can become permanently impaired in the “lazy” eye. In some cases, amblyopia is caused by strabismus (see below). Treatment includes special eye drops or patching the “good” eye to force the “lazy” eye to work. “Amblyopia is the most common cause of visual loss in children,” Dr. Orge says.

Strabismus: This is a condition in which the eyes are crossed or wander (misaligned). One eye may gaze straight ahead while the other moves upward, downward, inward or outward. Although sometimes glasses and other orthoptic measures can help, surgery to adjust the muscles of the eye is often needed.

Uveitis: This is a condition in which the inflammation is located inside the eyeball and is an important cause for the red eye. “Uveitis can cause significant scarring and vision loss if not diagnosed and treated in an expedited manner. This is a challenge in children as sometimes they do not have red eye or pain. For this reason, screening with special instruments in a pediatric ophthalmology clinic is critical,” Dr. Orge says.

Warning Signs of Eye Problems

Early detection of eye problems can protect your child’s sight. Dr. Orge says warning signs that your child may have an eye problem include:

• Persistent watery eyes
• Frequent eye rubbing
• Sensitivity to light
• White or yellow material in the pupil (lack of red reflex)
• Redness that does not go away 
• Pus or crust in the eyes
• Crossed or wandering eyes 
• Squinting
• Frequent head tilting or face turning
• Drooping eyelids or bulging eyes
• Eyes moving back and forth involuntarily

If your child has a vision problem, his or her eyes may need more frequent screenings,” Dr. Orge says. “Talk with your child’s pediatric ophthalmologist about what schedule is best for him or her.”

Related Links

The UH Center for Pediatric Ophthalmology and Adult Strabismus combines the specialized care of UH Eye Institute with the world-renowned physicians of UH Rainbow Babies & Children’s Hospital. Our center understands the importance of a child-centered environment for delivery of care and specialization of services. Learn more.