Pediatric Ophthalmology

Contact the Wills Eye Pediatric Ophthalmology Service:

Phone: 215-928-3240
Email: jscully@willseye.org

CHILDREN AND EYE DISEASE

Children can be afflicted by many eye diseases. They may be born with or may develop cataracts, glaucoma, retinal and orbital tumors, or other problems. More commonly, children may need glasses to see more clearly or intervention for misaligned eyes (strabismus) or poor visual development in one eye (amblyopia).

Infants

Vision is important as a baby begins to grow and learn. Even in infancy, it is important that your child receive regular eye examinations, probably by your pediatrician at first, then later by an ophthalmologist or other eyecare specialist. Certainly by pre-school your child should be having regular eye examinations to maintain proper eye health. 

Any of the following signs or symptoms may be indicative of a number of serious eye problems. If your infant experiences any of the following, see an ophthalmologist as soon as possible: 
  • Discharge from eyes 
  • Droopy eyelids 
  • A white pupil in either or both eyes 
  • Eyes that wander, shake or vibrate 
  • Eyes tearing or wet-looking, when not crying 
  • Any swelling or lump in or around the eyes or eyelids 
  • Child not looking at mother by three months of age 
  • Eyes that do not appear to look in the same direction 
  • Any difference in size, shape or color of any part of the eye or eyelids 
  • Redness of the eye 

Children

For children, eyesight is important because good vision is often related to learning. As with adults, regular eye examinations are important to maintain proper eye health, since some serious eye disorders produce no early warning symptoms. 

Any of the following signs or symptoms may be indicative of a number of serious eye problems. If your child experiences any of the following, see an ophthalmologist (Eye M.D.) as soon as possible: 
  • Pain in or around the eye
  • One eye turns in toward the nose or wanders out toward the ear, either constantly or occasionally                    
  • Eyes that do not appear to look in the same direction 
  • Child tilts or turns head when looking intently 
  • One eye closes occasionally, especially when the child is outside 
  • Eyes shake or vibrate 
  • Child covers one eye to look at things 
  • Squints, or squeezes eyes nearly closed, to see 
  • Cannot identify things across the room or farther away 
  • Frequent rubbing of eye 
  • Discharge from eyes (stuck together in the morning) 
  • Droopy eyelids 
  • A white pupil in one or both eyes 
  • Eyes tearing or wet-looking, when not crying 
  • Any swelling or lump in or around the eyes or eyelids 
  • Any difference in size, shape or color of any part of the eye (i.e. pupil) or eyelids 
  • Redness of the eye 
  • Functionally one-eyed 

Amblyopia

When a child is born with normal eyes, he or she has the potential for good vision in both eyes, but must learn to see with each of them. If for some reason, the child prefers to use one eye more than the other, the preferred eye learns to see well but the other suffers from lack of use. It does not learn to see as well, even with glasses. The non-preferred eye is said to be lazy or have amblyopia. This vulnerable period of visual development ends around age eight or nine. Learn more.

Nystagmus

Nystagmus is a condition where the eyes make repetitive shaking movements. The eyes can jerk exclusively in one direction, or make back and forth movements. Nystagmus can make the eye look jittery and affect both eyes or just one. Learn more.

Strabismus

Strabismus, also called “lazy eye,” crossed eyes, “wall eye”, occurs when the eyes do not work as a team - both eyes are not directed or focused at the same object. It exists in two to four percent 
of the general population and is the most common ocular disorder treated by pediatric ophthalmologists.


Retinoblastoma

Retinoblastoma is the leading eye cancer in infants and children. Early diagnosis and treatment is important for preventing metastasis and death of the child and additionally preserving the eye and vision. Other cancers can later occur in these children including pinealoblastoma, osteosarcoma, and melanoma. This pediatric cancer can be inherited from an affected parent who has retinoblastoma so it is important to examine all newborns of parents with retinoblastoma.

The diagnosis of retinoblastoma is made by an experienced eye doctor recognizing the classic features of retinoblastoma using indirect ophthalmoscopy. There are many eye conditions that can occur in children so the doctor must be confident that the child has a cancer before starting potentially serious treatments. This is important as the diagnosis must be correct before starting chemotherapy or radiotherapy. There are several tests that help to confirm retinoblastoma including ocular ultrasonography, fluorescein angiography, photographic imaging, optical coherence tomography, computed tomography, and magnetic resonance imaging. Learn more.

Retinopathy of Prematurity

When babies are born prematurely, especially before 32 weeks, and particularly when they have low birthweight or are very sick, the blood vessels of the retina inside of the eye may not develop properly. This can lead to blinding scar tissue or detachment of the retina.