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Pediatric Ophthalmology and Eye Muscle Disorders

Keeping eyes healthy from an early age is the best way to prevent the development of eye disease, and ensure that vision problems do not interfere with normal physical development and education. Often times, children with vision problems do not complain about trouble with their eyes, and many exhibit no outward signs of impairment. It's important for children to get regular eye exams to detect vision problems early. At Vantage EyeCare, we have pediatric ophthalmologists who treat a number of pediatric ophthalmology conditions including:

Amblyopia (Lazy Eye)

Amblyopia, also known as lazy eye, is a development disorder in which one eye has poor central vision and the other eye has normal central vision. It begins in early childhood, and if detected early, vision problems may be reduced.

The most common cause of amblyopia is a condition called strabismus in which the eyes are misaligned. The misaligned eye “turns off” to avoid double vision, and the child uses only the better eye. Another common cause is uncorrected refractive errors, where one eye is out of focus because it is more nearsighted, farsighted, or astigmatic than the other. The blurred eye essentially “turns off.”

Early diagnosis and treatment of amblyopia is critical to prevent vision loss. The earlier the treatment is started, the better the prognosis. The best time to correct amblyopia is during infancy or early childhood. If diagnosed later, treatment may take longer and be less effective.

Depending on the cause of amblyopia, treatment options may vary. Potential treatments include prescription glasses or contact lenses to correct refractive errors, patching the eye, and vision therapy. Patching the eye involves covering the good eye to force the child to use and strengthen the amblyopic eye. Left untreated, an amblyopic eye may never develop good vision and may even become functionally blind.

Nystagmus

Nystagmus is a vision disorder in which the eyes make involuntary jerking movements. You are typically born with this disorder or develop it in early childhood. Most commonly, the eyes move rapidly from side to side but they can also move up and down or in a circle. For the most part, nystagmus is caused by neurological problems. The part of the brain that controls eye movement does not function normally. However, adults may acquire nystagmus as a symptom of a condition such as stroke or head injury. Treatment for nystagmus may include prescription glasses or contact lenses. In addition, eye muscle surgery may be performed to help the head stay in a comfortable position which in turn helps to reduce eye movement.

Strabismus (Crossed Eyes)

Strabismus, also known as crossed eyes, is when both eyes are looking in different directions. One eye may be looking forward while the other eye is looking inward, outward, upward, or downward. The cause of strabismus can often be unknown. In some cases, a person may be born with it, or it may be caused by a neurological problem with the part of the brain that controls the eye muscles.

It's important to seek treatment for strabismus early to improve the likelihood of both eyes working together properly. If left untreated, it may worsen. Treatment options may vary but include eyeglasses or contact lenses, vision therapy, or eye muscle surgery.

Retinopathy of Prematurity

Retinopathy of prematurity (ROP) is an eye disease that occurs in premature babies. It affects the retina, the tissue that lines the back of the eye. ROP is a result of abnormal blood vessels growing on the retina. More often, ROP can resolve on its own as the baby grows without causing damage to the retina. However, in some cases, the abnormal blood vessels can leak and cause scarring to the retina. This can lead to the retina detaching from the back of the eye, causing blindness.

A pediatric ophthalmologist or retina specialist will monitor the ROP to watch for changes. If it looks like the eye disease is progressing, treatment may be recommended to prevent vision loss. Laser treatments and cryotherapy are two common treatment options.

Adult Eye Motility

Adults can be diagnosed with the same eye motility disorders that children are diagnosed with. In fact, motility disorders that were diagnosed in childhood can often continue to go unresolved as an adult. Eye motility disorders involve problems with controlling the movement of eye muscles. Common motility disorders include nystagmus and strabismus.

Nystagmus is fast, repetitive, involuntary movements of the eye that go from side to side, up and down, or in a circle. Adults can develop nystagmus as a result of certain diseases such as multiple sclerosis or stroke, head injury, certain medications, and alcohol or drug use.

Strabismus is when the eyes are misaligned. With this disorder, also known as crossed eyes, one eye looks in one direction while the other eye looks in a completely different direction. In children with strabismus, the brain is able to adapt by only using the image that one eye sees. In adults with strabismus, however, the brain is already trained to use the image that both eyes see, and as a result, double vision occurs. Although strabismus is often diagnosed as a child, adults can also develop strabismus from certain conditions such as stroke or injury.

As an adult, it is not too late to seek treatment for eye motility disorders. The same treatments that benefit children with eye muscle disorders will also benefit adults. Available treatments include prescription glasses or contact lenses, vision therapy, and surgery. It may be surprising to many that adults with eye motility disorders will often need to see a pediatric ophthalmologist for treatment. Eye motility disorders are more common in children than in adults so pediatric ophthalmologists often have more experience treating these disorders.

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