Pediatric Ophthalmology

Pediatric Ophthalmology

Our pediatric expertise encompasses the entire range of pediatric care, from comprehensive eye examinations to diagnosis and treatment of various medical problems.

Children and Young People Need Help Identifying Problems

Children may not recognize the symptoms of poor vision or be able to communicate them properly. Many conditions, if not treated at a young age, can result in permanent vision loss. At Edina Eye we specialize in treating all ages for common ailments such as amblyopia, strabismus, and tear duct obstruction, as well as atypical conditions. You can help at home by looking for signs and symptoms that your child may be experiencing vision problems. Below are some conditions that are noted in children to varying degrees.

• One Eye with Weaker Vision (Amblyopia) – Affecting about two percent of children, amblyopia occurs when one eye has better vision than the other eye. A difference in the refractive correction between the eyes or any condition that prevents a clear image can interfere with the development of vision and result in amblyopia. Because early treatment offers the best results, your pediatrician will refer you to an ophthalmologist.

• Misaligned Eyes (Strabismus) – About 4% of children have strabismus, where their eyes are not aligned. The eyes may turn inward, upward, downward or outward. Children with misaligned eyes may turn off the vision of one of the eyes so that they are not plagued with double vision. Children with strabismus should have a careful examination by an ophthalmologist because untreated strabismus may lead to amblyopia (poor vision in one eye) or loss of depth perception. Rarely, strabismus may indicate a more serious condition, such as cataracts or eye tumor (retinoblastoma).

• Crossed Eyes (Esotropia) – If a child’s eyes turn inward, she or he has esotropia. Some children are born with esotropia or develop it shortly after birth. Often in this situation, children require surgery to adjust the eye muscles. Excessive farsightedness (hyperopia) also causes esotropia. This problem most commonly occurs between the age of two years and six years and can be improved with glasses.

• Out-Turned Eyes (Exotropia) – If a child’s eyes deviate outward, she or he has exotropia. The condition may be present from birth, but is most commonly seen in children two years to seven years of age. Generally, the eyes turn out at first only on rare occasions. With time, however, more frequent outward turning of the eyes may be noted. Children with exotropia occasionally squint one eye when exposed to bright sunlight. Exotropia may be treated with eye patching, glasses, exercises, or muscle surgery.

• Tearing – The tear duct system, which allows the tears to drain from the eyes into the nose, is often clogged when children are born, but opens on its own within the first few months of life. In some infants, however, the system remains blocked, resulting in the eyes overflowing with tears and collecting mucus. If your child suffers from continued tearing or watering from the eyes, please consult your pediatrician. Gentle massage of the tear duct can occasionally assist in relieving the blockage. If massage and observation are unsuccessful, a tear duct probe or more involved surgery is occasionally required. Tearing also may result from other ocular conditions, the most serious of which is glaucoma.

• Refractive Errors (need for glasses) – It’s an enduring myth that sitting too close to the TV will damage a child’s vision, but it may suggest the child has trouble seeing from a distance and moves closer to see the screen more clearly. An eye examination will let you know if the child simply needs glasses. Using a specialized light and lenses, we are able to measure if a child is near sighted, far sighted, or has astigmatism even in children who are not able to read letters.

• Droopy Eyelids (Ptosis) – Some children’s eyelids do not fully open due to a weakness of a muscle that opens the upper eyelid or due to a poorly developed nerve. In mild cases, the condition is a cosmetic problem and needs to be followed closely to ensure that the vision is not affected. In more severe cases it blocks vision in the eye and may require surgery on the eyelid.

• Elevated Eye Pressure (Glaucoma) – Glaucoma in childhood usually requires surgery to prevent blindness. Early detection is essential. Warning symptoms are extreme sensitivity to light, tearing, and persistent pain. Signs include an enlarged eye, cloudy cornea, and lid spasm. If any of these are present, you should consult with your pediatrician and plan to see an ophthalmologist immediately.

• Eyes That Appear Misaligned (Pseudostrabismus) – Sometimes infants appear to have crossed eyes when in fact the eyes are straight. The cause for pseudostrabismus is presence of a wide nasal bridge, or extra folds of skin between the nose and the inside of the eye, giving the child a cross-eyed appearance. Most children outgrow this problem.

Examining Vision from Day One

At Edina Eye we recommend a vision assessment within a day of birth. This initial test, conducted by a primary care provider, should identify any potential problems. If it is suspected the infant has a problem with vision, a more thorough examination with a pediatric ophthalmologist will be scheduled.

If you sense your child has vision problems, schedule an eye appointment with an ophthalmologist. By the age of four months, babies should begin using both eyes fully. Signs of poor vision at this time include crossing of eyes, disinterest in familiar faces or age-appropriate toys, eyes that rove, and squinting. If you recognize any of these symptoms, we encourage you to call or log on for an appointment. Early detection and immediate action are essential components of successful pediatric ophthalmology.

Keeping an Eye on Your Child’s Vision

Children should be getting regular eye screenings with their primary care provider, followed by school screenings that start in preschool. If any potential issues are noted at the screenings or if the parents have any concerns, a complete examination with a pediatric ophthalmologist should be conducted.

Continuous Care

If the young person has an eye problem, she or he may require more frequent screenings, or comprehensive eye examinations. In the ideal scenario, a young person sees the same eye doctor from birth through adulthood to ensure complete and cohesive monitoring as the eyes grow with the child. Typically, a person’s eyes grow and change through their teenage years, sometimes into their twenties. Having your own eye doctor dedicated to analyzing that progression is a great advantage.

Such seamless care isn’t always practical, and digital record sharing now allows a positive exchange of needed information between doctors and clinics. But it is also safe to say that the more your doctor knows about your child’s eyes, the more she or he can do to help their ongoing eye health and the quality of their vision.

Eye Injuries

Children and young people tend to be more active and sometimes more careless than adults, resulting in eye injuries of varying degrees. At Edina Eye we are accomplished at treating eye injuries medically, surgically and cosmetically. We are also experts at detecting secondary problems caused by injuries. Our collective experience and proficiency at all aspects of injuries to the eye give our patients a superior level of professional analysis and optimal treatment possibilities.

Children and young people can help themselves by taking precautionary action against eye injuries, including wearing goggles or some other form of protective eyewear when participating in activities where eyes are more vulnerable to contact and injury. We offer a wide variety of protective eyewear and are experts at helping determine the best solution for each patient.

Computer Eye Strain

It’s believed prolonged exposure to computer screens won’t cause vision problems, but can cause eye strain. Young people show a variety of systems, the most common of which are these:

• Irritated eyes
• Red eyes
• Watery eyes
• Aching eyelids
• Heavy eyelids
• Eye muscle spasms
• Eyelid muscle spasms
• Headache

Sometimes children who do not normally need glasses may require corrective lenses for computer work. An eye exam with your doctor is the way to find out.

We Specialize in Treating Eye Problems of All Types and Severity

Pediatric ophthalmology is a specialized discipline requiring extensive training and a unique set of expertise. Young eyes are growing organs and you want the most disciplined and knowledgeable doctor closely assessing their appearance, color, and character. It’s only through vision screenings and comprehensive examinations that you and your doctor can determine if your child has normal, healthy eyes, or eyes with a condition that requires closer monitoring or even medical or surgical intervention.

Special Care for Precious Patients

At Edina Eye you receive leading pediatric ophthalmological expertise and that all-important understanding of how to care for young people. We appreciate the anxiety and emotions involved and strive to help our young patients and their families manage the surgery in the most comfortable and positive way possible. We also enhance your confidence with our stellar history of success. Here are some of the surgeries we use to treat our youngest patients.

Pediatric Strabismus Surgery

Children with misaligned eyes may undergo surgery to loosen or tighten the muscles that hold the eye in place, improving alignment of their eyes and ensuring these muscles can contract or lengthen in a normal way. Early detection is associated with successful surgeries.

Pediatric Tear Duct Surgery

One of the most common pediatric eye surgeries with an extremely high success rate, this procedure opens blockages in the tear duct. The surgeries are typically short in duration and performed under general anesthesia. Here are two common types of pediatric tear duct surgery:

• Probing – A surgical probe is gently inserted into the tear duct and passed through to open any obstructions.

• Stent – Silicone tubes are inserted into the tear ducts, stretching the ducts and allowing drainage. Stents can be left in place for many months before removal in the office.

Pediatric Eyelid Surgery

Children sometimes present with styes (also called chalazion) or other eyelid cysts that do not resolve with conservative treatment. Surgery is indicated to drain or remove the lesions that do not improve with time.