Your pediatrician may refer you to a pediatric ophthalmologist. Why a pediatric ophthalmologist and not one who treats adults? Because children are not little adults and should not be treated the same way. Unlike adults, children's bodies are still growing. Even their eyes.
Brain cells that control vision continue to develop throughout the first decade of a child's life. As a result, disorders that may have little effect on an adult's vision can have a profound or life-long effect on a child's ability to see. There are also some illnesses only seen in children. Other problems may not be exclusive to children, but may affect children differently. A pediatric ophthalmologist is trained to recognize and manage eye disorders and diseases in children from birth to adolescence.
Not only are children's bodies different from adults, they also vary in their ability to communicate. Children frequently cannot speak or are so sick or frightened they choose not to speak. As a result, they are not able to say what is bothering them or answer medical questions to help identify problems. Pediatric ophthalmologists are trained to assess a child's non-verbal response and expressions to make an accurate diagnosis.
Pediatric ophthalmologists can diagnose, treat and manage all children's eye problems. They are medical doctors who have had special training in the medical and surgical treatment of children's eyes. Because pediatric ophthalmologists only treat children, they know what children need. Some of the services they provide are:
- Eye exams
- Prescriptions for glasses or contact lenses
- Diagnosis and treatment of eye infections, eye inflammation or problems caused by conditions such as diabetes or juvenile rheumatoid arthritis
- Surgery for problems such as weak blocked tear ducts, cataracts, droopy eyelids or eye misalignment
If your pediatrician recommends your child see a pediatric ophthalmologist, take comfort in knowing you are going to someone who has the widest range of treatment options, the most comprehensive training and the greatest expertise in treating children's eyes.
East Tennessee Children's Hospital has two board-certified, fellowship-trained pediatric ophthalmologists: Gary Gitschlag, M.D., and Allyson D. Schmitt, M.D.
Answers to Common Questions About Your Child's Vision
As children grow, vision can change with them. It's important for parents to protect their child's eyes from possible injury and have their vision checked regularly. Ophthalmologist Dr. Gary Gitschlag answers some common questions parents have about their child's vision and medical problems that can occur.
Q: When should parents have a child's vision checked?
A: There should be an initial evaluation somewhere between the ages of three and four, and another evaluation when a child is between eight and 10 years old. If a child experiences any sudden and unexplained vision issues or if there is a family history of eye problems, parents should ask their child's doctor about seeing an ophthalmologist.
Q: What are some signs that a child might have issues with his/her vision?
A: Red eyes, unequal pupils, poor fixation skills, misaligned eyeballs, eyes that aren't clear, pupils that aren't round and equal, chronic tearing and light sensitivity are some signs of vision issues. Also, functional difficulties, like a child bumping into objects, could be a sign of a problem. Parents know their child better than anyone and should notify their pediatrician if they notice any of these problems.
Q: What are common eye problems in children?
A: Lazy eyes, where eyes turn in or out and appear to not work together; blocked tear ducts, which occurs in 10-15 out of 100 newborns; focus errors; and congenital (conditions existing from birth) abnormalities are common problems seen among children. These are usually diagnosed by the child's pediatrician, and they can be referred to a specialist if needed.
Q: What kind of family history should parents worry about?
A: Significant eye disease before preschool in family members should be a concern. It is important for children with this family history to be checked by an ophthalmologist to prevent possible complications in the future.
Q: What can parents do to protect their child's eyes?
A: Many eye injuries are preventable. It's important to always wear safety goggles during activities that include projectiles, such as paintball. In the sun, children should wear visors or baseball-type caps; when wearing sunglasses to shield eyes outdoors, the glassed should have UV protection to block harmful rays from the sun. Children can also hurt their eyes with sharp instruments, such as tools. Parents should keep these items out of the reach of small children to prevent possible eye injuries. If something is splashed in a child's eye, flush it out immediately before coming in for treatment. This will minimize the risk of further damage to the eye from the causticagent.
Q: What is a corneal abrasion?
A: A corneal abrasion is the eye's version of a skinned knee. The surface layer of the eye, the cornea, is torn. The sensory nerves are very dense on the surface of the eye, so abrasion can be very painful. This can be caused by jabbing a finger into an eye, getting grit in the eye then rubbing it, or the eye being scratched by some sort of object that gets in the eye. Once any foreign object in the eye is removed, a corneal abrasion can be treated with eye drops to prevent infection and reduce pain. Most corneal abrasions clear up fairly quickly with this easily administered treatment.
Q:What should I do if my child is cross-eyed? Will they need surgery?
A:If a child is cross-eyed and over three months old, they need to be seen immediately. It is normal for a newborn's eyes to appear as if they are wandering during the baby's first month or two as the visual system develops and the brain learns to make the eyes work together. After this age, there is a possibility of permanent vision loss if the misalignment is not treated. The medical term for crossed eyes is esotropia and can refer to eye crossing when focusing (which usually occurs in children that are farsighted), eye crossing that is unrelated to focusing, and eye crossing that is somewhat dependant on focusing. Surgery is not always required to fix crossed eyes; glasses, which help eyes focus, may correct a child's crossed eyes simply by letting the eyes relax. If the glasses don't work, an ophthalmologist may recommend surgery.
Q: Will sitting too close to the television or computer cause vision problems?
A:Sitting to close to a computer screen or TV is not going to cause vision problems. Children can actually focus up close better than adults, although eyes can become strained from being too close to a screen for long periods of time. Parents should encourage children to stay an arm's length away from the screen to keep this from happening and limit how long a child is in front of the television or computer. Sitting close to a TV or computer screen also may be a sign of nearsightedness so talk with your child's doctor if you have concerns.
Q:What is a sty? Can it affect my child's vision?
A:A sty is an infection along the eyelid. When the gland there is blocked, the oil produced by the gland occasionally backs up and forms a lump which can be red, painful, inflamed or swollen. Bacteria can infect the gland causing increased inflammation, pain and redness of the eye. A sty usually does not directly affect vision and may subside on its own in about a week. In rare cases, surgical treatment for a sty may be necessary. If the eye is swollen shut, any changes or disturbances in vision occur, redness appears around the entire eye, the sty bleeds or if swelling lasts for more than three weeks and the sty is not subsiding on its own, speaks to your child's doctor.