Pediatric ophthalmology

Pediatric ophthalmology is the branch of ophthalmology that is responsible for the detection, study, diagnosis, assessment, treatment and monitoring of eye problems in babies, children and adolescents, up to 18 years of age. At these ages, it is very important to detect and treat as soon as possible any pathology to avoid problems in the child’s visual development.
Normally, visual acuity of a pediatric patient improves from birth.

• At 3-4 years old: 50% visual acuity.
• Around 5-6 years old: they reach 100% visual acuity.

The relatives of pediatric patients should bear in mind the importance of routine check-ups with the pediatric ophthalmologist and it is recommended to carry out a schedule of ophthalmological visits that may vary according to the characteristics of the child.

• Before the child is 3-4 years of age, if family members detect any visual abnormality.
• The right age to carry out the first ophthalmological consultation is when they are 3-4 years old. At this age, collaboration when performing the ophthalmological consultation improves.
• Annual control up to 14 years of age.

¿When to visit the ophthalmologist?

• If the baby was born prematurely.
• If the eyes of the baby or boy/girl have tears or you observe a whitish pupil.
• If you observe that the baby or boy/girl diverts/twists either of the eyes or the eyelid droops.
• When there is a history of refractive error or ocular pathology in the family.

Visual pathologies in pediatric age

Lazy eye or amblyopia
Amblyopia or lazy eye is a decrease in the visual capacity of one or both eyes, due to lack of use during the period of visual development.
It can happen due to a refractive error (myopia, hyperopia, astigmatism), a strabismus, a cataract or any defect that does not allow the eye to receive a sufficiently clear image.

Children’s strabismus
Strabismus in childhood is the abnormal deviation of one or both eyes of the child in one of the main gaze positions. When this deviation appears, it causes an alteration in the patient’s binocular vision that makes it impossible for them to focus on the same point at the same time.
When this happens in children, an adaptation phenomenon appears, in which the brain keeps the best quality image, discriminating the poorest quality image that appears in the other eye, thus avoiding double vision.

Refractive defects
Myopia, astigmatism and hyperopia cause unfocused vision in the patient. An early detection of these refractive defects is very important since they can influence school performance.

Tear obstruction
It appears when the tear duct is not completely formed at birth, that is, it is obstructed. Thus, the patient has frequent tearing and sometimes rheum from birth. In most cases, these obstructions resolve spontaneously during the first months of life.

Inflammations in pediatric age
– Blepharitis is an inflammation of the eyelid margin that can be associated with conjunctival and/or corneal alterations.
– Conjunctivitis can arise from virus, bacteria or allergy reasons.
– Keratitis or corneal ulcer is a corneal inflammation due to dry eyes or caused by different infections.
– Cellulitis is a periorbital inflammation that requires a quick diagnosis. The main cause in childhood is ethmoidal sinusitis.
– The main cause in childhood is ethmoidal sinusitis. Uveitis is an intraocular inflammation related to juvenile rheumatoid arthritis or other infectious processes.

How to detect visual problems in my child?

Below, you can find a series of questions that we should ask ourselves when we suspect that our child may have a visual problem and has not had an ophthalmological consultation.

• Does my child deviate an eye?
• Does my child often wink the same eye when they are outdoors?
• Do they turn their head when they are paying attention to something?
• By covering one eye and then the other. Do they notice differences when recognizing an object?
• Do they get very close to the television or the paper when they are drawing or writing?
• Do they squint their eyes when they look at something far away?
• Do they blink frequently?
• Do they complain of headaches in the evenings?
• Do they have red eyes very often?
• Do they have flaking of the skin between their eyelashes or do they get styes frequently?