Paediatric problems

Most of the conditions below can be seen by a general ophthalmologist and are likely to be referred to a paediatric eye specialist for further treatment.

Cataract

In children, cataracts are usually congenital. A congenital cataract may be present at birth, and in severe cases might only be noticed in the first months of life with the characteristic white pupil.  If the cataract is affecting vision, it will need to be removed. Strong corrective lenses may also be prescribed - less dense cataracts may not require treatment. Early diagnosis and treatment are essential, in order to give the best opportunities for vision development.

Trauma/injury

Accidents happen with children, and any eye injury needs attention, no matter how minor it might seem. 

Foreign bodies

Any foreign bodies in the eye must be taken seriously – if you think anything may have penetrated the eye, get your child to a hospital immediately.

Congenital glaucoma

Malformation of the drainage angle of the anterior chamber results in increased intra-ocular pressure. This is more common in boys, and may become apparent soon after birth or in the first year. Symptoms may include photophobia and watering eyes. Glaucoma surgery will be required.

Congenital nasolacrimal duct obstruction

Many infants are born without fully developed tear ducts and tears are unable to drain from the eye. The resulting stagnant tears may become infected, causing conjunctivitis (Sticky Eye). Blocked tear ducks resolve spontaneously in nearly 90% of cases in the first 12 months of life – however antibiotic drops or ointment may be required if the eye becomes red.

Allergic conjunctivitis

This tends to occur in older children, particularly boys. The main features are itchy eyes which are irritated by rubbing, smoke or chlorine from swimming pools. Antihistamine drops can usually treat this, although more severe cases such as vernal keratoconjunctivitis may require stronger drops.such as topical steroids.

Strabismus (Squint)

A disorder sometimes called ‘lazy eye’, this may be evident at birth, but usually presents itself before the age of 4. If the eyes are not properly aligned, the vision will not develop in the turned eye and the child will develop lack of depth perception as well as blurred vision in the affected eye. Prompt treatment with an eye patch, glasses or surgery is important to optimise recovery. 

Retrolental fibroplasia

This occurs in premature babies who have been exposed to high levels of oxygen. This, in turn, may cause the blood vessels in the retina to constrict, causing new vessels to grow – unfortunately, they are thin walled and are likely to bleed. The subsequent haemmorhage and vessel contraction result in retinal detachment.

Refractive errors

Children may need to wear glasses under the age of seven to correct a convergent strabismus, where one eye deviates inwards, or they may simply be long sighted or short sighted. Myopia becomes more prevelant in children from about the age of seven years.

Ptosis

This is the dropping of the upper eyelid, it’s caused when the muscles that raise the eyelid aren’t strong enough to do so properly. Surgical correction is often needed. 

Retinoblastoma

A form of cancer that develops in the cells of the retina, retinoblastoma (Rb) has one of the highest cure rates of children cancers. The most common symptom is an abnormal looking pupil. Treatment will be decided both by an ophthalmologist and an oncologist.