Pediatric Ophthalmology and Strabismus
The Pediatric Ophthalmology and Strabismus Service is a collaboration of the Children's Hospital Ophthalmology Foundation (CHOF) and Mass. Eye and Ear. CHOF at Mass. Eye and Ear is one of the most comprehensive pediatric ophthalmology networks in the country. Our physicians provide evaluation, diagnosis and treatment for the full range of eye conditions that affect children, and for eye misalignment problems in children and adults.
Pediatric eye care comprises a wide range of evaluations and treatments for our young patients, from screening for normal vision to caring for the most complicated eye conditions.
Children should have routine vision and eye examinations at their regular primary care appointments with their pediatricians. If there is cause for concern or further evaluation, a pediatric ophthalmologist is best qualified to provide the necessary care. Once in treatment, it is best to make sure your child is consistent with recommended follow-up appointments, to allow the physician to monitor conditions closely and accurately.
If you think any symptoms seem urgent, it is best to take your child to the Mass. Eye and Ear Emergency Department immediately. Being proactive will only help your child’s condition.
Some of the conditions that we care for among our patients include:
Retinopathy of Prematurity: In conjunction with the Retina Service, we screen newborns at the Massachusetts General Hospital for this potentially blinding disease. Retinopathy of Prematurity affects infants born less than 32 weeks gestation and/or less than or equal to 1500 gms birth weight. Careful follow-up throughout childhood is necessary to screen for increased incidence of nearsightedness and eye misalignment (strabismus).
Poor Red Reflex: If a parent or primary care provider notices a white reflex coming from the eye(s) or the usual red reflex from the eyes appears abnormal, urgent consultation with a pediatric ophthalmologist is necessary. A condition called retinoblastoma, the most common intraocular tumor of childhood, could be responsible. Other serious, vision threatening causes, include congenital cataract and coloboma of the eyes.
Metabolic/Genetic Syndromes: Often, a pediatric ophthalmologist is asked by a primary care provider to evaluate the eyes of a patient with multiple congenital disorders. An example of this might be neurofibromatosis, or a genetic syndrome like Downs syndrome. We can help make the diagnosis by following the eye conditions that are associated with certain systemic conditions.
Childhood Strabismus: Strabismus is the medical term for eye misalignment, also known as crossed eyes or wandering eyes. Strabismus can develop at any time during childhood, but most commonly develops between birth and age 5. Untreated, strabismus can harm depth perception. If one eye becomes dominant, amblyopia, or poor vision, can also occur.
Amblyopia: Poor vision in one or both eyes that develops during childhood in an otherwise normal eye is called amblyopia. The most common causes of amblyopia, or poor vision from disuse of the eye, are strabismus and anisometropia, a difference in the power between the two eyes. Strabismus can often be easily identified by a parent or primary care provider. However, anisometropia is more difficult to identify. Vision screening at school or at a primary care doctor’s office can help detect poor vision in one eye. If you are uncertain about the accuracy of the vision screen or if there is a family history of amblyopia or strabismus, have your child evaluated between the ages of 3 and 5 by a pediatric ophthalmologist.
Adult Strabismus: Patients are surprised to hear that we see adults, too. We see adults who have a persistent misalignment from a previous childhood strabismus, as well as adults who develop double vision. We often can treat the double vision with prisms or surgery. Patients who have Graves disease may develop tight eye muscles leading to misalignment and double vision; we treat these patients in conjunction with our ophthalmic plastic surgery colleagues.
Our physician staff consists of eye care specialists certified by the American Board of Ophthalmology or who are board-eligible and preparing for certification.
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