2-3 % of the world’s population has amblyopia. This is where the visual system does not develop normally in one or both eyes. Many pediatricians will do yearly vision screenings to be sure amblyopia is not present. If your child fails a vision screening with the pediatrician, an appointment with a pediatric ophthalmologist such as Dr. Morrison is necessary.
Intermittent exotropia is the outward drift of one or both eyes. It affects 1% of people. The resting position of our eyes is out. All of us are using muscle tone at all times to hold our eyes straight. If a person is given anesthesia, as they go to sleep and relax their muscle tone, the eyes spontaneously drift out.
Ptosis is the medical term for a droopy eyelid. Many children are born with a weak muscle in the eyelid. It tends to be somewhat variable with the eyelid being lower when the child is sleepy or sick. If mild, this often improves with growth. For severe cases, eyelid surgery is needed, particularly when the eyelid is causing visual damage called amblyopia. Surgery can be completed at any age; however, we try to wait until around kindergarten age to give the best cosmetic result.
A stye is an infection of the eyelash follicle. It is a red bump that is painful to the touch. It generally lasts a week and does improve faster with topical antibiotic use. A chalazion is a blockage of the oil gland in the eyelid. All of us have about 30 oil glands in each eyelid that produces an oil that helps lubricate our tears. If the oil gland gets blocked, the oil leaks out into the eyelid, and causes an inflammatory reaction.
About 5% of infants are born with a blockage in the tear draining system in the eyelid. Tears are produced in the lacrimal gland above the eye. They drain across the eye to keep it moist, and then go through a small hole in the corner of the eyelid called a punctum. They then drain into the nose. That’s why your nose runs when you cry. If there is a blockage in this system, the eye waters constantly. Those tears can easily get infected causing mucous discharge
A cataract is a clouding of the lens in the eye. The lens sits behind the pupil and helps to focus light inside the eye. About 1 in 10,000 children are born with a cataract. If a cataract is present at birth, it must be removed surgically at an early age or amblyopia (lazy eye) will stop visual development in that eye. Dr. Morrison is an expert in pediatric cataract surgery, having participated in the first randomized trial of using this type of surgery in infants.
When a baby is born prematurely, blood vessels in the eyes are not mature either. Because the growth factors and oxygen outside the womb vs inside are different, the normal blood vessels can stop growing, and abnormal vessels can take over. If not treated, this will result in blindness. Treatment can be with an injection of medicine in the eye or laser eye surgery. All infants below a certain gestation age and birthweight are screened for retinopathy of prematurity (ROP).
Nystagmus is involuntary shaking of the eyes. It can happen to due early abnormalities of the optic nerve or retina and can be hereditary or idiopathic (meaning no one knows what caused it). Some types of nystagmus can be associated with structural abnormalities of the brain. Children with this form of nystagmus will need an MRI scan to further evaluate the cause. Nystagmus is always associated with some degree of visual blur, which can range from mild to severe. Some children with nystagmus will develop a “null” position.