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Children with vision issues or eye conditions require specialized care. At Fraser Eye Care, our pediatric specialist, Dr. Lucas Bonafede, is experienced in diagnosing and treating a range of childhood eye conditions. We use advanced technology and a gentle touch to provide high-quality, comprehensive eye care for young patients, including treatment for strabismus, blocked tear ducts, pediatric cataracts, and pediatric glaucoma, as well as other childhood eye conditions.
Strabismus is an ocular condition where the eyes are misaligned. Approximately 4 % of Americans have strabismus, affecting both children and adults, but more often occurring in childhood.1 The underlying cause is usually a dysfunction of way the brain controls eye movement, although in some cases there may be an issue within the eye muscle itself. Strabismus is classified into types, such as esotropia (inward turning eyes), exotropia (outward turning eyes), and hypertropia (vertical misalignment), depending on the direction of the eye misalignment.
There are several treatment options for strabismus, including prescription eyewear, eye exercises, and surgery. Untreated strabismus can lead to a condition called amblyopia (also called “lazy eye”). Which may leave patients with permanent vision loss in the affected eye. If strabismus surgery is necessary to resolve the condition and maintain vision, Dr. Bonafede will create a treatment plan for your child.
Blocked tear ducts affect approximately 10% of newborn babies.2 Symptoms of blocked tear ducts include yellowish discharge from the eyes, watery eyes, and redness in the eye area. Causes generally include lack of or delayed opening of the lacrimal drainage system (specifically the valve of Hasner in the nasolacrimal duct system). Untreated blocked tear ducts can cause infection of the eye drainage system, also called dacryocystitis leading to redness and swelling of the eye or nose.
Nonsurgical treatment options for pediatric blocked tear ducts include eye drops, antibiotics, and nasolacrimal massage. The vast majority of blocked tear ducts, over 90%, resolve with conservative treatment.3 If noninvasive methods fail, surgical options include punctal dilation, probing and flushing, balloon catheter dilation and stenting or intubation.4 If you are considering these procedures, schedule an appointment with Dr. Bonafede today.
Cataracts are most often associated with aging vision, but children can also have this eye condition, which is a clouding of the eye’s natural lens. A pediatric cataract can affect one or both eyes. Childhood cataracts are often congenital, meaning they are present at birth, but they can also be caused by an injury or underlying health issue.
Pediatric cataracts often cause vision loss, but surgery can restore vision. Pediatric cataract surgery involves removing the eye’s natural lens and replacing it with an artificial intraocular lens (IOL). While cataract surgery for adults is routinely performed using numbing eye drops, general anesthesia may be available for pediatric patients.
Retinopathy of Prematurity (ROP) is a potentially blinding vision disease that causes abnormal and poor development of the retinal blood vessels. Babies born before 31 weeks or weighing less than 1250 grams are at highest risk. There are 14,000 babies (or 0.35% of all babies) that are born every year to ROP; most cases are mild, causing no or minimal vision issues. However, approximately 400 to 600 infants in the U.S. have severe cases and suffer from blindness due to ROP.5
It is important that babies who are considered high risk for ROP at birth are seen by an experienced specialist for follow up treatment.
Glaucoma is another eye condition that can affect children even though it is widely known as an aging vision disease. Pediatric or juvenile glaucoma is a congenital condition and is usually diagnosed within the first year of life. Pediatric glaucoma symptoms include cloudy eyes, enlarged eyes, and sensitivity to light.
Pediatric glaucoma causes increased eye pressure that can damage the optic nerve. There is no cure for glaucoma, but there are a variety of treatments available to manage the condition and preserve vision. Medications and eye drops can be used to lower eye pressure. If needed, there are several types of laser therapy or microsurgery to improve the eye’s drainage system in order to manage eye pressure.
Drooping Eyelids (also called ptosis) happens when the upper eyelids fall below their expected position. In children this is most likely to occur at birth (also called congenital ptosis). 64% to 75% of congenital ptosis involves one eye, but at times can involve both upper eyelids.6
Not all children with ptosis need immediate surgical intervention, but close monitoring is highly recommended. One of the most common causes to amblyopia or “lazy eyes” is congenital ptosis, where the upper lids cover the pupil and inhibit vision.
Surgical management varies depending on the underlying cause, the degree of amblyopia, and the functionality of the patient’s upper eyelid muscle (Levator muscle). Patients with greater than 4 mm of Levator function generally receive a procedure called Levator muscle resection. For those with less than 4 mm function, a Frontalis suspension procedure is performed. Dr. Bonafede is experienced in treating ptosis and he is highly skilled in performing both of these procedures.
At Fraser Eye Care, we are dedicated to providing effective and compassionate eye care for the whole family. Contact us with any questions or to schedule an appointment.
1 American Association for Pediatric Ophthalmology & Strabismus. Strabismus. Available: https://aapos.org/glossary/strabismus Accessed August 24, 2020.
2 American Academy of Pediatrics. Tear Duct – Blocked. Available: healthychildren.org. Accessed August 24, 2020.
3 Lueder, Gregg T. Nasolacrimal Duct Obstruction in Children – American Academy of Ophthalmology. American Academy of Ophthalmology, 11AD
4 Mayo Clinic. Blocked Tear Duct – Diagnosis and Treatment. Mayo Clinic, 28 June 2019
5 National Eye Institute. Retinopathy of Prematurity. Available: https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/retinopathy-prematurity Accessed September 10, 2020.
6 Griepentrog GJ, Diehl NN, Mohney BG. Incidence and demographics of childhood ptosis. Ophthalmology 2011;118:1180-3
7 Lee V, Konrad H, Bunce C, Nelson C, Collin JR. Aetiology and surgical treatment of childhood blepharoptosis. Br J Ophthalmol 2002;86:1282-6
The Fraser Eye Care Center Doctors have either authored or reviewed and approved this content.
