Pediatric Eye Health

What is myopia?

Nearsightedness (myopia) is when close-up objects look clear but distant objects are blurry. With nearsightedness, the shape of your eye prevents light from bending properly, so that light is aimed in front of your retina instead of on your retina. When light is not focused on the retina as it should be, your vision is blurry.

Nearsightedness is often discovered in children when they are between ages 8 and 12 years old. During the teenage years, when the body grows rapidly, myopia may become worse. Between the ages of 20 and 40, there is usually little change.

Too much time spent indoors increases a child’s risk for nearsightedness. Studies show that more time outdoors in natural light reduces a child’s risk.

What is hyperopia?

Farsightedness (also called hyperopia) is a refractive error. This is when the eye does not refract—or bend—light properly. With farsightedness, the shape of your eye prevents light from bending properly, so that light is aimed behind your retina instead of on your retina. For example, your eye may be shorter than normal (from front to back) or the cornea at the front of your eye may be too flat. This causes light rays to focus behind the retina. Generally, this means distant objects are clear but near objects are blurred.

Most children are farsighted, yet they do not experience blurry vision. With mild farsightedness, most children see clearly near and far. As they get older, the eye grows and becomes longer, and mild farsightedness is reduced or eliminated.

What is amblyopia?

If your child has a misaligned eye or other noticeable abnormality, it might be amblyopia, or lazy eye. The condition affects roughly 2 or 3 people in every 100. Vision in the lazy eye is usually poorer than in the healthy eye. Because it may also be an inherited condition, all children who have a family history of the condition should have a comprehensive eye examination at by age 3.

How is amblyopia treated?

The doctor prescribes glasses to some children to help correct focusing errors and strengthen the weaker eye. The doctor may recommend patching or special drops for the stronger eye. In some cases, surgery is necessary.

What is strabismus?

Strabismus manifests most commonly in 1 of 3 ways:

• Congenital Esotropia: The most common form of strabismus found in infants when the eye turns inward.
• Accommodative Esotropia: This is most common in children 2 or older, when the eyes turn inward when the child tries to focus.
• Exotropia: An outward turning of the eye when a child attempts to focus on distant objects.

Strabismus often has genetic origins, but may also arise due to cataract, eye injury, or a disorder such as cerebral palsy, down syndrome, prematurity, or a brain tumor.

How is strabismus treated?

Special prescription glasses can help straighten the eyes. Other options may include surgery to correct the eye muscles or to remove a cataract. The doctor may also recommend patching if amblyopia is also present.

What is retinopathy of prematurity (ROP)?

ROP occurs when abnormal blood vessels grow in the retina. This causes the retina to detach from the back of the eye resulting in eventual blindness.

ROP occurs most often due to factors associated with premature birth of an infant. Those at the highest risk for ROP are born under 32 weeks of gestation and with a birth weight of less than 1,500 grams.

The early stages of ROP demonstrate no obvious symptoms so it’s important for a premature child to be examined.

How can ROP be detected?

Follow the exam recommendations given by the neonatologists at the hospital at which your child has received care. If left undiagnosed, serious problems -- including total vision loss -- can occur rapidly or later in life.

Can a learning disability be corrected with an eye exam?

Learning disabilities are not caused by vision problems, however an extensive eye examination can determine whether a visual defect is contributing to your child’s learning disability.

For more information on these and other topics in pediatric ophthalmology go to: www.aapos.org