Pediatric Ophthalmology Consultants

About Premature Baby Eyes

The physicians who are taking care of your baby have asked an ophthalmologist to examine your child’s eyes. This examination is especially important because your child was born prematurely and may have special eye problems that need careful attention. The Eye When a baby is growing inside its mother, it is in a protected environment. […]

Accommodative Esotropia

What is accommodative esotropia? Accommodative esotropia, or refractive esotropia, is one of the most common forms of strabismus (crossed eye). It refers to eye crossing that is caused by the focusing efforts of the eyes as they try to see clearly. Patients with refractive esotropia are typically farsighted (hyperopic). This means that the eyes must […]

Achromatopsia

What is Achromatopsia? Achromatopsia is a non-progressive and hereditary visual disorder which is characterized by the absence of color vision, decreased vision, light sensitivity, and nystagmus. The cause of this disorder is absence of functioning cones (photoreceptors) in the retina. Patients with achromatopsia are only able to perceive black, white and gray shades colors. Their […]

Albinism

What is albinism?                 Albinism is an inherited condition present at birth, characterized by a reduced or lack of pigment that normally gives color to the skin, hair, and eyes. [figure 1]. How common is albinism? One person in 17,000 has some type of albinism. Albinism affects people […]

Allergic Conjunctivitis

What is allergic conjunctivitis? Allergic conjunctivitis is a very common eye condition affecting more than 20% of the population. It is a reaction of the eye to allergens in the environment such as dust, pollen, animal dander, and medications. If someone is allergic to a particular substance and is exposed to it, an allergic reaction […]

Amblyopia

What is amblyopia?                   Amblyopia is decreased vision in one or both eyes due to abnormal development of vision in infancy or childhood.  In amblyopia, there may not be an obvious problem of the eye. Vision loss occurs because nerve pathways between the brain and the eye […]

Aniridia

What is Aniridia?                 Aniridia is an eye disorder where the iris (colored ring structure of the eye that forms the pupil) is malformed. In some cases, other structures of the eye are also poorly developed.  The word aniridia implies that there is “no iris,” but in fact […]

Anisocoria and Horner’s Syndrome

What is the pupil? The colored part of the eye is called the iris. It is a circular muscle, similar in shape to a donut. The empty hole in the middle, which allows light to enter the eye, is called the pupil. When in a bright room or outdoors the pupil usually constricts; conversely when […]

Anisometropia

What is Anisometropia? Anisometropia means that the two eyes have a different refractive power, so there is unequal focus between the two eyes. This is often due to one eye having a slightly different shape or size from the other causing asymmetric curvature (astigmatism), asymmetric far-sightedness (hyperopia), or asymmetric near-sightedness (myopia). Why is this a […]

Blepharitis

What is blepharitis? Blepharitis is an inflammation or infection of the eyelids. It is also known as granulated eyelids and is commonly a chronic condition. It can affect both children and adults. It is a benign condition but can cause frequent and annoying symptoms. What causes blepharitis? There is no one specific cause of blepharitis; […]

Brown Syndrome

What is Brown syndrome? Brown syndrome was first described by Dr. Harold W. Brown who originally described it as “Superior Oblique Tendon Sheath syndrome” (see figure 1). Calling this a “syndrome” is a misnomer in that the problem is isolated to the eye—specifically the superior oblique muscle/tendon and the trochlea.  It is a mechanical problem […]

Capillary Hemangioma

What is a capillary hemangioma?                               A capillary hemangioma (“strawberry” birthmark) is a benign (non-cancerous) tumor consisting of an abnormal overgrowth of tiny blood vessels. Capillary hemangiomas may not be present at birth, but appear within the first 6 months of […]

Cellulitis

What is cellulitis? Cellulitis is an infection or inflammation of the eyelid skin and/or the eye socket (orbit) and surrounding tissue. What is the orbital septum? The orbital septum is a fibrous membrane that separates the eyelid skin from the deeper structures of the orbit. What is preseptal cellulitis? Preseptal cellulitis is an infection or […]

Chalazion

What is a chalazion?                         A chalazion is a localized bump in the eyelid of varying sizes. {See Figure 1]. More than one chalazion can occur in an eyelid at the same time, and both upper and lower eyelids may be affected. A chalazion […]

Coloboma

What is a coloboma? A coloboma is a congenital defect in the structure of either the eyelid or the eye [See figure 1]. Is coloboma heritable? Coloboma can be inherited or can occur spontaneously. What medical problems are associated with coloboma? Coloboma of any eye structure can occur in isolation or it can occur with […]

Color Blindness

What is color blindness? Color blindness or color deficiency is the inability to see certain colors.  There are color-sensing pigments in the nerve cells of the eye that pick up red, blue, or green light.  People with color blindness lack some or all of these pigments.   If just one pigment is missing, it may be […]

Conjunctivitis

What is conjunctivitis? Conjunctivitis or “pink eye” is a condition where the eyes look pink or red and may have discharge. Symptoms may include burning, itching, irritation, discharge, or crusting of the lashes. What causes conjunctivitis? Conjunctivitis may be caused by bacteria, viruses, other infectious agents, chemicals, or allergies. How is conjunctivitis treated? There are […]

Convergence Insufficiency

What is convergence insufficiency? Convergence insufficiency is the inability to maintain binocular function (keeping the two eyes working together) while working at a near distance. Typically, one eye will turn outward (intermittent exotropia) when focusing on a word or object at near. What is the difference between convergence insufficiency and exotropia? In convergence insufficiency, eye […]

Cortical Visual Impairment

What is cortical visual impairment? Cortical visual impairment (CVI) is a decreased visual response due to a neurological problem affecting the visual part of the brain. Typically, a child with CVI has a normal eye exam or has an eye condition that cannot account for the abnormal visual behavior. It is one of the most […]

Cranial Nerve Palsy

What is a cranial nerve? The brainstem connects the spinal cord to the brain.  The brainstem performs spinal-cord like functions for the head.  The cranial nerves emanate from the brainstem.  They provide sensory and motor functions that deal with the special senses (smell, sight, hearing, equilibrium, and taste). Which cranial nerves pertain to the eyes? […]

Dermoid Cyst

What is a dermoid? A dermoid is an overgrowth of normal, non-cancerous tissue in an abnormal location. Dermoids occur all over the body. The ones in and around the eye are usually comprised of skin, hair, and/or fat [See figure 1]. Where are dermoids found around the eyes? There are two main dermoid types that […]

Diabetes Mellitus and Diabetic Retinopathy

What is Diabetes Mellitus? Diabetes mellitus, or simply diabetes, is a group of metabolic diseases in which a person has high blood glucose (sugar) levels, either because the pancreas does not produce enough insulin, or because cells do not respond to the insulin that is produced. There are three main types of Diabetes Mellitus (DM): Type […]

Dissociated Vertical Deviation

What is Dissociated Vertical Deviation (DVD)? DVD is a condition in which one eye drifts upward [See figure 1]. The eye may drift upward either frequently or infrequently. The amount of drifting mayvary during the course of the day.  DVD may be present in one or both eyes. It is possible that the up drift […]

Duane Syndrome

What is Duane Syndrome? Duane syndrome, also called Duane retraction syndrome (DRS), is a congenital and non-progressive type of strabismus due to abnormal development of the 6thcranial nerve. It is characterized by difficulty rotating one or both eyes outward (abduction) or inward (adduction).  There may also be changes of eyelid position on attempted movement of […]

Esotropia

What is esotropia?                           Esotropia is in-turning of one or both eyes [See figure 1]. It may be intermittent or constant and may occur with near fixation, distance fixation, or both. The crossing may occur predominantly with one eye or may alternate between eyes. […]

Exotropia

What is exotropia? Exotropia is a form of strabismus (eye misalignment) in which one or both of the eyes turn outward. It is the opposite of crossed eyes, or esotropia. Exotropia may occur from time to time (intermittent exotropia) or may be constant, and is found in every age group [See figures 1 and 2]. […]

Focus Effort and its Relationship to Crossing of the Eyes

(ACCOMODATIVE ESOTROPIA) Focus not required when looking at something over 20’ away. Focus effort (accommodation) needed to look at something closer. The brain also moves the eyes inward (convergence) with focus effort. Nature’s perfect plan is to provide a clear picture with proper focus and proper aiming. Sometimes nature’s perfect plan is upset. Too much […]

Fourth Nerve Palsy

What is a fourth nerve palsy? The fourth cranial nerve innervates the superior oblique muscle, so weakness of the nerve is also known as superior oblique palsy.  Weakness of the superior oblique muscle causes a combination of vertical, horizontal and torsional misalignment of the eyes.  The vertical misalignment is typically the most noticeable feature. Palsy refers to […]

Glaucoma for Children

What is glaucoma? Glaucoma is a group of diseases characterized by damage to the optic nerve that often occurs when the eye pressure is too high. This causes optic nerve damage and can result in severe vision loss. Most often the pressure is too high because the eye is able to make the fluid it […]

Herpes Eye Disease

What is Herpes?  Herpes Simplex is a common virus affecting humans.  There are two types of Herpes Simplex Viruses (HSV).  HSV Type 1 causes cold sores and can affect the face and eyes.  HSV Type 2 primarily causes genital infections. What are the symptoms of HSV in the eye? HSV can affect almost any part […]

Hyphema

What is a hyphema? A hyphema is an accumulation of blood in the anterior chamber of the eye.  This is the space between the cornea (front clear surface of the eye) and iris (colored part of the eye). What causes a hyphema? A hyphema is most often caused by blunt trauma to the eye.  It […]

Idiopathic Intracranial Hypertension

What is idiopathic intracranial hypertension? Idiopathic intracranial hypertension (IIH) is a disorder that results from an increase in the pressure of the Cerebro-Spinal Fluid (CSF) that cushions and protects the brain and spinal cord. The CSF is constantly produced in the brain and reabsorbed back into the bloodstream at a fairly constant rate.  This allows the fluid pressure around […]

Infantile Esotropia

What is infantile esotropia? Esotropia is an inward turning of one or both eyes. Infantile esotropia begins at birth or during the first year of life. Infantile esotropia is also called congenital esotropia [See figure 1]. Why does infantile esotropia occur? The cause of infantile esotropia is unknown. We know there is an inability to […]

Infantile Esotropia

Your child has a condition Ophthalmologists classify as infantile esotropia. This term describes crossing of the eyes occurring very early in life. Infantile esotropia is not the result of “bad muscles”; it is the result of inappropriate messages sent from the brain centers that control eye movements. These centers are deep in the brain and […]

Itchy Red Eyes

The inside of the eyelids and the surface of the eye respond to irritation by becoming red, swollen with tears and mucous discharge. If the irritant produces a release of immune cells, the reaction is called an allergic process and is accompanied by itching. One person might be more sensitive than another to certain irritants […]

Nasolacrimal Duct Obstruction

Abnormal or overflow tearing is a common condition in infants and babies. In fact, approximately one-third of all newborns have excessive tears and mucus. It is also common for babies’ eyelashes to stick together after sleep, a situation that can cause the eye(s) to become chronically infected. How do tears drain from the eye? Tears […]

Nystagmus

What is nystagmus? Nystagmus is an involuntary, shaking, “to and fro” movement of the eyes. These jiggling or jerking movements are usually in horizontal or vertical directions. What are the different types of nystagmus? Nystagmus is typically classified as congenital or acquired, with multiple subcategories. Congenital nystagmusonset is typically between 6 weeks and several months […]

Oculomotor Apraxia

What is oculomotor apraxia? Ocular motor apraxia (OMA) is the absence of, or a defect in, the control of voluntary purposeful eye movement.  Children with this condition have difficulty moving their eyes in a desired direction. In other words, their saccades (the normal, quick, simultaneous movement of both eyes in the same direction) are abnormal. Because of […]

Optic Nerve Atrophy

What is the optic nerve? The optic nerve is in the center of the retina and is a circular to oval pinkish area measuring 1.5 to 2 mm in diameter. From the center of the nerve radiate the major blood vessels of the retina.  The optic nerve itself carries over one million nerves that connect […]

Optic Nerve Drusen

What are optic nerve drusen? The optic nerve is the physical connection between the eye and the brain.  All the visual information taken in by the eye is transmitted to the brain along the optic nerve. Optic nerve drusen are abnormal globular collections of protein and calcium salts which accumulate in the optic nerve.  Drusen […]

Optic Nerve Hypoplasia

What is the optic nerve? The optic nerve is a collection of more than a million nerve fibers that transmit visual signals from the eye to the brain [See Figure 1]. The optic nerve develops the first trimester of intrauterine life. What is optic nerve hypoplasia? Optic nerve hypoplasia (ONH) is a congenital condition in […]

Optic Nerve Pit

What is optic nerve pit? An optic nerve pit is a small pocket adjacent to the optic nerve. A minute amount of the tissue of the retina protrudes backwards through that defect. This is a condition that he child is born with. It usually occurs in one eye only, however in 15% of children it […]

Optic Neuritis

What is optic neuritis? Optic neuritis is inflammation of the optic nerve [See figure 1]. As the photo demonstrates, the optic nerve becomes swollen and the blood vessels become larger.  This inflammation can cause loss of vision because the optic nerve is crucial for vision.  It is the structure that carries visual information from the […]

Patching of the Eye to Treat Amblyopia

What is patching? Patching is a technique for treating amblyopia (lazy eye). The good eye is covered to encourage the development of the lazy eye. Amblyopia can be caused by unequal refractive errors, crossed eyes, misaligned eyes (strabismus), or other abnormalities. When should treatment begin? Patching should begin as early as possible. When first applying […]

Progressive (High) Myopia

Myopia (“near-sightedness”) is a condition in which the optical system of the eye causes incoming light rays to focus in front of the retina, instead of focusing directly on the retinal surface. Various factors can cause this abnormal focus of light rays, including abnormalities of the lens or cornea, or by an eye that is […]

Pseudostrabismus

What is pseudostrabismus? Strabismus is the medical term for any eye misalignment. Pseudostrabismus refers to a false appearance of strabismus caused by an optical illusion.\ Why do some children’s eyes look crossed?                    The skin folds at the inner corner of the eyelids are called epicanthal folds […]

Retinoblastoma

What is retinoblastoma? Retinoblastoma is the most common primary malignant intraocular tumor in children.  Retinoblastoma originates from the retina (light-sensitive lining of the eye). One (unilateral) or both (bilateral) eyes may be affected and it typically occurs in children less than 5 years old. How common is retinoblastoma? Retinoblastoma affects approximately 300 children per year […]

Retinopathy of Prematurity

What is Retinopathy of Prematurity (ROP) Retinopathy of prematurity (ROP) is a potentially blinding disease caused by abnormal development of retinal blood vessels in premature infants. The retina is the inner layer of the eye that receives light and turns it into visual messages that are sent to the brain. When a baby is born […]

Rubinstein-Taybi Syndrome

What is Rubinstein-Taybi Syndrome? Rubinstein-Taybi Syndrome (RTS) is a genetic multi-system disorder characterized by facial abnormalities, broad thumbs and great toes, and developmental disability. It was first described in 1957 and was identified as a recognizable syndrome in 1963 by Jack Rubinstein and HooshangTaybi. How is RTS diagnosed? The diagnosis of RTS can be made […]

Sixth Nerve Palsy

What is cranial nerve VI palsy? Sixth cranial nerve palsy is weakness of the nerve that innervates the lateral rectus muscle. The lateral rectus muscle rotates the eye away from the nose and when the lateral rectus muscle is weak, the eye crosses inward toward the nose (esotropia). The esotropia is larger when looking at a […]

Stickler Syndrome

What is Stickler Syndrome? Stickler syndrome is a progressive genetic disorder of connective tissue throughout the body. The condition was first described by Dr. Gunnar B. Stickler in 1965 and was originally called “Hereditary Progressive Arthro-ophthalmopathy” because of its tendency to affect the joints and the eyes. What are the features of Stickler Syndrome? Stickler […]

Strabismus

What is strabismus and how common is it? Strabismus is any misalignment of the eyes. It is estimated that 4% of the U.S. population has strabismus. Are there different types of strabismus and if so, how are they named? There are many different types of strabismus. Strabismus is most commonly described by the direction of […]

Strabismus in Adults

What is adult strabismus? Strabismus is a condition in which the eyes are misaligned and point in different directions. Adult strabismus occurs in approximately one percent of the population. What causes adult strabismus? Most adult strabismus is simply persistent childhood strabismus. Strabismus which occurs in adulthood without a history of childhood strabismus should be carefully […]

Strabismus in Children

What is strabismus? Strabismus is a visual defect in which the eyes are misaligned and point in different directions. One eye may look straight ahead, while the other eye turns inward, outward, upward or downward. The eye turn may be constant, or it may come and go. The turned eye may straighten at times, and […]

Sturge-Weber Syndrome

What is Sturge-Weber syndrome?                            Sturge-Weber syndrome is characterized by a reddish discoloration of the skin on one side of the face (port wine stain) and malformation of blood vessels of the brain. Does every child with a port wine stain of the skin have Sturge-Weber syndrome? No. The reddish discoloration of the face may […]

The Eye and Learning Disabilities

The problem of learning disability has become a matter of increasing public concern, which has led to exploitation by some practitioners of the normal concern of parents for the welfare of their children. A child’s inability to read with understanding as a result of defects in processing visual symbols, a condition which has been called […]

Third Nerve Palsy

What is a third nerve palsy? The third cranial nerve controls the movement of four of the six eye muscles.  These muscles move the eye inward, up and down, and they rotate the eye. The third cranial nerve also controls constriction of the pupil, the position of the upper eyelid, and the ability of the […]

Thyroid Eye Disease

What are thyroid gland disorders? The thyroid gland, located in the neck, produces thyroid hormone which helps regulate our metabolism. It may produce either too much thyroid hormone (hyperthyroidisms) or too little (hypothyroidism). Imbalance in either direction can cause eye and vision problems. Symptoms of hyperthyroidism include fatigue, fast heartbeat, weight loss, heat intolerance, fine […]

Thyroid Eye Disorders

What is the thyroid? The thyroid is a butterfly shaped gland located at the base of the front of the neck.  The thyroid gland regulates the thyroid hormone, and plays an important role in regulating body metabolism. What are euthyroid, hyperthyroid, and hypothyroid? Normal thyroid hormone level in the blood is considered euthyroid. When the […]

Toxoplasmosis

What is toxoplasmosis? Toxoplasmosis is a disease that results from infection with the protozoan intracellular parasite Toxoplasma gondii. In the eye, Toxoplasma infections frequently cause significant inflammation and subsequent scarring which may temporarily or permanently impair vision.  Ocular toxoplasmosis can be congenital or acquired, and worldwide, toxoplasmosis is the most common cause of inflammation in […]

Uveitis and Iritis

The uvea is the middle layer of the eyeball. It consists of the iris, the ciliary body, and the choroids. The iris is the part of the eye you are looking at when you say a person has blue eyes or brown eyes. Its function is to change the size of the pupil (the round, […]

What is a Cataract?

A cataract is the clouding of the eye’s normally clear lens. Located directly behind the iris (the colored part of the eye), the lens focuses the light on the retina (the light sensitive tissue on the back of the eye). A cloudy lens inhibits light rays from reaching the retina and results in hazy or […]

What is Albinism?

Albinism is an inherited condition in which the eyes, hair and/or skin have less than normal amounts of pigment. Some children and adults with albinism can have a total lack of pigment with white skin and hair and pink-colored eyes. Others have only mildly decreased amounts of pigmentation. One form, ocular albinism, affects only the […]

What is Amblyopia?

Your child has better vision in one eye than the other. One eye is visually “lazy”. This is called amblyopia. Amblyopia may occur because of poor alignment (one eye straight; the other eye deviated inward, outward, upward, or downward). Amblyopia may result from unequal farsightedness, unequal nearsightedness, astigmatism, or combination of those conditions. Treatment and […]

What is Blepharitis?

Blepharitis is a chronic inflammation of the eyelids which causes irritation, itching, and occasionally red eye. The eyelids are composed of skin on the outside and mucous membranes on the inside. A cartilage-like plate, muscles, and glands are sandwiched in between. Blepharitis can begin in early childhood producing “ granulated eyelids “, and may continue […]

What is Browns Syndrome?

Brown’s Syndrome is a well defined clinical disorder with several causes that can be either congenital (present at birth) or acquired. True Brown’s Syndrome is characterized by a limitation of elevation of the affected eye, particularly when the eye is turned in towards the nose (adduction). This is usually due to an abnormality in the […]

What is Chalazion?

The term chalazion (pronounced kuh-Lay-zee-un) comes from a Greek word meaning small lump. A chalazion is an enlargement of an oil-producing gland in the eyelid called the meibomian gland. It forms when the gland opening becomes clogged with oil secretions. It is not caused by an infection from bacteria, and it is not cancerous. What […]

What is Conjunctivitis?

Conjunctivitis is the term used by medical eye doctors to describe inflammation of the conjunctiva. In ordinary terms, conjunctivitis is simply the most common cause of “pink eye”. The white of the eye (the sclera) is covered by a thin, filmy membrane called the conjunctiva which produces mucous to coat and lubricate the surface of […]

What is defective color vision?

Normal perception of color is something most of us take for granted. Color labels we attach to objects such as “blue sky” and “green grass” have specific meaning only to people with normal vision. “Colorblind” is an exaggerated term handed down over time, referring to individuals who have abnormal color vision. About eight percent of […]

What is herpes simplex?

Herpes simplex is a virus that infects the skin, mucous membranes and nerves. There are two major types of herpes simplex virus (HSV). Type I is the most common and is responsible for eye disease and the familiar “cold sore” or “fever blister”. Type II is responsible for sexually transmitted herpes and rarely causes infection […]

What is herpes zoster?

Herpes zoster, commonly known as “shingles” is a viral disease that causes a characteristic skin rash of small fluid-filled blisters (vesicles) which form scabs and can leave permanent scars. The first symptom is often severe pain or itching followed by redness of the skin, and finally, the appearance of a few or many of the […]

What is keratoconus?

Keratoconus is a condition in which the cornea becomes thin and protrudes. Keratoconus, literally means a cone shaped cornea. This abnormal shape can cause serious distortion of vision. What causes keratoconus? Despite continuing research, the cause of keratoconus remains unknown. Although keratoconus is not generally considered an inherited disorder, the chance of a blood relative […]

What is nystagmus?

Nystagmus is an unintentional jittery movement of the eyes. Nystagmus usually involves both eyes and is often exaggerated by looking in a particular direction. What causes nystagmus? Many conditions are associated with nystagmus. Sometimes the brain’s control of eye movement is poor, resulting in an inability to look steadily at an object. Some forms of […]

What is pseudostrabismus?

Pseudostrabismus is the false appearance of misaligned eye. When the eyes are truly misaligned, the condition is called strabismus. In strabismus, the eyes can drift in, out, up or down. In pseudostrabismus, the eyes appear crossed in but are actually straight. This is common in infants and young children due to their facial structures. The […]

What is Ptosis?

Ptosis is a drooping of the upper eyelid. The lid may droop only slightly, or it may cover the pupil entirely. In some cases, ptosis can restrict and even block normal vision. It can be present in children, as well as adults, and may be treated with surgery. Ptosis can affect one or both eyelids, […]

Williams Syndrome

What causes Williams Syndrome? Williams Syndrome is caused by a deletion of genetic material from a specific region of chromosome 7 that affects an elastin gene. Elastin is a protein that gives blood vessels strength and the ability to stretch.  It is a rare disorder and is also called Elfin Facies Syndrome. How is Williams Syndrome […]

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