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What is pediatric ophthalmology?

The term pediatric ophthalmology includes two terms, i.e., pediatric and ophthalmology. "Pediatrics" refers to the medical care of infants, children, and adolescents. "Ophthalmology" refers to the field of medicine that deals with diagnosing and treating eye disorders. Therefore, pediatric ophthalmologists diagnose and treat eye disorders in children.

Who is a pediatric ophthalmologist?

A pediatric ophthalmologist is an eye MD specializing in caring for children's eyes. Although all ophthalmologists have basic training in treating eye disorders in children, pediatric ophthalmologists receive specialized training in children's eye care.

Taking care of our children's eyesight and vision is essential because untreated or undiagnosed eye problems will affect their learning and academic performance. Doctors advise a comprehensive eye exam for babies born prematurely with a condition that increases their vulnerability to eye problems (such as Down syndrome), children with a learning disability, developmental delay, or a family history of childhood eye disorders.

What are the qualifications of a pediatric ophthalmologist? 

Pediatric ophthalmologists have the following levels of education and training:

• Four years of medical school
• One year of medical or surgical internship
• Three more years of ophthalmology residency training
• One other year of fellowship training in pediatric ophthalmology

Pediatric ophthalmologists are licensed doctors. They are permitted to perform eye exams and surgeries (such as microsurgery or laser surgery), prescribe eyeglasses and contact lenses, diagnose eye diseases caused by systemic diseases (such as diabetes, juvenile rheumatoid arthritis) or neurological disorders, diagnose refractive errors or visual processing disorders, and provide care for eye injuries.

What factors affect vision during childhood, and what are the symptoms?

The most common factors affecting eyesight during childhood include amblyopia (lazy eye), cataract, eyelid lesions, developmental disorders, conjunctivitis, congenital glaucoma, strabismus (occurs when both eyes do not line up), inflammation (surface or inside the eyes), blocked tear ducts, and refractive problems.

Symptoms you should look out for:

Infants are not able to express their problems. Therefore, you have to be looking for symptoms that indicate eye-related issues. Some common symptoms of pediatric eye-related problems are:

• Frequent eye rubbing
• Continuously watery eyes
• Persistent redness
• White or yellow material in the pupil
• Light sensitivity
• Squinting
• Wandering eyes
• Pus or crust in the eyes
• Drooping eyelids
• Involuntary back-and-forth movements of eyes

Besides these symptoms directly related to the eyes, you must look for behavioral changes. Behavioral changes that indicate vision-related problems in your child are continuously decreasing school performance and strain or headache while reading or watching television. If you see any such symptoms, please immediately take your child to a pediatric ophthalmologist. Any delays in diagnosis or treatment might lead to lazy eyes or blindness.

In addition, in any case of developmental delay, eye injury, trauma, or family history of eye diseases, it is essential to consult a pediatric ophthalmologist immediately.

Common eye conditions in children

An ophthalmologist near you can detect early signs of underlying eye problems in children and provide proactive treatment to prevent vision impairment. Some of the common eye conditions in newborn babies and children include the following:

• Lazy eye or amblyopia

Amblyopia is the most prevalent cause of vision defects in children. It happens when the vision in one eye reduces due to a lack of nerve coordination between the eye and the brain. The problematic eye may appear normal, but the brain favors the other healthy look. If left untreated, the condition could permanently impair vision in the affected eye. Ophthalmologists may recommend eye drop medications or patching the healthy eye to help the affected eye to function normally. 

• Blocked tear ducts

It is a common eye condition among newborns that occurs when a tear duct membrane that drains into the nose does not open properly after birth. This restricts proper tear drainage, causing mucous discharge, eye infections, and perpetual watery eyes. In most cases, it resolves without treatment. Some babies may require surgical procedures or a gentle massage to open the tear membrane. 

• Uveitis

Uveitis occurs when inflammation occurs inside the eyeball, causing a red eye. It is a severe eye condition that requires immediate medical attention. If left untreated, uveitis can cause vision loss and severe scarring in children. Diagnosing the disease may become more challenging as children's eyes might not always show signs of pain or red-eye symptoms. Pediatric ophthalmologists use special screening instruments to diagnose uveitis early and provide appropriate treatment. 

• Pediatric cataracts

Cataracts cloud eye lenses, causing severe amblyopia or blurred vision and requiring immediate medical attention. They mainly develop in older adults. Sometimes, children may be born with cataracts, or some may acquire them during childhood due to other conditions like genetic or metabolic diseases and diabetes. Some cataracts may require surgery to restore normal vision in children and babies. 

• Strabismus

It is a condition where the eyes are misaligned or crossed. One eye may look straight, whereas the other may move inward, outward, upward, or downward. Sometimes, prescription glasses and orthopedic treatments can help correct vision in the affected eye. However, some children may require surgery to adjust the muscles in the affected eye.

How is strabismus diagnosed?

Children older than four months with suspected strabismus should see a pediatric ophthalmologist and undergo a comprehensive eye examination. This review includes assessing the child’s medical history to ascertain the symptoms, family history, general health, and any medications influencing the condition. 

The doctor may also ask the child to read letters from an eye chart. This is called the visual acuity test, and it helps them observe a kid's visual behavior. Ophthalmologists also conduct refraction tests, using corrective lenses to measure how the eyes focus light. Additional tests check the alignment and focus of the eyes.

The doctor may ask the child to dilate the pupils to evaluate the health of the internal eye structure. Other important factors considered when diagnosing strabismus include how the condition developed—whether it appeared suddenly or over time, whether it was present in the first six months of life or occurred later, whether it affects the same eye consistently or alternates between eyes, the degree of the eye turn, and whether it is constant or intermittent.

Why should you see a pediatric ophthalmologist? 

Visiting a pediatric ophthalmologist can benefit a child's overall health and well-being. It can also help correct any visual challenges early on. Here are some of how they help children:

• Early Detection and Treatment:

Pediatric ophthalmologists specialize in identifying eye issues in children at an early stage. Early detection allows prompt intervention and treatment, preventing potential complications and ensuring optimal visual development.

• Vision Correction:

Pediatric ophthalmologists address refractive errors such as nearsightedness, farsightedness, and astigmatism. Correcting these issues early in childhood is crucial for developing a clear and comfortable vision.

• Strabismus and Amblyopia Management:

Amblyopia, also called lazy eye, and Strabismus, also called misalignment of the eyes, are common childhood eye conditions. Pediatric ophthalmologists employ various treatments, including glasses, eye patches, or surgery, to correct these issues and enhance binocular vision.

• Visual Rehabilitation:

Children with visual impairments from congenital cataracts or other eye diseases benefit from pediatric ophthalmology services. Specialists work towards visual rehabilitation to improve the child's visual function and quality of life. 

• Prevention of Eye Diseases:

Regular eye examinations by pediatric ophthalmologists contribute to the prevention of eye diseases through early detection. This proactive approach helps manage conditions like pediatric glaucoma or retinal disorders.

• Coordination with Pediatricians:

Pediatric ophthalmologists collaborate with pediatricians and other healthcare providers to ensure comprehensive care. Coordinating is essential for managing systemic conditions that may impact a child's eyes.

• Support for Special Needs Children:

Children with developmental delays or special needs may require specialized care. Pediatric ophthalmologists are trained to work with these children and provide tailored approaches to their unique visual needs.

• Educational Support:

Pediatric ophthalmologists guide parents and educators about creating an optimal visual environment for children. The specialists recommend lighting, seating, and other factors contributing to a child's visual comfort.

Pediatric ophthalmology is crucial for protecting and enhancing a child's vision. By identifying issues early, intervening when necessary, and providing continuous care, these specialists actively contribute to children's comprehensive health and growth. Routine eye check-ups with a pediatric ophthalmologist are indispensable elements of a child's healthcare regimen.

Will my child need glasses permanently? How and when should they wear them?

As your child gets older and their eye shape stabilizes, their need for glasses may lessen, depending on the severity of the problem. So they may not need glasses permanently.

Unless advised otherwise, your child should wear glasses whenever awake but should remove them during intense play or swimming. Goggles can be used for eye protection during swimming.

Getting your child to wear glasses can be challenging. The best approach is to gently place the glasses back on their face each time they remove them. Immediately distract them with their favorite toy to shift their focus away from the glasses. Stay positive and patient, repeating the process if they continue to take the glasses off.

Things to keep in mind before booking an appointment 

When choosing the best ophthalmologist near you, ensure they have completed the education and training to prescribe medication and perform surgeries on children's eyes. In addition, board certification in ophthalmology and membership of the selected doctor in organizations demonstrate his commitment to the specialty. 

Before booking an appointment, carefully read the reviews from previous patients. There might be cases when you get mixed reviews for the same doctor. The difference in the studies depends upon the condition treated, the service availed, and the follow-up care. In such cases, recommendations from friends, families, your family physician, and your optometrist prove great help because they know you and your child personally and will only recommend it if they are sure of the quality of care.

How do you find a pediatric ophthalmologist in Philadelphia?

To book the top eye doctors for your child in Philadelphia, PA, visit the Zocdoc website. Zocdoc assists you with hassle-free booking by providing a list of the leading pediatric ophthalmologists in the city. There are several filters to make an in-person or online appointment according to your time and locality. Moreover, it allows you to choose from the doctors covered in your insurance program plan. 

You need to select the insurance carrier and plan in the dropdown menu, and it will show a list of all the doctors that meet your search criteria and the available slots. If you need clarification while selecting the doctor for your child, you can refer to the ratings and reviews. Patients who have completed an appointment booked on Zocdoc provide these reviews.

Our online patient help center can assist if you need help finding ophthalmologists who accept your insurance. With Zocdoc, you can link your medical, dental, and vision insurance plans to your account. However, you can use only one insurance plan per appointment. 

You can include your secondary insurance details in the appointment notes for those with multiple insurance plans. Alternatively, you can enter your secondary insurance information if your healthcare provider uses Zocdoc’s Intake forms.

Children often need proper eye care because of school on weekdays and the unavailability of doctors on weekends. However, many doctors offer appointments on weekends. Zocdoc helps you check the real-time availability of ophthalmologists near you.

Pediatric vision health in Philadelphia

Reportedly, thousands of Philadelphia schoolchildren with undiagnosed eye problems are not getting the treatment or glasses they need. Pennsylvania law requires that schools screen all students once every year. Although schools screen all students, they only sometimes complete follow-up care after a student fails a screening test. Several reasons act as barriers to follow-up vision care in children, such as limited access to care, difficulty in finding a provider, and lack of awareness about the insurance programs that cover the cost of eye care and glasses.

Of late though, the rates of vision screening in the United States have gone down. The National Survey of Children’s Health (NSCH) reported that caregiver-reported vision screening reduced by 13.6% from 2016 to 2020. This trend continued into 2021 as the most recent NSCH data suggest slightly fewer than 55% of children under 17 years have undergone visual screening.

Sources

WebMD

Public Citizens for Children and Youth

University Hospitals

Eye Physicians of Long Beach

Cleveland Clinic

NIH National Library of Medicine

NIH National Eye Institute

The Discovery Eye Foundation

The content herein is provided for general informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Medical information changes constantly, and therefore the content on this website should not be assumed to be current, complete or exhaustive. Always seek the advice of your doctor before starting or changing treatment. If you think you may have a medical emergency, please call your doctor or 9-1-1 immediately.