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Paediatric Ophthalmology and Strabismus or Squint Services

About Pediatric Ophthalmology, Strabismus or Squint

Pediatric ophthalmology is a sub-specialty of ophthalmology concerned with eye diseases, visual development, and vision care in children. Pediatric ophthalmologists focus on the development of the visual system and the various diseases that disrupt visual development in children. Pediatric ophthalmologists also have expertise in managing the various ocular diseases that affect children. Pediatric ophthalmologists are qualified to perform complex eye surgery as well as to manage children's eye problems using glasses and medications. Many ophthalmologists and other physicians refer pediatric patients to a pediatric ophthalmologist for examination and management of ocular problems due to children's unique needs. In addition to children with obvious vision problems, children with head turns, head tilts, squinting of the eyes, or preferred head postures (torticollis) are typically referred to a pediatric ophthalmologist for evaluation. Pediatric ophthalmologists typically also manage adults with eye movement disorders (such as nystagmus or strabismus) due to their familiarity with strabismus conditions.

Symptoms of Pediatric Ophthalmology Disease

Redness

Erythema

Induration

Tenderness

Warmth of the periorbital tissues

Tears Obstruction

Opacity

Misalignment


Types of Pediatric Ophthalmology Disease

Conjunctivitis

Ophthalmia neonatorum
Ophthalmia neonatorum is defined as conjunctivitis within the first month of life.There are three main types of neonatal conjunctivitis they are chemical, bacterial, and viral.


Childhood conjunctivitis
Acute conjunctivitis is the most common eye disorder in young children and is the most frequent ophthalmologic complaint seen in the pediatric emergency department.


Orbital and periorbital cellulitis

Orbital and ocular adnexal infections are more common in children than adults and must be accurately distinguished from periorbital infections, be-cause the pathogenesis, treatment, and potential severity of sequelae vary considerably.Periorbital cellulitis is much more common than orbital cellulitis. It presents clinically with erythema, induration, tenderness, or warmth of the periorbital tissues.


Lacrimal system infections

Infections of the lacrimal system are named according to the location of infection. Infection of the nasal lacrimal duct, located between the medial canthus of the eye and the nasal bridge, is known as dacryocystitis and can occur in the setting of acute or chronic obstruction of the duct.


Congenital

Nasal lacrimal duct obstruction
The most common congenital ophthalmologic finding in newborns is nasal lacrimal duct obstruction. Tears are produced in the lacrimal gland which rests within the temporal portion of the superior lid. They then circulate over the eye toward the punctum located in the nasal corner of the eye where the two lid margins unite. Typically, tears drain through the punctum and canalicular system into the nasolacrimal sac and then into the duct which drains intra nasally through the valve of Hasher. When the drainage path is obstructed, most commonly at the level of the valve of Hasner, patients present with watery discharge from the eye, often bilaterally.


Congenital cataracts
A cataract is an opacity of the lens of the eye requiring prompt diagnosis and treatment to prevent partial or complete blindness. Congenital cataracts can be present at birth and associated with certain congenital infections such as rubella, toxoplasmosis, HSV, or cytomegalovirus. They can also develop in the first several months of life secondary to several metabolic conditions, such as galactosemia or peroxisomal disorders, or in genetic conditions such as trisomy 21 or Turner syndrome.

Congenital glaucoma
Pediatric glaucoma is divided into primary and secondary types depending on the presence of isolated angle malformations (primary) versus other underlying ocular abnormalities (secondary). Both types maybe present at birth (congenital) or develop at any age (infantile or juvenile). The common finding with any form of glaucoma is increased intraocular pressure, which, if left undiagnosed and untreated, can lead to optic nerve damage and vision loss. Additional damage, such as large refractive errors, astigmatisms, strabismus, and amblyopia, may occur as a result of congenital or infantile glaucoma, because the visual system is undergoing crucial stages of development during in-fancy, and any disruption to the visual axis may have multiple sequelae.


Misalignment

Ocular misalignment, generally referred to as strabismus, is not uncommon in newborns and young children and may be of enough concern to the parents to prompt an emergency room visit. It is important to distinguish normal misalignment from more worrisome clinical presentations. Newborns commonly have an ocular instability that is characterized by variable, intermittent ocular misalignment throughout their first several months of life. This misalignment is most commonly secondary to immaturity of the extra ocular muscles and self-resolves by 3 to 4 months of life.



Treatment of Pediatric Ophthalmology Disorders

Earlier childhood eye muscle problems that have persisted or recurred

Eye muscle weakness as a result of cranial nerve palsies (involving the third, fourth, or sixth cranial nerves)

Myasthenia gravis-related eye problems

Eye muscle problems resulting from trauma to the head or eyes

Thyroid-related eye muscle imbalance


Treatment options available at Vasan – Dubai

The management of squint, double vision and other disorders of eye alignment and movement, both in children and adults

The management of amblyopia or lazy eyes

Refraction in young children using eyedrops (cycloplegic refraction) for those who have difficulty getting a good refraction

General eye problems such as eye sore, allergic conjunctivitis and lumps on the eyelids (stye and chalazion)