UC San Diego Shiley Eye Institute UC San Diego Shiley Eye Institute The Viterbi Family Department of Ophthalmology UC San Diego Shiley Eye Institute
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Afshari, Natalie A. Baxter, Sally L. Borooah, Shyamanga Brown, Stuart I. Camp, Andrew Do, Jiun Ferreyra, Henry A. Freeman, William R. Goldbaum, Michael H. Granet, David B. Haw, Weldon W. Heichel, Chris W. Hennein, Lauren Huang, Alex A. Huang, Lingling Kikkawa, Don O. Kline, Lanning Korn, Bobby S. Lee, Jeffrey E. Liu, Catherine Y. Moghimi, Sasan Movaghar, Mansoor Nguyen, Thao P. Nudleman, Eric Puig-Llano, Manuel Robbins, Shira L. Rudell, Jolene Savino, Peter J. Scott, Nathan L. Spencer, Doran B. Toomey, Christopher B. Vasile, Cristiana Weinreb, Robert N. Welsbie, Derek S.
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Pediatric Conditions

For children, good vision is extremely important because it is so intrinsically involved with learning and development. Regular eye examinations are important to maintain proper eye health, even if your child does not yet speak and since some serious eye disorders produce no early warning symptoms. Although prevention is the best defense, eye problems or injuries still can occur suddenly and unexpectedly. And when they do, recognizing their signs and symptoms and knowing what to do is vital to preserving your child's vision.

Any of the following signs or symptoms suggest your child has a serious eye problems. If your child experiences any of the following, see an ophthalmologist as soon as possible.

Crossed Eyes
Crossed eyes are a commonly used term for the technical phrases esotropia. This condition occurs where either eye may look straight ahead and the other eye will be turned inward toward the nose. The condition develops generally in early infancy or childhood. Many children during the first three to four months of life will have some intermittent crossing of their eyes. However, persistent crossed eyes
in young children after the age of three to four months should be considered a serious condition. The eye that is turned begins to be ignored by the brain and eventually that image can be fully suppressed. If the condition is not properly treated, that can lead to permanent functional blindness.

Esotropia can also occur in the teen and adult population. This can be related to systemic disorders like: high blood pressure, diabetes, strokes or other brain injuries. These health-related problems will either affect the nerves that communicate between the brain and the eye or the eye muscles themselves. The first sign of a problem is usually double vision. This should result in a prompt referral to a physician. Treatment of misalignment of the eyes includes correcting a refractive error with glasses. Patching or other devices to force the use of the less-preferred eye is commonly used. After these basic interventions, if the eyes are still not aligned, surgical adjustment of the eye muscles may be needed. Detection of these eye problems, both in childhood and later years, is crucial. Your child should be examined by their pediatrician during the pre-school years and evaluated for this and other disorders.

Eye Exams
All children should have an initial eye evaluation by their pediatrician within the first few days to one week of life. In fact, many hospitals evaluate a child before they are discharged after birth. During each of the babys well-visit examinations, the pediatrician will be asking you questions about your babys eyes and doing brief screening evaluations. Persistent misaligned eyes after the age of three or four months, persistent discharge from the eyes, an irregularity of the eye or an general health problem that may relate to the eye, will initiate referral to an ophthalmologist. Typically, at age one and then age three, the pediatrician will be doing some ore extensive screening appropriate to the childs age. At age three, if a child does not seem to have equal visual acuity in both eyes or does not reach a certain level on the eye chart, your pediatrician will decide to send your child for an eye examination.

Between three and five years of age, if you believe your child is having difficulty seeing or if there is a family history of needing glasses at an early age, it certainly is worthwhile having an eye exam. Most children should have an eye exam before they begin first grade. It is always helpful to bring a child to someone who specializes in children, for example a pediatric ophthalmologist. Remember, any child, any age can be examined.

Glasses are used to produce a clear image on the back wall of the eye or the retina. This is similar to focusing an image onto film in a camera. In children, a special examination requiring the use of strong, long-acting drops, is needed in order to make an independent assessment of their need for glasses.

Nearsighted children are ones in which objects that are close are clear while objects that are far away, are not. This is called myopia. Farsightedness, or hyperopia, is sight which is better at a distance than near. Eventually, this does occur in adulthood when the lens of the eye can no longer focus for ourselves. However, children are actually normally farsighted. The lens inside their eye can easily focus this for them and they remain with clear vision. However, large amounts of farsightedness can induce eye strain and this strain can even lead to crossing of the eyes. Astigmatism is a condition where the eye is not completely round. This causes a distortion of the optical image coming into the eye.

There are special considerations in fitting a child for glasses. For example, polycarbonate is the lens material of choice. This protects children who are at a higher risk for lens shattering. Additionally, frames that are picked for children should be especially for kids and not just a pair of small adult eyeglasses. Remember, it is never too early to have a child's eye examined if you think there is a problem. For more information regarding eye glasses, contact your health care provider.

Lazy Eyes
Lazy eye is a commonly used term for both amblyopia and strabismus. Amblyopia generally results in poor vision without any obvious injury or disease to the eyeball. Strabismus represents any misalignment of the eyes. Amblyopia can be treated using an eye patch and more frequently, the use of blurring drops. The younger the age of the child when amblyopia is diagnosed, the easier and more successful treatment is. Generally, amblyopia becomes most difficult to treat after the age of seven or eight but with persistence, even in these more advanced years, some success is possible. Untreated amblyopia will result in a permanent decrease in vision, even to the level of functionally blind. Strabismus, or misalignment of the eyes, is quite serious. Strabismus often leads to amblyopia. If strabismus occurs during early childhood, it is generally an otherwise benign condition. Treatment requires either glasses or sometimes, surgical intervention. Acquired misalignment of the eyes as an adult, can be an indication of a more serious underlying problem and must be evaluated promptly.For more information regarding lazy eye, amblyopia or strabismus, contact your health care provider.

Reading/Learning Disabilities
Many people are quite misinformed regarding reading and learning disabilities. Learning disabilities are generally not related to eye problems. Most learning disabilities involve difficulty processing information by the brain. Many reading difficulties trace back to difficulties with the skills of reading. This is different than indicating an eye or vision problem. However, any child being evaluated for a reading disability should have a complete eye evaluation. There are simple things that can be identified and detected and treated that can impact learning. Specialists What a great program in which to be involved in helping students with these difficulties should be aware of these issues. The school system provides in-depth resources for both the identification and treatment of these issues.

Sunglasses serve two major functions. They decrease the amount of sunlight reaching your eye for comfort and protect your eye and surrounding structures from the devastating damage of ultraviolet light. Ultraviolet light has been linked to the formation of cataracts, macular degeneration, intraocular tumors, skin cancer on the lids and pterygium, an abnormal growth on the eye's surface. It has been estimated that up to seventy percent of your life time sun exposure occurs under the age of eighteen. Ultraviolet light and sun exposure damage is cumulative. In addition, a child's eyes are more susceptible to ultraviolet exposure because the lens in their eye is clearer. Therefore, decreasing the amount of sun exposure in childhood becomes essential. Children who cannot tolerate sunglasses should wear a wide-brimmed hat, which will provide some UV protection.Sunglasses should be purchased that have complete ultraviolet blockage. Do not be misguided by price- higher priced sunglasses usually represent fashion trends or durability, not UV protection. Also, if sunglasses do not fit properly their UV protection is minimized or lost.

The easy way to remember when to wear sunglasses is this: When you go outside you should protect your eyes; consider sunglasses the "suntan lotion for the eyes."

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