Pediatric ophthalmology is a sub specialty of ophthalmology concerned with vision care and eye diseases in children. A pediatric ophthalmologist provides comprehensive care in diagnostic, treatment and management of infant vision and common childhood vision disorders. Surgery to correct ocular misalignment and double vision in children are also performed by a pediatric ophthalmologist.
Pediatric ophthalmologists are physicians who have completed a three year residency in ophthalmology after the medical school and one year internship and one or two year fellowship in pediatric ophthalmology and strabismus. Pediatric ophthalmology fellowships are accredited by the American Association for Pediatric Ophthalmology and Strabismus in the US.
Role of a pediatric ophthalmologist in child vision care:
- It could be opined that in young infants and children the visual system is not fully mature. As such, equal input from both eyes is required for proper development of visual centers in the brain in a human being. There could be the danger of permanent irreversible loss if the child's growing eye does not provide clear and focused image to the developing brain. A pediatric ophthalmologist provides early detection and effective treatment under such circumstances.
- Children suffer from reduced vision in one or both eyes from Amblyopia, uncorrected refractive errors and misalignment of the eyes called strabismus. It is the domain of the pediatric ophthalmologist to detect such innate errors in children and provide effective and efficient treatment. Among the vision problems that the pediatric ophthalmologist evaluates for the child include:
- Amblyopia: This is caused in an infant whose brain does not recognize the sight from the eye. In other words, there is poor vision in the eye appearing normal.
- Strabismus: This is misalignment of the eyes in any direction. About 4% of the children are affected by this disorder.
- Refractive errors: Such errors can cause decreased vision resulting in visual discomfort, eye strain and also Amblyopia.
- Genetic disorders: Approximately about 8% of genetic syndromes affect the eyes of children. Examination by a pediatric ophthalmologist helps to diagnose such genetic conditions. Sometimes certain eye conditions such as high internal pressure 'intraocular pressure' which can lead to glaucoma can be inherited in family members even when they are young. It is imperative on the part of the parent to inform the pediatric ophthalmologist about such conditions. Many pediatric ophthalmologists participate with multi disciplinary medical teams that treat children with genetic syndromes.
Tests conducted by pediatric ophthalmologist
- Penlight Eye Inspection: A small penlight is aimed into the child's eye, beginning with the newborn infants. The pediatric ophthalmologist checks and makes sure that the eye structures and eyelids appear normal and also if the eyes react appropriately to the presence of light. The pediatric ophthalmologist also checks for any early signs that eyes might be misaligned.
- Red Reflex test: The internal eye structure in particular, the red reflection from the inner back of the eye where the light sensitive retina is located is examined for the presence of any eye disease. This is done using an ophthalmoscope.
- Snellen Eye chart: This eye check contains letters and numbers which are used to test the sharpness of vision. This test can be done on children above the age of three years depending upon their comprehension. Sometimes certain cards with pictures are used to test for visual acuity testing.