Pediatric ophthalmology
Encyclopedia
Pediatric ophthalmology is a sub-speciality of ophthalmology
concerned with eye diseases, visual development, and vision care in children.
, a 1-year internship, 3-year residency
in ophthalmology, and a 1-2 year fellowship
in pediatric ophthalmology and strabismus
. Pediatric ophthalmology fellowships in the United States are accredited by the American Association for Pediatric Ophthalmology and Strabismus
.
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 (strabismus) due to their familiarity with strabismus conditions.
Children experience a variety of eye problems, many quite distinct from adult eye diseases. Pediatric ophthalmologists are specially trained to manage the following disorders:
Pediatric ophthalmologists often work in conjunction with orthoptists in the treatment of strabismus.
was an American physician
frequently credited as the world's first pediatric ophthalmologist. Costenbader and Marshall M. Parks
(his mentee who would later be known to many as "the father of pediatric ophthalmology") began the first ophthalmology fellowship trained program of any subspecialty at the Children's Hospital in Washington, D.C., now known as the Children's National Medical Center
. Parks trained many pediatric ophthalmologists during his career and was instrumental in the establishment of the American Association for Pediatric Ophthalmology and Strabismus
, a national organization dedicated to improving the quality and management of pediatric ocular disease. Over time, over 30 programs were developed for the training of pediatric ophthalmologists throughout the United States. The American Academy of Pediatric Ophthalmology and Strabismus works with the American Academy of Pediatrics
on issues related to pediatric eye disease and vision screening guidelines.
Ophthalmology
Ophthalmology is the branch of medicine that deals with the anatomy, physiology and diseases of the eye. An ophthalmologist is a specialist in medical and surgical eye problems...
concerned with eye diseases, visual development, and vision care in children.
Training
In the United States, pediatric ophthalmologists are physicians who have completed medical schoolMedical school
A medical school is a tertiary educational institution—or part of such an institution—that teaches medicine. Degree programs offered at medical schools often include Doctor of Osteopathic Medicine, Bachelor/Doctor of Medicine, Doctor of Philosophy, master's degree, or other post-secondary...
, a 1-year internship, 3-year residency
Residency (medicine)
Residency is a stage of graduate medical training. A resident physician or resident is a person who has received a medical degree , Podiatric degree , Dental Degree and who practices...
in ophthalmology, and a 1-2 year fellowship
Fellowship (medicine)
A fellowship is the period of medical training in the United States and Canada that a physician may undertake after completing a specialty training program . During this time , the physician is known as a fellow...
in pediatric ophthalmology and strabismus
Strabismus
Strabismus is a condition in which the eyes are not properly aligned with each other. It typically involves a lack of coordination between the extraocular muscles, which prevents bringing the gaze of each eye to the same point in space and preventing proper binocular vision, which may adversely...
. Pediatric ophthalmology fellowships in the United States are accredited by the American Association for Pediatric Ophthalmology and Strabismus
American Association for Pediatric Ophthalmology and Strabismus
The American Association for Pediatric Ophthalmology and Strabismus is an academic association of pediatric ophthalmologists and strabismus surgeons. The pediatric ophthalmology fellowships in the United States are accredited by the AAPOS...
.
Clinical expertise
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 surgeryEye surgery
Eye surgery, also known as orogolomistician surgery or ocular surgery, is surgery performed on the eye or its adnexa, typically by an ophthalmologist.-Preparation and precautions:...
as well as to manage children's eye problems using glasses
Glasses
Glasses, also known as eyeglasses , spectacles or simply specs , are frames bearing lenses worn in front of the eyes. They are normally used for vision correction or eye protection. Safety glasses are a kind of eye protection against flying debris or against visible and near visible light or...
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
Torticollis
Torticollis, or wryneck, is a stiff neck associated with muscle spasm, classically causing lateral flexion contracture of the cervical spine musculature...
) are typically referred to a pediatric ophthalmologist for evaluation. Pediatric ophthalmologists typically also manage adults with eye movement disorders (strabismus) due to their familiarity with strabismus conditions.
Eye problems in children
- Infections (conjunctivitis).
- StrabismusStrabismusStrabismus is a condition in which the eyes are not properly aligned with each other. It typically involves a lack of coordination between the extraocular muscles, which prevents bringing the gaze of each eye to the same point in space and preventing proper binocular vision, which may adversely...
is a misalignment of the eyes that affects 2-4% of the population; it is often associated with amblyopia. The inward turning gaze commonly referred to as "crossed-eyes" is an example of strabismus. The term strabismus applies to other types of misalignments, including an upward, downward, or outward turning eye. - AmblyopiaAmblyopiaAmblyopia, also known as lazy eye, is a disorder of the visual system that is characterized by a vision deficiency in an eye that is otherwise physically normal, or out of proportion to associated structural abnormalities of the eye...
(aka lazy eye) occurs when the vision of one eye is significantly better than the other eye, and the brain begins to rely on the better eye and ignore the weaker one. Amblyopia affects 4% of the population and is clinically diagnosed when the refractive errorRefractive errorA refractive error, or refraction error, is an error in the focusing of light by the eye and a frequent reason for reduced visual acuity.-Classification:...
of one eye is more than 1.5 diopters different than the other eye. The management of amblyopia involves correcting of significant refractive errors and using techniques that encourage the brain to pay attention to the weaker eye such as patching the stronger eye.(occlusion therapy) - Blocked tear ducts.
- PtosisPtosis (eyelid)Ptosis is a drooping of the upper or lower eyelid. The drooping may be worse after being awake longer, when the individual's muscles are tired. This condition is sometimes called "lazy eye", but that term normally refers to amblyopia...
- Retinopathy of prematurityRetinopathy of prematurityRetinopathy of prematurity , previously known as retrolental fibroplasia , is an eye disease that affects prematurely-born babies. It is thought to be caused by disorganized growth of retinal blood vessels which may result in scarring and retinal detachment. ROP can be mild and may resolve...
- Visual inattention
- Pediatric cataracts
- Pediatric glaucomaGlaucomaGlaucoma is an eye disorder in which the optic nerve suffers damage, permanently damaging vision in the affected eye and progressing to complete blindness if untreated. It is often, but not always, associated with increased pressure of the fluid in the eye...
- Abnormal vision development
- Genetic disorders often cause eye problems for affected children. Since approximately 30% of genetic syndromes affect the eyes, examination by a pediatric ophthalmologist can help with the diagnosis of genetic conditions. Many pediatric ophthalmologists participate with multi-disciplinary medical teams that treat children with genetic syndromes.
- Congenital malformations affecting vision or the tear drainage duct system can be evaluated and possibly surgically corrected by a pediatric ophthalmologist.
- Orbital tumours
- Refractive errors such as myopiaMyopiaMyopia , "shortsightedness" ) is a refractive defect of the eye in which collimated light produces image focus in front of the retina under conditions of accommodation. In simpler terms, myopia is a condition of the eye where the light that comes in does not directly focus on the retina but in...
(near-sightedness) and astigmatismAstigmatism (eye)Astigmatism is an optical defect in which vision is blurred due to the inability of the optics of the eye to focus a point object into a sharp focused image on the retina. This may be due to an irregular or toric curvature of the cornea or lens. There are two types of astigmatism: regular and...
can often be corrected with prescriptions for glasses or contacts. - Accommodative insufficiencyAccommodative insufficiencyAccommodative insufficiency involves the inability of the eye to focus properly on an object. Approximately 80 percent of children diagnosed with CI also demonstrate AI....
- Convergence insufficiencyConvergence insufficiencyConvergence insufficiency or Convergence Disorder is a sensory and neuromuscular anomaly of the binocular vision system, characterized by an inability of the eyes to turn towards each other, or sustain convergence.-Symptoms:...
and asthenopiaAsthenopiaAsthenopia or eye strain is an ophthalmological condition that manifests itself through nonspecific symptoms such as fatigue, pain in or around the eyes, blurred vision, headache and occasional double vision... - Evaluation of visual issues in education, including dyslexiaDyslexiaDyslexia is a very broad term defining a learning disability that impairs a person's fluency or comprehension accuracy in being able to read, and which can manifest itself as a difficulty with phonological awareness, phonological decoding, orthographic coding, auditory short-term memory, or rapid...
and attention deficit disorder.
Pediatric ophthalmologists often work in conjunction with orthoptists in the treatment of strabismus.
History
Frank D. CostenbaderFrank D. Costenbader
Frank D. Costenbader was an American physician frequently credited as the world's first pediatric ophthalmologist.-References:...
was an American physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
frequently credited as the world's first pediatric ophthalmologist. Costenbader and Marshall M. Parks
Marshall M. Parks
Marshall Miller Parks was an American ophthalmologist known to many as "the father of pediatric ophthalmology".-Early life:...
(his mentee who would later be known to many as "the father of pediatric ophthalmology") began the first ophthalmology fellowship trained program of any subspecialty at the Children's Hospital in Washington, D.C., now known as the Children's National Medical Center
Children's National Medical Center
- Introduction :Children’s National Medical Center , is the only exclusive provider of pediatric care in the Washington, D.C., area and the only freestanding children’s hospital between Philadelphia, Pittsburgh, Norfolk, and Atlanta...
. Parks trained many pediatric ophthalmologists during his career and was instrumental in the establishment of the American Association for Pediatric Ophthalmology and Strabismus
American Association for Pediatric Ophthalmology and Strabismus
The American Association for Pediatric Ophthalmology and Strabismus is an academic association of pediatric ophthalmologists and strabismus surgeons. The pediatric ophthalmology fellowships in the United States are accredited by the AAPOS...
, a national organization dedicated to improving the quality and management of pediatric ocular disease. Over time, over 30 programs were developed for the training of pediatric ophthalmologists throughout the United States. The American Academy of Pediatric Ophthalmology and Strabismus works with the American Academy of Pediatrics
American Academy of Pediatrics
The American Academy of Pediatrics is the major professional association of pediatricians in the United States. The AAP was founded in 1930 by 35 pediatricians to address pediatric healthcare standards. It currently has 60,000 members in primary care and sub-specialist areas...
on issues related to pediatric eye disease and vision screening guidelines.
See also
- Eye exam
- Infant visionInfant visionThe science of infant vision gives a verifiable basis for some practices of pediatric ophthalmology and gathers measurements intended to describe, monitor and predict:* development of retinal photoreceptor cells...
- Ophthalmoscope
- Orthoptics
- School vision screening
- Strabismus surgeryStrabismus surgeryStrabismus surgery is surgery on the extraocular muscles to correct the misalignment of the eyes. With approximately 1.2 million procedures each year, extraocular muscle surgery is the third most common eye surgery in the United States.-Types:...
- Visual acuityVisual acuityVisual acuity is acuteness or clearness of vision, which is dependent on the sharpness of the retinal focus within the eye and the sensitivity of the interpretative faculty of the brain....