Pediatric Eye Care

At West Texas Eye Associates, we provide general wellness exams, glasses and contact lens prescriptions, therapy for amblyopia (lazy eye), treatment of medical problems such as strabismus, and eye surgery when indicated.

By age 4, your child should have a thorough optometric eye examination to make sure his or her vision is developing properly and there is no evidence of eye disease. Vision changes can occur without you or your child noticing them. Your child should receive an eye examination at least once every two years-more frequently if specific problems or risk factors exist, or if recommended by your eye doctor. The earlier a vision problem is detected and treated, the more likely treatment will be successful. Your doctor can prescribe treatment including eyeglasses, contact lenses or vision therapy to correct any vision problems if needed.

Signs that may indicate a vision problem:

• Holding a book too close or sitting close to the TV
• Squinting
• Tilting their head
• Frequently rubbing their eyes
• Short attention span for the child’s age
• Turning of an eye in or out
• Light sensitivity

Two of the most important pediatric eye problems are Strabismus (“crooked eyes”) and Amblyopia (a “lazy eye”). Because vision is developing between birth and nine years of age, early detection and treatment of these problems is essential to ensure optimal outcomes.

Strabismus is a general term for misaligned or crooked eyes. The eyes may turn in (“crossed eyes” or esotropia), turn out (“wall eyes” or exotropia) or may deviate vertically (hypertropia). The two principal causes of Strabismus are muscle imbalances and extreme amounts of farsightedness (hyperopia). Muscle imbalances may begin at any time but generally appear before six months of age. As a result of the misalignment, the crooked eye may become lazy or amblyopic.

Surgery is necessary to align the eyes. Prior to surgery, any Amblyopia present is treated with patching of the good eye. The surgery is performed by loosening (or recessing) a tight muscle (by setting it farther back on the eye) or by tightening (or resecting) a loose muscle (by removing a section of muscle and reattaching it to the eye). Sometimes both techniques are used together. It may only be necessary to operate on one eye, but in the vast majority of cases surgery is needed on both eyes in order to achieve the best alignment. Surgery is usually performed under general anesthesia on an outpatient basis.

The procedure takes about twenty to thirty minutes for each muscle to be operated upon. Following the surgery eye bandages or patches are usually not required. Pain following the procedure is generally mild, similar to that experienced with a pulled or strained muscle. In nearly all cases over-the-counter pain medication is all that is required to control any discomfort.

Our goal at West Texas Eye Associates s always to obtain an excellent ocular alignment. Individual patients, however, do vary in their response to surgery, resulting in an 80% to 90% success rate in achieving satisfactory alignment after one operation. However, with time, about 20% to 30% of patients may need re-operation if misalignment reappears.

Amblyopia is poor vision in an eye that did not develop normal sight during early childhood. It is often called a “lazy eye”. Usually only one eye is affected by amblyopia. It is a common condition affecting three out of every 100 children. The three major causes are:

Strabismus (crooked eyes) – Misaligned or crossed eyes are the most common cause of amblyopia. The brain “turns off” the crooked eye to avoid double vision and the child uses only the better eye.
Unequal focus (refractive error) – Amblyopia can occur when one eye is more out of focus than the other because it is more nearsighted, farsighted or astigmatic than the fellow eye. The unfocused eye “turns off” and becomes amblyopic or lazy. Although the eye has poor vision it can appear normal. Consequently, this type of Amblyopia is the most difficult to detect.
Obstructed Vision – An eye disease such as a cataract (cloudy lens in the eye) or ptosis (a droopy eyelid) may obstruct light from getting into the eye, blocking adequate vision and leading to the development of Amblyopia. This is often the severest form of Amblyopia.

How is Amblyopia treated?

To correct Amblyopia, a child must be made to use the weak eye. This is generally accomplished by patching or covering the good eye.

In the case of Cataract or Ptosis (droopy eyelid), these problems must first be surgically corrected. In the case of unequal focus, glasses are prescribed. Full or part-time patching may be needed for all patients for a period of weeks to months. During this time, periodic checkups will be needed to monitor the level of vision in each eye. Even after vision has been restored in the weak eye, part-time patching may be required over a period of years to maintain improvement.

Extreme farsightedness is also a common cause of crossed eyes (Esotropia) in children. This usually begins after age one and is often associated with Amblyopia. Treatment is best accomplished with glasses to correct the farsightedness. Amblyopia, if present, is treated with patching. In a few cases, if the eyes do not fully straighten with spectacles alone, it may be necessary to use eye muscle surgery to correct any residual eye misalignment.

Tips for your child’s first visit:

• Make an appointment early in the day. Allow about one hour.
• Talk about the examination in advance and encourage questions.
• Explain the examination in terms your child can understand

You should bring your child in at any time if you notice unusual symptoms.

Many vision problems are only treatable in childhood and the doctors at West Texas Eye Associates are committed to providing the highest quality pediatric eye care to you and your child.