Pediatric ophthalmology

Pediatric Ophthalmology is a subspecialty of ophthalmology that is concerned with eye diseases, visual development and care in children.

Pediatric Ophthalmology

A pediatric ophthalmologist is a surgeon who is first trained in diseases and surgery of the eye after finishing medical school. They then pursue further training in the diagnosis, treatment and surgery of those eye disorders that are unique to children and adults with strabismus. Pediatric ophthalmologists diagnose, treat and manage all children’s eye problems.

Pediatric ophthalmologists generally provide the following services: surgery, micro and laser surgery, surgery for crossed eyes (strabismus), wandering eyes, treatment of blocked tear ducts, retinal problems and infections. These doctors have the ability to diagnose problems of the eye caused by diseases of the body such as diabetes, juvenile rheumatoid arthritis and other medical and neurological diseases.

Why is the pediatric eye and visual system different from an adult’s?

The brain’s visual processing and eye movement control centers are not fully developed or mature when we are born. The eye is also still growing and organizing areas of highly specialized function. These cells and their functions are developing throughout the first decade of life. Because of the immaturity of the child’s visual system, disorders that may have little effect on an adult’s ability to see can have a profound and lifelong effect on a child’s vision. For example, poor vision or a “lazy eye” due to inadequate stimulation of these brain cells (aka amblyopia) is a common cause of vision loss in this age group.

Pediatric Ophthalmology focuses on childhood eye misalignment and disorders, as well as adult eye movement problems.

What is strabismus?

 Strabismus is a misalignment of the eyes. There are many forms of strabismus, for instance, one eye may be turned in (esotropia) or turned out (exotropia), as well as other ocular misalignments. Eye alignment is normally unsteady at birth, but the eyes should be straight by 4 months of age. Any infant who continues to show an eye misalignment after 4 months of age or a child who later acquires strabismus should have a complete eye examination. Strabismus can be treated with surgery, glasses, or eye exercises, depending on the degree of strabismus and the cause.

Children present a variety of eye problems that are quite distinct from those of adults.

What causes blocked tear ducts?

The cause of blocked tear ducts is a delay in the opening of the tear ducts inside the nose. This duct is the tiny tube that leads from the inner corner of the eye to inside the nose. Healthy eyes constantly make tears to keep the eye moist. Tears normally drain from the tear duct down into the nose. Eyes can become watery because of too many tears (crying) or because the tear duct is blocked.

1 in 5 newborns has a tear duct that is not fully developed. One or both eyes can be affected. In time, the tear duct finishes developing and the problem disappears. This usually happens within a few weeks of birth, although massage therapy of the duct is sometimes needed. In some infants it can take several months and occasionally a surgical procedure must be performed to unblock the tear duct.

Blocked tear ducts

What is amblyopia?

 Amblyopia (commonly called lazy eye) is the medical term for a loss of vision in an apparently healthy eye. This occurs in infants and young children if there is an imbalance of the image received between the two eyes. An eye imbalance can occur when there is cataract, strabismus, ptosis (droopy eyelid), eye injury, or refractive error that is worse in one eye. Amblyopia usually does not have symptoms and often is discovered at a school vision screening. It is ideally treated by an eye doctor before the child is 6 to 10 years old or the vision loss will be permanent. Treatment entails correcting the underlying problem and encouraging the child to use the lazy eye by wearing glasses and/or wearing a patch over the “good” eye or by instilling an eyedrop to the good eye.

Our Pediatric Opthalomologist

Joseph Napolitano, MD


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