What You Need to Know about Seven Childhood Eye Diseases

According to the American Academy of Ophthalmology (AAO), there are a number of eye conditions that can affect children. Some conditions are structural and affect the alignment of the eye. Others are infections or other types of diseases. Based on information provided by the AAO, parents and physicians should be alert to the following list of symptoms of the most common non-refractive childhood eye disorders.

A diagnosis of amblyopia—commonly referred to as “lazy eye”—means one eye has not developed in tandem with the other. The result is limited vision in the affected eye compared to the other eye. Sometimes amblyopia occurs because the eyes are misaligned, a condition known as strabismus. About 2 to 3 percent of the American population has amblyopia.

Amblyopia in a child is often apparent when one eye turns to the side. This causes poorly transmitted visual signals from the affected eye to the brain, since the brain relies on signals from the normal eye. The National Eye Institute notes that covering the dominant eye for two-to-six hours per day with an eye patch is the most common way for physicians to treat amblyopia.

When vision is impeded by an eyelid drooping down and covering all or part of the eye, the diagnosis is most often ptosis. According to a 2016 study by the National Institutes of Health, physicians most often recommend surgery to correct ptosis, noting a second procedure sometimes is necessary.

Cataracts do not just affect older adults. Children can develop the same type of whitening and clouding of the eye lenses so vision is reduced. Childhood cataracts may cause a child to shield their eyes in bright light, or scowl or squint when not necessary. The child’s eye may “wobble” with rapid movements.

A long-term infection in the eye, which may cause irritation and watering, may be caused by improper drainage of a child’s tear ducts. When blocked tear ducts are a congenital condition, they often open without intervention by the child’s first birthday. An ophthalmologist may recommend a specific massage technique to help.

Conjunctivitis is caused by a bacterial or viral infection of the eye, with both forms being highly contagious. The word “conjunctivitis” refers to inflammation in the conjunctiva, the slender membrane encasing the whites of the eye and the surfaces of the inner eyelids.

With conjunctivitis, a child’s eye appears intense pink or red, may itch and has a watery or gooey discharge. If a virus is present, the child also typically runs a fever and experiences a runny nose and a raw, scratchy throat.

Often referred to as “pink eye,” conjunctivitis may also be the result of an allergy, in which case it is not contagious. Children diagnosed with the contagious form of pink eye need to refrain from attending school until the condition clears, which usually takes a week.

A stye is caused by a bacterial infection. The infection causes a small painful lump on the eyelid at the base of an eyelash or in one of the eyelid’s oil glands. The affected eye is usually swollen and red with pain and tenderness. A stye most often goes away on its own, with the process helped by a warm water compress to help the stye rupture and clear of pus. A stye inside the eyelid may need attention from an ophthalmologist to properly heal.

A stye may appear similar to another type of nodule called a chalazion, a firm round lump that forms on the eyelid due to a blocked oil gland. A chalazion is not typically painful. If this is the first time your child has developed a stye or chalazion, it may be best to see an ophthalmologist to confirm the diagnosis and offer treatment or antibiotic eye drops.

Preseptal cellulitis is caused by a bacterial infection attacking the soft tissue of the eyelid and around the eye, resulting in swollen inflamed tissue. There is usually an obvious entryway for bacteria through a cut or scrape, or through infected sinuses. There is usually no pain with eye movement and vision is not impaired. Conversely, if the child has a fever and swelling and extreme pain without any visible laceration or sinus infection, seek medical help right away. These symptoms may be caused by a more serious condition called orbital cellulitis that affects the eye itself. Early stages of the two eye conditions are often confused, but with orbital cellulitis, the eye may protrude, vision is impaired and there is difficulty in moving the eye.

Early diagnosis and treatment are crucial to maintaining a child’s ocular health. The ability to see clearly is of vital importance to learning in school, participating in sports, and, in later years, learning to drive and to function well in the workplace. The American Academy of Ophthalmology, along with its partner organization the American Association for Pediatric Ophthalmology and Strabismus, recommends regular vision screenings throughout childhood. If a child’s eye problems are noted and treated early, there is a better chance of treatment and correction.

Physicians can check vision in babies for common neonatal conditions shortly after birth. A pediatrician or a pediatric ophthalmologist can conduct a red reflex test to make sure a newborn has normal vision. The American Academy of Pediatrics recommends this test be performed on all infants. A doctor will use an ophthalmoscope to look for abnormalities in the back of the eye, as well as clouding of the visual axis that might indicate the presence of cataracts or other problems with the cornea.

The American Academy of Pediatrics further recommends regular ongoing visual screenings throughout childhood as part of a well-child program. Children should have a second eye exam when they are between 6 and 12 months of age. At about age 3, and again before starting school, visual acuity should also be tested. With older children, this can be done using an eye chart or an ocular photoscreening test which does not require active participation by the child.

If a doctor suspects a child is experiencing one or more conditions after a visual acuity screening, a comprehensive follow-up eye exam with pupil dilation should be conducted to closely examine the entire structure of the eyes.