Pediatric ophthalmology is a sub-specialty of

ophthalmology Ophthalmology (, ) is the branch of medicine that deals with the diagnosis, treatment, and surgery of eye diseases and disorders. An ophthalmologist is a physician who undergoes subspecialty training in medical and surgical eye care. Following a ...

concerned with

eye disease This is a partial list of human eye diseases and disorders. The World Health Organization (WHO) publishes a classification of known diseases and injuries, the International Statistical Classification of Diseases and Related Health Problems, or ...

s, visual development, and vision care in children.

Training

In the United States, pediatric ophthalmologists are

physicians A physician, medical practitioner (British English), medical doctor, or simply doctor is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through the study, diagnosis, prognosis ...

who have completed

medical school A medical school is a tertiary educational institution, professional school, or forms a part of such an institution, that teaches medicine, and awards a professional degree for physicians. Such medical degrees include the Bachelor of Medicine, ...

, a 1-year

internship An internship is a period of work experience offered by an organization for a limited period of time. Once confined to medical graduates, internship is used to practice for a wide range of placements in businesses, non-profit organizations and g ...

, 3-year

residency Residency may refer to: * Artist-in-residence, a program to sponsor the residence and work of visual artists, writers, musicians, etc. * Concert residency, a series of concerts performed at one venue * Domicile (law), the act of establishing or m ...

in ophthalmology, and a 1-year

fellowship A fellow is a title and form of address for distinguished, learned, or skilled individuals in academia, medicine, research, and industry. The exact meaning of the term differs in each field. In learned or professional societies, the term refers ...

in pediatric ophthalmology and

strabismus Strabismus is an eye disorder in which the eyes do not properly align with each other when looking at an object. The eye that is pointed at an object can alternate. The condition may be present occasionally or constantly. If present during a ...

. Pediatric ophthalmology fellowships in the United States are accredited by the

American Association for Pediatric Ophthalmology and Strabismus The American Association for Pediatric Ophthalmology and Strabismus (AAPOS) 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 surgery Eye surgery, also known as ophthalmic surgery or ocular surgery, is surgery performed on the eye or its adnexa. Eye surgery is part of ophthalmology and is performed by an ophthalmologist or eye surgeon. The eye is a fragile organ, and require ...

as well as to manage children's eye problems using

glasses Glasses, also known as eyeglasses (American English), spectacles (Commonwealth English), or colloquially as specs, are vision eyewear with clear or tinted lenses mounted in a frame that holds them in front of a person's eyes, typically u ...

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, also known as wry neck, is an extremely painful, dystonic condition defined by an abnormal, asymmetrical head or neck position, which may be due to a variety of causes. The term ''torticollis'' is derived . The most common case ha ...

) are typically referred to a pediatric ophthalmologist for evaluation. Pediatric ophthalmologists typically also manage adults with eye movement disorders (such as

nystagmus Nystagmus is a condition of involuntary (or voluntary, in some cases) Eye movement (sensory), eye movement. People can be born with it but more commonly acquire it in infancy or later in life. In many cases it may result in visual impairment, re ...

) due to their familiarity with strabismus conditions.

Eye problems in children

Children experience a variety of eye problems, many quite distinct from adult eye diseases. Pediatric ophthalmologists are specially trained to manage the following disorders: *Infections (

Conjunctivitis Conjunctivitis, also known as pink eye or Madras eye, is inflammation of the conjunctiva, the thin, clear layer that covers the white surface of the eye and the inner eyelid. It makes the eye appear pink or reddish. Pain, burning, scratchiness ...

). *

Strabismus Strabismus is an eye disorder in which the eyes do not properly align with each other when looking at an object. The eye that is pointed at an object can alternate. The condition may be present occasionally or constantly. If present during a ...

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. *

Amblyopia Amblyopia, also called lazy eye, is a disorder of sight in which the brain fails to fully process input from one eye and over time favors the other eye. It results in decreased vision in an eye that typically appears normal in other aspects. Amb ...

(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 error Refractive error is a problem with focus (optics), focusing light accurately on the retina due to the shape of the eye and/or cornea. The most common types of refractive error are myopia, near-sightedness, hyperopia, far-sightedness, astigmatis ...

of one eye is more than 1.5 diopters different from the other eye (

anisometropia Anisometropia is a condition in which a person's eyes have substantially differing refractive power. Generally, a difference in power of one diopter (1D) is the threshold for diagnosis of the condition. Patients may have up to 3 diopters of anis ...

) or one of the eye is misaligned for a long period of time (

). 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 duct The nasolacrimal duct (also called the tear duct) carries tears from the lacrimal sac of the eye into the nasal cavity. The duct begins in the eye socket between the maxillary and lacrimal bones, from where it passes downwards and backwards. The o ...

s. * Ptosis *

Retinopathy of prematurity Retinopathy of prematurity (ROP), also called retrolental fibroplasia (RLF) and Terry syndrome, is a disease of the eye affecting prematurely born babies generally having received neonatal intensive care, in which oxygen therapy is used beca ...

Nystagmus Nystagmus is a condition of involuntary (or voluntary, in some cases) Eye movement (sensory), eye movement. People can be born with it but more commonly acquire it in infancy or later in life. In many cases it may result in visual impairment, re ...

*Visual inattention *Pediatric

cataracts A cataract is a cloudy area in the lens of the eye that leads to a decrease in vision of the eye. Cataracts often develop slowly and can affect one or both eyes. Symptoms may include faded colours, blurry or double vision, halos around ligh ...

Pediatric glaucoma Primary congenital glaucoma is a rare eye condition that is present at birth or develops early in childhood. It occurs due to improper drainage of the eye's fluids, which leads to increased pressure inside the eye, known as intraocular pressure. Th ...

*Abnormal vision development *

Genetic disorders A genetic disorder is a health problem caused by one or more abnormalities in the genome. It can be caused by a mutation in a single gene (monogenic) or multiple genes (polygenic) or by a chromosome abnormality. Although polygenic disorders are ...

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 A birth defect is an abnormal condition that is present at birth, regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities can range from mild to severe. Birth de ...

affecting vision or the tear drainage duct system can be evaluated and possibly surgically corrected by a pediatric ophthalmologist. *Orbital

tumours A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...

*Refractive errors such as

myopia Myopia, also known as near-sightedness and short-sightedness, is an eye condition where light from distant objects focuses in front of, instead of on, the retina. As a result, distant objects appear blurry, while close objects appear normal. ...

(near-sightedness),

hyperopia Far-sightedness, also known as long-sightedness, hypermetropia, and hyperopia, is a condition of the eye where distant objects are seen clearly but near objects appear blurred. This blur is due to incoming light being focused behind, instead o ...

(far-sightedness) and

astigmatism Astigmatism is a type of refractive error due to rotational asymmetry in the eye's refractive power. The lens and cornea of an eye without astigmatism are nearly spherical, with only a single radius of curvature, and any refractive errors ...

can often be corrected with prescriptions for glasses or contacts. * Accommodative insufficiency *

Convergence insufficiency Convergence insufficiency is a sensory and neuromuscular anomaly of the binocular vision system, characterized by a reduced ability of the Human eyes, eyes to turn towards each other, or sustain Convergence (eye), convergence. Symptoms The sympto ...

and

asthenopia Eye strain, also medically termed as asthenopia (), is a common eye condition characterized by non-specific symptoms such as fatigue, pain in or around the eyes, blurred vision, headache, and occasional double vision. These symptoms tend to ...

*Evaluation of visual issues in education, including

dyslexia Dyslexia (), previously known as word blindness, is a learning disability that affects either reading or writing. Different people are affected to different degrees. Problems may include difficulties in spelling words, reading quickly, wri ...

and

attention deficit disorder Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by symptoms of inattention, hyperactivity, impulsivity, and emotional dysregulation that are excessive and pervasive, impairing in multiple con ...

. Pediatric ophthalmologists often work in conjunction with

orthoptist Orthoptics is a profession allied to the eye care profession. Orthoptists are the experts in diagnosing and treating defects in eye movements and problems with how the eyes work together, called binocular vision. These can be caused by issues with ...

s in the treatment of strabismus.

History

Frank D. Costenbader was an American

physician A physician, medical practitioner (British English), medical doctor, or simply doctor is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through the Medical education, study, Med ...

frequently credited as the world's first pediatric ophthalmologist.Marshall MM
"The History of the Costenbader Society: Costenbader's Challenges."
March 19, 2000. Costenbader and

Marshall M. Parks Marshall Miller Parks (July 6, 1918 – July 25, 2005) was an American ophthalmologist known to many as "the father of pediatric ophthalmology".Joe Holley"D.C. Physician Illuminated The Ailments of Young Eyes."''Washington Post''. Sunday, August 2 ...

(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 Hospital (formerly Children's National Health System, DC Children's Hospital, Children's National Medical Center) is a freestanding, 323-bed, pediatric acute care children's hospital located in Washington, D.C. It is affili ...

.Joe Holley
"D.C. Physician Illuminated The Ailments of Young Eyes."
''Washington Post''. Sunday, August 21, 2005; Page C11."Marshal M. Parks, M.D."
Obituary. Accessed September 19, 2006. Parks trained many pediatric ophthalmologists during his career and was instrumental in the establishment of the

, 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 The American Academy of Pediatrics (AAP) is the largest professional association of pediatricians in the United States. It is headquartered in Itasca, Illinois, and maintains an office in Washington, D.C. The AAP has published hundreds of poli ...

on issues related to pediatric eye disease and vision screening guidelines. Other notable pediatric ophthalmologists have included: Jack Crawford,

John T. Flynn John Thomas Flynn (October 25, 1882 – April 13, 1964) was an American journalist best known for his opposition to President Franklin D. Roosevelt and to American entry into World War II. In September 1940, Flynn helped establish the America Fi ...

, David S. Friendly,

Eugene R. Folk Gene Folk (September 7, 1924 - February 28, 2003) was an American ophthalmology, ophthalmologist who specialized in the diagnosis and treatment of strabismus. A charter member of the American Association for Pediatric Ophthalmology and Strabismus, ...

, David Guyton, Robison D. Harley, Eugene Helveston, Arthur Jampolsky,

Barrie Jay Barrie is a city in Central Ontario, Canada, about north of Toronto. The city is within Simcoe County and located along the shores of Kempenfelt Bay. Although it is physically in the county, Barrie is politically independent. The city is part ...

, Phillip Knapp, Burton J. Kushner,

Henry Metz Henry S. Metz is an American pediatric ophthalmologist. He was the CEO of the Smith-Kettlewell Institute in San Francisco from 2003 to 2008. Much of his early research concerned eye movements and strabismus, including saccadic velocity measureme ...

Marilyn T. Miller Marilyn T. Miller (died 2021) was an American pediatric ophthalmologist specializing in the diagnosis and treatment of congenital eye diseases and strabismus. She held leadership positions in her field. Training Miller graduated from the Unive ...

John Pratt-Johnson John Ashburnham Pratt-Johnson, FRCS(C.), FRCS(Edin.), (June 6, 1929 - September 9, 2015) was a Canadian ophthalmologist and Emeritus Professor of Ophthalmology, University of British Columbia, Vancouver, British Columbia, Canada. He was a famous ...

, Arthur Rosenbaum, William E. Scott, Gunter K. von Noorden,

Mette Warburg Mette Warburg (23 January, 1926 - 11 March, 2015) was a Danish eye specialist. Her specialist areas were pediatric ophthalmology and ophthalmic genetics. Biography Warburg was born in Copenhagen. Her father Erik was a notable cardiologist and her ...

, and Abbas Bagheri Lotfabad.

References

External links

American Association for Pediatric Ophthalmology and Strabismus
{{DEFAULTSORT:Pediatric Ophthalmology Pediatric ophthalmologists Ophthalmology, Pediatric Ophthalmology