Great Information from AAPOS (American Association for Pediatric Ophthalmology and Strabismus)
For more detailed eye disorder information, visit Alaska Blind Child Discovery (ABCD).
Eye Smart from American Academy of Ophthalmology
Medical Information videos from ACES
Vision and Learning
Much of what we learn comes through the five senses; Vision is a primary method of learning about things very close (microscope) or even very distant (stars and galaxies). Clear, steady eyes that are able to focus close, and align efficiently allow detailed messages about images, symbols, letters and words to be detected by the retina, transmitted via the optic nerves and tracts to the occipital cortex of the brain. From the occipital cortex, messages are interpreted and then compared with other areas of the brain for comparison, interpretation and memory.
Some children with poor vision, defocus, misalignment, nystagmus and retinal or nerve disease still may be able to learn well, and even read if the processing and comparison of their imperfect images is efficient enough. Dyslexia is a language disorder of inefficient processing letters, words and phrases- it is usually not a “tracking” problem.
- Reading Problems (pdf)
A cataract is whenever the crystaline lens of the eye is not clear. Cataracts can occur in infants and children rapidly leading to dense AMBLYOPIA; as a result surgeons from Alaska Children’s Eye address these urgently with examination, special eye measurement, microsurgery and rehabilitation with special contact lenses, spectacles, eye drops and patching. Cataract is a common cause of adult blindness in America and in other remote parts of the world. Dr. Winkle is an expert at adult cataract surgery helping him hone his skill for pediatric cases and overseas missions.
The normal eyelids open and close protecting the eye from dryness and injury; abnormal eyelids can cause blurriness, pain, tearing, inflammation, scarring and even blindness. Eye surgeons at ACES provide eyelid surgery to adults and children including repair of PTOSIS (droopy lids), ECTROPION (everted lid), ENTROPION (inverted lid), TRICHIASIS (lashes rubbing the eye) and DERMATOCHALASIS.
The human eye is a living camera that can gather real-time, detailed information about tiny objects up close- to galaxies far away. With satisfactory, normal childhood visual development (not disrupted by amblyopia) both eyes can view an object between 10 cm and 6 meters processing the simultaneous images into depth perception and stereopsis (3D vision). An eye that can focus on a distant object without accommodative effort is called EMMETROPIC. Eyes that are out-of-focus are said to have one or more REFRACTIVE ERRORS. Distant images become blurred due to MYOPIA- also called nearsightedness; this occurs if the eye is too long, or the focusing power of the cornea and lens are too strong. HYPEROPIA, also called farsightedness- is caused by the eye being too short, or the power of the cornea – lens being not strong enough. If the cornea, or the lens of the eye is not uniformly round curved (like a soccer ball), then the cornea becomes football-shaped and the refractive error is called ASTIGMATISM. As people age, and get near 40 years old, the accommodative power of the cilliary body is not sufficient to bend the gradually inflexible crystalline lens- and near object become progressively blurry- a refractive error called PRESBYOPIA. The refractive error changes with age.
Chalazia / Stye (eyelid lumps)
Changes in the shape and comfort of the eye lid may be a simple, self limited process like a skintag, or it may represent a tumor. Inflmmation of one or more of the 50 oil glands in each lid may cause hordeolum (stye) or chalazion. These may be prevented by eating quality omega-3 oils from Flax Seed or Fish. May of these will be cured by lid hygiene and application of warm packs to the lids several times per day- however persistent chalazia may require surgical incision and drainage. Painful or growing lumps behind the lids may require removal by orbitotomy.
Babies and children may develop high pressure in one or both eyes that can injure the optic nerve and cause blindness. Congenital glaucoma causes a very large eye with excess clear tearing, sensitivity to light and eventually a hazy cornea. Most forms of childhood glaucoma require surgical treatment but some can be managed with medications. Congenital glaucoma is rare but very serious.
Eye Birth Defects
The eye may have changes call “dysgenesis” from before birth and patients with clinical syndromes may have characteristic findings in their eyes of particular interest to geneticists and pediatricians.
Iritis / Uveitis
Iritis is inflammation of the iris or ciliary body. It is a form of Uveitis- the name for inflammation of the vascular, inner layer of the eye. Iritis is detected by finding circulating white blood cells (WBC) in the aqueous humor between the pupil, the iris and the back of the cornea. Iritis usually causes pain, redness of the conjunctiva near the limbus, and sensitivity to light, but iritis can also be asymptomatic- especially in children with Juvenile Rheumatoid Arthritis (JIA). Iritis can cause scarring, glaucoma and cataracts. There are many causes of iritis including inflammatory conditions in the rest of the body. Iritis is treated by finding the cause, and then using anti-inflammatory medications, such as corticosteroid drops or pills, and cycloplegic drops.