It is not uncommon for children to experience eye problems impacting on the eyelid, tear drain system and eye socket due to an injury, a tumour or congenital birth defect. Eye conditions can impact your child’s health beyond vision impairment and yet symptoms of serious eye conditions often go unnoticed or will not be reported by young children.
Paediatric eye disease can be difficult to assess and demands a high level of skill from an ophthalmologist trained to care for babies and children (paediatric care). Early detection and treatment is essential for the best outcomes.
Conditions and Treatments:
Blocked tear ducts
As many as one-third of babies may be born with an underdeveloped tear-duct system. In many cases this will clear up by the child’s first birthday on its own, but occasionally it can lead to infection. Symptoms include excessive tearing, redness and discharge and may require surgical clearing of the blockage. This is a quick and simple procedure. However, it will generally require IV anaesthesia due to the age of the child.
Ptosis
This condition may be present in some children at birth (congenital) or develop as they grow (acquired). It is a weakness in the eyelid lifting muscles, causing the eyelid to droop. In more severe cases, surgery is usually required to correct the condition as it can be associated with other problems which may affect vision such as astigmatism, blurring or amblyopia (lazy eye).
Eyelid malposition
Benign essential blepharospasm
Ptosis is the most common malposition seen in children; however, other conditions are seen and treated including entropion, ectropion and benign and malignant lesions. An appearance of any lesion, especially in the eye region, requires prompt paediatric and/or ophthalmologic evaluation and treatment. In most cases, the lesion will be a benign dermoid cyst that can easily be treated.
Tumours
Orbital and ocular tumours are benign (non-cancerous) or malignant (cancerous) tumours that develop in or around the eyes. Many of these types of tumours are congenital (present at birth) and are benign, but many can be difficult to diagnose. All tumours can cause vision problems if left untreated. Removal methods include radiation, surgical removal and cryotherapy (freezing) and reconstructive surgery may be required depending on the type and location of the tumour.
Retinoblastoma
Retinoblastoma is the most common of paediatric tumours in young children, particularly common in children under 3 years of age. It occurs when abnormal cells in the retina grow in an uncontrolled way and can be diagnosed by the cloudy white appearance of the pupil when exposed to bright light. Any diagnosis of cancer in a child is overwhelming and a cause for anxiety. The good news is, most cases can be successfully treated and vision preserved.
Fractures
In very young children, falls are the most common cause of facial and orbital trauma. As your child grows and takes on more physical challenges on the sporting field and in the playground, other injuries can occur. An orbital fracture may be accompanied by nausea and vomiting or pain from eye movement. Prompt treatment is important to prevent further damage caused by the fracture. A trap door fracture is very common in children because their bones are more flexible and causes entrapment of eye muscles and tissues behind the eye. In most cases, surgical repair is necessary but generally produces very good results with minimal risk depending on the extent of the original injury.

