Pediatric Retina Care
The vast majority of retinal and macular conditions occur in patients who are over the age of 50. However, some retina conditions are specific to infants and children.
Retinopathy of Prematurity (ROP)
When babies are born prematurely (before 32 weeks), their development is disrupted, which can cause a wide range of health problems, especially if they are born weighing less than 3.3 lbs. One of these health problems is retinopathy of prematurity (ROP), a retinal condition that is characterized by abnormal neovascularization in the retina. Like many other retinal vascular diseases, ROP features the presence of abnormal blood vessels that leak fluid under and around the retina.
Symptoms of Retinopathy of Prematurity
ROP is a progressive disease that can eventually lead to retinal detachment and permanent vision loss. However, in the earliest stages, there may not be any noticeable symptoms. As time goes on, children with advanced cases of ROP may exhibit symptoms such as:
- Crossed eyes
- Severe myopia (nearsightedness)
- Cloudy white discoloration in the pupils
- Unusual eye movement
Treatment for Retinopathy of Prematurity
In mild cases of ROP, treatment may not be necessary. However, in more severe cases, treatment may include laser photocoagulation, which halts abnormal neovascularization by burning the edges of the peripheral retina. While laser photocoagulation can help preserve central vision, it can damage peripheral vision. In some cases, anti-vascular endothelial growth factor (anti-VEGF) medications may be recommended. Anti-VEGF eye injections are commonly used to treat many retinal conditions but are considered to be off-label for ROP.
The human retina contains millions of photoreceptor cells known as rods and cones, which are responsible for our ability to process light and see in fine detail, respectively. Retinitis pigmentosa is an inheritable retinal condition characterized by the abnormal deterioration of the rods and cones contained within the retina. As the photoreceptors cells deteriorate, the eyes lose functionality and the ability to properly detect light.
Symptoms of Retinitis Pigmentosa
Retinitis pigmentosa generally first manifests during childhood. Symptoms include:
- Poor night vision
- Reduced peripheral or central vision
- Difficulty reading
- Difficulty discerning fine details in images
- Not seeing objects and tripping over them
- Tunnel vision
Treatment for Retinitis Pigmentosa
Currently, there are no standards of treatment for retinitis pigmentosa. However, nutritional supplements such as Vitamin A can potentially help slow the disease’s progression. There are also low vision aids and rehabilitation services that can help patients with retinitis pigmentosa lead a fulfilling and active life. Retinitis pigmentosa, and many other inheritable retinal conditions, are heavily studied, so there is always the possibility of a new treatment being developed in the near future.
Juvenile retinoschisis is a rare vision disorder that is caused by a recessive genetic mutation carried on the X chromosome. The overwhelming vast majority of cases occur in male children. In retinoschisis, the proteins responsible for organizing retinal cellular structure do not function properly, which results in the retina splitting into two layers.
Juvenile Retinoschisis Symptoms
Juvenile retinoschisis is generally detected when the affected child has difficulty reading or exhibits other signs of poor vision. Some other symptoms in infants and very young children can include:
- Involuntary eye movement
- Crossed eyes
- Hyperopia (farsightedness)
- Excessive squinting
- Declined visual acuity
Juvenile retinoschisis often occurs in two waves. Vision first declines during childhood but then normalizes in early adulthood. During the patient’s 50s or 60s, their vision will likely start declining again at a significant rate.
Treatment for Juvenile Retinoschisis
As with retinitis pigmentosa, there is currently no treatment available for juvenile retinoschisis. The condition is mainly managed through the use of low vision aids and vision rehabilitation. In the rare instance that a patient with juvenile retinoschisis experiences a retinal detachment or vitreous hemorrhage, surgical intervention may be required.