|
Jay M. Bernstein, M.D.
Dr. Jay Bernstein graduated from Alfred University in 1975, and Northwestern University School of Medicine in 1980. His ophthalmology residency was performed at the University of Medicine & Dentistry. After residency, he went on to Moorefield Eye Hospital in London for sub-specialty training (fellowship) in Pediatric Ophthalmology and Strabismus. He has been in practice for nearly two decades, specializing in all aspects of pediatric eye care, pediatric and adult strabismus surgery and BOTOX® injection treatment for strabismus.
Dr. Bernstein is board certified by the American Board of Ophthalmology and was a member of the American Academy of Pediatrics Executive Board Section.
Many of us have had the experience of joy that comes from a new eyeglass prescription that improves our vision. We initiate a visit to the ophthalmologist because we are aware that we could be seeing better. Most children, however, are unaware of their visual status and do not know if their vision is good.
Parents often wonder "Does my child have normal vision?" In children, routine eye exams are even more important so that various eye and vision disorders can be detected early and treated. In this way, the intellectual and social development can proceed unimpeded.
 Your baby's eyes: A good start for good vision
Your baby's eyes are his or her windows to the world, and to you. It is important that you protect your baby's vision as he or she grows.
Newborns can see the shape of their parent's faces. By three months, a baby can focus on objects and follow them with his or her eyes. By 6 months, babies will use their eyes to find and focus on objects.
Yes, your newborn's eyes should be checked by a pediatrician (children's doctor) or family physician in the nursery to make sure they are all right. Your baby's eyes are not like yours. They still need to grow. If both eyes are not working the right way, your baby's vision might never develop properly.
It is important to have your baby's eyes examined when he or she is:
- A newborn
- 6 months old
- 3 ½ years old
Many serious eye diseases that affect babies can be found at a very early age. The earlier they are found, the easier it is to fix the problem.
Some newborns have a greater chance of having eye problems than others:
- Was your baby born early?
- Did your baby weigh less than 5 lbs. at birth?
- Does anyone in your family have an eye disease?
- Did you use drugs while you were pregnant?
If you answered yes to any of these questions, then you should take your baby to a special doctor -an ophthalmologist (off-thal-MOL-ojist). An ophthalmologist is a medical doctor specially trained to treat eye problems. At 6 months and 3 ½ years, your baby's eye health should be checked again by the doctor.
Here are some signs that your baby might have an eye problem:
- Crossed eyes or eyes that don't line up after your baby is 2 months old
- Milky white or yellowish pupils (the dark circle in the center of the eye)
- The front of the eye looks swollen
- Tearing or discharge from the eye that won't go away
- The white part of the eye looks red
- A drooping eyelid
- Eyes that move so quickly they seem to shake or dance
If you see any of these warning signs, take your baby right away to an ophthalmologist, a medical eye doctor. But remember, even if you don't see any of these signs, it's important that your baby's eyes are checked at 6 months and 3 ½ years.
back to top
Refractive Errors, Strabismus, and Amblyopia
 The most common difficulty children face is refractive errors, usually myopia (nearsightedness). With this condition, distant objects are blurred because the eye has too much focusing power, and light rays come to a focus before they reach the retina.
Astigmatism (an optical distortion of the eye) and farsightedness (the relaxed eye does not have enough focusing power for clear distance vision) are other refractive errors children may have. Children may have difficulty seeing the blackboard at school, or the soccer ball downfield, and suffer poor performance. Fortunately, many of these children come to medical attention as they often fail school eye exams, whereupon the refractive error can be discovered and remedied with glasses.
Also common amongst children is strabismus (misalignment of the eyes). The eyes may be crossed inwards (esotropia), or outwards (exotropia). When this occurs, either on an intermittent basis or on a sustained basis, each eye will see a different object causing double vision. Double vision is extremely disturbing, and the child will go to great extremes to remedy it, sometimes by changing head posture.
Up to the age of 7-9, the visual system is sufficiently flexible so as to ignore the image from one eye, thereby decreasing or eliminating double vision. The trouble with this adaptation is that, after a short while, the brain and visual system will not develop the neurological pathways needed to see with the deviated eye. This condition is called "Amblyphia".
Many parents refer to this as "lazy eye", meaning the actual eye is healthy but does not see. Because children may take a negative connotation to having a lazy eye, the term amblyopia is preferred. It is important to detect the presence of amblyopia because after the age of 7-9, the visual system becomes set and cannot properly process visual information from the amblyopic eye.
In addition to strabismus, refractive errors producing worse vision in one eye can cause the child to preferentially use the other eye, causing the visual system to ignore the relatively more blurred eye producing amblyopia.While refractive errors are usually treated with glasses, strabismus is usually treated with patching of the good eye, such that the visual system is forced to use the amblyopic eye and develop good neurological pathways.
Pink Eye
Since children are exposed to numerous viruses during the cold season, schools and play groups are known to experience outbreaks of 'pink eye'.
This condition represents a viral infection of the mucus membranes of the eye (the conjunctiva) caused by the cold/flu virus (usually the Adenovirus). Some patients may primarily have chest involvement, throat involvement (sore throat), or eye involvement ('pink eye'). The ocular involvement can range form mild to severe, consisting of redness, discharge, lid swelling, discomfort or pain. Thus the ocular infection actually represents a viral conjunctivitis.
This condition is extremely contagious, and sunglasses/towels, etc. should not be shared during the infectious period (7 days before and 7 days after system onset). It is appropriate to keep children home during this time to avoid spreading the infection to others. However, since children are contagious for 7 days before they even develop symptoms, it is almost impossible to prevent all spread of the virus.
The viral nature of the infection means that antibiotic drops, which kill only bacteria, are ineffective in treating the condition. There are supportive comfort eyedrops which are available, along with cool compresses, which forms the backbone of viral conjunctivitis treatment.
back to top |
