Pediatric ophthalmology 1266386 204243057 2008-04-08T16:27:17Z BozMo 57817 clarify that this is US-centric. In the UK for example they are generally surgeons NOT physicians '''Pediatric ophthalmology''' is a sub-speciality of [[ophthalmology]] concerned with [[eye disease]]s and vision care in children. ==Training== In the United States, pediatric ophthalmologists are [[physicians]] who have completed [[medical school]], a 1-year [[internship]], 3-year [[Residency (medicine)|residency]] in ophthalmology, and a 1-2 year [[fellowship (medicine)|fellowship]] in pediatric ophthalmology and [[strabismus]]. Pediatric ophthalmology fellowships in the United States are accredited by the [[American Association for Pediatric Ophthalmology and Strabismus]]. ==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]] as well as to manage children's eye problems using [[glasses]] 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 are typically referred to a pediatric ophthalmologist for evaluation. ==Eye problems in children== [[Image:EyeTestPoster.jpg|thumb|Public education poster urging eye exams for children ([[Works Progress Administration]], circa 1937)]] 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). *[[Strabismus]] 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]] (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]] of one eye is more than 1.5 diopters different than the other eye. 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. *Blocked [[tear duct]]s. *[[Ptosis (eyelid)|Ptosis]] *[[Retinopathy of prematurity]] *Visual inattention <ref>[http://www.eyedoctor.homestead.com/BabyEyes.html Your Baby's Eyes-Development, Vision Examination and Eye Problems Explained<!-- Bot generated title -->]</ref> *Pediatric [[cataracts]] *Pediatric [[glaucoma]] *Abnormal vision development *[[Genetic disorders]] 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]] affecting vision or the tear drainage duct system can be evaluated and possibly surgically corrected by a pediatric ophthalmologist. *Orbital [[tumours]] *Refractive errors such as [[myopia]] (near-sightedness) and [[astigmatism (eye)|astigmatism]] can often be corrected with prescriptions for glasses or contacts. *[[Accommodative insufficiency]] *[[Convergence insufficiency]] and [[asthenopia]] *Evaluation of visual issues in education Pediatric ophthalmologists often work in conjunction with orthoptists in the treatment of strabismus. ==History== [[Frank D. Costenbader]] was an American [[physician]] frequently credited as the world's first pediatric ophthalmologist.<ref name="Marshall">Marshall MM. [http://costenbadersociety.org/hist/csthst.pdf "The History of the Costenbader Society: Costenbader's Challenges."] March 19, 2000.</ref> Costenbader and [[Marshall M. Parks]] (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]].<ref name="Holley">Joe Holley. [http://www.washingtonpost.com/wp-dyn/content/article/2005/08/20/AR2005082001266.html "D.C. Physician Illuminated The Ailments of Young Eyes."] ''Washington Post''. Sunday, August 21, 2005; Page C11.</ref><ref>[http://costenbadersociety.org/mmp/obit.pdf "Marshal M. Parks, M.D."] Obituary. Accessed September 19, 2006.</ref> Parks trained many pediatric ophthalmologists during his career and was instrumental in the establishment of the [[American Association for Pediatric Ophthalmology and Strabismus]], 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]] on issues related to pediatric eye disease and vision screening guidelines. ==References== <div class="references-small"> <references/> </div> ==See also== *[[Eye exam]] *[[Infant vision]] *[[Ophthalmoscope]] *[[Orthoptics]] *[[School vision screening]] *[[Strabismus surgery]] *[[Visual acuity]] ==External links== *[http://www.AAPOS.org American Association for Pediatric Ophthalmology and Strabismus] [[Category:pediatrics]] [[Category:Ophthalmology]]