In more advanced stages, surgery becomes necessary to remove excess fluid. Surgery may also be necessary if partial or complete detachment of the retina has occurred. Coats disease can recur throughout life, and it is important to schedule regular follow up appointments with a pediatric retina specialist.
Familial exudative vitreoretinopathy FEVR is a genetic condition that affects the blood vessels that support the retina. FEVR is sometimes symptomless, but it can cause a wide variety of eye issues including bleeding, retinal detachment, and excessive myopia that can be helped with glasses. FEVR is diagnosed by a retinal specialist after a full eye exam that may include a fluorescein angiography test, which shows any leakage from damaged blood vessels.
A penetrating injury occurs when a foreign object becomes embedded in the eye. Such objects can increase risk of serious infection or can be toxic. Surgery is often necessary, beginning with a vitrectomy, which removes the foreign body as well as any loose blood or particles. Subsequent surgeries may be needed. Trauma often affects multiple tissues and functions in the eye. Because of this, retinal specialists often coordinate care with other specialists, including experts in glaucoma, oculoplastics, cornea, cataract, and pediatric ophthalmology.
Retinopathy of prematurity ROP affects very premature babies. In this disease, abnormal blood vessels grow between the retina and the front of the eye.
These blood vessels are fragile and can bleed. The exact causes of ROP are unknown, but poor infant growth and genetic factors are suspected factors. Babies born weighing less than 2. These stages usually resolve without treatment.
However, ongoing monitoring from a pediatric ophthalmologist is important to determine whether glasses or other treatments are needed to ensure healthy visual development. Early ROP can develop over several weeks into stage 3 ROP, where blood vessels grow off the surface of the retina and into the center of the eye.
Laser therapy can often be used to reduce abnormal blood vessels. In cases where the laser cannot be used, medications can be a viable alternative. A retina specialist can provide more information on treatment options.
Stages 4 and 5 of ROP result in partial or total retinal detachment. In these cases, microsurgery is required to prevent additional detachment of the retina or to reattach it. In most cases, careful monitoring and treatment of earlier stages of ROP prevent it from reaching these advanced stages. It is important that patients with ROP receive rehabilitation with a pediatric ophthalmologist. Children who have recovered from ROP are at a high risk of conditions like strabismus improper alignment of the eyes and refractive errors, which can impair visual development.
Stargardt disease is an inherited form of macular degeneration that affects children and young adults. It causes deterioration of the cells in the center of the retina that convey information to the brain. Over time, Stargardt disease causes a blurred, distorted, dark, or empty area in the center of vision. Definitive treatment is not yet available, but it is recommended that patients avoid bright light and vitamin A supplements. X-linked retinoschisis XLR causes a splitting of the retina and can affect the central and side vision. It is an inherited disease and occurs almost exclusively in males.
Because XLR causes the layers of the retina split more easily than normal, jarring or eye trauma may cause injury to the retina. Imaging studies can be helpful in XLR, and occasionally a trial of eye drops or medications may be considered. Surgery may also be recommended. The industry has also started to pay more attention to this particular field. I truly believe the future of pediatric retina research is much brighter, because we see more and more young doctors becoming interested in this field. Not only this, ROP, pediatric retinal detachment, Stickler syndrome, and retinoblastoma are challenging diseases as well.
Without proper management, such children may become blind or even lose their lives. With these topical articles, we sincerely hope we can offer new knowledge in the diagnosis and management of these patients. In addition, our invited experts provide their valuable experience and tips regarding surgical management of these cases. Kids are not small adults. The philosophy needed to handle these cases is very different from that with adults.
The surgical settings and the instruments used during the surgery may also be very dissimilar. It is, therefore, very important to understand the differences before you start to take care of these children. Without such knowledge, a doctor can do far more harm than good for their patients.
Of course, there are many more diseases than we can cover in this TJO pediatric retina special edition. I would like to express my sincere appreciation for the huge efforts of these world-renowned experts in contributing to this special issue. Without their professional assistance, it would have been impossible to achieve this remarkable outcome. National Center for Biotechnology Information , U. Journal List Taiwan J Ophthalmol v. Taiwan J Ophthalmol. Wei-Chi Wu. Author information Copyright and License information Disclaimer. Address for correspondence: Prof. E-mail: moc.
This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4. Open in a separate window. References 1.
Click to Email us. Vision develops over several years, with children's eyes fully maturing around age seven. For this reason, it is critical that pediatric eye problems be detected and treated as early as possible. This is despite the fact that perhaps the most devastating causes of blindness stems from retinal diseases. Medicine Ophthalmology. Section 1 comprehensively covers clinical assessment and management of medical retinal diseases in infants and children. Since children with retinal problems tend to have multiple eye conditions, we are equipped to treat each through teams of sub-specialists whose collaborative efforts are geared to maximizing outcomes while minimizing the number of procedures young patients must undergo.
Lens-sparing vitreous surgery for tractional stage 4A retinopathy of prematurity retinal detachments. Trese MT.