Common Conditions

The following is a list of common pediatric eye conditons:

Excessive Tearing

Common causes of excessive tearing in young children include blockage of the tear drainage system, embedded foreign bodies, allergic conjunctivitis, and corneal abrasions. One of the most common causes of tearing in children is blockage of the tear drainage system. This condition affects up to 6% of all newborns. Parents notice tearing and sticky matting of the affected eye, even when the child is not crying. The blockage often resolves on its own by six months of age with conservative management such as massage of the lacrimal sac and antibiotics. If symptoms don't resolve on their own, Dr. Chen can perform a highly effective, 5 minute procedure to permanently eliminate the symptoms.

Lumps in the Eyelid

A variety of disorders can cause lumps in the lids of children. Most can be distinguished by clinical appearance and pattern of growth. Some of the more common lid conditions in children include:

Chalazion: Parents may notice a firm nodule on the lid near the eye lashes. This type of lump can be associated with inflammation and redness. Warm compresses, massage, and topical antibiotics can hasten recovery. Persistent lesions can be surgically excised

Capillary Hemangiomas: These vascular lesions frequently involve the eye lids. When on the surface of the skin, capillary hemangioms are sometimes called a "strawberry nevus". They are reddish in color and frequently grow in size in the first months of life. If they are located more deeply, parents may note a soft bluish lump. Most capillary hemangiomas involute and shrink spontaneously in late childhood. However, these children should be seen by an eye doctor periodically to make sure that the lesion is not affecting visual development.

Dermoids: Parents usually notice a slowly growing nodule located along the outside margin of the eyebrow. Dermoids may rupture spontaneously or from trauma, causing localized inflammation. These lesions can be treated with complete surgical excision.

The most serous disorder which needs to be considered when evaluating a lid lump in a child is a cancer called rhabdomyosarcoma. Parents may notice a discrete mass or diffuse swelling of a lid. Proptosis, or protrusion of the eyeball, may develop rapidly. If rhabdomyosarcoma is suspected, radiologic imaging should be performed. A biopsy is necessary to confirm the diagnosis.


Amblyopia is visual loss that occurs secondary to interruption of normal visual development in children. Amblyopia affects between 2-5% of the general population. Amblyopia is significant in that it is a potentially reversible condition that if untreated results in permanent visual loss.

Abnormal visual development occurs whenever a clearly focused image is not maintained during the fist months to years of life. This can be the result of poor focus (refractive error), poor aim (strabismus), or media opacity.

Critical factors in determining the severity of amblyopia include age of onset, severity of the insult, and how soon treatment is initiated in the child. In general, the younger the child, the more severely vision is affected. The earlier appropriate treatment is started, the better the prognosis.


Strabismus is a visual defect in which the eyes are not aligned, and point in different directions. One eye may look straight, and the other eye may turn in, out, up, or down. Two main causes of strabismus are focusing problems, and eye muscles that are unable to keep the eyes aligned. When strabismus is due to focusing problems, a common cause is farsightedness. That child then has to strain to focus, causing the eye to turn inward.

If strabismus isn't treated in a timely manner, the brain may start ignoring the misaligned eye. This can lead to amblyopia and loss of depth perception.

Refractive Errors

For a clear image to be formed by our eyes, light rays must be bent, or “refracted” properly to focus precisely on the retina. The retina is the nerve layer located at the back of the eye that sends visual signals to the brain. A refractive error occurs when an eye doesn’t refract light properly, and a blurred, out of focus image is seen.

Different types of refractive errors include myopia (nearsightedness), hyperopia (farsightedness), astigmatism (distortion of vision), and presbyopia (aging eyes).

For patients with Myopia (nearsightedness) near objects look clear, but distance objects appear blurred. This is due to the myopic eye being longer than normal, resulting in light rays focusing in front of the retina.

The Hyperopic eye is shorter than normal, and light from near objects, such as reading material, focuses behind the retina. Children tend to be slightly hyperopic. As the child and their eyes grow, the hyperopia usually lessens.

Astigmatism distorts vision for both near and far objects, and can be found in combination with myopia or hyperopia. Astigmatism results when the cornea, the front clear window of the eye, curves more in one direction than in the other, like a football.

Presbyopia results in difficulty reading at close range. It is a normal condition that affects many adults after the age of 40. As we age, the lens becomes more rigid and less flexible, and is unable to focus near images properly. Presbyopia can be corrected with bifocals or trifocals.