All children who, after birth, exhibit visible ocular pathology, or have systemic pathology with possible ocular involvement or in situations of known hereditary pathology, should be referred to a Pediatric Ophthalmologist.
Additionally, it is essential that all pre-school children (from the age of 3 years) should undergo an ophthalmological examination for an accurate assessment of visual acuity. In this examination it is also important to evaluate and exclude the presence of problems that may lead to amblyopia (also known as "lazy eye"), a situation often insidious as it may arise from a refractive error or difference between the two eyes (myopia, hyperopia and / or astigmatism) which can be completely asymptomatic, thus easily unnoticed.
Another situation that often leads to amblyopia is strabismus.
Strabismus is often noticed by parents as a squint in one or both eyes that may be constant or intermittent. Strabismus is usually associated with refractive errors and can be treated only with correct refraction with occlusive therapy, with or without amblyopia treatment. However, there are cases where surgical correction is necessary. In these cases a careful pre-operative evaluation is necessary so that the results obtained are effective and predictable.
Correction of refractive errors in children (myopia, farsightedness and / or astigmatism) is carried out with the use of spectacles, although a refraction evaluation is often variable, making in most cases, a second consultation necessary, where the child is evaluated under cycloplegia (or pupillary dilation) so that the refractive error is as accurate as possible. Moreover, in the immature eye the refractive error found is not of a permanent and stable nature, whether it is myopia or farsightedness, as the constant growth of the eyeball conditions a variability that requires a periodic reassessment.
Obstruction of the nasolacrimal canal in children of 18 months or less is another frequent pathology that can lead to chronic or recurrent conjunctivitis and / or dacryocystitis. This situation is usually treatable with daily tear duct massage administered by the parents, but in some situations it may need probing of the tear duct under sedation so that the correct lacrimal drainage pathway can be reestablished.
There are also other pediatric ocular pathologies with particular characteristics, such as congenital cataract and glaucoma, as well as multiple anomalies that may involve any structure of the eye such as the eyelids, cornea, iris, retina and optical nerve. Many of these conditions, such as congenital cataracts, can be surgically solved and should be treated early in order to avoid unilateral or bilateral amblyopia.