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Poor visual fixation in an infant over 6 weeks of age may be indicative of poor visual development for which a pediatric ophthalmology evaluation should be considered.
White pupil – The pupil is the center hole in the colored part of the eye (iris) which under most conditions appears black and, with flash photography, the reflection often has a red or orange coloration. If the pupil appears grayish to white or if the red reflex is white or not noticeable with flash photography, this may be indicative of two serious eye problems – a cataract or a tumor in the eye. If a white pupil were observed, an urgent pediatric ophthalmology evaluation is indicated.
Excessive light sensitivity, also called photophobia, which is often associated with lots of tearing and sometimes redness to the white of the eye, may indicate a problem with the cornea such as a scratch or abrasion, foreign body, or excessive stretch caused by congenital glaucoma. If these signs were present, an emergent pediatric ophthalmology evaluation is necessary.
Droopy eyelid, referred to as ptosis, may interfere with vision if the eyelid were to cover the pupil’s visual axis and may cause an irregular astigmatism which might result in amblyopia. If one or both eyelids droop significantly after two months of age, a pediatric ophthalmology evaluation is now necessary.
Jerky or dancing eye movements may represent nystagmus. Nystagmus refers to the eyes moving in a slow to fast, typically side-to-side movement. Nystagmus may indicate retinal or optic nerve problems that could result in less than normal vision. Nystagmus is often not observed until the first or second month of age, but whenever it is noted and if it persists should stimulate a pediatric ophthalmology evaluation.
Misalignment eyes or strabismus that persists after 3-4 months of age warrants a timely pediatric ophthalmology evaluation.
Overflow of tears with or without accumulating discharge is suggestive of a tear duct obstruction. External eyelid and eyelash cleaning and occasionally eye medications are necessary to limit the discharge. If these problems persist till 9 months old, evaluation and treatment by a pediatric ophthalmologist is indicated.