Paediatric ophthalmology

Paediatric ophthalmology is an area of ophthalmological specialization that focuses on the development and preservation of eyesight in children. It requires careful management, provided in reassuring surroundings conceived specifically for children, and using specially adapted equipment.

Treatment of ophthalmological conditions in children from birth to adolescence.

Sight screening

Early detection of any disorders that might hamper correct development of the visual function is vitally important, particularly since children rarely verbalise issues with their sight, even if they cannot see clearly.
The presence of any visual defect (hyperopia, myopia, astigmatism), strabismus or any anomaly in the formation of the eye may negatively impact eyesight in one or both eyes.

When the eyesight does not develop correctly during the first years of life, this is referred to as amblyopia. Cases where only one eye is affected (unilateral amblyopia) are of particular concern because of the competition that arises between the two eyes and the ability of the child’s brain to suppress signals from the affected eye, which in turn may severely limit the development of sight in that eye. Unfortunately, this situation often goes unnoticed because the child compensates with his or her “good” eye.

Amblyopia affects 5 to 10% of children. Fortunately, it can be reversed if treatment is begun as early as possible and adapted to each individual case since, up to 7 years of age, the brain’s neuroplasticity makes recovery possible. Beyond the age of 7 – which is when the brain reaches maturity insofar as the development of sight is concerned – there is, sadly, virtually no likelihood of recovering the vision in an amblyopic eye. This is why it is so important to detect sight problems early in life.

Problematic visual behaviour

Certain signs may indicate sight problems; these include blinking, headaches, redness in the eye at the end of the day, tilting the head to one side, sensitivity to light, or the child may appear clumsy, occasionally close one eye, or have eye “tics”.
Learning difficulties at school during reading or writing exercises may also be a warning sign.
The child may often finally be referred after a visit to a paediatrician or following school visits by the SSEJ (Service de santé de l’enfance et de la jeunesse – the state-run children’s health service).
Some children are more at risk: those born prematurely, those with a genetic anomaly, a family history of strabismus, glasses, etc.

Refractive errors

One child in every eight presents a refractive error.
Hyperopia, myopia and astigmatism can be corrected with corrective lenses from a very early age. Wearing glasses will not “cure” the problem, but will allow the eyesight to develop properly.


Strabismology is the field that deals with problems arising from misalignment of the visual axes.
Strabismus can be classified as esotropic (cross-eyes), exotropic (lazy or wall-eyes) and hypertropic (vertical misalignment), and may be early-onset, acquired, constant or intermittent. For this reason, it is important to detect strabismus as soon as possible.

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