Oftalmologia Pediátrica e Estrabismo

What is Paediatric Ophthalmology?

It is a branch of ophthalmology dealing with the prevention, screening, diagnosis and treatment of eye diseases in children and adolescents. Vision plays a fundamental role in a child development, as it is responsible for most of the information received during childhood.


Birth represents a new stage in the existence of a human being. The cut of the umbilical cord materializes the biological independence for which the baby must be prepared.
At birth, all the morphological structure of the visual system is complete. The eyes, the optic nerve and the cortical system of sight are then prepared to function but yet very immature. Only visual experience and continuous stimulation by light enable the development of the several mechanisms of vision. These mechanisms, including functions related to movement, orientation, colour and binocular disparity, must be integrated in order to form the image of an object, and dissociated for distinguishing it from the background and the other objects. Vision must be associated with attention: the capacity to decide to fix the eyes on a certain object, or to move the gaze towards another one, represents a complex capability that requires a cortical development only acquired with visual experience.


It begins at the moment of birth and continues during the first 8 or 10 years of life. Any disorder interfering with this learning process and this acquisition of capabilities will have inevitably consequences at long term.
Vision plays a main role in the interaction of the child with the world, since 80% of all the information is received by the eyes. This is particularly important for the growth and development of individuals, as their general learning, knowledge of the world and new experiences deeply depend on vision.
The ophthalmological examination of a child is not limited to evaluating the visual function! It allows the physician to diagnose and/or evaluate the existence of systemic diseases and/or development alterations.
Visual disorders, and their relation with general health, are specific to this age group and require a differentiated approach.

When should your child have the first eye examination?

A paediatrician knows that a child’s eyes should be examined since the first days of its life. He checks up any morphologic alteration or unnatural pupillary reflexes, in order to immediately refer the baby to a specialist in paediatric ophthalmology.
Furthermore, a paediatrician always refers his patients to this specialist in case of:
- History of ocular diseases in the family;
- Children at risk: premature babies, children with neurological alterations, facial dysmorphies or genetic diseases;
- Children with strabismus, as soon as it is detected.

The factors of risk of amblyopia, such as strabismus, refractive errors and opacity of transparent structures, should be screened as earlier as possible. The detection is very easy to make when the child is over 1 year old.
Visual acuity can be measured at any age, but the method can be more or less complex according to the patient’s age. Still, over 3 years of age, it is possible to evaluate it with very simple methods available to all eye care professionals. This measurement should always be made before going to school for the first time.

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