Pediatric ophthalmology can help children with specific vision needs.

Children have unique visual needs and as a parent, you always want the best for them. Our pediatric ophthalmologist is specially trained to manage eye diseases common in children whether it is strabismus (eye misalignment), amblyopia, conjunctivitis, or a routine exam. Many children won’t voice complaints about their eyes because they don’t realize something is wrong. However, vision needs can affect how they learn, how they play, and how they grow.

The good news is, poor vision and various conditions can be detected through regular eye exams. Dr. Gail L. Ganser is Lynchburg’s only pediatric ophthalmologist and can offer your family the best care. Under her care, early detection and treatment of vision issues helps children achieve their best possible eye health.

Child on mothers lap with pediatric eye doctor appointment


What is a Pediatric Ophthalmologist?

Pediatric ophthalmologists are medical and surgical doctors who specialize in the eye problems of children. In particular, vision develops in the brain until about age 9 years and can be adversely affected when the eyes are not straight or do not focus correctly. A child can grow up with good vision if these problems are detected and treated at a young age. All ophthalmologists have some training in children’s eye problems, but the pediatric ophthalmologist has had additional training and practice in examining children and caring for their eyes. If your primary care doctor suggests that your child have his or her eyes checked, a pediatric ophthalmologist will have the greatest knowledge of the possible conditions and the greatest experience in examining children effectively.

Why does a child need glasses?

Children may need glasses for several reasons—some of which are different from adults. Because a child’s visual system is growing and developing, especially during the first 5-6 years of life, glasses may play an important role in ensuring normal vision development. The main reasons a child may need glasses are:

  • To provide better vision, so that a child may function well in his/her environment
  • To help straighten the eyes when they are crossed or misaligned (strabismus)
  • To help strengthen the vision of a weak eye (amblyopia or “lazy eye”). This may occur when there is a difference in prescription between the two eyes (anisometropia). For example, one eye may be normal, while the other eye may have a significant need for glasses caused by near-sightedness, far-sightedness or astigmatism.
  • To provide protection for one eye if the other eye has poor vision.
When should I have my child’s eyes examined?

The American Academy of Ophthalmology and Piedmont Eye Center suggest that all children have their eyes examined by the age of 3. Of course, some conditions present even in newborns. If a problem is suspected, an eye exam should be performed.

How can a baby’s eyesight be tested?

A baby’s eyes can be tested even before they can give a verbal response. The ophthalmologist can test for vision fixation and motility. A dilated exam allows for measurement of refractive error with an instrument called a retinoscope. The doctor can determine the correct power of lens by holding lenses of varying power in front of the eye.

Does my baby have crossed eyes?

If a child’s eyes appear to be misaligned (crossed in or more rarely deviated outward), it is possible a condition known as ‘strabismus’ is present. Only an eye specialist can determine if this is present and prescribe treatment. In some cases, glasses may correct the condition whereas others may require surgery.

What is amblyopia?

A common vision problem in children is amblyopia, or “lazy eye.” It is so common that it is the reason for more vision loss in children than all other causes combined. Amblyopia is a decrease in the child’s vision that can happen even when there is no structure problem with the eye. The decrease in vision results when one or both eyes send a blurry image to the brain. The brain then “learns” to only see blurry with that eye, even when glasses are used. Only children can get amblyopia. If it is not treated, it can cause permanent loss of vision.

Will glasses help a child with amblyopia to see better?

Maybe, but they may not correct it all the way to 20/20. With amblyopia, the brain is “used to” seeing a blurry image and it cannot interpret the clear image that the glasses produce. With time, however, the brain may “relearn” how to see and the vision may increase.

How is amblyopia treated?

One of the most important treatments of amblyopia is correcting the refractive error with consistent use of glasses. Penalization of the dominant eye by wearing an eyepatch or dilating eyedrops is frequently required.

What is strabismus?

Strabismus is a medical term for any misalignment of the eyes.

How many people are affected by strabismus?

It is estimated that 4% of the United States population has strabismus.

Are there different types of strabismus and if so, how are they named?

Yes, there are different types of strabismus. Strabismus is most commonly described by the direction of the eye misalignment; esotropia, exotropia, hypotropia, and hypertropia.

What is exotropia?

Exotropia is the outward turning of one or both eyes. A commonly used term for exotropia is “wall-eyed.”

What is hypertropia?

Hypertropia is one eye higher than the other.

What causes strabismus?

Most strabismus is caused by an abnormality of the poorly understood neuromuscular (including brain) control of the eye movements. Less commonly, a problem with the eye muscles themselves causes strabismus.

How is strabismus related to amblyopia?

Eye misalignment can cause amblyopia in children. When the eyes are looking in different directions, the brain receives 2 different visual images. The brain ignores the image from the misaligned eye to avoid double vision, resulting in poor vision development (amblyopia).

Who develops strabismus as a child?

Any child can have strabismus. However, premature children and those with syndromes or brain disorders have an increased risk of strabismus.

How is strabismus treated?

The goal of strabismus treatment is to straighten the eyes and allow the eyes to be used together (binocular vision). Treatment may involve eyeglasses (glasses for children), eye exercises, or eye muscle surgery (strabismus surgery). Other problems present along with the strabismus (including amblyopia, ptosis, and cataract) are usually treated prior to eye muscle surgery.

What is conjunctivitis?

Conjunctivitis or “pink eye” is a condition where the eyes look pink or red and may have discharge. Symptoms may include burning, irritation, discharge, or crusting of the lashes.

What causes conjunctivitis?

Conjunctivitis may be caused by bacteria, viruses, other infectious agents, chemicals, or allergies.

How is conjunctivitis treated?

If the conjunctivitis is caused by bacteria, treatment with antibiotic drops or ointment may be indicated. Viral conjunctivitis does not respond to antibiotics but resolves without treatment.