Eye Conditions


Up to 5% of children will have amblyopia, which is a condition where one eye sees better than the other eye. Amblyopia is most frequently caused by one eye having a much higher refractive error (need for glasses) than the other eye. Amblyopia can also be seen in a eye that is not aligned straight, causing the brain to ignore and subsequently not fully develop the misaligned eye. Early diagnosis and treatment is critical for maximal improvement.


Any misalignment of the eyes is called strabismus and this affects about 4% of people. One or both eyes may turn inwards (esotropia), outwards (exotropia), upwards (hypertropia), or downwards (hypotropia). Children with strabismus may have amblyopia, poor depth  perception, and eye strain. Adults with strabismus ofen have double vision.Treatment may involve glasses, prism, patching, exercises, and eye muscle surgery.


Inward turned eyes are called esotropia. Children can develop esotropia early in infancy and often will need eye muscle surgery if severe. Esotropia can also develop later in childhood and be associated with excessive farsightedness (hyperopia). Glasses to help relax the eyes from focusing too hard can be used to help this type of crossing.


Eyes that turn outwards are seen in exotropia. This typically presents in children around age 3. Exotropia is typically intermittent and first seen when the child is tired or inattentive. Children will sometimes close one eye to help realign the eyes and may squint in bright light. Exotropia can sometimes be controlled with patching and exercises. Eye muscle surgery can be done if exotropia is not improving or if it is severe.


Double vision is known as diplopia. This most frequently occurs in adults (and rarely children) with misaligned eyes,in which the eyes are not working together. Many adults have long standing deviations that worsen and decompensate over time leading to poor control and diplopia. Neurologic disorders, thyroid disease, diabetes, and high blood pressure can also be associated with diplopia. Glasses, prism, and eye muscle surgery are treatment options.

Nasolacrimal Duct Obstruction

Babies are often born with a clogged tear duct system, which prevents the drainage of tears into eyelid opening where the tears are naturally supposed to drain. In many infants, the tear duct system naturally opens in the first few months of life. Continued blockage leads to excessive tears, crusting, and eyelid irritation. If the system does not open on its own, a tear duct opening procedure can be performed. Rarely, excessive tearing is caused by a more serious condition such as infantile glaucoma.


A chalazion is a bump on the eyelid caused by a blocked oil gland. Chalazia often will improve on their own over several days to a few weeks. Applying warm compresses over the eyelid can help allow the clogged gland to open. Occasionally an anti inflammatory
drop/ointment can help aid drainage. If there is a secondary bacterial infection with swelling and redness of the lid, oral antibiotics are sometimes required. A chalazion that does not resolve on its own, may require surgical drainage.

Refractive Errors

Poor vision in the eyes is often the result of the need for corrective eyewear. Myopia (nearsightedness) occurs when light rays focus in front of the retina because the eye is too long. This results in objects in the distance being blurry.  Hyperopia (farsightedness) is when light rays focus behind the retina. This can makes things at near harder to see and can also affect distance in some cases. Astigmatism occurs when the eyes are too curved. This results in light rays focusing in different spots, causing visual distortion at near and distance.