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Pediatric Eye Care

The American Academy of Ophthalmology suggests children with seemingly normal vision have their first eye exam by age four. Although most children have no eye problems, many ocular conditions may go unnoticed by the family. The Eye Center physicians routinely treat children with nearsightedness, farsightedness, astigmatism, "crossed eyes" (strabismus), "lazy eyes" (amblyopia), blocked tear ducts, and other conditions.

Pediatric Specialist

Julie Kiessling Calderwood, M.D.

Board Certified Pediatric Ophthalmologist

Specializing in pediatrics, strabismus surgery and comprehensive ophthalmology Dr. Calderwood is a native of Huntsville, Alabama. She attended the University of Alabama at Birmingham where she graduated Magna Cum Laude with her bachelor's degreee in Biology. Dr. Calderwood then went on to attend UAB, University of Alabama School of Medicine. Following her internship at Baptist Health System in Birmingham, Alabama, Dr. Calderwood completed her residency training in ophthalmology at the University of Tennessee Health Science Center in Memphis, Tennessee. She then completed a fellowship in pediatric ophthalmology and strabismus at the hamilton Eye Institue, Le Bonheur Children's Hospital, and St. Jude Children's Research Hospital in Memphis, Tennessee. Dr. Calderwood joined The Eye Center in 2015.

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Common Eye Conditions

Strabismus

Strabismus is a visual problem in which the eyes are not aligned properly and point in different directions. One eye may look straight ahead, while the other eye turns inward, outward, upward, or downward. The eye turn may be consistent, but sometimes it may come and go.

Strabismus Surgery

What is strabismus surgery?

Strabismus surgery loosens or tightens eye muscles, which changes the alignment of the eyes relative to each other.

What kind of anesthesia is used?

The type of anesthesia depends on patient age and health as well as patient preference. Most children and adults undergo general anesthesia. The procedure is usually performed as an outpatient.

What is a recession?

A recession weakens function by altering the attachment site on the eyeball. A suture is placed through the muscle at the attachment site to the eye. The muscle is detached from the surface of the eye and reattached further back from the front of the eye.

What is a resection?

A resection strengthens muscle function by reattaching a muscle to the eyeball at the original insertion site after a portion is removed. A suture is placed through the muscle at the intended new attachment site. The segment of muscle between the suture and the eyeball is removed and the shortened muscle is reattached to the eye.

Are the eyes red after strabismus surgery?

It is normal for the white part of the eyes to be red after surgery. It may take several weeks or occasionally months for the redness to disappear. The eyes are usually scratchy and are sore upon movement. The soreness usually improves after a few days.

Are patches or medicine used after surgery?

No patch is usually required immediately after surgery. We will prescribe an antibiotic or combination antibiotic/steroid drop or ointment after surgery.

Nasolacrimal Duct Obstruction

What is a tear duct obstruction?

Tears normally drain through small openings in the corners of the upper and lower eyelids and enter the nose through the nasolacrimal duct. A tear duct obstruction prevents tears from draining through this system normally. If the tear duct is blocked, there will be backflow of tears and discharge from the eye. The most common cause is the failure of a membrane at the end of the tear duct (valve of Hasner) to open normally at or near the time of birth.

How common is nasolacrimal duct obstruction?

Over 5% of infants have symptoms of nasolacrimal duct obstruction affecting one or both eyes. Over 90% clear spontaneously during the first year of life.

What is the treatment of a blocked tear duct?

When obstruction is persistent, one or more of the following treatments may be recommended: tear duct massage, topical antibiotic eye drops, tear duct probing and/or tear duct intubation.

When should tear duct probing be performed?

If the tear duct remains blocked, a nasolacrimal duct probing may be performed at 12 months of age or sooner if chronic infections occur.

How does tear duct probing work?

A smooth probe is gently passed through the tear duct and into the nose. Using probes of progressively larger diameters can widen a tear duct system.

What type of anesthesia is used for tear duct probing?

Children have a brief general anesthetic in an outpatient surgery setting.

How successful is tear duct probing?

Tear duct probing is generally over 90% successful. Sometimes additional procedures with enhancements are necessary.

Chalazion

What is a chalazion?

A chalazion is a localized bump in the eyelid of varying sizes. More than one chalazion can occur in an eyelid at the same time, and both upper and lower eyelids may be affected.

Why do chalazia occur?

Usually there is no known underlying cause. However, chronic inflammation of the oil gland openings (blepharitis), predisposes to the development of a chalazion. Persistent blepharitis may result in recurrent chalazia. Blepharitis may be aggravated by poor eyelid hygiene that includes eye rubbing in children. Certain skin types may be more prone to chalazia and blepharitis.

What are the treatment options for chalazia?

Most chalazia resolve by themselves within several days to weeks, but sometimes can take months to completely disappear. Warm compresses over the affected area can promote drainage of the blocked gland. Anti-inflammatory ointments may be needed. Oral antibiotics may be used if the chalazion is associated with bacterial infection of the surrounding eyelid tissues (cellulitis). A large, swollen, or persistent chalazion might require surgical drainage. General anesthesia is usually necessary to drain chalazia in young children.

How can chalazia be prevented?

A consistent daily regimen of eyelid scrubs using baby shampoo or pre-moistened eyelid cleansing wipes can reduce the chances of developing new chalazia. This is especially useful when blepharitis is present. For those with a recurrent problem, regular use of topical or oral antibiotics is sometimes prescribed.

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Pediatrics