Paediatric Retinal Disorders
Paediatric retinal disorders are a group of conditions that affect the retina, the light-sensitive layer at the back of the eye, in infants and children. The retina plays a vital role in vision development, and any damage during childhood can lead to permanent visual impairment or blindness if not treated on time.
Many retinal disorders in children may be congenital (present at birth) or acquired later. Early diagnosis is crucial because children may not be able to express visual problems clearly.
Common Paediatric Retinal Disorders
1. Retinopathy of Prematurity (ROP)
A condition affecting premature babies, where abnormal blood vessels grow in the retina.
- Occurs in babies born too early or with low birth weight
- Can lead to retinal detachment if untreated
- Requires regular screening and timely treatment
2. Retinal Detachment in Children
Separation of the retina from its underlying layers.
- Associated with trauma, high myopia, or previous eye surgery
- May present with sudden vision loss, floaters, or squint
- Often needs urgent surgical intervention
3. Inherited Retinal Disorders
Genetic conditions affecting retinal function, such as:
- Retinitis pigmentosa
- Leber congenital amaurosis
- Cone-rod dystrophies
These conditions often cause progressive vision loss and may affect night vision or peripheral vision.
4. Coats’ Disease
A rare condition causing abnormal blood vessels in the retina.
- Usually affects one eye
- Leads to retinal swelling or detachment
- Commonly seen in young boys
5. Retinoblastoma
A rare but serious eye cancer in children.
- Usually diagnosed before 5 years of age
- Presents with white reflex in the pupil (leukocoria) or squint
- Early detection can be life-saving and vision-saving
Symptoms & Warning Signs
- White or abnormal reflex seen in photographs
- Poor visual response or not tracking objects
- Squint or misaligned eyes
- Sudden vision loss or blurred vision
- Difficulty seeing in low light or at night
- Frequent eye rubbing or eye pain
⚠️ Many retinal disorders are silent in early stages, making regular screening essential for early detection.
Diagnosis
Diagnosis of paediatric retinal disorders requires a detailed and child-friendly eye evaluation, which may include:
- Comprehensive paediatric eye examination
- Dilated fundus examination
- Retinal imaging
- Ultrasound of the eye
- Electroretinography (ERG) for inherited retinal disorders
- Genetic testing in selected cases
Management & Treatment
Treatment depends on the type, severity, and stage of the paediatric retinal disorder. Early and appropriate management is essential to preserve vision and prevent long-term complications.
Non-Surgical Management
- Observation and regular monitoring
- Prescription glasses or low-vision aids
- Medical management for associated conditions
Surgical / Interventional Treatment
- Laser therapy (ROP, Coats’ disease)
- Intravitreal injections
- Vitreo-retinal surgery for retinal detachment
- Chemotherapy / radiotherapy for retinoblastoma (specialized centers)
Prognosis
- Visual outcome depends on early detection and timely treatment
- Some inherited retinal disorders may be progressive but can be closely monitored and supported
- Regular follow-up is essential to preserve remaining vision and prevent complications