Experienced Child Eye Surgeon in New Jersey

When dealing with childhood visual disorders, it is important to seek the medical care of one of the experienced child eye surgeons in your region. We are excited to have one of the region's top pediatric ophthalmologists, Dr. Glen Bianchi, on our elite staff at Westwood Ophthalmology Associates. Dr. Bianchi is a board certified ophthalmologist who has completed sub-specialist fellowship training in the field of pediatric ophthalmology. He is experienced in the diagnosis and treatment of childhood visual disorders.

Early detection is an important key in the successful treatment of childhood visual disorders. Only an experienced pediatric ophthalmologist can adequately assess and effectively treat your child’s vision problem. If you suspect your child suffers from a visual disorder, trust your child’s eyes to one of the premier child eye surgeons in all of northern New Jersey. Contact Westwood Ophthalmology to arrange an appointment with Dr. Bianchi.

» Amblyopia
» Strabismus

Amblyopia

What is Amblyopia?

Amblyopia is the medical term for poor vision in one or both eyes that is not the result of an eye disease or injury. It is sometimes referred to as “lazy eye.” The eye itself is actually healthy and normal in this condition. Amblyopia is fairly common, affecting about 2%-4% of the population. Amblyopia occurs during early childhood, when the visual system is still developing and vulnerable to disruption. Poor vision occurs because something has interfered with the normal development of vision in the eye, causing a “blurry” image to be seen by that eye. The most common causes include strabismus (misaligned eyes) and a large difference in the refractive error (the prescription) between the two eyes.

If the eyes are not aligned properly or “crossing,” they each perceive a different target. The brain is presented with two completely different images and cannot fuse them together into one clear image. It’s as if the eyes have completely confused the brain. Since we could not function while seeing two different images all the time—constant double-vision, if you will—the brain automatically “shuts off” or ignores one of the two images so that we can function. This suppression of one eye leads to amblyopia or permanent poor vision if left uncorrected.

Likewise, if one eye is much more farsighted, nearsighted or astigmatic than the other eye (even though the eyes, in this case, are aligned and focused on the same target), then the brain is presented with one very sharp image and one very blurry image. If the difference is great enough the brain once again cannot knit these two images together into one clear image—they’re too different. To avoid visual confusion the brain subconsciously ignores or “turns off” the blurrier eye. In each of these examples the eyes themselves are not diseased. There are several other problems that can cause amblyopia, but these are far less common. They include such conditions as congenital cataracts and congenital droopy eyelid (“ptosis”), which physically obstruct vision in one or both eyes.

For more information on amblyopia, contact Dr. Bianchi, one of the premier child eye surgeons in New Jersey now practicing at our laser eye surgery and vision correction center, Westwood Ophthalmology.

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Early Diagnosis is Key

Amblyopia only happens in childhood during the so-called critical period of visual development—the first 7-9 years of life. During these early years the immature visual system consisting of the eye and certain parts of the brain are actively developing. If anything interferes with the creation of a focused, clear image in one eye during this period of time, the brain may start to ignore or suppress the blurry eye in favor of the clearer eye as described above. If the blurred image is not corrected by age 7 or 8, poor vision in that eye may become permanent. Once the critical period of visual development is over, no eyeglasses or surgery can recover lost vision due to amblyopia. The visual loss has then become “locked in” by the brain. That is why it is so important to identify amblyopia in young children, so that we may correct it and recover lost vision before it’s too late.

Why does amblyopia matter? Most importantly, it may lead to irreversible vision loss in one or both eyes. This leaves the patient with only one good seeing eye. If anything were to happen to the good eye in the future, the patient would be left severely visually impaired. Vision loss could also prevent development of normal depth perception. Vision must be good and equal in both eyes in order to see in three dimensions. There are some occupations that require perfect depth perception. An amblyopic patient might be prevented from entering these fields.

If you suspect your child suffers from amblyopia, it is imperative you immediately contact one of the experienced child eye surgeons in your area. In Westwood, New Jersey, our laser eye surgery and vision correction center has one of the region’s top child eye surgeons now on staff. Dr. Bianchi will perform a thorough eye exam on your child and design a customized treatment plan aimed at preventing permanent vision loss.

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Treatment of Amblyopia

The good news is that with early intervention Dr. Bianchi can restore vision in an amblyopic eye—in many cases to a perfect 20/20. Often eyeglasses are necessary, but the mainstay of treatment for amblyopia is patching of the stronger eye. By forcing the child to use the weaker eye, vision slowly improves over the course of weeks to months. The duration of patching each day may range from a couple of hours to all waking hours, depending on the severity of the amblyopia.

Surgery may be necessary early on for such things as cataracts and droopy eyelids. Surgery to straighten misaligned eyes, however, is typically performed after patching treatment has been carried out to improve vision in the amblyopic eye.

There are also special eye drops available (Atropine) that significantly blur the stronger eye and can be used just like patching therapy. These drops, however, do have systemic side effects and take significantly longer to improve the vision than patching. Typically, eye drops are reserved for patients who cannot tolerate patching therapy.

Success in treating amblyopia depends primarily on the severity of the amblyopia and the age of the patient when it is discovered. Earlier is definitely better in amblyopia treatment. Recent studies, though, have shown that even young teenagers can show small improvements in vision in amblyopic eyes with patching.

Your child should have his or her vision screened by the pediatrician when they are first able to reliably communicate verbally—usually around the age of 3 or 4. If a problem is discovered they should be referred to an ophthalmologist for further evaluation. Only a thorough evaluation from an ophthalmologist comfortable with and experienced in the care of children can rule-out more serious eye diseases and make the diagnosis of amblyopia.

If your child suffers from amblyopia, contact Westwood Ophthalmology to arrange an appointment with Dr. Bianchi.

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Strabismus

What Is Strabismus?

Strabismus is the medical term for misaligned eyes. The eyes may become misaligned horizontally or vertically for a variety of different reasons. When the eyes are turned inward the condition is referred to as “Esotropia.” When the eyes turn outward it is called “Exotropia.” One eye may appear to be turned in or out most of the time, or the deviating eye may alternate. In most cases of strabismus the eyes and the eye muscles are perfectly healthy.

The true cause of this family of disorders is not fully understood, but it appears to be neurologic in origin, representing an imbalance in the brain circuits that control eye movements and alignment. It often appears that one eye is predominantly involved or to blame in these conditions, but it’s important to understand that the disorder actually involves both eyes. Eye movements are very highly coordinated by the brain, with each eye very closely linked to the movements of the other. It’s like a very sophisticated ballet. If anything should go wrong with one eye, the opposite eye is automatically affected and involved. The majority of strabismus occurs during childhood, but it may happen to adults, too. The causes, however, are very different in these two groups of patients. The condition is most often congenital or of unknown origin in otherwise healthy children. Diabetes, thyroid disease, head trauma, strokes and tumors are a few of the more common causes of adult-onset strabismus.

For more information on strabismus or to arrange an appointment with one of the top child eye surgeons in the northern New Jersey area, contact our laser eye surgery and vision correction center.

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Early Detection is Key

Strabismus is serious because it may lead to loss of vision in one eye and also prevents the development of normal binocular vision. Poor vision in one eye may develop because the brain may start to ignore the image from the misaligned eye (amblyopia). In order for the eyes to work together and see in three dimensions (depth perception) they must be aligned on the same visual target. The brain then combines these two pictures into one three-dimensional image that gives us depth perception.

When the eyes are misaligned the brain is presented with two very different pictures that it cannot combine into one image. The brain responds by ignoring one of the images to avoid visual confusion. The child then loses depth perception and may also lose vision in the “ignored” eye. If a child reaches the age of 7 or 8 with eyes that are not aligned, he or she may never develop normal depth perception. If strabismus occurs in an adult patient it often causes disabling double-vision. It is also clear that the abnormal appearance of misaligned eyes can have a significant social impact on a patient’s life. Self-esteem as well as work and personal relationships can be adversely affected by this condition.

A child’s visual system is actively developing up to about the age of 7 or 8. Vision or depth perception that has been lost due to strabismus can be regained if appropriate treatment is received before this window of time closes. Treatment to restore normal alignment can generally regain some, if not all, depth perception if it is performed before that critical age has passed. In general, the earlier the alignment is restored the better the visual outcome.

Because early detection directly affects the success of the strabismus treatment, you must seek qualified medical care for your child upon the first signs of a visual disorder. It is important you receive care from one of the experienced child eye surgeons in your area. New Jersey ophthalmologist Dr. Bianchi is a specialized pediatric ophthalmologist experienced in the diagnosis and treatment of strabismus. He will perform a thorough eye examination on your child in order to detect the presence of any disorder and recommend an appropriate course of treatment.

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Treatment of Strabismus

The treatment offered depends on the kind of strabismus a child has. Some forms of strabismus respond to eyeglasses alone and others require surgery. Some require both. Occasionally, even bifocal glasses are necessary. Often patching will be necessary to treat amblyopia that is commonly associated with strabismus.

Prisms ground into eyeglasses may be able to correct small misalignments in adults, but surgery is required for moderate to large deviations. Many doctors have told their adult strabismus patients for years, incorrectly, that surgery won’t help them or would only be “cosmetic.” In fact, surgery on adults has real medical benefits: eliminating double vision, improving depth perception and enlarging the field of vision.

Many patients report improved self-esteem, communication skills, job opportunities, reading and driving with successful treatment. If you believe your child suffers from one of these disorders, contact Dr. Bianchi in Westwood, New Jersey at our modern laser eye surgery and vision correction center, serving the Pascack Valley area for over 25 years.

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