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Pediatric

What are congenital disorders around the eyes?

A variety of congenital disorders can include the eyelids, lacrimal system and orbits including:

  • congenital ptosis
  • nasolacrimal duct obstruction
  • dermoid cysts
  • eyelid and facial anomalies
  • tumors
  • benign eyelid lesions
  • chalazia
  • lacrimal disorders
  • traumatic facial injuries
  • craniofacial defects
  • trauma, orbital fractures
  • eyelid infections or abcess

Patients are often born with congenital disorders such as congenital ptosis, tear duct disorders, dermoid cysts, or develop them within a year of life, and others can be acquired over time or with trauma/injury. Many of these disorders can be isolated and surgically repaired as an outpatient procedure, while others can be a part of a syndrome of disorders. These patients often require the care of several specialists. Surgery is often performed at a Children’s surgery center with doctors experienced in the treatment of pediatric patients. Dr. Amato has extensive experience in the management of pediatric oculoplastic disorders and will discuss your or your child’s particular needs at your initial consultation. Children typically recover quickly after eyelid and tear duct surgery, but may have bruising and swelling for a few weeks.

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What is the most common orbital mass in children?

Capillary hemangioma and dermoids are benign orbital masses that appear most commonly in children. If small, hemangioma can be observed or treated with medication (beta-blockers) if there is problematic growth. Dermoid cysts can be removed usually after a year of life to avoid rupture and recurrence or episodes of inflammation. There are less common benign and malignant tumors seen in children namely rhabdomyosarcoma, neuroblastoma, retinoblastoma, and glioma and immediate evaluation and treatment by a team of specialists are essential.

What are common injuries around the eye seen in children?

Children can suffer from orbital fractures or lacerations affecting the bones, eyelids and tear ducts. An orbital floor fracture is a common injury from a softball injury or blunt trauma to the eye resulting in a broken bone under the eye. Patients often have trouble looking up, or double vision. This type of injury may require surgery to restore eye movement and position. Other lacerations from falls, dog bites, or accidents may require repair by an eyelid or tear duct specialist to ensure the best cosmetic and functional result. Dr. Amato works with doctors at Texas Children’s and Dell Children’s hospital and has experience treating children of all ages.

Before

congenital ptosis after

After

What is congenital eyelid ptosis?

Children with congenital eyelid ptosis can be so severe that it is blocking visual development and may require more immediate surgery to improve their chances for full visual development. Their eye doctor can follow many children then decide to have ptosis surgery at school age. Patients with congenital ptosis may require adjustment surgery for the eyelids in the future.

What is congenital blocked tear duct?

Children can also be born with a blocked tear duct membrane that causes discharge and tearing. Usually, with massage of the tear duct within the first year of life, many patients will improve, and surgery can be avoided. Others can undergo a probing of the tear drain to open the membrane and improve tearing. For more information, please refer to Post-op instructions for children under Forms and Pediatric Oculoplastic Surgery section of www.ASOPRS.org.

If there is a recurrence of tearing or infections, children may require a small silicone stent to be placed into the tear drainage system that is removed a few weeks to months later. Rarely, a tear duct may get infected, or be improperly developed and further surgery is performed to open the tear duct in a DCR (dacryocystorhinostomy or balloon procedure). A Jones tube is a procedure that can replace a tear duct through a glass tube in cases where the tear duct has not developed or cannot be opened. Accessory tear ducts can also be seen that may cause tearing, which can usually be repaired.

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If you are ready to take the next steps, or simply want more information about a procedure, please contact our team! Dr. Amato looks forward to speaking soon.