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Pediatric Oculoplastic Surgery

Kids are not just little adults. Their care needs to be approached differently starting with their experience in the office. Going to the doctor can be scary for the child and the parents. Drs. Gay and Paul are both parents and are excellent in connecting with their pediatric patients. Next, I will discuss a few common conditions we see and treat in children.

Congenital Ptosis

This is a condition where the child is born with one or both upper eyelids lower than they should be. In most cases the eyelid muscle does not function properly, and the eyelid appears droopy. If the eyelid does not open fully it may block vision and can result in a condition called amblyopia. Amblyopia can be a permanent condition affecting vision for the rest of the child’s life. If there are signs of amblyopia surgery is done as soon as possible. If there aren’t signs of amblyopia than the low eyelid can be observed. Every case is different, but a good time to consider ptosis surgery if there isn’t amblyopia is prior to starting school. There are several techniques to lift the eyelid to its appropriate height. The surgery is tailored to your child’s needs. Congenital ptosis requires a surgeon who is comfortable with this condition since the approach is much different than treating age related ptosis.

Dermoid Cyst

This is a common condition that we see in our pediatric patients. Usually the parent notices a deep bump in the upper eyelid or under the eyebrow. The dermoid cyst is present at birth. It is usually seen by the parents in the first 6 months of life but can occasionally be found at a later age. A dermoid cyst is a benign mass (i.e. not cancer) that usually contains structures found in skin including epidermis, keratin, hair, and other structures. If the cyst ruptures it can cause severe inflammation, so it is recommended to remove them with surgery. As with almost all our surgeries on children we do this surgery under general anesthesia for the child’s comfort and safety. We prefer to wait until the child is about 2 years of age, but it can be done sooner on a case by case basis.

Chalazion(Styes)/Lumps/Bumps

There are several different conditions that result in a lump or bump on the eyelid. These will be individually evaluated and treated appropriately. What most people refer to as a stye is a blocked oil gland in the eyelid. The opening gets blocked and the oil can’t drain. The eyelid swells and can become infected. Most styes respond to warm compresses, but if they don’t, they may need an injection or to have them surgically drained. There are several other conditions in children that cause growths on the eyelid. If your child has anything on the eyelids then they deserve to be seen by an eyelid specialist. If you child needs something removed, we do it in an OR with anesthesia, so your child is comfortable and safe.

Trauma

As they saying goes, “Kids will be kids.” Children and teens are at high risk of injuries to their faces and eyelids due to sports, car accidents, dog bites, household accidents, etc. We treat lacerations (cuts) to the eyelids and face, bone fractures of the face/orbit, and damage to the eye. Each injury is unique and requires an individualized approach for the best results.