Retinal Disease in Children

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Early diagnosis and treatment may halt the progression of retinal diseases that affect infants and children. Duke's pediatric retinal surgeons and eye specialists work closely with you and your child to prevent or minimize vision loss. We provide counseling and tools to help your child manage their condition.

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Understanding Pediatric Retinal Disease

Diseases of the retina -- the light-sensitive tissue at the back of your eye that sends information about what you're seeing to your brain -- can affect infants through adolescents in many different ways. Various developmental, genetic, or inflammatory factors may result in retinal disease in newborns and children. Accidental or sports-related trauma is another cause for retinal injury in children. Severity and management of these issues varies widely, which is why a comprehensive diagnosis and expert management is crucial to minimizing the impact these diseases have on your child’s vision. Retinal diseases in children include the following.

Retinopathy of Prematurity
Affects premature babies. It causes moderate to severe abnormal blood vessel growth in the retina that may require laser treatments, eye injections, or surgery.

Retinal Detachments
Occurs when the retina detaches from the back of the eye. It may result from trauma or ocular developmental disease.

Juvenile Macular Degeneration
An inherited disorder in which the macula, the part of the retina responsible for central vision, breaks down. The most common form is Stargardt disease.

Retinoblastoma
An eye cancer that begins in the retina, typically in young children.

Uveitis
A complex condition that can cause chronic inflammation in the front, middle, or back of the eye.

Our Locations

Learn about the child-friendly services offered at the Duke Eye Center in Durham.

Duke Eye Center

Imaging Tests

Advances in imaging technology have made it possible for children with retinal diseases to be diagnosed early and receive prompt treatment and appropriate follow-up care. However, the diagnostic process can take three hours or longer. Sometimes it may be necessary for our young patients to be sedated so they can stay still while images are taken of the inside of the eye.

For these reasons, it is important that your child is cared for by pediatric retinal specialists who are specially trained to care for young children and to use sophisticated technology designed for evaluating children's eyes and vision. We offer these services in the child-friendly Duke Pediatric Retina and Optic Nerve Center's pediatric imaging suite, located at the Duke Eye Center in Durham.

Fluorescein Angiography

Dye is injected into a vein, and a camera-like device takes pictures as the dye moves through the blood vessels in the back of the eye. This test is usually reserved for imaging of more serious retinal conditions.

Electroretinography

This test measures the electrical response of the light-sensitive cells imostly in the macula, which is at the center of the retina. A small electrode is placed on each eye to diagnose macular degeneration.

Optical Coherence Tomography (OCT)

This computer-guided imaging device creates a detailed 3D view of the inside of the eye. It enables doctors to more accurately diagnose childhood retinal, macular, and optic-nerve conditions. The Duke Eye Center research team has pioneered a handheld OCT device to capture retina images in children. Our pediatric retina specialists may use this technology to achieve a more detailed assessment of your child’s retina.

Photography

A fundus camera takes ultra-wide photographs of the back part of the eye to detect retinal tears, retinal detachments, or retinopathy. We use the latest imaging technology for diagnosing and documenting eye disease that may first develop around the edges of the retina, which may not be detected with traditional imaging tools.

Ultrasound

Noninvasive sound waves travel through closed eyelids to create high-resolution images of the inside of the eye to help detect retinal tears, holes, or detachments.

Visual Field Testing

For older children who are capable of understanding and following instructions, an automated vision test may be performed to check for blind spots and other vision defects caused by diseases of the retina or optic nerve.

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Treatment Options

Performing retinal surgery on infants and children is usually more challenging than for adults. Our specialized team of retina surgeons are experts in diagnosing and treating the full range of pediatric retina diseases.

Retinal Tear or Detachment

Your retinal surgeon may use lasers or a freezing probe to seal a retinal tear and/or reattach the retina. The procedure may be done in conjunction with a buckle technique that pulls the eye wall close to the retina to seal tears or holes. If the detachment is extensive, the surgeon may perform a vitrectomy, which requires tiny incisions in the eye to remove scar tissue. In older children who have the ability to remain face-down for long periods, your surgeon may fill the eye with gas that presses the retina back into place and prevents the detachment from recurring. Alternatively, the eye may be filled with silicone oil to keep the retina in place for a longer time. This requires a second procedure to remove the silicone oil.

Juvenile Macular Degeneration Management

Juvenile macular degenerations like Stargardt or Best diseases are a group of inherited macular disorders affecting children and young adults. While there is no treatment for juvenile macular degeneration, our pediatric retinal specialists use imaging tools to evaluate how well the retina is functioning and recommend tools and visual aids that can help your child adapt and remain active. Genetic counseling may be recommended for your family, as this is an inherited disease.

Retinopathy of Prematurity (ROP) Management

Infants who need surgery are seen by pediatric retinal surgeons who use computer-assisted imagery (OCT) to obtain a detailed 3D view of the inside of the eye. Severe ROP may be treated with laser therapy to shrink or seal abnormal blood vessels, cryotherapy (a freezing procedure), or eye surgery. A medication called anti-VEGF (vascular endothelial growth factor) may be injected to allow normal blood vessels to grow and inhibit leakage.

Related Conditions

Why Choose Duke

Specially Trained Pediatric Retinal Surgeons
A team of pediatric eye specialists manage your child’s condition and develop detailed treatment recommendations. We work closely with a dedicated expert in pediatric retinal imaging, as well as specialists who focus on disorders of the optic nerve to ensure your child’s condition is managed effectively.

Guidance and Tools for Your Child's Care
Your child may benefit from the guidance and tools found in our low vision rehabilitation program. If they have an inherited condition, your family may choose to work with our genetic counselors. We have everything you need to ensure your child receives the best possible treatment now and as they grow.

Access to Clinical Trials
Your child may have access to new therapies through our clinical trials, which are paving the way toward new treatments and ways to prevent retinal diseases.

Consistently Ranked Among the Nation's Best Children's Hospitals

Duke Children's Hospital & Health Center is proud to be nationally ranked in 9 pediatric specialties.

This page was medically reviewed on 12/14/2023 by

Lejla Vajzovic, MD | Ophthalmologist