A child’s eyes are precious, but, unfortunately, not immune to problems. The American Optometric Association recommends the first eye exam at six months with good reason; as with other ailments, early detection is key to prompt treatment, and, sometimes, it can even save a child’s life.

This article covers just a few eye diseases that manifest in childhood.

Before We Start

There are many ocular diseases that affect children and I will not have the chance to cover all of them here. I encourage my colleagues to remain vigilant during pediatric eye exams and for any parents reading this to follow the American Optometric Association guidelines to ensure that these conditions are diagnosed in time.

There are also several conditions that are related to refractive error, focusing ability, the eyes working together, and the visual system that will not be covered here. Detecting these conditions is just as important but, for now, the focus is on pathology.

X-Linked Retinoschisis aka Juvenile Retinoschisis

What It IsX-linked retinoschisis is a congenital condition, meaning that children are born with the predisposition for it. X-linked retinoschisis causes poor connections within the retina, the neural layer of the eye responsible for vision. These poor connections cause a splitting of the retinal layers resulting in poor vision.

How Is It Diagnosed: An eye doctor such as an optometrist or ophthalmologist can detect x-linked retinoschisis during a comprehensive eye exam and genetic testing can confirm the diagnosis.

Prognosis: The prognosis can vary because the presentation varies. Some children have better vision than others. Preserving vision and having ways for the child to adapt in mind in case of further vision loss can help.

Tip for Parents and for Those Affected: Early detection is key but adaptation is also important. Finding the right resources to help the child, or adult,  not only function but lead a fulfilling life is key.

Because the condition is x-linked, it can be passed on from parent to male offspring. If you or someone in your family has the condition you can get yourself tested and your child tested early. There is also ongoing research to help treat this and other retinal conditions by various organizations including Foundation for Fighting Blindness.


What Is It: This is perhaps the most heartbreaking condition to diagnose because it is an ocular malignancy (eye cancer) that affects children. Retinoblastoma is the most common ocular malignancy in children and typically affects children under the age of four.

How Is It Diagnosed: An eye doctor such as an optometrist or ophthalmologist often has the best opportunity to detect retinoblastoma because they are focused on the eye, though an attentive pediatrician can also spot the problem. If a healthcare provider suspects retinoblastoma, they will refer the family for further testing to confirm.

Prognosis: As with other cancers, the prognosis for retinoblastoma depends strongly on how early the condition is diagnosed. Once your clinical team makes a definitive diagnosis, their goals will be to preserve life, preserve the globe, and preserve vision– in that specific order.

Tip for Parents: If you notice that one eye is showing up “whiter” than the other on a photo or video, make sure to take your child to an eye doctor right away. However, because early detection leads to the best outcomes, you shouldn’t wait until you notice a problem to take your child for an eye exam.

Congenital Cataract

What It Is: A cataract is the clouding of the lens inside the eye. While most cataracts affect adults, congenital cataracts affect babies and can present either at birth or soon after birth. The clouded lens will decrease vision in the affected eye and prevent proper development of the visual system. If a cataract is not detected in time, the affected eye may never learn how to see properly.

How Is It Diagnosed: An eye doctor such as an optometrist or ophthalmologist often has the best opportunity to detect cataracts during a comprehensive eye exam.

Prognosis: If detected quickly, congenital cataracts can be removed surgically. In some cases, the child will need some form of visual rehabilitation to avoid amblyopia (lazy eye) and to ensure that both eyes learn to work together.

Tip for Parents: Like retinoblastoma, congenital cataracts might make the pupil look whiter.

Coat’s Disease

What It Is: Coat’s disease is an ailment of the retinal vessels that leads to abnormal vessel growth. The abnormal vessels can cause several complications including a retinal detachment.

How Is It Diagnosed: Coat’s disease affects males more than females and is typically diagnosed within the first two decades of life. An eye doctor will be able to note the changes in the back of the eye during a comprehensive eye exam, but they will often want additional imaging to confirm the condition.

Prognosis: The prognosis for Coat’s disease can vary and depends on several factors. Individuals with Coat’s disease will need extra eye care to deal with potential complications.

Tip for Parents and Patients: If your eye care provider suspects Coat’s disease, they will work to rule out other conditions and conduct additional testing. Once diagnosed, regular follow-up with your eye care provider is key to preserving vision.

Regular eye exams with an optometrist are key to keeping your child’s eyes happy and healthy. Schedule your child’s pediatric eye exam in Santa Monica today!

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