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How a Facebook photo led to a rare diagnosis

By Esther Pomeroy

For University of Utah Health Care BrandView

Published: Thursday, May 8 2014 10:15 a.m. MDT

Human eyes aren't fully developed until about age seven. It's important to get your child several eye exams before then.

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Three-year-old Rylee received a rare diagnosis last fall after a photo her mom posted to Facebook revealed an unusual glow in her left eye. A friend noticed the glow, prompting Rylee's mother to take Rylee to a retinal specialist, where she was diagnosed with Coats disease which causes abnormal development of the blood vessels at the back of the eye and can lead to blindness.

Rylee's condition is rare, but her story is a great reminder of the fact that eye exams are a must for young children.

Early detection helps prevent vision loss

Our eyes develop throughout early and middle childhood. Certain aspects of vision don't fully mature until age seven. Because of this, it is critical that pediatric eye problems be detected and treated as early as possible.

Pediatricians conduct eye exams as part of routine care, which is sufficient for most children. However, in other situations it is important that children see a specialist, usually a pediatric ophthalmologist. Babies in high-risk groups, including those who are born prematurely or who have certain genetic risk factors, are usually referred to pediatric ophthalmologists very early in their infancy.

A child with a parent or sibling who has a condition like amblyopia (lazy eye), early childhood cataracts, early childhood glaucoma, or retinoblastoma (a rapidly-developing cancer that begins in the back of the eye), needs to begin a relationship with an ophthalmologist from birth. The doctor will follow their progress over several years, and be on the alert for any problems.

Robert Hoffman, M.D., a pediatric ophthalmologist at the University of Utah's John A. Moran Eye Center, recommends scheduling an appointment for your child if he/she complains of pain, or if you notice any of the following:

  • Misalignment of eyes/trouble focusing
  • Any dramatic changes in the appearance of the eye
  • Light sensitivity
  • Difficulty seeing
  • A white-eye (rather than red-eye) effect in photograph. Should you notice this, make an appointment with an ophthalmologist immediately as it can be a symptom of retinoblastoma, which is rare but potentially fatal.
  • When You Think Your Child Needs Glasses

    Dr. Hoffman warns that the basic vision exams provided by many optical shops don't always cover all the bases for young children. Kids sometimes end up with glasses, he says, because they are bored or distracted during vision exams, leading to incorrect responses. They may also insist that they are unable to see well because they want to copy a friend or older sibling who has glasses. To ensure that your child really needs glasses, Dr. Hoffman says to make sure you visit a doctor who can provide a dilated eye exam, which provides a more accurate measurement of required correction in children.

    Common Pediatric Eye Issues

  • Misaligned eyes (crossed eyes, wall-eye, lazy eye, etc.)
  • Difficulties with tear drainage
  • Cataracts (clouding of the lens of the eye)
  • Glaucoma (increased pressure in the eye)
  • Injury: Dr. Hoffman cautions parents to keep sharp objects and dangerous chemicals (including bleach, laundry detergent, and oven spray) out of the reach of small children. Children should also stay away from fireworks and BB guns, and if possible wear safety glasses when playing any sports involving projectiles (such as baseball and basketball).
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