The Ophthalmology Program provides complete, coordinated diagnosis and treatment of pediatric eye disorders to help all children achieve their full vision potential. Our team of doctors and technicians specialize in providing high-level, evidence-based care for young patients in a family-friendly environment.
We use innovative science and the latest technology to find, identify and treat a wide variety of eye disorders. We offer many medical and surgical treatment options for eye diseases that occur during childhood.
The Family Choice Award is one of Seattle Children’s top honors and is especially meaningful because patients and families are the ones who nominate. Opthalmology won the 2023 award in the department category. Read the full story.
“We are so incredibly honored to receive this award. The Ophthalmology team includes a cohesive group of doctors, surgeons, ophthalmic technicians and administrators who all do so much to enhance the care of our patients. There is not a single team member who doesn't wake up every day motivated to provide great care to patients and families. Receiving this award is so special for us and brings incredible joy and meaning to all of us!”
— Dr. Michelle Trager Cabrera, Head of Ophthalmology
Conditions We Treat
We see infants and children with a variety of disorders that affect the eyes, including:
Blocked tear ducts (Children 1+ Year Old)
Many children are born with tear ducts that aren't completely developed. This problem can cause blocked tear ducts, infections and over-production of tears. Blocked tear ducts often clear up by themselves and require no treatment. If tear ducts become infected, call your child's doctor quickly because the infection can spread to other parts of the face. Signs of infection include redness, pus and swelling.
Disease of the optic nerve and brain
There are many conditions that affect vision by harming the vision centers of the brain, including the visual cortex (where vision is processed) and the optic nerves (where light signals are sent from the eye to the brain). Our program works with other specialists to provide comprehensive care for specific diseases such as tuberous sclerosis complex, optic pathway gliomas, and other brain tumors. We use visual evoked potential to look at signaling in the brain and test visual function, and have developed specialized imaging analysis of the optic nerve using optical coherence tomography.
Eye movement disorders
Eye movement disorders usually involve uncontrollable movements of the eye or eyes that are not able to focus properly. For example, your child’s eyes may cross in or drift out (strabismus), they may have decreased vision in one eye (lazy eye, or amblyopia) or they may have double vision. Our team includes an orthoptist who is specially trained to measure your child’s vision and eye movement issues. Our orthoptist works with our ophthalmologists or optometrist to diagnose and develop a plan for your child which may include eye muscle exercises, glasses for double vision, a temporary patch for the eye or other treatments for eye muscle issues.
Strabismus (ocular misalignment)
Strabismus is a type of eye movement disorder in which a child's eyes look crossed. Strabismus is usually caused by an imbalance in the muscles that help the eyes stay straight and move together properly. Surgery on the eye muscles can help the eyes look straight. Children may have lasting vision loss in the less-used eye (amblyopia) if the condition is not treated in early childhood.
Some children are born with cataracts, which are a clouding of the eye's lenses. The clouding prevents images from being seen clearly or at all. In babies and young children, cataracts must be treated to prevent lasting problems with development of vision.
Eyelid abnormalities and tumors
Children can have a wide range of eyelid problems. Some problems include swelling and redness (inflammation) and infection, tumors that may or may not be cancer, and problems with the structure of the eyelid itself. In most cases, eyelid disorders don't threaten a child's vision or life. But sometimes their symptoms can cause pain or discomfort. Less often, the disorders can be serious.
As in other parts of the body, tumors can form in the eyes when cells grow uncontrollably and form a lump of tissue. Tumors can be cancerous (malignant) or without cancer (benign). Retinoblastoma is a disease in which cancer cells form tumors in the tissues that line the inside of the back of the eye (retina). Although the disease can occur at any age, it usually shows up in children younger than 5 years. Read more.
Glaucoma is a disorder that causes fluid pressure to build up inside the eye. This can cause damage to the optic nerve. It can occur in infants and children, although it is much more common among older adults. Unless found early by routine screening tests, glaucoma usually goes undiagnosed until some vision is lost.
Inherited retinal degeneration
Some children are born with diseases that affect the retina (the part of the eye that senses light). These conditions include inherited retinal degeneration, which can cause blindness from birth or later in life. Our clinic works with Seattle Children’s Genetics Program to provide tools to diagnose conditions that affect the retina, including multifocal and full-field electroretinogram, handheld and tabletop optical coherence tomography (retinal imaging), and genetic testing.
Children with significant visual impairment can be seen by our low vision specialist, Vivian Manh, OD, for a complete evaluation. Through our low vision clinic, Dr. Manh works with vision specialists in schools and the community to provide a comprehensive approach to functional vision, identifying the best tools to help children achieve academic success and improve quality of life.
Uveitis is inflammation in the eye that can lead to long term vision damage. It is commonly associated with rheumatologic conditions such as juvenile idiopathic arthritis. Our combined uveitis/rheumatology subspecialty clinic provides state-of-the-art care for children with uveitis, including medical and surgical treatments.
Vestibular balance disorders
Vestibular balance disorders are problems that occur in the sensory system of the inner ear. This system works with eyesight to help people maintain their balance. Vestibular balance disorders can cause dizziness and imbalance, as well as nausea, anxiety, changes in hearing and other symptoms that can affect your child's daily life.
Conditions We Do Not Treat
Children with these conditions can be treated by an eye doctor outside of Seattle Children’s, including most children with developmental disabilities and underlying medical conditions. Please see our list of eye care providers (PDF) that has been vetted by our faculty.
Failed or abnormal vision screening
Decreased vision of unspecified duration and cause
Refractive errors (astigmatism, myopia, hyperopia)
Blocked tear duct (in patients under 1 year old)
- Learn more about Nasolacrimal Duct Obstruction (Blocked Tear Ducts) (PDF) (Spanish)
Chalazion or stye (except for surgery)
Squinting, blinking, eye-rubbing, floaters, visual disturbances
- Learn more about Your Child’s Vision.
Children who only need glasses
Baseline or screening exams
Children older than 12 months who need baseline or screening exams for farsightedness, nearsightedness, reading problems, or tracking problems (not including crossed eyes, or strabismus) unless the patient is referred to us by an eye care specialist.
Services We Offer
Our Ophthalmology program offers tests to identify eye disorders in children, including:
An electroretinogram measures the electrical response of the cells in the eye that are sensitive to light (retina). The test helps doctors evaluate disorders of the retina. The retina is the lining in the eyeball that is sensitive to light. It transfers signals to the optic nerve, which sends them to the brain, where they are seen as images. An electroretinogram can help doctors decide whether surgery on the retina may help your child.
Oculomotor testing (eye movement testing)
Oculomotor means eye movement. These tests measure how and when your child's eyes move in response to images, light, moving objects and head motion. Doctors compare your child's eye movement with that of other children of the same age to see if your child shows the usual response.
Visual evoked potential
This test measures the electrical signals to the brain that happen when your child sees something. Simply put, the test records the amount of time it takes for these electrical signals to reach the brain. Doctors use visual evoked potential tests to check sight, especially in babies and young children.
Rotary chair testing
Rotary chair testing helps doctors understand the cause of balance problems. The test measures eye movements as your child sits in a chair that moves in precise circular patterns. The doctor compares your child's eye movement with that of other children of the same age to see if your child shows the usual response. Rotary chair testing can help doctors find out how your child's visual and inner ear (vestibular) systems are working together.