#1 Ranked Children’s Hospital by U.S. News & World Report
MyPatients provides referring primary care providers with secure access to their patients’ information.
Boston Children's has launched the world's 1st program dedicated to offering hand transplants to children who qualify.
Innovation insider is a semi-monthly e-newsletter analyzes innovations at Boston Children’s, other academic medical centers and from industry.
Read the latest blog by a Boston Children's doctor, clinician or staff member.
There are many ways you can help children and their families get the care they need.
We’ve got an appointment with the Pediatric Oculoplastic Program. What should we expect at our first visit?
Boston Children’s Hospital’s Pediatric Oculoplastic Program team is committed to ensuring that your experience is as pleasant as possible.
We know that the family is the most important source of emotional support for children. That’s why we provide families with information about our services, tests and treatments in advance so that you know what to expect and in turn, can help prepare your child for a visit to the doctor.
What you discuss with your doctor at your child’s appointment will depend upon your child’s condition, but all visits begin the same way.
Upon arrival, you’ll meet with an orthoptist (eye technician) who will take your child’s basic medical history, give him a vision test and evaluate his depth perception and basic eye function.
Your child may also have a complete eye exam with dilation.
You’ll then see the doctor who will complete your child’s eye exam by looking at the inside of his eyes and examining the following areas:
After the eye exam is complete, you’ll speak with the doctor about your child’s diagnosis and treatment plan, which will depend upon his condition.
Common conditions and treatment plans
Every child is unique, and your child’s long-term vision depends upon your child’s exact condition. But generally speaking, most of the conditions we treat can be corrected with relatively simple surgical procedures.
Read on to learn about some common treatment plans. For more information about recovery from these surgical procedures, see the Long-Term Outlook section of this page.
Congenital ptosis — If your child has a very severe case of ptosis with almost no eyelid function, she could be at risk of losing vision, so the doctor may choose to operate when your child is as young as 5 to 6 months old.
However, this is very rare; a more common time for surgery is around a year old because by that time it will be clearer how well the eyelid muscle (levator) is actually going to work. Once your doctor is able to assess your child’s levator function, she’ll know which surgical procedure is most appropriate.
If your child has a relatively mild case of ptosis and his vision is not affected, you may elect to wait until your child is older and can decide for herself whether she wants to have the surgery.
Tear duct obstruction — Your doctor will often perform an assessment by putting a small amount of pressure on the lacrimal system and observing the results. She’ll also check to make sure the external apertures of the system are open to allow tears to come out.
Typically, your doctor will want to wait to perform surgery until your child is at least a year old. The reasons for this are twofold:
Orbital dermoids — If your child’s dermoid is located near the nose or has any other abnormal characteristics, your doctor may order an MRI to ensure that she doesn’t have any other associated conditions.
Then you’ll discuss what the surgical process will be like and a timeline for treatment.
Infantile hemangioma — These benign vascular tumors can be a problem if they expand enough to cause the eyelid to droop and cover the pupil or if they’re deep and press on the orbit of the eye, which can cause a distortion in vision or amblyopia (lazy eye).
What is the long-term outlook for my child?
Every child is unique, and your child’s long-term vision depends upon your child’s exact condition. But generally speaking, most of these surgical procedures have very high success rates.
Ptosis — Children who have surgery to correct congenital ptosis sometimes need to have another procedure when they are older.
Your doctor will discuss this possibility with you in more detail.
Tear duct obstruction — For 80 percent of the children who have the surgery, one probe into tear duct is sufficient to remove the obstruction. For the other 20 percent, more complicated surgery may be necessary.
Orbital dermoids — Once they are removed, they don’t grow back.
Infantile hemangioma — Once the hemangioma is removed or stops growing (usually when your baby is around one year old) it rarely recurs.
NEW SURGICAL TECHNIQUE DECREASES FACIAL SCARRING
Every surgical operation results in a scar of some size. However, John B. Mulliken, MD, co-director of Children’s Vascular Anomalies Center, developed an innovative way to reduce scars resulting from surgical removals of hemangiomas. To learn more, see the Research & Innovation section.
We understand that you may have a lot of questions when your child is scheduled for oculoplastic surgery. We’ve provided some answers to those questions in these pages, but there are also a number of other resources at Boston Children’s Hospital to help you and your family through this difficult time.
Children’s Behavioral Medicine Clinic helps children who are being treated on an outpatient basis at the hospital — as well as their families — understand and cope with their feelings about:
o being sick
o facing uncomfortable procedures
o handling pain
o taking medication
o preparing for surgery
o changes in friendships and family relationships
o managing school while dealing with an illness
o grief and loss
Visit here or call 617-355-6688 to learn more.
Visit our For Patients and Families site for all you need to know about:
Online resources: The American Society of Ophthalmic and Plastic and Reconstructive Surgery has an informative page.
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”