Pediatric Medical Retina Service | Overview
The Pediatric Medical Retina Service at Boston Children’s Hospital offers comprehensive assessment and management of infants and children with retinal and visual disorders. Our program combines clinical evaluation with advanced electrophysiological and psychophysical testing to give your child an accurate diagnosis and define her visual capabilities.
When diagnosing or treating your child, we collaborate with other specialists within the Boston Children's network, including neurologists, geneticists, and other experts.
Children referred here may be having an unexplained loss of vision or symptoms such as night blindness, loss of peripheral vision, nystagmus (an involuntary oscillatory movement of the eyes), or an abnormal sensitivity to or intolerance of light (photophobia).
Although retinal disorders are uncommon, we care for many children with them because young visually impaired patients come to our center from the New England region and beyond. Our specialists follow many patients for years, sometimes for more than a decade, which contributes to our understanding of visual development and the course of visual disorders.
The Boston Children's Hospital Pediatric Medical Retina Service offers pediatric patients the most advanced, extensive, and thorough diagnostic testing of retinal function. In addition to a complete ophthalmic examination, procedures performed include the electroretinogram (ERG), the sweep visual evoked potential (sVEP), and the dark-adapted visual threshold (DAT).
Electroretinography (ERG) is performed to assess the function of the photoreceptors (the rods and the cones) and other retinal cells. Our experts have published papers on basic research on the development of ERG responses that serve as the basis for interpreting the ERG responses in the pediatric population. In addition to the full-field ERG, we perform multifocal ERG (mfERG) testing that assesses the central retina, which is affected by macular degenerations.
The sweep visual evoked potential (sVEP) allows us to determine the visual acuity of patients who cannot be tested with conventional acuity tests and assess the effect of optic nerve abnormalities on vision.
Behavioral measurements (psychophysics) of dark-adapted visual thresholds (DAT) quantify retinal sensitivity. This procedure tests the patient's night vision and helps determine what is the dimmest light the patient can see in the dark. This helps monitor the course of a patient's disease. When paired with the results of the clinical examination, the results of these and other tests, such as infrared pupillography, assessment of color vision, and perimetry (visual fields), help establish diagnoses and characterize the visual capabilities of the individual patient.
When a diagnosis is determined, appropriate treatment is administered and/or the patient is referred to the appropriate services. These services include:
- any pediatric low-vision service that offers devices such as magnifiers, telescopes, and others
- recommendations for strategies to make the best possible use of vision
- appropriate educational and support services