Understanding Pediatric Eye Disorders: Key Insights from AAP 2025

Announcer:
You’re listening to Clinician’s Roundtable on ReachMD. On this episode, Dr. Laura Enyedi will discuss highlights from her presentation on diagnosing childhood ocular disorders at the 2025 American Academy of Pediatrics National Conference and Exhibition. Dr. Enyedi is a Professor of Ophthalmology and an Associate Professor in Pediatrics at Duke University School of Medicine in Durham, North Carolina. Let’s hear from her now.

Dr. Enyedi:
We have a big goal here. We’re going to try to introduce pediatricians to a lot of different diagnoses that they may encounter in their offices—so common and serious eye disorders that present to pediatricians—and we want to give them some ideas about problems where they might be able to start the treatment themselves and those that may need to have referral to a pediatric ophthalmologist. And because there’s such a backlog for most pediatric ophthalmologists—it’s months to get an appointment—we also want to give pediatricians an idea of timeline and how urgent some of these referrals are.

Some of the common things that we’re going to talk about are pseudostrabismus, real strabismus, esotropia, and intermittent exotropia. We’re going to talk a little bit about myopia control, which has become a really hot topic in the ophthalmology world—and I’m sure pediatricians get questions from parents about it—capillary hemangiomas, ptosis, dermoid cysts, nasolacrimal duct obstruction, chalazions and styes, and eye trauma, just so that pediatricians have some tools to at least initially manage some of these things.

We’re also going to go over some of the things that are more vision-threatening or even life-threatening that we don’t want pediatricians to miss. We want them to be able to get their patients to us quickly for evaluation so that we can get patients on the right path—things like the capillary hemangioma and coloboma syndromes, retinoblastoma and leukocoria, orbital tumors, including rhabdomyosarcoma, and abusive head trauma. These are all things we don’t want to miss because they can kill children. And then we don’t want to miss the vision-threatening things that can blind children, like cataracts, glaucoma, and amblyopia.

There’s a lot of things that can be diagnosed with the red reflex test—the red reflex test is something that all pediatricians do. We’re going to review for them exactly how to do it, share some of the AAP guidelines on how to do it, and talk about the many diagnoses that can be diagnosed with a red reflex test—not only strabismus, but also things like cataracts and even a retinoblastoma with leukocoria. Leukocoria is a white pupillary reflex, and the thing we have to rule out with leukocoria is retinoblastoma because that is a very treatable disease that can kill children if not treated. But there’s lots of other things that can present as leukocoria, so we’re going to cover that diagnostic tool and all the different diagnoses that the red reflex test can help us with.

We’re going to go through an extensive differential diagnosis for things like rapidly expanding proptosis in children to make sure that pediatricians don’t miss the most serious things like rhabdomyosarcoma, which, again, is one of those things that’s treatable if we catch it and deadly if we miss it.

I want to express my gratitude to our pediatrician colleagues for the work that we do together and for all the efforts that they put in to support ocular health. I know a lot of the care doesn’t even get to my office because the pediatricians are taking care of that, and we want to continue to support them and give them some tips and pearls on how they can continue to do that. And we also want to continue to partner with them to get in the kids that really do need to be seen in a timely manner to make sure that we protect children’s vision as well as their overall health.

Announcer:
That was Dr. Laura Enyedi discussing her presentation on managing ocular conditions from the 2025 American Academy of Pediatrics National Conference and Exhibition. To access this and other episodes in our series, visit Clinician’s Roundtable on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!