Paediatric Oculoplastic Surgery in Sydney with Dr Hugo Lee

Amblyopia, often referred to as “lazy eye,” occurs when the connection between the brain and one eye does not develop properly during childhood. Much like how most people develop a dominant hand, the visual system can develop a strong preference for one eye when, ideally, both eyes should work together with near-equal strength.

Importantly, amblyopia often has no obvious symptoms. A child may appear to see normally when both eyes are open, and the condition can go unnoticed without screening. As amblyopia becomes more pronounced, signs may include an eye that begins to wander or turn, frequent squinting, closing one eye to see more clearly, or a noticeable preference for using one eye over the other. Conversely, children born with misaligned eyes (strabismus) who are not treated early are also at risk of developing amblyopia.

Many underlying conditions can lead to amblyopia, and most are treatable or reversible when detected early, which is why early childhood vision screening is essential. Common causes include strabismus, uncorrected refractive errors (where blurred images are focused on the eye), visual obstruction (such as congenital ptosis or cataract), or intrinsic eye conditions that impair vision, such as congenital glaucoma.

Ptosis baby treatment is recommended when a drooping eyelid begins to interfere with a baby’s vision or normal visual development. In mild cases, where the eyelid does not block the pupil, careful monitoring may be all that is needed. Surgical corrections are also performed when clear asymmetry affects the child’s psychosocial development.

Chalazia (often referred to as styes) are the most common eyelid cysts seen in paediatric oculoplastic practice. They typically appear as a small, red, pea-like lump on the eyelid and often cause more concern for parents than discomfort for the child, as many chalazia are relatively painless despite their inflamed appearance.

A chalazion forms within the tarsal plate, the firm “cartilage” of the eyelid, when one of the oil-producing glands becomes blocked. These glands (meibomian glands) open along the eyelid margin just behind the eyelashes, with around 20–30 openings on each lid. Blockage can occur due to thickened oil secretions, local irritation, or bacterial overgrowth, which can allow the cyst to enlarge, sometimes quite rapidly.

Initial treatment usually involves warm compresses and careful eyelid hygiene to help clear the blockage. If the chalazion becomes large, troublesome, or persists for more than six weeks despite these measures, a minor surgical procedure to drain the cyst from within the eyelid may be considered. In adults, this can often be performed in the clinic under local anaesthesia, whereas in children it is usually carried out under general anaesthesia to ensure comfort and safety.

In most cases, treatment for a baby’s blocked tear duct (congenital nasolacrimal duct obstruction) involves a simple probing procedure performed under general anaesthesia.

A fine instrument is used to gently open the tear drainage pathway, often with the assistance of an endoscope to visualise the nasal opening of the tear duct. This allows tears to drain normally and helps reduce persistent watering or discharge. In many cases, a soft silicone tube is placed in the tear duct during surgery to prevent scarring or re-narrowing during healing. These tubes are temporary and are usually removed easily in the clinic during a postoperative visit.

In rare cases, a more definitive procedure, known as a dacryocystorhinostomy (DCR), may be required to establish tear drainage. In children, this surgery is almost always performed endonasally (through the nose) to avoid facial scarring. The procedure is similar in principle to that performed in adults and is discussed in more detail in the adult oculoplastic section.

In many cases, paediatric oculoplastic surgery provides long-lasting results and does not require repeated procedures. However, because children’s eyes and faces continue to grow, some conditions may need ongoing monitoring or additional treatment over time. This can be the case with conditions such as congenital ptosis or certain eyelid or orbital concerns.

Dr Lee takes a long-term view of your child’s eye health, carefully planning treatment and follow-up to support healthy development. Parents are kept informed at every stage, with clear guidance about what to expect as their child grows and when review appointments may be needed.

While every child’s recovery is different, most children recover quickly after paediatric oculoplastic surgery. Many are back to their usual routines within a few days to a week, with minimal discomfort. Mild swelling or bruising may occur but typically settles on its own over a short period. Parents receive clear, practical aftercare instructions and reassurance about what is normal during the healing process.