Pediatrics

PEDIATRIC OPHTHALMOLOGIST

Villegas MD specializes in the diagnosis and treatment of complex pediatric intraocular (inside the eye) diseases in San Juan, Puerto Rico. Evaluation of intraocular and retinal pathology in children poses significant challenges because many children do not cooperate for a detailed examination in the office. In cases where intraocular tumors or blinding disease is suspected, examination under anesthesia with multimodal imaging techniques is of utmost importance to establish a diagnosis. Early diagnosis is paramount to developing an individualized treatment plan and achieving optimal long-term outcomes.

Sedated Neuroradiology  |  Specialized Testing

Sedated Neuroradiologic Studies

Prior to evaluation under anesthesia, children may need to undergo a sedated CT or MRI scan with or without intravenous contrast. Sedation allows children to remain still in order to obtain the best possible images.

A CT scan is a computerized X-ray that provides good visualization of the orbital tissues, eye, and bones. An MRI scan uses magnetic fields and radio waves to create high-resolution images of the orbit, eye, and brain. Both of these studies take about one hour. Contrast may be prescribed to highlight suspected tumors. These studies may be important because many pediatric intraocular conditions are associated to systemic findings.

Widefield Fundus Photography

&

Fluorescein Angiography

During the last 10 years, examination under anesthesia with widefield fundus photography and fluorescein angiography has changed the way we approach posterior segment disease in children. Advanced imaging techniques allow us to deliver the most cutting-edge treatment options and individualize them to each patient. Photography and angiography allows us to detect subtle changes that improve our precision in diagnosis and management. These modalities can be performed in the clinic or under anethesia.

High-Resolution Ultrasonography

Evaluation of children with posterior segment disease, iris or ciliary body lesions may be evaluated under anesthesia with ultrasonography. This allows detailed examination of the tumor surface and intratumoral components. Ultrasound biomicroscopy (UBM) allows visualization of anterior segment and ciliary body lesions that have historically been difficult to study.

Standardized A-scan, B-scan, and high-resolution ultrasonography (10 and 20 MHz B-scan, 25 MHz and 50 MHz UBM) allow unparalleled imaging when complex pathology is present. 

Optical Coherence Tomography

Optical coherence tomography (OCT) has changed the paradigms in the management of different retinal conditions including diabetic retinopathy, age-related macular degeneration, neovascular membranes, intraocular tumors, and retinovascular disease. However, this technology has not been traditionally available to children. OCT in children has allowed us to treat pediatric patients with the same state of the art technologies available to adults. OCT can be performed in the clinic or under anesthesia.