Dr. Kahana has a particular passion for oculoplastic conditions that affect children. Children are not “little adults,” and require a unique approach with specialized skills and tools. Dr. Kahana has extensive experience with pediatric oculoplastic disorders, a result of his deep interest in the topic and years of academic research on the developmental biology of the eye and associated structures. Dr. Kahana has authored numerous manuscripts on the topic of pediatric oculoplastic surgery, taught courses, developed novel techniques, and advanced the science of pediatric oculoplastic surgery.
The “critical period of visual development”
At birth, vision is not fully developed, and a newborn’s visual acuity is relatively poor. Children’s ability to see improves dramatically over the first 7 years of life, and particularly in the first 2-3 years – the “critical phase of visual development.”
Visual development is driven by brain development in the visual cortex and vision processing centers in the brain. Development of those parts of the brain required for good vision occurs with visual input from the child’s eyes. In Nobel Prize-winning work, Professors David Hubel and Torsten Wiesel of the Johns Hopkins University showed that brain development required visual input from the eyes (view video). If visual input was impaired, then the brain would not develop the ability to see well.
Importantly, there is a critical period of brain development in which the brain can develop the ability to see well. If the visual axis is covered during this time then the brain will never develop the ability to see well – even after the obstruction is removed. Hence, it is very important – even critical – to have a good assessment of visual function by a fellowship-trained pediatric ophthalmologist, and to take this issue into account when deciding on when to perform eyelid surgery.