Paediatrics

 

Children typically have a slightly different range of eye problems to adults. They also require a unique approach to examining their eyes.

Our paediatric ophthalmologists specialise in examining, diagnosing and treating eye problems in children.

They aim to make each examination pleasant and welcoming for your child.

More on what we do

Some of the most common childhood eye problems are lazy eye (amblyopia) and squint (strabismus). These conditions are treated primarily by the orthoptic team, who are specialists in measuring children’s vision and eye movements. The eyes will need to be examined to check for refractive error (the need for spectacles) or any eye health problems. This is usually carried out by our optometry department.

If there are any concerns, or if further treatment such as squint surgery is required, your child may be referred to the paediatric ophthalmology clinic for further assessment.

Medical problems with children’s eyes will be managed in the paediatric ophthalmology clinic. Some may have interim follow-up with the orthoptists.

The first seven years of life is crucial to normal visual development. Rapid development of the visual system occurs between birth and the age of two. Most development of the visual systems is complete by around the age of seven. No child is too young to be seen by our paediatric team.

Patients are usually transferred to the appropriate sub-specialist adult service at age 18.

Treatments

Spectacles are usually the only treatment needed for lazy eye (amblyopia) or strabismus (squint). Often, amblyopia is caused by one eye receiving a clear image and the other eye being out of focus. Because the focussing muscles within the eye are linked between the two eyes, the out of focus eye will never be brought into focus naturally. Glasses treat amblyopia by providing a clear image to both eyes so that they develop at the same rate.

The focusing muscles in the eyes are linked to the muscles that turn the eyes inward. If the focussing muscles are having to work extra hard to overcome an underlying spectacle prescription, this can stimulate the muscles that turn the eyes inward, causing strabismus. Glasses can help to relax the focussing muscles, in turn relaxing the muscles that turn the eyes inward and correcting the strabismus.

Glasses do not make the eyes weaker, contrary to some common urban myths. Usually glasses will need to be worn all the time, but the orthoptist or optometrist will advise if this is not the case.

Some cases of amblyopia are not helped by glasses, or only partially corrected by glasses. In these cases, occlusion therapy can help by using eye patches or eye drops to obscure the vision in the better eye, forcing the “bad eye” to focus and develop to its full potential.

Some cases of strabismus are not helped by glasses, or only partially corrected by glasses. In these cases, squint surgery may be considered. Not all squints are suitable for surgery. The pros and cons of squint surgery will be discussed on a case by case basis. Squint surgery will not remove the need for glasses in most cases. The procedure involves surgically repositioning or shortening the muscles which control eye movement. It is usually carried out under general anaesthetic as a day case, meaning you can go home the same day. There is an urban myth that the eye is removed from its socket during surgery. This is not true.

Many medical problems, such as conjunctivitis (infection of the surface of the eye), allergic eye disease, or uveitis (inflammation of the eye), may be treated with eye drops. Our specialist clinical staff can give you hints and tips on how to best put the drops in your child’s eye depending on what drops are required. Medical eye conditions will be discussed on a case-by-case basis due to the wide range of conditions we see.

The paediatric team have close links with the Rehabilitation Officers for Visually Impaired Children (ROVIC). The ROVICs work for social services and provide wonderful support for children with eye conditions and their families. We also liaise closely with the Associate Teachers for Visual Impairment (ATVI) to make sure children with significant vision impairment have optimal support in school. Our optometry department also conducts specialist paediatric low vision assessments.

Our team

Consultants: Mr James Benzimra and Mr Sam Marshall-Evans

Orthoptists (click here)

Optometrists (click here)

Where to find us

RD&E Wonford, Barrack Rd, Exeter EX2 5DW

Level 1, Outpatients Department

Contact us

Secretary for medical paediatric ophthalmology: 01392 406008

Orthoptic secretaries: 01392 406031

Community services

Some orthoptic and optometry follow-up may be available in community settings closer to home. This will be discussed with you if appropriate.

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