What we treat
We see all general paediatric eye conditions. Some of the common childhood eye problems that we treat are below. Please click on the items in the list below for more details:
Refractive errors
Strabismus / squint
Amblyopia
Eye movement disorders
Visual impairment
Eye conditions associated with Down's syndrome
Eye conditions resulting from genetic disorders
Retinopathy of prematurity (ROP)
Retinoblastoma
The structure of the eye
Refractive errors
A refractive error is a need for glasses. There are three types of refractive error – hypermetropia (long-sightedness), myopia (short-sightedness) and astigmatism. Hypermetropia occurs from a short-length eye and causes blurred near vision, and if the amount of hypermetropia is large it may also cause blurred distance vision. Myopia occurs when the eye is too long and causes blurred distance vision. Astigmatism arises from an abnormal curvature of the eye and causes blurred vision at all distances.
For details of how we treat refractive errors, please visit our services section on this website.
Strabismus / squint
A strabismus or squint occurs when the eyes are not properly aligned. One eye can turn inward or outward or upwards or downwards. A squint can lead to amblyopia (see below) or may be a sign of pathology within the eye, so it is important that any children with a suspected squint are examined as soon as possible. Some squints can be controlled with glasses; however some squints will require surgery.
For details of how we treat strabismus and squints, please visit our services section on this website.
Amblyopia
Commonly referred to as lazy eye, amblyopia can develop if there is abnormal or decreased visual stimulation in early childhood. It can be caused by squint, unequal or large refractive errors, or from conditions that disrupt visual input into the eye such as congenital cataract and ptosis (droopy eye lid). The visual system is fully developed by the age of eight, and treatment of amblyopia has very limited success after this age. It is important that amblyopia is treated as young as possible to ensure every child enters adulthood with good vision in both eyes.
For details of how we treat amblyopia, please visit our services section on this website.
Eye movement disorders
Eye movement disorders can occur if the muscles that move the eye not working properly – some children are born with these conditions, whilst others develop later in life as a result of nerve damage within the brain. A thorough eye examination is required if an eye movement problem is present as these are frequently associated with other conditions. Some eye movement disorders resolve spontaneously whilst others will require surgery.
Visual impairment
Unfortunately there are some eye conditions that glasses and surgery cannot cure, and as such the patient has a permanent visual impairment. With patients such as this we provide ongoing care with the aim of preventing further loss of vision. In addition to regular reviews patients can attend a special clinic where the vision and visual function is tested. We will check to see if low vision aids such as magnifying glasses may benefit your child. A number of different professionals (consultant, orthoptist, optometrist and paediatrician) are present ensuring all necessary clinical tests are done on the one day. An advisor from the Metropolitan Society of the Blind is also present and can discuss any benefits or services your child may be entitled to. With parental permission we can arrange for teachers from the vision impairment team to attend your child’s school.
Eye conditions associated with Down’s syndrome
There is higher incidence of eye disorders amongst children with Down’s syndrome. These disorders include squint and refractive error. We have a specialised clinic to assess and manage ocular disorders for children with Down’s syndrome. We follow the guidelines created by the Down’s Syndrome Medical Interest Group.
Eye conditions resulting from genetic disorders
A recent study conducted in our clinic showed that 10 percent of our patients have eye conditions that are genetic in origin. These conditions can be rare, and as such require in-depth assessment.
Patients with ocular genetic disease are referred onto a clinic at Moorfields Eye Hospital where further highly specialised tests are performed by our own paediatric ophthalmologist. If required, and with parental permission, genetic testing and counselling can be arranged.
Peri-orbital cellulitis
Peri-orbital cellulitis is caused by a bacterial infection, which can occur at any age, however it occurs more frequently in children.
Peri-orbital cellulitis can be classified as pre-septal or orbital depending on the structures that are involved. Symptoms of peri-orbital cellulitis include swelling and redness of the eyelids, pain, fever, general discomfort of the eye, decreased eye movements and bulging of the eye.
The hospital is the only centre in central and east London able to treat children with peri-orbital cellulitis and uses a care pathway to provide excellent care for these children.
For details of how we treat peri-orbital cellulitis, please visit our services section on this website.
Retinopathy of prematurity (ROP)
This is a condition which can affect the retina in a baby’s eye, when born prematurely. It can result in impairment or potentially total loss of vision. We provide a dedicated screening service for most premature babies at The Royal London Hospital and provide treatment options. We are one of only a few units to audit our level of screening for retinopathy of prematurity and to take measures to improve it dramatically.
For details of how we treat retinopathy of prematurity, please visit our services section on this website.
Retinoblastoma
Retinoblastoma is a rare eye cancer that affects infants and young children. Barts and The London is a designated centre for the treatment and genetic screening of this condition. It is one of only two centres in the country and is the only centre in the south of England to provide this facility.
Click here to find out more about our retinoblastoma services (to be redirected to the main Barts and The London website).
Click here to be redirected the dedicated website for our retinoblastoma genetic screening unit.
