Paediatric Ophthalmologist in Sydney

What is paediatric ophthalmology?

Children do not always realise that their vision is blurred, or they may not be able to explain what they are seeing. Some childhood eye conditions can therefore be difficult for families to recognise without an eye assessment.

Paediatric ophthalmologists are specialist eye doctors who assess eye health and visual development in children. They work closely with orthoptists and other eye-care professionals to diagnose the cause of a vision or eye-movement problem and recommend appropriate treatment or monitoring.

What does a paediatric ophthalmologist treat?

Paediatric ophthalmology may include assessment and management of conditions such as:

• Strabismus (squint or turned eye)
• Amblyopia (lazy eye)
• Myopia (short-sightedness), hyperopia (far-sightedness) and astigmatism
• Progressive childhood myopia
• Congenital and childhood cataract
• Paediatric glaucoma
• Eye-movement and binocular-vision disorders
• Inherited or congenital retinal and eye conditions
• Selected eyelid, tear-duct or developmental eye problems, depending on the specialist and clinic

Squint and lazy eye are not the same thing

A squint, also called strabismus, occurs when the eyes are not aligned in the same direction. One eye may turn inwards, outwards, upwards or downwards.

Amblyopia, often called lazy eye, is reduced visual development in one eye and sometimes both eyes. It can develop when one eye receives a consistently poorer visual image during early childhood. Strabismus, unequal glasses prescriptions and childhood cataract are among the possible causes.

Because vision continues to develop during childhood, early identification and treatment can be important.

Signs your child may need an eye assessment

Consider arranging an eye assessment if you notice your child:

• has an eye that turns in, out, up or down
• closes or covers one eye
• regularly tilts or turns their head to see
• squints to see distant objects
• holds books, toys or screens unusually close
• sits very close to the television
• has difficulty seeing the board at school
• frequently bumps into objects or appears to have poor depth perception
• has persistent watering, discharge or unusual light sensitivity
• has an unusual appearance of the pupil or eye in photographs

URGENT: Seek prompt medical assessment if you notice a white or unusual pupil, sudden loss of vision, severe eye pain, a significant eye injury, or another sudden and concerning change in your child's eye or vision.

Childhood myopia

Myopia, or short-sightedness, commonly begins during childhood. Children with myopia may have difficulty seeing the classroom board, squint at distant objects or sit close to screens.

A standard glasses prescription can correct blurred distance vision. If myopia is progressing, additional myopia-control strategies may be considered to slow progression. The most appropriate approach depends on the child's age, prescription, rate of progression, eye measurements and individual circumstances.

Management may involve collaboration between an ophthalmologist, optometrist and orthoptist. Options can include specialised optical correction and prescription eye drops in selected children.

What happens at a paediatric eye appointment?

1. History and age-appropriate vision testing

An orthoptist or another member of the eye-care team may ask about your child's vision, development, medical history and family eye history. Testing is adapted to the child's age and may use letters, pictures, matching tasks or other methods.

2. Eye alignment and movement assessment

The orthoptist may assess how the eyes line up and work together, including eye movements, binocular vision and signs of strabismus or amblyopia.

3. Dilating eye drops

Many new paediatric patients require eye drops to dilate the pupils. The drops help the ophthalmologist measure the child's focusing prescription accurately and examine the inside of the eye.

The drops need time to work. While you wait, your child can usually relax in the waiting area or take a short break if clinic staff advise that this is appropriate.

4. Ophthalmologist examination

Once the pupils are dilated, the ophthalmologist examines the eyes, reviews the test results and discusses the diagnosis, whether treatment is needed and the recommended follow-up.

How long does the appointment take?

Paediatric eye appointments are often longer than a standard eye test because children may need orthoptic testing, dilating drops and an ophthalmologist examination. Allow around 1-2 hours, and sometimes longer if additional testing is required or the drops take longer to work.

What to bring to your child's appointment

• A current referral from your GP or optometrist, if you have one
• Your child's Medicare card and any relevant concession, DVA or private-health information
• Current glasses or contact lenses
• A list of medicines and eye drops
• Previous eye reports or test results, if available
• Photographs that show an intermittent eye turn, unusual pupil or other concern that may not always be visible in clinic
• Sunglasses or a wide-brimmed hat for after pupil dilation
• A snack, drink and a favourite quiet activity for younger children

What to expect after dilating eye drops

Dilating drops can make the pupils appear larger and may temporarily blur near vision or increase sensitivity to bright light. The effects usually last for several hours and can sometimes last longer depending on the drops used and the child.

Your child may find reading, homework or close-up tasks more difficult until the effects wear off. Sunglasses or a hat may make outdoor light more comfortable.

How are children's eye conditions treated?

Treatment depends on the diagnosis and may include:

• Observation and regular eye examinations
• Prescription glasses
• Eye patching or eye-drop treatment for selected cases of amblyopia
• Myopia-management strategies for progressive childhood myopia
• Treatment of underlying eye disease
• Eye-muscle surgery for selected cases of strabismus
• Cataract, glaucoma or other eye surgery when clinically required

Not every child needs treatment. In some cases, careful monitoring is the most appropriate approach.

Do I need a referral?

A valid referral is generally required to claim the Medicare rebate for a specialist ophthalmology consultation. GPs and optometrists can refer children to an ophthalmologist. If you are unsure whether your child needs a referral or whether an existing referral is still valid, contact the clinic before the appointment.

Child-friendly eye care

Children's eye examinations often require a different approach from adult examinations. Age-appropriate testing, time to become comfortable with the clinic environment and clear explanations can help make the visit easier for both children and parents.

Paediatric ophthalmology services are available at selected personalEYES locations. Contact our team to confirm the most appropriate clinic and specialist for your child's needs.

Book a paediatric eye appointment

If you are concerned about your child's vision, eye alignment or eye health, speak with your GP, optometrist or the personalEYES team about the appropriate next step.

Call personalEYES on 1300 68 3937 or book an appointment online.