Paediatric ophthalmology

This condition is treated in the Ophthalmology (Eye) clinic.

Pre-referral work-up

History

The following conditions are not routinely seen at the Royal Hobart Hospital Eye Clinic and may be appropriately managed by the general practitioner, local ophthalmologist or optometrist:

• Chalazion:without a trial of three months of conservative treatment (gentle heat and massage)
• Uncomplicated nasolacrimal duct obstructionwhere infant less than one year of age as most spontaneously resolve

All referrals should comply with the Standard Referral guidelines and include in particular:

• Visual acuity: Refer all children less than 10 years with reduction in vision of one or both eyes.
• Red reflex: any white pupil reflex in children, any asymmetric red reflex
• Congenital glaucoma: Infant with epiphora, photophobia, and blepharospasm
  • May have enlarged or cloudy cornea or corneas
  • May have a positive family history
• Strabismus: Exotropia or esotropia
  • Constant or intermittent
  • Alternating or not; can either eye take up fixation
  • Objection to cover of either eye
  • Eye movements
• Anisometropiawhere known (significant refractive difference between the eyes)
• Amblyopia:reduced visual acuity, objection to cover of one eye
• Ptosis: obscuring the line of sight or not
• Comorbidities: developmental, neurological and/or other problems
• Suspected vernal catarrh (a form of allergic conjunctivitis in a younger age group) with severe itch, stringy mucoid discharge and marked conjunctival thickening/cobblestone appearance
• Infantile nasolacrimal duct obstruction: Duration and age of onset
  • Associated episodes of conjunctivitis or dacrocystitis

Interim/GP management

To refer a patient with this condition, please see the Ophthalmology clinic page for the full referral process and templates.

Four year old vision check: All children should have an appropriate vision check at this age. They need to be referred to the Royal Hobart Hospital Eye Clinic if they have reduction in vision in one or both eyes.

Nasolacrimal dust obstruction: Observe infant with uncomplicated nasolacrimal duct obstruction where infant less than one year of age as most spontaneously resolve.

Chalazion: Trial of three months of conservative treatment (gentle heat and massage) prior to referral.

For more information please see the HealthPathways Tasmania website.

Clinic appointments

? Red location flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency

Emergency - ring on call Ophthalmic Registrar to discuss.

? Infant with epiphora, photophobia, and blepharospasm or suspicion of congenital glaucoma

? Enlarged or cloudy cornea or corneas

? Painful red eye

? Sudden loss of or reduction in vision

? Sudden onset ptosis or diplopia or ocular misalignment

? Suspected papilloedema or raised intracranial pressure

? White pupil reflex in children

If you, or someone else, are experiencing a serious and life-threatening injury or illness call triple zero (000) immediately or go to the nearest Emergency Department.

Learn more about when to access emergency care and non-emergency care options if the injury or illness is not serious or life-threatening.

Urgent (Category 1)

? Reduced vision in amblyogenic age group

? Children with amblyogenic conditions under the age of 10

? Ptosis in children under 10

? Suspected vernal catarrh (a form of allergic conjunctivitis in a younger age group) with severe itch, stringy mucoid discharge and marked conjunctival thickening/cobblestone appearance

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will endeavour to see these patients within ten days, or sooner if clinically indicated.

Availability

North

THS Northern Region does not offer a public eye clinic. See Health Pathways for more information

North West

Unavailable.

South

Wellington Clinics (Level 11)
Phone: 03 6166 0000
Fax: 03 6234 9454