Paediatric orthoptic service

Welcome to the paediatric orthoptic service. We hope your child’s visit will be as pleasant as possible.

What do you need to know about the department?

Where is the orthoptic department?

The orthoptic department is on the first floor (Level 3), in outpatients. The orthoptic clinic is situated in the eye clinic, clinic 3.

The department diagnoses and treats conditions such as squint, double vision, reduced or delayed development of vision and lazy eyes.

If a child has a squint, double vision or specific types of reduced vision or abnormal eye co-ordination, this will be assessed by the orthoptist. The aim of orthoptic tests is to:

• Assess vision.
• Establish if a squint is present.
• Diagnose the type of squint.
• Test the ability to use the eyes together (binocular vision).
• Carry out and monitor treatment for lazy eye and squint.

What is the difference between an appointment with an orthoptist, an ophthalmologist (eye doctor) or an optometrist?

An orthoptist is a health care professional who specialises in assessing and treating visual conditions in adults and children.

It is likely that when you visit the eye clinic, your child’s vision will be assessed by an orthoptist prior to the doctor’s consultation. He/she may also test the alignment of your child’s eyes to find out if they have binocular vision (when both eyes work together) or to confirm the presence of a squint (turn, glide, or lazy eye.) This gives an insight into the long-term visual capabilities of your child.

As babies and pre-school children are not able to simply read down the letter chart as adults do, the orthoptist is trained in a variety of ways to assess how children see. The tests are usually played as games and are completely non-invasive; the orthoptist will try to make the hospital visit as much fun and as non-threatening as possible.

If one or both of your child’s eyes are impaired, the orthoptist will be the primary person to provide support for wearing glasses. If needed, they may recommend patching therapy which is aimed at covering the good eye in order to allow the vision in the weaker or lazy eye to improve. You will probably visit the orthoptist regularly to monitor your child’s sight and to demonstrate improvement following glasses and/or patching. We always try to have stickers on hand to give as rewards!

A paediatric ophthalmologist (or eye surgeon) is a qualified doctor who specialises in children’s eye problems and surgery. In addition, there are several other doctors who make up the medical team. The ophthalmologist will usually see your child once the initial assessment has been made by the orthoptist. He/she will test to see if your child is long or short sighted and will examine your child’s eyes.

The doctor will discuss your child’s eye problems with you and will explain the treatments available for your child’s eye condition. If glasses are required, the doctor will give you a prescription and an NHS voucher to take to either the Addenbrooke’s dispensing optician (who is available on Monday and Wednesday mornings and all day on Thursday) or your high street optician, for the glasses to be made. The doctor will arrange for your child to have regular follow-up appointments with the orthoptists to check their visual progress with the glasses.

An optometrist is an optician who is qualified to prescribe glasses. If your child wears glasses, regular glasses checks (refraction test) will be needed until your child is old enough to visit a high street optometrist. For young children, the refraction test usually requires eye drops to be instilled approximately 20-30 minutes prior to the test. These dilate the pupils so that an accurate measurement can be made. The hospital optometrist will check the glasses are the correct strength after the orthoptists have assessed your child’s vision.

A paediatric nurse is available to support and facilitate any treatment required for your child.

Some young children require specialised contact lenses and there are visiting contact lens specialists who have clinics on Mondays and Thursdays.

An eye clinic liaison officer is available if you have any concerns about visual impairment, educational support or need advice.

Failed attendance policy

Please contact us in advance if you are unable to attend your appointment. Currently over 12% of our available appointments are missed. Each missed appointment costs the hospital over £100. We are striving to reduce the number of missed appointments and to improve our appointments system accessibility and methods of contacting us. Please help us! If a child misses an appointment, one further appointment is offered. If two appointments (either on separate days or combined appointments with the orthoptist and the eye doctor or optometrist on the same day) are missed, the child will be discharged from the clinic and the parent/ carer and the referring GP will be notified by post. Further appointments will require a re-referral to the hospital from the GP.

When is the orthoptic clinic open?

The orthoptic clinic is open Monday to Friday 08:00-17:00.

Must I go to Addenbrooke’s if another clinic is closer?

Orthoptic appointments are also available at:

• Saffron Walden Hospital
• Anglia Ruskin University Eye Clinic

Please inform a member of staff if you would prefer your child to be reviewed at either of the above hospitals.

What do I do if my child’s glasses are broken?

First of all contact your child’s opticians who dispensed the glasses. They may be able to repair or replace the glasses using the form G.O.S. 4. If your child’s glasses have been dispensed by the hospital dispensing optician (RYCO Optics), please contact them direct on the telephone number they have given you.

Otherwise, contact us for advice on 01223 216528. Please have your child’s details available, including their Addenbrooke’s Hospital number, name, address and date of birth.

Facilities available in the clinic and hospital

There is a canteen and shop in the outpatient reception area. Once you have notified the eye clinic receptionist of your arrival, if you wish to go there please inform a member of staff. No hot drinks are allowed in the clinic but there is a cold water dispenser. Children should be supervised if using this facility. A quiet room may be available if you need to feed your baby – please ask a member of staff if you require this. Baby changing facilities are available between the eye clinic and clinic 7.

The clinic may seem very busy and crowded at times, as there may be several different clinics in progress on the same day.

There is a children’s waiting area with a separate toy room and a television with a selection of DVDs for the children to watch whilst waiting for their appointment. You may also wish to bring books or toys to entertain your child.

We do our best to keep to appointment times, but you need to allow up to two hours if your child has a double appointment with the orthoptist and doctor or optometrist as eye drops may need to be instilled. It is advisable to make alternative arrangements on appointment days for other children who have to be collected from school.

Some website addresses you may find helpful:

• Louise Allen (opens in a new tab)
• British and Irish Orthoptic Society (opens in a new tab)
• RYCO Optics (opens in a new tab)

Useful telephone numbers/email addresses

• Orthoptic department – telephone: 01223 216528 (with 24 hour answer machine for messages), email the orthoptics department
• Paediatric ophthalmology nurses – telephone:01223 596414, email the paediatric opthalmology nurses
• Medical secretary – telephone: 01223 216700
• Eye clinic liaison officer – telephone: 01223 216577
• Dispensing optician – telephone: 07809 721879