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Why are opthalmology appointments important?

One of the main roles of the ophthalmology team is to check for inflammation of the eye (called uveitis). It is common in children with juvenile idiopathic arthritis (JIA) and may occur in other inflammatory diseases. If inflammation is left untreated it can cause loss of vision quite quickly in some cases. It is therefore necessary to check the eyes on a regular basis, because a child with arthritis and their parents will not know when inflammation of the eye is present as uveitis is often presents without any symptoms.

Urgent assessment should be sought if a child with arthritis develops:

  • red eyes
  • eye pain in response to bright light
  • abnormal pupils
  • clouding of the eye
  • difficulty seeing.

Younger children may develop unusual blinking, persistent eye rubbing, behaviour suggesting visual difficulty, or a new squint.

The opthalmology team

Dr Sri Sharma

Consultant Ophthalmologist

Our ophthalmology consultant is a specialist eye doctor who will assess a patient’s eyes and can make decisions about treatment changes. She can do some extra checks if needed and may arrange extra appointments at the Oxford Eye Hospital if needed.

Miss Sharma is in our paediatric clinic on alternate Fridays and our adolescent clinic one Tuesday a month.

James Bayley

Uveitis specialist nurse practitioner

The specialist nurse practitioner checks patient’s eyes at routine screening visits. If there has been a flare of uveitis or changes in treatment are needed, an additional appointment may be needed with our ophthalmology consultant.

What happens at an opthalmology appointment?

Eye checks are painless, but may appear daunting and sometimes younger children may simply not want to sit still. However, as time passes, this process generally becomes easier. Our play specialist can help with managing these checks.

The patient's general vision is checked and a special microscope (slit lamp) is used to look for inflammation. This requires the patient to place their chin on a supporting chin rest, while the light is shone towards the eye at different angles. The main overhead room light is often turned off to slightly darken the room, though the light from the vision chart is usually left on.

On the day the consultant visits the department, eye drops may be used to enlarge (dilate) the pupil to look at the back of the eyes. This can sometimes cause blurring of the vision for a while, but it should clear.

How long will ophthalmology appointments be needed?

The first ophthalmology appointment should happen within 6 weeks of a diagnosis of JIA.

Screening appointments are then generally every 3-4 months until your child is around 11 years of age. This may vary depending on age of diagnosis. They may be more frequent or continue longer than rheumatology follow up.

If your child has had uveitis, appointments may need to continue for longer and be more frequent.

What happens when your child is referred to the Oxford Eye Hospital?

The presence of inflammation in the eyes can sometimes give rise to complications that may lead to reduced vision. It may be necessary to see another specialist at the Oxford Eye Hospital to help with managing these.

Depending on the type of eye problem, your child may be referred to one of the following clinics:

Orthoptic clinic: a full orthoptic assesment will allow the orthoptist to recognise if your child has a squint (lazy eye/turn in the eye) and also to see whether the eyes are working together effectively as a pair.

Optometry: Refraction clinic. This clinic will carry out the glasses test. Your child will need drops to dilate the pupils. These drops take thirty minutes to work to fully dilate the pupils. Once the pupils are dilated the optometrist will be able to accurately carry out the test using various different types of equipment.

Optometry: Low vision. If your child has reduced vision and glasses and other treatments are not sufficient, then the paediatric low vision specialist will be able to help your child further by enhancing their vision with the use of specialist visual aids such as magnifiers.