What Happens at a Paediatric Ophthalmology Appointment?

Being told your child needs to see an eye specialist can feel worrying especially if you’re unsure what will happen during the appointment.

Whether your GP, school nurse, or optician has made the referral, knowing what to expect can make the experience calmer for both you and your child.

A visit to a paediatric ophthalmologist in London is designed to be friendly, gentle, and reassuring. The goal is simple: to understand how well your child can see, check for any eye alignment or health issues, and make sure their vision develops properly.

In this guide, we’ll walk you through the full process from the first waiting-room moment to the final discussion with the doctor so you can arrive informed, relaxed, and ready.

What Is a Paediatric Ophthalmologist?

A paediatric ophthalmologist is a medical doctor who specialises in diagnosing and treating eye problems in babies, children, and teenagers.

Unlike general opticians, they are trained not only to assess vision but also to handle medical or surgical conditions affecting children’s eyes, such as:

• Lazy eye (amblyopia)
• Squint (strabismus)
• Refractive errors (short-sightedness, long-sightedness, astigmatism)
• Congenital cataracts
• Eye infections or injuries
• Genetic or developmental eye diseases

Children’s eyes are still developing, which means early detection and treatment are crucial. A paediatric ophthalmologist knows how to make young patients comfortable while performing detailed tests that guide proper treatment.

Why Your Child Might Be Referred

There are many reasons a GP, optician, or teacher might recommend an eye specialist visit.

Common signs include:

• Squinting, rubbing eyes, or sitting too close to screens.
• One eye turning inwards or outwards.
• Complaints of blurred vision or headaches.
• Difficulty seeing the board at school.
• Excessive tearing or light sensitivity.
• Concerns raised during routine vision screening.

Sometimes, the referral is purely precautionary especially if there’s a family history of eye problems. Even when your child seems to see well, a detailed eye exam can catch issues before they affect learning or long-term sight.

Preparing Your Child for the Appointment

For many children, an eye appointment is a new experience and like any unfamiliar situation, it can cause some anxiety.

Here are a few ways to prepare them:

• Explain simply: Tell your child that the doctor will “look at how well your eyes work” and that there won’t be any painful tests.
• Bring comfort items: A favourite toy, book, or snack helps keep them relaxed in the waiting area.
• Schedule wisely: Choose a time when your child is usually alert and not tired mornings often work best.
• Bring previous records: If they’ve had a school vision test or optician visit, bring the results for comparison.

Knowing what to expect helps make the visit smooth for both parent and child.

What Happens When You Arrive

You’ll be greeted by the clinic staff and asked to fill out a short questionnaire about your child’s health, family history, and any concerns you’ve noticed.

The paediatric ophthalmology team usually includes:

• An orthoptist, who checks eye movements and visual coordination.
• An optometrist, who measures vision and prescribes lenses if needed.
• The ophthalmologist, who examines the eyes’ internal health and oversees diagnosis and treatment.

Depending on your child’s age, cooperation level, and symptoms, the full appointment can take 45 minutes to 2 hours.

Step 1: History and Observation

The appointment often begins with a gentle chat. The doctor or orthoptist will ask about:

• Pregnancy and birth history (as some premature babies have higher risk of eye issues).
• Developmental milestones.
• Any known health conditions or medications.
• Family eye history (such as strabismus or amblyopia).

They may also watch your child’s eyes while they talk or play subtle movements, blinking patterns, or alignment clues help guide the next steps.

Step 2: Vision Testing

Depending on your child’s age, different tools are used to measure visual acuity:

• Babies (under 1 year):
  Visual attention tests using lights, toys, or tracking objects.
• Toddlers (1–3 years):
  Picture charts with familiar symbols (like a house or apple).
• Preschoolers (3–5 years):
  Matching games or letter-based charts (e.g. Lea or Kay Pictures).
• Older children:
  Standard letter or number charts, just like in adult eye exams.

The specialist checks each eye separately sometimes covering one to ensure both are working equally.

Step 3: Eye Alignment and Movement Tests

Next, the orthoptist assesses how your child’s eyes move and work together.

These tests help identify issues like:

• Strabismus (squint): when one eye turns in or out.
• Convergence insufficiency: difficulty focusing on close objects.
• Amblyopia (lazy eye): when one eye doesn’t develop normal vision.

The orthoptist may use:

• A torchlight to watch how pupils react.
• Prisms or cover tests to measure alignment.
• 3D perception games to check binocular vision.

These assessments are painless and often feel like play to young children.

Step 4: Refraction Test (Checking for Glasses Needs)

If vision seems blurry or uneven between the eyes, a refraction test is performed.

For older children, this involves reading letters through lenses to find which combination makes things clearest.

For younger children, the specialist uses a retinoscope a light-based tool that estimates how the eye focuses without requiring verbal feedback.

Often, dilating drops are used before this test. The drops temporarily relax the focusing muscles so the doctor can measure the eye’s natural refractive power accurately.

Step 5: Pupil Dilation and Eye Health Examination

After applying the drops, your child’s pupils will slowly widen. This can cause slight stinging for a few seconds, followed by temporary blurred vision and light sensitivity.

Once the pupils are dilated, the ophthalmologist uses a slit lamp microscope or an ophthalmoscope to examine:

• The cornea and lens.
• The retina and optic nerve.
• Blood vessels and macular region.

This helps detect structural or medical conditions such as congenital cataracts, inflammation, or retinal abnormalities.

Step 6: Discussion of Findings

After the examination, the ophthalmologist will sit down with you to explain the results in plain language.

You’ll learn:

• Whether your child’s vision is within the normal range.
• If glasses or patching are needed.
• Whether further tests or treatment are recommended.
• How often follow-up visits should take place.

If a condition such as lazy eye or squint is found early, the doctor will outline a personalised treatment plan often involving glasses, patching, or vision therapy before considering surgery.

What Treatments Might Be Recommended

Depending on your child’s diagnosis, the following treatments may be suggested:

1. Glasses (Spectacles)

Correct refractive errors such as short-sightedness, long-sightedness, or astigmatism.

2. Patching Therapy

Used to treat amblyopia by covering the stronger eye to strengthen the weaker one.

3. Eye Exercises (Orthoptic Therapy)

Improve coordination, focus, and muscle balance.

4. Eye Drops

Used to blur the stronger eye (as an alternative to patching) or manage inflammation or allergies.

5. Surgery

In cases of persistent strabismus or congenital cataract, surgery may be considered usually performed by the same ophthalmology team.

Treatment plans are always tailored to your child’s age, comfort, and specific needs.

How to Support Your Child After the Visit

Following the appointment, you may need to help your child adjust to new glasses, eye patches, or eye drops. Here’s how to make the process easier:

• Make it fun: Let your child choose their glasses frames or decorate their eye patch.
• Use encouragement, not pressure: Positive reinforcement builds confidence.
• Stick to routines: Follow the patching or drops schedule closely for best results.
• Attend follow-ups: Regular visits ensure progress and make adjustments if needed.

Remember, most childhood eye issues are treatable especially when caught early.

The Importance of Early Detection

Vision develops rapidly in the first few years of life. If one eye isn’t seeing properly and the brain “ignores” it, permanent vision loss (amblyopia) can occur even if the eye itself is healthy.

That’s why early detection and consistent follow-up are critical. Many problems caught before age 8 can be corrected or significantly improved with proper care.

Even after treatment, your paediatric ophthalmologist will continue to monitor your child’s vision to ensure it remains stable as they grow.

Paediatric Ophthalmology at Eye Clinic London

At Eye Clinic London, we understand that children’s eye care requires patience, empathy, and expertise. Our clinic is designed to be child-friendly and welcoming, with age-appropriate tools, gentle testing methods, and specialist care from start to finish.

Our paediatric ophthalmologists in London work closely with orthoptists and optometrists to provide comprehensive care for conditions like:

• Squint and amblyopia.
• Refractive errors.
• Congenital or developmental eye disorders.
• Inflammatory or allergic eye diseases.

We also collaborate with schools and paediatricians to ensure continuity of care, helping children maintain healthy, comfortable vision for life.

Tips for Parents Between Appointments

• Encourage outdoor play studies show it helps reduce the risk of myopia (short-sightedness).
• Limit continuous screen time use the “20-20-20” rule (look 20 feet away every 20 minutes for 20 seconds).
• Keep glasses clean and properly fitted.
• Watch for new symptoms like squinting, eye rubbing, or blinking.
• Maintain regular annual eye checks even if everything seems fine.

These small steps help maintain your child’s visual comfort and development.

The Role of Technology in Modern Paediatric Eye Care

Modern clinics now use advanced tools such as:

• Digital retinal imaging for non-invasive eye health checks.
• Handheld autorefractors for quick refraction in younger children.
• 3D imaging to monitor optic nerve and retinal changes.

These technologies make the experience faster, more accurate, and more comfortable for children who may struggle to stay still.

In addition, telemedicine follow-ups and digital progress tracking now allow parents to stay connected with their care team between appointments.

When to Seek Urgent Help

While most paediatric eye issues are routine, there are times you should seek medical attention quickly:

• Sudden vision loss or eye pain.
• Persistent redness, swelling, or discharge.
• A visible white reflex in the pupil.
• Eye injury or foreign body.
• Double vision or new squint.

Early medical assessment can prevent complications and preserve vision.

Frequently Asked Questions:

1. How long does a paediatric ophthalmology appointment usually take?
   Your child’s first appointment can take anywhere from 45 minutes to two hours, depending on their age, cooperation, and the number of tests needed. Because some tests involve dilating eye drops that take time to work, it’s a good idea to plan for a longer visit. The team will always move at your child’s pace to keep the experience relaxed and positive.
2. Will my child need eye drops during the appointment?
   In most cases, yes. The doctor may use dilating drops to widen your child’s pupils so they can get a clear view of the back of the eyes and measure how well the eyes focus. The drops might sting slightly and cause blurry vision or light sensitivity for a few hours, but the effects are temporary and completely safe.
3. How should I prepare my child for their first visit?
   Start by explaining that the doctor will “look at how your eyes work” and that nothing will hurt. Bring along their favourite toy or book to help them feel comfortable, and schedule the appointment at a time when they’re usually alert and happy. If you have any previous test results or medical records, take those with you so the doctor has a full picture.
4. What if my child can’t read letters yet?
   Don’t worry paediatric eye specialists use age-appropriate methods. For babies, doctors might track how they follow a light or toy. Toddlers often use picture charts with simple shapes or familiar images. Even preschoolers can take part through matching games. The goal is always to make testing fun and easy to understand.
5. Can my child still see an ophthalmologist if they already wear glasses?
   Absolutely. In fact, regular reviews are important even for children who already wear glasses. The doctor checks whether the current prescription still suits your child’s eyes, whether both eyes are working together, and whether there are any new concerns that might affect vision or comfort. Kids’ eyes change quickly as they grow, so keeping up with appointments ensures their prescription stays accurate.
6. What happens if my child needs glasses or patching therapy?
   If glasses are needed, the doctor will explain your child’s prescription and help you understand how full-time or part-time wear will support their vision. If patching therapy is recommended to treat a lazy eye, you’ll receive clear guidance on how many hours per day the patch should be worn and for how long. Many parents find that turning patch time into a fun routine like decorating the patch or using a reward chart helps their child adjust easily.
7. Are children’s eye surgeries safe?
   Yes. When surgery is recommended, it’s usually because other treatments haven’t fully corrected the problem. Paediatric eye surgeries, such as for squint correction or congenital cataracts, are performed by highly trained specialists using child-specific techniques and anaesthesia. Your doctor will explain everything beforehand, including how to prepare, what to expect on the day, and what recovery will look like.
8. How often should my child have follow-up appointments?
   Follow-up frequency depends on the diagnosis. Some children only need yearly check-ups, while others especially those with conditions like amblyopia or strabismus may need visits every few months to track progress. Your ophthalmologist will create a personalised schedule to make sure your child’s vision continues to develop properly.
9. Can screen time affect my child’s vision?
   Prolonged screen use can lead to eye strain, fatigue, and sometimes blurred vision, especially in school-aged children. It doesn’t cause permanent damage, but it can make existing focusing issues worse. Encourage regular breaks using the 20-20-20 rule: every 20 minutes, look at something 20 feet away for at least 20 seconds. Outdoor play is also proven to help reduce the risk of short-sightedness.
10. What signs mean I should book another appointment sooner?
    If you notice your child squinting, rubbing their eyes frequently, closing one eye to focus, or complaining of headaches or blurred vision, it’s best to arrange a review. You should also book a prompt visit if there’s any redness, discharge, or a visible change in the way their eyes move or align. Early action can prevent small issues from becoming bigger problems.

Final Thoughts: Caring for Your Child’s Eyes Early Makes All the Difference

Your child’s eyes play a vital role in how they explore and make sense of the world from recognising faces and learning in school to building confidence and independence. The earlier you spot and treat any eye issues, the better the chances of achieving clear, lasting vision. Even small signs, like squinting at the TV, rubbing their eyes, or sitting too close to screens, can sometimes point to something that needs attention.

By booking regular eye check-ups and paying attention to any changes in your child’s visual habits, you’re taking an important step towards protecting their sight for life. Thanks to modern techniques and child-friendly approaches, most eye conditions can be diagnosed and treated quickly and safely.

If you’re looking for paediatric ophthalmologist in London, our friendly specialists at Eye Clinic London are here to guide you through every stage from diagnosis and treatment to long-term care ensuring your child’s vision gets the support it deserves.

References:

1. Hashemi, H., Pakzad, R.M., Yekta, A.P., Bostamzad, P.M., Aghamirsalim, M.M. & Sardari, S.M. (2018) Global and regional estimates of prevalence of amblyopia: a systematic review and meta-analysis, Strabismus, 26(4), pp. 168-183. Available at: https://pubmed.ncbi.nlm.nih.gov/30563466/
2. Ryu, W.Y., Choi, D.G. & Kim, S.J. (2021) Clinical characteristics and treatment outcomes of pediatric strabismus: A 10-year retrospective review, Korean Journal of Ophthalmology, 35(3), pp. 217-225. Available at: https://pubmed.ncbi.nlm.nih.gov/33956973/
3. American Academy of Ophthalmology Pediatric Ophthalmology/Strabismus Panel (2022) Pediatric Ophthalmology/Strabismus Preferred Practice Pattern®, Ophthalmology, 129(1), pp. P1–P122. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC10655158/
4. Marsh-Tootle, W.L. & Corliss, D.A. (2020) Vision screening for children 36 to <72 months: recommended practices, Public Health Reports, 135(1_suppl), pp. 54S–65S. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC7041892/
5. Iwata, Y., Shimoyama, K. & Ota, A. (2024) Developing a novel pediatric eye chart assessing visual acuity by minimum separation thresholds, Children, 11(4), 397. Available at: https://www.mdpi.com/2227-9067/11/4/397