All Paediatricians are well qualified to take very good care of their patients in most cases. However, there are certain instances when a Paediatrician chooses to refer his / her patients to a Sub Specialty Expert. Below is a list of recommended guidelines for referral to the Paediatric Ophthalmology Subspecialty:
Referral Guidelines for Paediatricians to Pediatric Ophthalmology Subspecialty
| Assessment by Paediatrician | Refer for a possible Diagnosis of |
|---|---|
| * Absence of a social smile / eye contact by 3 months of age * Difference of 2 lines or greater between eyes on vision testing with pediatric eye chart in children older than 3-4 years |
Reduced Visual Acuity |
| * Ptosis / eyelid mass that persists > 3-4 weeks | May lead to Amblyopia |
| * Clinically enlarged lacrimal sac and bluish discoloration of the overlying skin in the first weeks of life * Tearing past 11-12 months |
Mucocele / Dacryostenosis |
| * Excess tearing + photophobia + corneal enlargement and clouding | Congenital Glaucoma |
| * White / Dull / Asymmetric Red Reflex | Retinoblastoma / Congenital Cataract |
| * DifAs per AAP Survey1, 56% pediatricians say it is very importaference in Pupil Size > 1mm * Dilated Pupil + Limited Eye Movement |
Horner’s / Neuroblastoma / 3rd Nerve Palsy |
| * Infants > 3 months of age with constant ocular deviation | Strabismic Amblyopia |
| * Premature Infants <2 kgs / <34 weeks | Retinopathy of Prematurity |
As per AAP Survey1, 56% pediatricians say it is very important to refer strabismus to a pediatric subspecialist
1 Periodic Survey #67 Of Fellows American Academy of Pediatrics Division of Health Services Research presented at the Pediatric Academic Societies annual meeting, May 2008
