Ophthalmology

1. Wearing of Personal Protective Equipment (PPE)

All our staff will now be wearing PPE for every patient encounter. This is obviously a new look for us and we are aware that it is not a very child-friendly look but this way we can keep everyone safe! Some equipment can be kept on for the whole session (eg masks) but most will be changed in between patients.

2. Cleaning of equipment and rooms

There will be more stringent cleaning in between patients after they enter a room. This includes a wipe down of all equipment, surfaces, door handles, and switches.

3. Waiting areas   

Please practice social distancing whilst in the hospital. There are now modified waiting areas to encourage physical distancing. There are also newly formed sub-wait rooms that are situated in the clinic corridor rather than the main waiting areas. It is also possible that you may be asked to stay inside a clinic room for a short duration of time instead of being sat back in the waiting room in between seeing different clinicians.

4. Telephone Clinics,  Video Clinics, and Virtual Clinics

We are currently reorganising our services to accommodate the above clinics. These clinics will replace a conventional face-to-face appointment. However, they will only take place if we deem that a patient is suitable for it. If you have been placed into a Telephone or Video clinic, a standard appointment letter will be sent to you and you will be expected to make yourself available during that allocated date and time. If your child has been put into a Virtual clinic, a review of your clinical notes will take place and the decision will be communicated to you via phone or letter.

5. Discharge by phone or letter 

If your child is a long term or stable patient who is ready for transition or for discharge from clinic, we may contact you via one of the two ways above to confirm this decision. We appreciate that a few families will prefer a telephone call to discuss some specific points. If you receive a letter informing you about a discharge from the service but you wish to discuss this with the clinical team, feel free to get in touch with us.

Please bear with us as these new adjustments may result in delays to the usual standard of care.

During the current period of social distancing we are aware that you will be concerned that your child’s treatment will be affected.

We would like to reassure you that the Ophthalmology Team are reviewing all our patient records to ensure that your child’s treatment will not be adversely compromised.

As per The Royal College of Ophthalmologists guidelines, we will continue to offer appointments (face to face) to any child who is at risk of immediate sight loss.

We will always ensure that the risk of a child attending our clinics is balanced against the risk of sight loss.

Over the remainder of 2020, our services will be reshuffled to accommodate more patients but yet to continue seeing them in a safe and reliable way. This may involve more virtual appointments such as telephone and video appointments. In clinic, there may be modifications such as spaced out seating in waiting rooms, longer waits in between clinicians due to the wearing of personal protective equipment (PPE), and the use of different examination techniques.

During this period of lockdown, our eye clinics are still open for emergency and urgent cases. This includes all referrals from general practitioners, accident and emergency physicians, and community optometrists.

If your child has new eye signs or symptoms that worry you, then please seek help as you would normally.

For the majority of patients undertaking occlusion therapy (patch over one eye) we are happy for parents/carers to continue to patch their child without the need to attend clinic during this isolation period.

We would recommend patching your child 1-2 hours per day as maintenance therapy.

From evidence based practice, we know that we can quickly address any changes in vision by altering patching regimes once normal clinics resume.

If your child was undertaking Atropine Occlusion (drops to blur vision in good eye) you may have received a letter requesting that you stop atropine during this period. You may have already been sent patches to try whilst awaiting your next appointment.

If you require patches or would like to discuss your child’s patching regime in more detail then please contact our Ophthalmology Department and one of the Orthoptist’s will contact you in due course.

Orthoptic Department telephone number: 0151-252-5215

If your child requires a repair or replacement spectacles this can be done from the opticians that the spectacles were originally acquired.  Optical practices are allowed to open for essential eye care or emergency assessment. Due to social distancing it is recommended to contact the practice before attending the practice.

If it is more than 12 months since your child last received their spectacle prescription it is likely that Alder Hey will need to send further information to your optician. Your optical practice will advise if this is required. Please contact us on one of the numbers below.

If you are already a patient and you need to contact us, please call one of the below numbers:

0151 293 3595
0151 252 5961
0151 252 5839 
0151 252 5828

If you have an appointment you need to rearrange or cancel, please contact our Appointment Centre.

On your child’s first visit to Ophthalmology, it is likely that they will be seen by a variety of professionals in the department and you may be here for several hours. Once you have booked in at reception, your child may have their eyesight tested by a nurse or healthcare assistant or they may need to see an Orthoptist.

Orthoptists are concerned with the diagnosis and treatment of ocular motility disorders and problems relating to children’s visual development. The orthoptist will assess what your child can see, the position of the eyes, the ocular motility and the state of binocular function (use of the two eyes together).Any findings will be explained to you.

Your child is likely to need eye drops. These dilate the pupils so that the Optometrist or doctors can view the back of the eye and assess if there is a need for glasses accurately. The drops do sting a little at first but this wears off very quickly. Your child will have blurred vision for close vision and may be sensitive to bright light. These are normal side effects and wear off usually after a few hours but may last up to 24 hours. You will then be directed back to the waiting room to allow time for the drops to take effect, which may take at least 30 minutes.

Your child may not need to attend all departments within Ophthalmology each time you visit, and may not need drops every time.

Community Orthoptic clinics 

We currently offer new and follow up Orthoptic clinics for patients at:

South Liverpool NHS treatment centre, 32 Church Road, Garston, Liverpool L19 2LW. 0151 295 9000.

May Logan Centre – 294 Knowsley Road, Bootle, L20 5DQ - call 0151 922 8588
These clinics typically accept new patient referrals from school nurses or health visitors and also accommodate follow up appointments generated from this.
 
Useful links 
 

Vision 2020

Action for Blind People

Nystagmus Network

Squint Clinic

RNIB

In the summer of 2019, our department sat down and compiled a list of values that we felt were important to us and our patients. These 5 values were unanimously voted as the most important ones.

1. Always ensure our patient experience is a positive one.

2. Ensure clinics start and run on time to the best of our abilities.

3. Work as a team.

4. Inform patient’s family: What will happen during appointment, diagnosis, and future management. Communication is Key!

5. Treat patients, families and colleagues the way I would like my family and I to be treated.

Medical

1. Fellowship program

Alder Hey runs a successful fellowship program. Each fellowship lasts for approximately 12 months. There is currently one fellowship post although there might be capacity to increase this to two posts in 2021. The fellow rotates through all subspecialist clinics as well as paediatric eye emergency clinics. He/she will have ample opportunities to work with all consultants. There is good exposure to surgery in paediatric ophthalmology, the majority of which will be in strabismus training. During this fellowship, there will be exposure to rare pathologies, advanced paediatric conditions, interesting diagnostic conundrums, and also general paediatric ophthalmology. There are numerous opportunities to do research, teaching and audit. There is a weekly departmental teaching, a fortnightly surgical MDT, and a monthly journal club – all of which requires active participation from the fellow. Our current fellow is: Dr.Persefoni Kourti, National and Kapodistriako University of Athens.
 

2. Deanery training

We have two registrars (junior doctors) who work in our department for a period of 6 months as part of their Mersey Ophthalmology training. These registrars are also part of the regionwide on-call rota for ophthalmology. We offer a robust timetable which includes plenty of time for research and professional developmental activities. There are ample training opportunities available and we are concordant with the training syllabus from the Royal College of Ophthalmologists. We also take pride in being able to support our registrars when they are taking their college exams, either through extra teaching, simulated exam scenarios during clinics, or the granting of study leave.
 

3. Medical student

Currently, we host Year 4 medical students from the University of Liverpool for adhoc clinics or as part of their undergraduate rotation in Alder Hey (email UG-education@alderhey.nhs.uk). Medical students will have a chance to get exposure to ophthalmology as a specialty and obtain a closer look at the interesting world of paediatric ophthalmology. We also have the ability to house medical students for their student selected component.
 
There are potential opportunities for interested medical students who wish to complete a MRes (intercalated degrees) in a paediatric ophthalmology project in conjunction with the University of Liverpool. We would encourage you to get in touch to discuss this @ ophthalmology@alderhey.nhs.uk
 

4. International Observers

We are a friendly department that has hosted many international observers over the last few years. Alder Hey has had an international partnership with the Beijing Huatong Guokang Foundation since 2018. Throughout this partnership, we have so far facilitated observerships for 7 ophthalmologists from China for a period of 3 months each.

For enquires about any of the training and education programmes above: email ophthalmology@alderhey.nhs.uk

Optometry

1. Prereg programme

Alder Hey offers a week long observation week for graduate optometrists on the scheme for registration. This is a unique opportunity to gain valuable paediatric experience in Orthoptics, optometry and ophthalmology skills. The programme is designed to achieve as many competencies that are required within the colleges’ scheme for registration. If you are a pre-registration optometrist and would like to apply for an observation week please contact ophthalmology@alderhey.nhs.uk

Orthoptics 

1. Undergraduate orthoptics

Alder Hey is an affiliated clinical teaching centre for undergraduate Orthoptic students. We accept students from the university of Liverpool and Sheffield. We support students of all levels of experience from first years to third years. We also support the clinical training of undergraduate optometrists, junior doctors and nurses.