Paediatric Specialty  Mr. Innes

 The paediatric clinic takes place weekly.  There are approximately forty patients seen per clinic by Consultant, experienced Clinical Assistant and Specialist Registrar.  Usually there are ten or twelve new patients and the rest are return patients.  In addition pre-operative strabismus cases attend.  Trainees are encouraged to assess the case notes at the start of the clinic and select new or return cases to see personally.  Free access to the Consultant is maintained.  A video slit lamp and video indirect ophthalmoscope facilitate some discussions.  An Orthoptic clinic runs concurrently and free access between clinics is maintained. Management and examination techniques are taught.

This service is supported by Optician run clinics at other times for treatment of simple refractive errors in children, so that the paediatric clinic does not become over-run by refraction cases.  Trainees are encouraged to attend the optician clinic if refraction skills have to be honed.

 Mandatory objectives

§        To be familiar with the management of the child who is thought not to see

§        To perform clinical assessment and discuss the case with Consultant

§        Examine child in theatre if appropriate

§        Request and interpret special tests eg Neurophysiology, Radiology

§        Seek appropriate help with management eg from Paediatrician

 §        To be familiar with the management of the child with strabismus

§        To perform clinical assessment and discuss the case with Consultant and Orthoptist

§        To gain experience of refraction in children and to order appropriate spectacle correction

§        Liaise with Orthoptist with regard to occlusion therapy

§        Perform supervised surgery on child (or adult) strabismus

§        Identify in clinic children with less common types of strabismus and see with Consultant

§        To be familiar with Orthoptic reports and their interpretation

 §        To observe and perform supervised screening for ROP in Neonatal Intensive Care

§        Special arrangement on Friday pm instead of Sunday am

 §        To learn to probe and syringe for congenital nasolacrimal obstruction

 §        To learn to use the Air Tonometer and Optitot camera on children.

§        To learn to use the OMIM and GeneEye databases

 Desirable objectives

§        To observe paediatric cataract surgery

§        To perform supervised surgery on less common types of strabismus

§        To see and assess (supervised) any cases of suspected NAI

§        To observe brow suspension procedures.

§        To observe electrodiagnostic tests in infants.

 It is my belief that the training given in this subspeciality provides all of the essential and desirable experience  as set out in the Curriculum of Higher Specialist Training in Ophthalmology to enable Trainees to reach a level 4 level of competence.