Clinical Clinical care changes lives

Changing lives for the better is our mission at SickKids. While our educational programs help train the next generation of leaders, and our research ensures that we are developing more effective treatments, the clinical care we provide allows us to directly improve health outcomes for children.

Major Clinical Activities

  • A cataract is a cloudy lens in the eye that disrupts the amount and quality of light that enters it. Cataract surgery requires specialized care and consideration for children. A baby’s visual system is not fully developed, which means that cataract surgery must be accompanied by extensive rehabilitation to ensure they can develop vision later in life.

    Cataract service: Traumatic cataract
  • The cornea is the clear portion of the eye in front of the iris that acts as its window to the world. Problems with corneal clarity will impair sight directly, and it can easily be affected by infections or injury. A number of conditions can cloud the cornea from birth and cause permanent impairment of vision. Treatment of corneal scarring demands specialized expertise and can require corneal transplantation.

    Cornea and external diseases service: Corneal ulcer
  • Glaucoma is a condition that damages the optic nerve. Some children are born with it, while others develop it during childhood. Irregularities in the eye’s drainage system cause a build up of pressure within the eye that can lead to loss of vision. Glaucoma requires specialized care and consideration in children. Not only is a baby’s visual system not fully developed, a child’s eye can grow out of proportion because of the increase in pressure. Treatments including medication and surgery are used to reduce this pressure.

    Glaucoma service: Optic nerve cupping
  • Our Neuro-Ophthalmology Service provides highly specialized care to patients experiencing impaired vision as a result of diseases of the brain. These include conditions such as inflammation of the optic nerve, optic disc swelling, brain tumors and strokes.

    Neuro-ophthalmology service:Optic nerve drusen
  • Ocular Genetics is fast becoming an increasingly essential part of ophthalmology, as most eye disorders are determined by variations in our genes. The Ocular Genetics program at SickKids is unique in the country and one of very few in the world.

    Ocular genetics service: Stargardt disease
  • The Ophthalmic Plastic and Reconstructive Surgery Service—commonly referred to as “oculoplastics”—provides treatments for children who are born with or develop disorders related to the tear ducts, eyelids and eye sockets. The unit consists of both clinical and surgical divisions that manage a wide range of disorders.

    Oculoplastics service: Hemangioma
  • Our Retina Service provides clinical consultation, care for patients requiring specialized diagnosis, and leads surgical treatments for retinal disorders. Although the majority of our patients come from Ontario, complex cases from across Canada and the world are often referred to our service.

    Retina service: Coat's disease
  • Retinoblastoma is a form of cancer that rapidly develops from a child’s retina cells, and is the most common form of malignant tumor found in children’s eyes. Unfortunately, 70% of cases worldwide lead to death, with a disproportionate number of deaths occurring in developing countries where access to early detection is unavailable.

    Retinoblastoma: Retinoblastoma
  • Retinopathy of Prematurity (ROP) is a potentially blinding disease that affects premature newborns. It is associated with abnormal growth in the retina’s blood vessels that leads to retinal scarring or detachment. Infants who are born at least ten weeks early, or that weigh less than 1250 grams, are at risk of developing ROP.

    Retinopathy of prematurity service: Neurovascular tufts in retinopathy of prematurity
  • Strabismus is a condition where the eyes are not properly aligned, causing adverse effects on vision. Our Strabismus Service also treats a wide-range of related issues, including problems with depth perception, double vision, eye muscle problems and “lazy eye.”

    Strabismus service: Strabismus surgery
  • Uveitis is an inflammation of the uvea—the middle layer of the eye—that can lead to permanent loss of vision. Screening for uveitis and caring for patients afflicted by it is a complex clinical problem that requires a multidisciplinary approach.

    Uveitis service: Iris adhesions
  • Our Visual Electrophysiology Unit (VEU) performs a wide array of tests to assess the health of different components of the visual system. These tests allow us to examine the integrity the retina and the optic pathway, as well as the macula, a highly specialized region in the retina that we are now able to study in great detail. Additionally, we offer various methods of assessing colour vision, clearness of vision, and 3D depth perception.

    Visual electrophysiology service: Choroideremia

CASE STUDY: INNOVATIVE TREATMENT RESTORES EYE SENSTATION

Abby Messner lost feeling in her left eye after a non-malignant tumour in her brain was removed at age 11. As a result of this condition—called corneal anaesthesia—her eye would not blink to protect against dust and debris. Despite her best efforts to care for her eye, this led to a scar forming on her cornea that doctors worried would lead to permanent vision loss.

Her condition also prevented her from enjoying her favourite activities, such as playing competitive sports like hockey and swimming, or just entering the dry air of a mall. Even a windy day posed a danger to Abby’s eye.

This led SickKids’ Dr. Ali to propose an innovative new surgery for Abby—a nerve graft that would restore feeling to her left eye.

Working with plastic and reconstructive surgeons at the hospital, Dr. Ali developed a treatment that took a nerve from Abby’s calf, transplanted it into her functioning right eye, and connected it to her left eye.

Within three months, sensation was restored. This new treatment addressed the root problem of the condition rather than its complications, in a less invasive fashion than other surgeries used to treat corneal anaesthesia.

SickKids has since used this surgery in seven other cases and continues to study the effects of the treatment.