Tests and treatments

Antibiotic eye drops/ointment

Examples: Chloramphenicol, Fusidic acid (Fucithalmic®), Levofloxacin (Oftaquix®)

How do antibiotics work?

Antibiotics prevent or treat infections caused by bacteria. They do this by killing bacteria or preventing them from growing. There are many different types of antibiotics and your child has been given the best one for their problem. It might take a few days before your child feels better

What should I tell the pharmacist or doctor?
Tell the pharmacist or doctor if your child is allergic to any antibiotic, or other medication.

How to give eye drops/ointment
Before giving either drops or ointment, it is important to wash and dry your hands.

Eye drops: You only need to place one drop in each eye. If you need to give more than one type of eye drop, leave at least five minutes between applying each type of medicine.

Eye ointment: Pull down the lower lid and squeeze about 1/2 a centimetre (1/4 of an inch) of ointment into each eye. You need to take care not to touch the eye with the end of the tube.

How often and for how long should I give antibiotics?
Antibiotics need to be given at regular times throughout the day. The pharmacist or doctor will tell you how frequently.

You should always complete the full course of treatment, even if your child seems better, as otherwise the infection could return.

What are the main side effects?
Mild side effects: Eye drops and ointment can cause mild stinging, blurred sight or a funny taste in the mouth soon after putting them in.

Allergic reactions: The signs of an allergic reaction can include:

·         Severe redness, swelling and irritation of the eye or eyelids

·         Swelling of eyelids, lips or face

·         Difficulty breathing

·         Rash on the skin

If your child experiences any of these symptoms, stop the medication and seek medical attention immediately.

How do you store antibiotics?
Most eye drops/ointments can be stored at room temperature and should be thrown away four weeks after you open them. Some antibiotics need to be stored in a fridge and some need to be thrown away after one week. Check with your pharmacist when you need to discard the medication.

Do not use medicines after the expiry date written on the packaging.

How do antibiotics work?

Antibiotics prevent or treat infections caused by bacteria. They do this by killing bacteria or preventing them from growing. Eye drops or ointments are generally given to treat infections at the front of the eye. For some infections, your child might be given antibiotic tablets, capsules or syrup.

There are many different types of antibiotics and your child has been given the best one for their problem. It might take a few days before your child feels better.

What should I tell the pharmacist or doctor?
Tell the pharmacist or doctor if your child is allergic to any antibiotic, or other medication.

How often and for how long should I give antibiotics?
Antibiotics need to be taken at regular times throughout the day. The pharmacist or doctor will tell you how frequently, and whether the antibiotics need to be taken with food or on an empty stomach. For syrups, ask your pharmacist if you need a 5ml spoon or an oral syringe. Antibiotic syrups need the bottle to be well shaken before use.

You should always complete the full course of treatment, even if your child seems better, as otherwise the infection may return.

What are the main side effects?
Mild side effects: Antibiotics can sometimes cause an upset stomach, diarrhoea or an unpleasant taste.

Allergic reactions: The signs of an allergic reaction can include:

·         Severe redness, swelling and irritation of the eye or eyelids

·         Swelling of eyelids, lips or face

·         Difficulty breathing

·         Rash on the skin

If your child experiences any of these symptoms, stop the medication and seek medical attention immediately.

How do you store antibiotics?
Tablets and capsules can usually be stored at room temperature in their original packaging. Some syrups need to be stored in the fridge and have an expiry date of five to 14 days. Check with your pharmacist when you need to discard the medication.

Do not use medicines after the expiry date written on the packaging.

Examples: Zovirax® (Aciclovir) eye ointment, Virgan® (Ganciclovir) eye gel

How do they work?

Antiviral medications are used to treat infections caused by viruses. They stop viruses from spreading or multiplying. Eye ointment or drops are used to treat simple viral eye infections. Tablets or suspensions might also be required in more severe cases. It can take a few days before your child’s eyes feel or look better.

What should I tell the pharmacist or doctor?
Tell the pharmacist or doctor if your child is allergic to any antibiotic, or other medication.

How to give eye drops/ointment
Before giving either drops or ointment, it is important to wash and dry your hands.

Eye drops: You need to place only one drop in each eye. If you need to give more than one type of eye drop, leave at least five minutes between applying each type of medicine.

Eye ointment: Pull down the lower lid and squeeze about 1/2 a centimetre (1/4 of an inch) of ointment into each eye. You need to take care not to touch the eye with the end of the tube.

Contact lenses: should be removed before putting in eye drops. Wait 15 minutes before putting the contact lenses back in the eye. Check with the pharmacist that the eye drops or ointment are safe to use with contact lenses.

How often and for how long should I give antivirals?
Antivirals need to be given at regular times throughout the day. The pharmacist or doctor will tell you how frequently.

You should always complete the full course of treatment, even if your child seems better. Otherwise, the infection could return.

What are the main side effects?
Mild side effects: Antivirals can sometimes cause eye irritation, redness and swelling.

Allergic reactions: The signs of an allergic reaction can include:

· Severe redness, swelling and irritation of the eye or eyelids

· Swelling of eyelids, lips or face

· Difficulty breathing

·Rash on the skin

If your child experiences any of these symptoms, stop the medication and seek medical attention immediately.

How do you store antivirals?
Most antiviral drops/ointments can be stored at room temperature and should be thrown away four weeks after you open them. Some antivirals need to be stored in a fridge and some need to be thrown away after one week. Check with your pharmacist when you need to discard the medication.

Do not use medicines after the expiry date written on the packaging.

Examples: Aciclovir (Zovirax®), Valtrex® (Valaciclovir)

How do they work?

Antiviral medications are used to treat infections caused by viruses. They stop viruses from spreading or multiplying. Eye ointment or drops are used to treat simple viral eye infections. Tablets or suspensions might also be required in more severe cases, or if the infection is not responding to eye drops. It can take a few days before your child’s eyes feel or look better.

What should I tell the pharmacist or doctor?
Tell the pharmacist or doctor if your child is allergic to any antibiotic, or other medication.

How often and for how long should I give antivirals?
Antivirals need to be given at regular times throughout the day. The pharmacist or doctor will tell you how frequently and whether the antivirals need to be taken with food or on an empty stomach. Your child must drink plenty of liquids such as water whilst taking antiviral medications. Antiviral suspensions require the bottle to be well shaken before use.  Some antiviral tablets can be dispersed in a glass of water, which should be stirred before drinking. Check with the pharmacist or in the product leaflet provided.

You should always complete the full course of treatment, even if your child seems better. Otherwise the infection could return.

What are the main side effects?
Rarely, antivirals can cause an allergic reaction. The signs of an allergic reaction can include: severe redness, swelling and irritation of the eye or eyelids, rash, swelling of the lips or face, or difficulty with breathing.

Other side effects are not common but can include: feeling sick, diarrhoea, headache, drowsiness, being very irritable and, very rarely, kidney problems or low blood cell counts.

If your child experiences any of these symptoms, stop the medication and seek medical attention.

How do you store antivirals?
Tablets/capsules and suspensions can usually be stored at room temperature in their original packaging. Aciclovir suspension should be discarded 28 days after opening.

Botulinum toxin can be used in the treatment of squint (misaligned eyes) in both adults and children. Sometimes it is a one off treatment and sometimes a course of injections are needed. Your doctor will be able to explain which applies to you.

Read more about botulinum toxin.

What is it?

Your child has a natural lens inside your eye that helps them to see. The lens should be clear like glass but a cataract makes the lens cloudy. During cataract surgery the surgeon removes the cloudy lens from their eye and might replace it with a man-made lens.

How does the world look to your child?

If your child has had cataracts since they were a baby they may not realise it. They might think their eyesight is normal and that everyone sees things the way they do. But cataracts usually make vision less clear and in some children the vision may be very blurry.

Why does your child have to have surgery?

Not all cataracts need an operation, but having a bad cataract is a problem that can only be fixed by surgery. Currently there isn’t any other medical treatment which gets rid of a cataract but sometimes glasses will help your child to see better. The doctor will talk to you and your child to help decide whether surgery is the best thing to help them right now.

What will happen afterwards?

After your child's operation they will be given eye drops to help their eye get better. The doctor will need to see them in the clinic regularly. One of your child's eyes might have weaker vision and need patching treatment. Some children need a contact lens or glasses to see afterwards.

Are there any side-effects?

Children’s eyes are delicate and sometimes there can be a problem, such as an infection or too high pressure in the eye, which needs more treatment after the operation. The eye doctors will keep a check on your child and treat any problem which happens.

Will the operation work?

Most children do see better after the operation.

Examples: Atropine, Mydrilate® (Cyclopentolate), Homatropine, Mydriacyl® (Tropicamide), Phenylephrine

How do they work?

Corticosteroids or ‘steroids’ treat inflammation (redness, soreness, swelling of the eye). Inflammation may be caused by injury, infection, allergy or occur after surgery. Corticosteroid eye drops and ointments sometimes also contain an antibiotic to prevent or treat an infection.

What should I tell the pharmacist or doctor?
Tell the pharmacist and doctor if your child is allergic to any antibiotic or other medication.

How to give eye drops/ointment
Before giving either drops or ointment, it is important to wash and dry your hands.

Eye drops: You only need to place one drop in each eye. Some eye drops, including Pred Forte® and Maxidex®, require the bottle to be shaken before use. If you need to give more than one type of eye drop, leave at least five minutes between applying each type of medicine.

Eye ointment: Pull down the lower lid and squeeze about 1/2 a centimetre (1/4 of an inch) of ointment into each eye. You need to take care not to touch the eye with the end of the tube.

Contact lenses: Your child should not wear contact lenses when using these drops/ointments as this can increase the chance of infection.

How often should I give steroids?
Steroids need to be taken at regular times throughout the day. The pharmacist or doctor will tell you how frequently. The doctor might also prescribe a steroid eye ointment to keep the inflammation down overnight. 

What are the main side effects?
Mild side effects: Eye drops and ointment can cause mild stinging, blurred sight or a funny taste in the mouth soon after putting them in. 

Other side effects: Serious side effects such as glaucoma (high pressure) or cataracts (cloudy lens of the eye) can occasionally occur with the use of long-term or very high dose steroids. The eye doctors will check the eyes for this in the clinic and it is very important that your child keeps their clinic appointments if taking steroids.

If your child’s vision becomes cloudy or the eye becomes worse seek medical attention immediately.

How do you store steroids?
Most eye drops/ointments can be stored at room temperature and should be thrown away four weeks after you open them. Some need to be stored in a fridge and some need to be thrown away after one week. Check with your pharmacist when you need to discard the medication.

Do not use medicines after the expiry date written on the packaging.

Counselling at the Richard Desmond Children’s Eye Centre at Moorfields provides a safe and confidential space where children and young people from the age of three to eighteen can talk to someone who will listen, empathise and help them to better understand what they’re going through. It can lead to improvements in family relationships, friendships and self-esteem, as well as enabling them to better process their thoughts and regulate their emotions.

Read more about counselling for children and young people.

Why is my child being referred?

A doctor has referred your child for electrophysiology tests to assess how their visual system processes visual information. The tests can help to diagnose the cause of a visual problem. They are also useful for monitoring the progression of a visual disorder or the effects of any treatment. These tests are particularly useful as young infants and children are often unable to communicate or describe in detail any problems they might have with the way they see.

What is a visual electrophysiology test?

When your child looks at something, an image of the object is projected onto the retina at the back of their eye. The retina converts this optical image into very small electrical signals, which pass along the optic nerve to the brain, where the sensation of ‘seeing’ occurs. Visual electrophysiology measures these very small signals generated by the eye and the brain.

Read more about electrophysiology in children

What is it? 

An examination under an anaesthetic is a long way of describing one of the easiest operations carried out in a children’s eye hospital. Nothing much happens except the doctor gets to have a good look at your child's eye (the examination part) while they are sleeping (the anaesthetic part). Because they are asleep they don’t move around so much which makes it a lot easier for the doctor. 

How does it work? 

If your child's eye is to be examined in this way your child will be brought to a children’s ward and given a medicine that makes them sleep. The medicine is called a general anaesthetic. Onceyour child is asleep he/she will be taken to the operating theatre to be examined. 

The operation is very quick and your child will be in and out of the hospital in a day.  You can stay nearby at all times and you will have a chance to chat to the doctor after they have examined your child's eye and told you what they have found. 

Following the examination it is very important that your child has plenty to drink and tries to eat some food if he/she can.

Why does my child have to have an EUA?

If an ophthalmologist can study your child's eye really closely they will get a much better idea of how to treat any problems they may have with seeing.

Sometimes when they are examining your child's eye while they are sleeping they discover something which they believe should be treated immediately. They would then do the operation while your child continues to sleep. This is most common if your child has an eye condition called glaucoma.

What will happen afterwards?

Your child may feel a little bit sick for a while but after a day or so they will be back to normal. 

What is it?

FA stands for fluorescein angiography. It’s a way of studying what is happening at the back of your child's eye. The blood in our body flows through tiny blood vessels. An FA helps a doctor see exactly where the blood vessels are in your child's eye, their size and any problems they might have.

How does it work?

The pupil is the dark circle in the centre of your child's eye which acts as a sort of window into their eye. First they will be given eye drops to make the pupil grow larger.

Then a small amount of harmless yellow dye is injected into their arm. Some special cream on their arm will mean your child won’t feel the injection much. The yellow dye travels through their body and eventually passes through the blood vessels inside your child's eye. At this point some photographs are taken of the back of the eye.

Why does my child have to have an FA?

An FA helps the doctor make a diagnosis. If the FA shows that the vessels at the back of your child's eye are swollen or has something else wrong with them, the doctor can then decide how best to help them.

What will happen after?

Your child probably won’t have any unpleasant side effects from an FA, but you should stay at the hospital for at least half an hour afterwards just to make sure. Some people do feel a bit sick or itchy. The important thing is that your child drinks plenty of water to help flush the yellow dye out of their body.

If your child feels unwell after you have left you should take them to the nearest hospital and let them know.

Read more about fluorescein angiography

Glaucoma means that the pressure in the eye is too high. The high pressure damages the optic nerve that takes vision information from the eye to the brain. Glaucoma operations bring the pressure in the eye down and stop damage to the optic nerve.

Read more about glaucoma surgery

Examples: Viscotears® (Carbomer 980), Celluvisc® (Carmellose), Hypromellose, Sno Tears® (Polyvinyl Alcohol), Ilube® (Acetylcysteine), Lacrilube® ointment and Simple eye ointment

How do they work?

Lubricant eye drops/ointments are used to treat dry and irritated eyes and sometimes to help the eye to heal. They work in various ways – most simply wet or moisturise the eyes, others can remove excess tear mucus made by the eye. Sometimes, eyes with a dry surface can appear watery, which occurs when dryness is caused by the tear film not clinging to the eye.

What should I tell the pharmacist or doctor?
Tell the pharmacist and doctor if your child is allergic to any antibiotic or other medication.

How to give eye drops/ointment
Before giving either drops or ointment, it is important to wash and dry your hands.

Eye drops: You only need to place one drop in each eye. If you need to give more than one type of eye drop, leave at least five minutes between applying each type of medicine.

Eye ointment: Pull down the lower lid and squeeze about 1/2 a centimetre (1/4 of an inch) of ointment into each eye. You need to take care not to touch the eye with the end of the tube.

Contact lenses: should be removed before putting in eye drops.  Wait 15 minutes before putting the contact lenses back in the eye. Check with the pharmacist that the eye drops or ointment are safe to use with contact lenses.

How often should I give lubricants?
Some drops are watery and others are thicker like a gel or cream. Watery eye drops can be used many times during the day, whereas thicker eye drops are used less often, usually one to four times a day.

Often the drops are to be used ‘when required’, which means the eye drops should be used whenever your child feels his/her eyes are itchy, red or irritated. As a suggestion, this can be up to four or six times a day. If the drops are used more frequently, contact your doctor to prescribe a preservative-free eye preparation, as frequent use of eye drops with preservatives can irritate the eyes.

What are the main side effects?

Mild side effects: Eye drops and ointment can cause mild stinging, blurred sight or a funny taste in the mouth soon after putting them in. 

Occasionally, the drops can cause an allergic reaction with redness, swelling and irritation of the eye or eyelids.

If your child experiences symptoms that you think might be due to the drops, speak to your pharmacist or doctor.

How do you store these drops?
Most eye drops/ointments can be stored at room temperature and should be thrown away four weeks after you open them. Some need to be stored in a fridge and some need to be thrown away after one week. Other single-dose preparations are discarded after single use. Check with your pharmacist when you need to discard the medication.

Do not use medicines after the expiry date written on the packaging.

Examples: Atropine, Mydrilate® (Cyclopentolate), Homatropine, Mydriacyl® (Tropicamide), Phenylephrine

How do they work?

These eye drops or ointments relax the muscles of the eye so as to widen (dilate) the pupil, which is the central black area in the middle of the iris, the coloured part of the eye. These medicines also relax the focusing muscles of the eye, which means that most children will also experience blurred vision

What should I tell the pharmacist or doctor?
Tell the pharmacist and doctor if your child is allergic to any medication or if your child has high blood pressure or a heart condition.

Why are they used?
These drops help the doctor examine the back of the eye. Dilating the pupil can also help to reduce inflammation and discomfort in the eye after surgery or injury, or treat inflammation which occurs in certain conditions. They can also be used to help treat amblyopia (‘lazy’ eye).

How long do the effects last?
Mydriacyl® (Tropicamide), Mydrilate® (Cyclopentolate) and Phenylephrine work for a few hours. They are used one to four times a day at home.

The effects of Atropine and Homatropine last longer, so they are usually used once or twice a day.

How do you use these drops/ointments?
Before giving either drops or ointment, it is important to wash and dry your hands.

Eye drops:You only need to place one drop in the eye. If you need to give more than one type of eye drop, leave at least five minutes between applying each type of medicine.

Eye ointment: Pull down the lower lid and squeeze about 1/2 a centimetre (1/4 of an inch) of ointment into each eye. You need to take care not to touch the eye with the end of the tube.

Contact lenses: should be removed before putting in eye drops.  Wait for 15 minutes before putting the contact lenses back in the eye. Check with the pharmacist that the eye drops or ointment are safe to use with contact lenses.

What are the main side effects?
These drops can cause temporary stinging and blurred vision. Blurred vision can last for hours or even days depending on the type of eye drop. The eyes might also be more sensitive to bright light. Occasionally, the drops can cause a sore red eye or eyelids.

Very rarely, these drops or ointments can cause a rapid heart beat, dry mouth, high temperature, constipation, or difficulty in passing urine. This can occur when small amounts of the medicine are absorbed into the body from the eyes.  If your child experiences symptoms that you think could be due to the drops, contact your pharmacist or doctor.

How do you store these drops/ointments?
Most eye drops/ointments can be stored at room temperature and should be thrown away four weeks after you open them. Some need to be stored in a fridge and some need to be thrown away after one week. Other single-dose preparations are discarded after single use. Check with your pharmacist when you need to discard the medication.

Do not use medicines after the expiry date written on the packaging.

What is it?

Does your child need to wear glasses? That is what a refraction test can find out. When your child visits an eye hospital their eyes may be tested by an ophthalmologist who will want to know how well they can see with each eye. One of the tests they do is called refraction. The refraction test will help the ophthalmologist decide if wearing glasses will help your child to see better.

How does it work?

During the test your child will sit a short distance from a chart with letters of the alphabet on it. The letters at the top of the chart are very large and the letters at the bottom very small. The ophthalmologist will ask your child to cover each eye in turn and read the letters aloud, from top to bottom. This is to find out just how clearly each eye can see. Your child may also be asked to hold a page and read some lines from it.

Your child will then have to wear a trial frame. This is a bit like a pair of glasses without any lenses in it.  The ophthalmologist will slip different lenses into the trial frame to see if they make your child's eyesight any better. They will also shine a light into your child's eyes while they wear the trial frame. 

Why does my child have to have a refraction test? 

Refraction is done when the ophthalmologist wants to know if your child's vision can be improved with glasses. Your child may have a problem with their eyes that could require an operation. But they might not need the operation straight away if glasses can help them to see better.
If your child has already had an operation, refraction will show any changes in their eyes and help find a new pair of glasses that are suitable.

What will happen afterwards? 

After refraction your child will given a prescription for a new pair of glasses. There are plenty of cool styles and colours of frames available to choose from.

The information you find here has been put together especially for children and young people with sight loss and their families.  

Read more about services for children and young people with sight loss and their families.

The information you find here has been put together especially for children and young people with sight loss and their families at Bedford. 

Read more about services for children and young people with sight loss and their families at Bedford. 

What is it?

An ultrasound is similar to an x-ray and is used to make a picture of the inside of your child's eye. Just like an x-ray, ultrasound doesn’t hurt at all, takes only a few minutes, and your child won’t need to be asleep while it happens.

How does it work?

A bat can “see” in the dark by making high pitched sounds and listening to the echoes, which tells it the position of nearby objects and food. Dolphins and whales can do this also.

Ultrasound works in a similar way. Your child will close their eye and something that looks a bit like a small wand is moved over it. The wand sends ultrasound into your child's eye, but they won’t hear anything or feel any pain. The echoes bounce back to a computer which uses the echoes to make images which show what the inside of your child's eye looks like.

Why does my child need an ultrasound?

An ophthalmologist may need to examine your child's eye. To do this, they will usually just shine a light into the eye. But if your child has some blood in their eye, or a cataract, it can make it hard for the ophthalmologist to get a really good look. So they will use ultrasound instead.

It might also be necessary to know the length of your child's eye, from front to back. 

What will happen afterwards?

Your child will be sitting down during an ultrasound test. Afterwards you and your child will be shown the images of the inside of their eye and the ophthalmologist will explain what the pictures show.