Pediatric eye problems are often very different from those of adults for the simple reason that children’s eyes are still developing. It’s very important to have kids’ eye issues evaluated early and treated promptly because untreated childhood eye disorders can lead to long-term vision problems. From the youngest children who can’t tell us what they see, to those getting their first pair of glasses, Nemours’ pediatric ophthalmology (eye) experts focus on kids’ unique eye care needs.
Why Measuring Results Matters
To provide pediatric care that's among the safest and most effective, we measure our results and compare them to national rates. Why? So we can:
- help you make decisions about your child’s care
- be clear about our results
- improve so we can consistently deliver better, safer care
Here are a couple of outcomes we track and focus on to improve the experience for both you and your child.
Successful Tear Duct Surgery for Young Kids
Giving Children Born With Blocked Tear Ducts the Care They Need
About 6 to 10 percent of all newborns are born without a fully developed tear duct in one or both eyes (called “congenital nasolacrimal duct obstruction”). This can lead to blockage of the tear duct, excess tears and infection. Fortunately, 90 percent of all cases clear up on their own. But if the problem doesn’t go away in the first year of life, children may need surgery.
We’re proud to say that in 2017 only 2.1 percent of the kids under 4 years old who had tear duct surgery at Nemours returned to the operating room for another operation within six months. That means 98 percent of our patients had a successful surgery* — compared to the national average of just 84 percent. We’re able to make sure our tear duct operations are a success because our ophthalmologists select the right procedure based on children’s symptoms, age and other conditions. We’re also able to ensure our surgeries are a success because of timely:
- referrals by our pediatrician and family practice colleagues
- scheduling to make sure children see a surgeon and get to the operating room at the appropriate time for their age
Tear Duct Surgery Patients Under 4 Years Old Who Returned to the Operating Room Within Six Months of Initial Surgery
Total number of Nemours tear duct obstruction surgery patients, 2015-2017
Nemours percentage of patients who returned for tear duct surgery, 2015
Nemours percentage of patients who returned for tear duct surgery, 2016
Nemours percentage of patients who returned for tear duct surgery, 2017
National average (benchmark)
Data source: Nemours data collected from electronic health records of nasolacrimal duct surgery patients at Nemours/Alfred I. duPont Hospital for Children (in Wilmington, Del.); Nemours duPont Pediatrics, Bryn Mawr (in Bryn Mawr, Pa.); Nemours duPont Pediatrics, Deptford (in Deptford, N.J.); Nemours patients at Jefferson Hospital for Neuroscience (in Philadelphia); Nemours Children’s Hospital (in Orlando); and Nemours Children’s Specialty Care/Wolfson Children’s Hospital (in Jacksonville, Fla.). *Surgical success = single surgery, decreased risk of infection, resolution of tearing and discharge symptoms. Children with Down syndrome (Trisomy 21) or complicated craniofacial anomalies were excluded from this data.
Benchmark: Pediatric Eye Disease Investigator Group et al. Primary treatment of nasolacrimal duct obstruction with probing in children younger than 4 years. Ophthalmology. 2008 Mar;115(3):577-584.e3. Epub 2007 Nov 8.
Pediatric Eye Disease Investigator Group et al. Primary treatment of nasolacrimal duct obstruction with nasolacrimal duct intubation in children younger than 4 years of age. J AAPOS. 2008 Oct;12(5):445-50. doi: 10.1016/j.jaapos.2008.03.005. Epub 2008 Jul 2.
Consistent Communication for Streamlined Care
Making Sure Everyone’s Informed
If your child has eye problems and needs to go to the hospital, a pediatric ophthalmologist’s expertise will always be available. Our specialists may offer consultations for kids in the emergency room or staying in the hospital. Or, they may monitor children who just had eye surgery. When doctors change shifts or are no longer on call, they have to transfer their patients’ care to another provider. That means they need to share crucial information and provide updates so that the doctor taking over your child’s care will know exactly what’s going on. This is called the “physician hand-off” or “physician sign-out.”
At Nemours, as part of our daily and weekend on-call sign-out, we send an email with information about patient phone calls, ED calls and consults. The on-call provider gives detailed updates to other providers and administrative staff following night and weekend calls, with patient information and any follow-up instructions. We do all of this to:
- inform the primary provider of patient issues
- arrange appropriate follow-up care in the clinic or operating room
- document patient and family concerns
- make sure every patient’s doctor will be able to address issues if they arise
Formal hand-off communication helps ensure patient safety and continuity of care for patients and their ophthalmologist even after hours, on weekends and during holidays. At Nemours, our ophthalmologists have performed patient sign-outs in 95 percent of cases — that’s double the national average of only 47 percent.
Physician Hand-Offs of Ophthalmology Patients
National average (benchmark)
Data source: Nemours data collected for ophthalmology patients at Nemours/Alfred I. duPont Hospital for Children (in Wilmington, Del.); Nemours Children’s Hospital (in Orlando); and Nemours Children’s Specialty Care/Wolfson Children’s Hospital (in Jacksonville, Fla.).
Benchmark: Hospital Survey on Patient Safety Culture, 2016 User Comparative Database Report, Agency for Healthcare Research and Quality, U.S. Dept. of Health and Human Services, AHRQ Publication No. 16-0021-EF, March 2016.
Our Differentiators: What Sets Us Apart
Why Choose Nemours Ophthalmology
Here are just some of the reasons families choose us for their child’s eye care:
- Experienced, highly skilled eye surgeons. Our pediatric ophthalmologists are board-certified and fellowship-trained at nationally recognized institutions to provide the highest level of surgical and medical care for complex eye problems.
- Award-winning physicians. Many on our team are recognized in “Best Doctors in America®” and local magazines as “Top Doctors” in the region.
- Advanced pediatric eye procedures. We perform state-of-the-art operations, including laser surgery, to treat and repair kids’ eyes. Pediatric eye surgery is often done on an outpatient basis, so in many cases, your child may not have to stay overnight in the hospital.
- Expert providers recognized for their medical contributions. We’re active in local, national and international professional societies (e.g., the American Academy of Pediatrics, and American Association for Pediatric Ophthalmology and Strabismus). We also regularly share our knowledge at scientific meetings and in peer-reviewed medical journals.
- Comprehensive eye care for the simplest to most complex eye problems. We treat nearly every childhood eye condition in kids from birth to age 18. And our doctors and surgeons have special expertise in treating complex eye issues in premature babies.
- Coordinated, team approach for kids with special health needs. Nemours ophthalmologists coordinate care with other specialists your child may see. You can often visit multiple doctors on the same day, in the same place.
- Award-winning electronic health records (EHR) system. Our EHR helps us keep all of our providers on the same page. And MyNemours, the parent portal of our EHR, gives you secure access to your child’s records and allows you to communicate by email with your provider(s).
- Advancing research for childhood eye disorders. Our specialists are also researchers who look for new and better ways to detect and treat strabismus (cross-eyes), amblyopia (lazy eye) and retinopathy of prematurity (abnormal blood vessel growth). Our research also includes studying ocular coherence tomography (OCT) changes in children with sickle cell disease (changes in the retina which lines the inside of the eye and is responsible for transmitting light to the optic nerve) and attitudes about cortical visual impairment (vision loss due to brain damage).