Why a paediatric orthoptic oncology service matters | Scientific Program 2027

University Hospitals of Leicester NHS Trust, United Kingdom

Title: Why a paediatric orthoptic oncology service matters

Abstract:

Visual impairment is a common but under-recognised complication in children with intracranial tumours, with over half of patients reportedly not receiving timely ophthalmic assessment. Tumours affecting visual pathways—such as optic pathway glioma, craniopharyngioma and astrocytoma, can significantly impact vision and quality of life. A dedicated paediatric orthoptic- led oncology service plays a crucial role in early detection and management of these ocular diseases.

To evaluate the role and clinical impact of a specialised paediatric orthoptic–led oncology service in identifying, monitoring, and managing visual dysfunction in children with intracranial tumours.

A retrospective review was conducted of children referred to this service at Leicester Royal Infirmary between May 2024 and September 2025. Data collected included diagnosis, types of visual deficits (e.g. reduced visual acuity, visual field loss, ocular motility disorders) and frequency of follow-up. Visual pathway disease was categorised and quantified to assess patterns of presentation and service utilisation.

A range of visual impairments were identified across the cohort, with many patients requiring ongoing monitoring and multidisciplinary management i.e. 35% had an ocular motility disorder, 17.5% had visual field abnormality, 30% had reduced vision and 12.5% had pupil testing abnormality. Regular orthoptic assessments enabled early detection of visual changes, timely intervention and appropriate onward referrals for treatment. Follow-up frequency reflected the complexity and progression of visual involvement.

A dedicated paediatric orthoptic-led oncology service enables early detection and management of visual pathway disease in children with intracranial tumours, improving outcomes, supporting multidisciplinary care, and reducing delays in diagnosis and intervention.

Biography:

Shenika graduated from the University of Liverpool in 2011 and has over 15 years of experience as an Orthoptist, with specialist expertise in neuro-ophthalmology, paediatric oncology, paediatric cataracts, and neurology. She began her career at Barts Health NHS Trust, London, where she consolidated her clinical expertise and developed leadership and management skills.

Since joining University Hospitals of Leicester NHS Trust in 2018, Shenika has continued to advance her specialist practice through postgraduate training in OCT interpretation, medical exemption master's module, and leadership and management education. She has established an orthoptist-led idiopathic intracranial hypertension (IIH) service and a specialist paediatric oncology clinic, while playing a key role in paediatric cataract, glaucoma monitoring, and pituitary clinics. Working in a large teaching hospital, Shenika regularly teaches medical students, pre-reg optometrists and orthoptic students.

As Deputy Head Orthoptist, Shenika provides clinical and operational leadership for teams of orthoptists, visual field technicians, and ophthalmic photographers. She is passionate about service development, innovation, and improving patient outcomes through the delivery of high-quality, multidisciplinary care.