Why a paediatric orthoptic oncology service matters

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.