Review highlights gaps in transition from paediatric to adult eye care

A scoping review published in the European Journal of Ophthalmology highlights the limited but clinically important evidence base for transition programmes supporting children and adolescents as they move from paediatric to adult ophthalmology services. Kumar and colleagues wrote that, “For young people, transition programmes between paediatric and adult services ensure continuity of care,” while also aiming to improve confidence and autonomy in health management.¹

The review focuses on an issue familiar to paediatric ophthalmologists, retina specialists, glaucoma specialists, uveitis services, and low-vision teams: many childhood-onset eye diseases require lifelong monitoring, but the structure of care often changes abruptly when patients age out of paediatric systems. Without coordinated transition, young adults may disengage from follow-up, delay treatment, or enter adult care without adequate knowledge of their diagnosis, medications, visual prognosis, or genetic implications.

The article, authored by Ameeta Kumar, Shiama Balendra, Desta Bokre, and Annegret H. Dahlmann-Noor, is described as a scoping review examining transition programmes for children moving from paediatric to adult eye care services.¹

Clinical context for ophthalmology

Transition planning is well established in broader paediatric chronic disease care. NICE (National Institute for Health and Care Excellence) recommends that transition from children’s to adults’ services be developmentally appropriate, person-centered, and planned in advance rather than triggered solely by age.² Similarly, US consensus guidance emphasizes preparation during adolescence, assessment of self-management readiness, and coordination between paediatric and adult clinicians.³

In ophthalmology, these principles may be particularly relevant because many patients with childhood-onset visual disorders depend on ongoing surveillance despite feeling clinically stable. Examples include congenital glaucoma, paediatric uveitis, inherited retinal disease, retinopathy of prematurity sequelae, optic nerve disorders, and complex anterior segment or neuro-ophthalmic conditions. For some patients, transition also intersects with education, driving eligibility, employment, low-vision support, genetic counseling, pregnancy planning, and disability services.

The risk is not simply administrative loss to follow-up. A young adult who does not understand the chronicity of uveitis, the need for glaucoma monitoring, or the inheritance pattern of retinal disease may miss time-sensitive care. Conversely, a well-structured transition process can help adult ophthalmology services receive patients with clearer clinical summaries, medication histories, surgical histories, imaging records, and individualized escalation plans.

What transition programmes may include

Transition programmes in chronic disease care commonly include written transition policies, early discussion with patients and caregivers, readiness assessments, joint paediatric-adult clinics, named coordinators, portable medical summaries, and explicit education on self-management.²˒³ Prior systematic work outside ophthalmology has found that transition interventions vary widely in structure and outcomes, with limited high-quality comparative evidence.⁴

For ophthalmology clinics, the practical question is how much of this infrastructure can be integrated into routine care. A large tertiary paediatric eye service may be able to develop formal joint clinics with adult subspecialists. Smaller practices may rely on standardized referral templates, patient-held summaries, medication education, and scheduled first adult appointments before discharge from paediatric care.

Interpretation and next steps

The review underscores a gap between the long-term nature of many paediatric eye diseases and the relatively underdeveloped evidence base for ophthalmology-specific transition models. The clinical rationale for transition planning is strong, but evidence on which programme elements improve attendance, disease control, patient-reported confidence, or vision-related quality of life remains limited.¹

Future studies should define ophthalmology-specific outcomes, including attendance at first adult visit, treatment adherence, avoidable disease reactivation, patient knowledge, caregiver role adjustment, and adult service satisfaction. Comparative evaluations across subspecialties would also help determine whether patients with high-risk inflammatory, glaucomatous, or inherited retinal disease need different transition intensity than patients with stable visual impairment or surveillance needs.

For now, the review supports a pragmatic message: transition from paediatric to adult eye care should be treated as a clinical process, not a clerical referral.

References

1. Kumar A, Balendra S, Bokre D, Dahlmann-Noor AH. Transition programmes for children moving from paediatric to adult eye care services: a scoping review. European Journal of Ophthalmology. Published online June 19, 2026. Accessed June 19, 2026. https://journals.sagepub.com/doi/10.1177/11206721261462355

2. National Institute for Health and Care Excellence. Transition From Children’s to Adults’ Services for Young People Using Health or Social Care Services. NICE guideline NG43. Published February 24, 2016. Accessed June 19, 2026. https://www.nice.org.uk/guidance/ng43

3. American Academy of Pediatrics; American Academy of Family Physicians; American College of Physicians; Transitions Clinical Report Authoring Group. Supporting the health care transition from adolescence to adulthood in the medical home. Pediatrics. 2011;128(1):182-200. doi:10.1542/peds.2011-0969. Accessed June 19, 2026. https://publications.aap.org/pediatrics/article/142/5/e20182587/38577/Supporting-the-Health-Care-Transition-From?autologincheck=redirected

4. Crowley R, Wolfe I, Lock K, McKee M. Improving the transition between paediatric and adult healthcare: a systematic review. Arch Dis Child. 2011;96(6):548-553. doi:10.1136/adc.2010.202473. Accessed June 19, 2026. https://pubmed.ncbi.nlm.nih.gov/21388969/