THE PAEDIATRIC CORNEA SERVICE

The Paediatric Cornea Service is a subspecialty service which aims to be a resource for the management of paediatric corneal conditions nationally and regionally. It operates at both Singapore National Eye Centre (SNEC) and KK Women's and Children's Hospital (KKH).

A FULL SUITE OF SERVICES BY A MULTIDISCIPLINARY TEAM

At SNEC, we have a full suite of state-of-the-art imaging modalities for diagnosis and surgical planning, as well as dedicated sedation and examination-under-anaesthesia (EUA) facilities for children who may need extended examination.

These are supported by a team of nursing and allied health professionals experienced in working with children and parents. Refraction (for prescription of glasses) and contact lens services are also provided by our team of optometrists who play an integral role in the visual rehabilitation of patients.

The service is well-supported by a multidisciplinary team of specialists in paediatric ophthalmology, retina, glaucoma, oculoplastic and genetics for patients with complex eye conditions. Similarly, the service also leverages on the expertise of paediatric medical specialists in KKH for the coordinated care of patients who need multidisciplinary care beyond the eye.

Our Services

CONGENITAL CONDITIONS

The service sees the broad spectrum of paediatric cornea and anterior segment disorders, which may be due to congenital or acquired causes, both common and rare.

Congenital conditions may include:

  • Congenital corneal opacities such as Peters anomaly

  • Anterior segment dysgenesis

  • Limbal dermoid

  • Endothelial dystrophy

  • Corneal cloudiness secondary to either ocular (e.g., congenital glaucoma) or systemic (e.g., mucopolysaccharidosis and cystinosis) diseases

ACQUIRED CONDITIONS

The service also manages a myriad of acquired conditions in the both the acute and ambulatory settings. These may range from common acquired conditions to rare conditions.

Common ones include:

  • Ocular allergy

  • Blepharokeratoconjunctivitis

  • Corneal infections (e.g., contact lens-related infective keratitis, herpetic keratitis or other forms of atypical keratitis)

Rare ones include:

  • Severe cicatricial conjunctivitis due to Stevens-Johnson syndrome

TRUAMATIC CORNEAL INJURIES

The service also provides emergency surgical support for traumatic corneal injuries as well as visual rehabilitation in the aftermath of trauma.

PAEDIATRIC CORNEAL TRANSPLANTATION

The cornerstone of the Paediatric Cornea Service is the provision of corneal transplantation services in children. Widely regarded as a highly specialized field, paediatric corneal transplantation is performed only in a small number of tertiary and quaternary centres globally. This is due to the complex nature of the surgery, as well as the need for multidisciplinary care and follow-up.

The types of corneal transplantation we perform include:

  • Conventional full-thickness penetrating keratoplasty

  • Selective lamellar keratoplasty (partial-thickness) when only one layer of the cornea is affected

This may include various forms of anterior lamellar keratoplasty (e.g., deep anterior lamellar keratoplasty [DALK] and hemi-automated anterior lamellar keratoplasty [HALK]) and endothelial keratoplasty (e.g., Descemet stripping automated endothelial keratoplasty [DSAEK] and Descemet membrane endothelial keratoplasty [DMEK]).

This may also extend to emergency or semi-urgent procedures such as corneal patch grafts and complex ocular surface reconstruction using amniotic membrane transplantation, as well as combined surgeries with the oculoplastic service in children with congenital lid and ocular surface malformation.

How GPs Can Refer

For GP referrals to the Paediatric Cornea Service, please contact SNEC at:
Tel: 6322 9399
Email: [email protected]

The Paediatric Cornea Service is run by Dr Woo Jyh Haur, Senior Consultant at the Corneal and External Eye Disease Department, SNEC. For enquiries, please contact Dr Woo at [email protected].