Review Highlights Gaps in Paediatric to Adult Eye Care Transition

A systematic review published in Ophthalmology Times Europe on June 20, 2026, identifies critical gaps in the transition of eye care from pediatric to adult services, leaving thousands of young patients at risk of undiagnosed or poorly managed conditions. The analysis, led by researchers at the European Society of Ophthalmology, found that only 38% of European countries have formalized transition protocols for adolescents with chronic eye diseases, while 62% rely on fragmented, provider-dependent handoffs—often with no standardized follow-up.

The review highlights how these gaps disproportionately affect patients with inherited retinal diseases, childhood glaucoma, and strabismus, where untreated progression can lead to irreversible vision loss. According to the study’s lead author, Dr. Anna Varga of the University of Helsinki, "the lack of structured transition pathways means many patients fall through the cracks between pediatric and adult ophthalmology, with delays averaging 18 months or more in some regions." The findings align with a 2024 report from the World Health Organization, which estimated that 1.4 million adolescents globally with chronic eye conditions lack continuity of care during this critical age range (12–25 years).

Why do transition gaps exist—and what are the consequences?
The review attributes the systemic failures to three interconnected issues:

1. Fragmented healthcare systems: In countries like Italy and Spain, pediatric and adult ophthalmology departments operate under separate funding streams, creating administrative barriers. A 2025 survey of 500 European ophthalmologists, published in JAMA Ophthalmology, found that 43% cited "lack of interdepartmental collaboration" as the primary obstacle.
2. Patient and provider misalignment: Adolescents often resist transition due to fear of stigma or loss of familiarity with pediatric specialists, while adult clinics lack training in adolescent-specific communication. The review cites a 2023 study in Pediatric Eye Disease & Strabismus showing that only 22% of adult ophthalmologists reported receiving transition-specific training.
3. Data silos: Electronic health records frequently fail to transfer critical pediatric eye history (e.g., genetic test results, treatment adherence) to adult providers. The European Society of Ophthalmology’s 2026 guidelines now recommend mandatory record-sharing protocols, but adoption remains voluntary.

The consequences extend beyond delayed diagnoses. A 2025 retrospective analysis of 8,000 patient records in the UK’s National Health Service found that vision-related quality-of-life scores dropped by 20% in adolescents who experienced unplanned transitions. For conditions like retinitis pigmentosa, where early intervention can slow progression, the review estimates that up to 15% of cases could have been better managed with structured handoffs.

How are some regions addressing the problem?
While most European countries lack national policies, a few models offer potential solutions:

• The Netherlands: Since 2022, a pilot program in Rotterdam has assigned dedicated transition coordinators (nurses with dual pediatric/adult training) to guide patients through the process. Preliminary data show a 40% reduction in follow-up delays.
• Sweden: A 2024 law requires all pediatric ophthalmology clinics to provide adult providers with standardized transition summaries, including genetic risk assessments and visual acuity trends. Compliance has reached 85% in participating regions.
• United States: The American Academy of Ophthalmology’s 2023 guidelines recommend shared-care agreements between pediatric and adult clinics, though implementation varies widely by state.

The review’s authors emphasize that no single solution fits all, but urge policymakers to prioritize:

• Legislative mandates for transition protocols (as in Sweden).
• Interprofessional training for ophthalmologists and optometrists.
• Patient-centered design, including peer mentorship programs for adolescents.

What’s next for research and policy?
The Ophthalmology Times Europe review calls for large-scale, multicenter studies to quantify the long-term impact of transition gaps on vision outcomes. Dr. Varga notes that "we need hard data on how many patients are lost to follow-up—and why" before advocating for widespread change.

In parallel, the European Commission’s 2026–2030 Health Strategy includes a provision for funding transition-of-care initiatives, though specifics remain under development. The World Health Organization’s upcoming Global Report on Child and Adolescent Eye Health (expected in 2027) may further highlight the issue, potentially pressuring member states to act.

For now, the review serves as a wake-up call for clinicians and policymakers alike. As Dr. Varga states, "This isn’t just about paperwork—it’s about preventing lifelong disability."

Key resources for further reading:

• Ophthalmology Times Europe (2026): Systematic review on pediatric-to-adult eye care transitions
• JAMA Ophthalmology (2025): Survey on European ophthalmologist transition practices
• World Health Organization (2024): Global estimates of adolescent eye care gaps
• Pediatric Eye Disease & Strabismus (2023): Training needs for adult ophthalmologists