Ophthalmology & Vision Sciences

This program cares for patients with genetically determined retinal diseases and other eye conditions as well as systemic disorders with associated eye involvement. These disorders are one of the leading causes of irreversible blindness in childhood. The ocular genetics service is one of the unique programs in North America and our multidisciplinary team takes pride in offering personalized care to patients with rare blinding disorders.  

Working with the Molecular Diagnostic Laboratory at SickKids and other certified labs across North America and Europe, we are able to offer genetic testing and diagnosis in a majority of patients in a reasonable time frame. This approach helps to establish an accurate diagnosis, and provide appropriate prognosis and clinical management. Further, understanding the genetic cause helps with understanding the mode of disease transmission in the family and may also open up future therapeutic possibilities.   

This program deals with retinoblastoma, the leading cause of ocular malignancy in childhood. Our retinoblastoma team provides service to 100 per cent of children with retinoblastoma in Ontario, as well as Alberta and Manitoba. The Toronto Chemotherapy Protocol, developed by SickKids, is currently being validated through a multicenter, international clinical trial. We led the Canadian Strategy Working Group to produce the first Guidelines for Retinoblastoma Care, published worldwide. This program is a good example of translational research that brings molecular biology knowledge from the laboratory to bedside in order to improve patient outcomes. 

This program integrates the various clinical subspecialties involved in the investigation of normal and abnormal vision development. The clinical subspecialties include strabismus, neuro-ophthalmology, and ocular genetics. Neuro-ophthalmology is at the heart of NeuroVision. We provide highly specialized care to patients who have visual problems as a result of various brain diseases. We also provide services to patients with complex strabismus and amblyopia. 

This program integrates the various clinical subspecialties of glaucoma, cataract, corneal diseases and transplantation, oculoplastics and retina.

It focuses on surgical innovation. Our talented surgeons aim to optimize the surgical management of various causes of vision loss, including trauma, severe retinal damage and congenital ocular/orbital/lid deformities. Management methods include selective corneal transplantation, ocular surface reconstruction, corneal neurotization, iris repair, cataract removal and intraocular lens placement, glaucoma surgery, and management of uveitis among others. We deal with the most complex surgical cases in the country. 

Retinopathy of prematurity (ROP) is a potentially blinding disease in infants born prematurely. Timely treatment is critical to reduce the risk of permanent blindness. We use an innovative approach to enable remote screening for ROP using telemedicine and digital imaging.

We have established a multidisciplinary ROP team for the daily screenings and medical treatments of ROP. Our valued retina surgeons are responsible for the management of the most complex cases requiring surgical “rescue”. Our Telemedicine Project includes the Sudbury and Barrie sites, and was the first-place award recipient of the Celebrating Innovations in Health Care 2010 from the Ministry of Health and Long-Term Care. 

See Research activities for more information on the various research being conducted by each of our teams. 

An ophthalmologist is a fully licensed medical doctor who specializes in medical and surgical eye problems. Each clinic is held under the supervision of a staff ophthalmologist. They will assess and explain your child’s eye condition and discuss a plan of care, such as follow-up, testing, surgery and more. They can also determine if your community physician can see you.

Our staff ophthalmologists are: 

• Dr. Asim Ali, MD, FRCSC, Ophthalmologist-in-Chief, Professor 
• Dr. Andrew Budning, MD,CM, MSc. FRCSC, Associate Professor 
• Dr. Raymond Buncic, MD, FRCSC, Professor
• Dr. Crystal Cheung, MD, FRCSC, Lecturer
• Dr. Dan DeAngelis, MD, FRCSC, Assistant Professor 
• Dr. Brenda Gallie, MD, FRCSC, Professor 
• Dr. Elise Héon, MD, FRCSC, Professor 
• Dr. Peter Kertes, MD, FRCSC, Professor 
• Dr. Stephanie Kletke, MD, FRCSC, Assistant Professor
• Dr. Stephen Kraft, MD, FRCSC, Professor 
• Dr. Ashwin Mallipatna, MS, DNB Assistant Professor
• Dr. Kamiar Mireskandari, MBChB, FRCSEd, FRCOphth, PhD, Professor 
• Dr. Rajeev Muni, MD, FRCS(C), Assistant Professor 
• Dr. Nasrin N. Tehrani, MBBCh, MSc, FRCS Ed(Ophth), FRCSC , Assistant Professor 
• Dr. Georges Nassrallah, MD, FRCSC
• Dr. Arun Reginald, MD, FRCSC, Assistant Professor 
• Dr. David Smith, MD, FRCSC, Assistant Professor 
• Dr Michael Wan, MD, FRCSC, Assistant Professor 
• Dr. Ajoy Vincent, MD,FRCSC, MBBS, MS, Associate Professor 
• Dr. Agnes Wong, MD, PhD, FRCSC, Professor 

Optometrists are eye doctors who examine, diagnose, treat and co-manage non-surgical ocular diseases and visual abnormalities. They also determine any refractive errors and prescribe corrective lenses. You are most likely to meet an optometrist if your child needs glasses and/or contact lenses. 

Orthoptists are certified eye care professionals who specialize in the non-surgical treatment of vision disorders. They assess, evaluate and identify disorders particularly in the areas of strabismus and amblyopia. You are most likely to meet an orthoptist if your child has oculomotor problems. 

Certified ophthalmic assistants perform preliminary eye function testing and diagnostic procedures. They both work with the ophthalmologist responsible for your child’s care. 

Fellows and residents in the eye clinic are fully licensed medical doctors who have chosen Ophthalmology as their specialty and are learning to diagnose and treat ophthalmic disorders under the supervision of our expert physician staff. 

Fellows are fully licensed ophthalmologists.  They are selected to obtain specialized experience in the treatment of paediatric eye disorders.  

Residents are licensed medical doctors training to be ophthalmologists. During their intensive training, residents work at different hospitals associated with the University of Toronto. 

Information clerks are responsible for the clerical activities in the clinic, such as registration and necessary paperwork. Information clerks can answer non-medical questions only, such as how long your appointment might be. They will direct you to an appropriate team member for other questions. 

Information coordinators organize the operation of the clinics assigned under their responsibility. They schedule your child’s clinic appointments, surgeries and medical tests (if ordered). They are the link to your ophthalmologist. 

The nurses in the eye clinic are registered nurses, who have special skills and knowledge of paediatric ophthalmology. They provide care to your child during sedated procedures, assist the doctor with examinations and provide various types of teaching to parents. Staff nurses deliver support and can refer you to the appropriate person or agency as required. 

Ophthalmic imaging specialists are photographers or technicians who have specialized training to provide imaging of all the structures of the eye. They use state-of-the-art technology to do various tests and procedures, which help to diagnose your child’s eye problem. 

SickKids Social Workers are graduate-trained clinicians who promote resilience, enhance coping and capacity, and provide expertise at the intersection of mental and physical health in children, youth and families receiving services at the hospital.  

A social worker may be asked to provide support to a child and family whose child is experiencing vision loss and/or requires ongoing medical treatment that may result in a variety of psychosocial needs including: assistance with coping and adaptation, developmental concerns, school-related needs, issues with peers, and financial concerns.

An Ocular Genetic Counsellor (OGC) has specialized knowledge of eye genetics. OGCs meet with families who have one or more family members affected with a genetic eye condition. OGCs will discuss topics appropriate to a child’s diagnosis. This information includes the cause, inheritance pattern, risks, reproductive options, genetic testing, research opportunities, vision aids and support groups. Psychosocial matters related to vision loss can also be discussed.

This process helps the family to make informed decisions and better understand the eye condition in their family. Learn more about Genetic Counselling at SickKids. 

The SickKids Retinoblastoma Program, in the Department of Ophthalmology and Vision Sciences, conducts numerous outcome assessment projects and perform basic science investigations on all aspects of retinoblastoma. Dr. Ashwin Mallipatna, Head of the Retinoblastoma Program, and Dr. Stephanie Kletke, Co-Supervisor of the Retinoblastoma Fellowship, envision a world where every child diagnosed with the childhood eye cancer, retinoblastoma, no matter their location, can receive timely and quality care. In support, Dr. Brenda Gallie and Dr. Helen Dimaras guide retinoblastoma research and international collaborations. Dr. Gallie's prolific contributions to the field include seminal publications in genetics, and the development of a point-of-care data collection system. Dr. Dimaras is also a public-health researcher achieving accolades in patient-partnered research through the Canadian Retinoblastoma Research Advisory Board. They co-lead the One Retinoblastoma World network, which is a global health network of people around the world devoted to optimizing global retinoblastoma care. Together, the team actively investigates better treatment methods and factors that can affect retinoblastoma diagnosis and care worldwide, fostering the development of national strategies and guidelines.

The Ocular Genetics Program, led by Drs. E. Héon and A. Vincent, is translational and unique in Canada integrating clinical, translational and basic research. This multidisciplinary team provides comprehensive assessment of patients with inherited eye disorders, provides genetic testing and counseling.  

The unsolved cases are offered a research stream of genome sequencing analysis which has been very successful at identifying missing variants (80%). Our work combines genetic, molecular, bioinformatics approaches and the use of animal models.  

Dr. Ajoy Vincent develops innovative electrophysiology protocols to better understand our molecular findings. He also leads a research mouse ocular phenotyping unit which also allows us to further explore our novel molecular findings. 

Our collaborative network is Local, National and International which allows us to not only better understand rare inherited retinal diseases but also participate in several discussion groups and clinical trials aiming to improve the outcome of patients. Some trials are Natural History studies which are important to identify the outcome measures of change, tailored to the patient population studied. Other clinical trials evaluate novel therapeutic opportunities.  

In that context, we are leading a study on 'Patient Reported Outcomes for children affected with inherited retinal diseases' which will help us better understand the patient’s perspective of visual impairment.  

Sponsored by Fighting Blindness Canada, we developed, administer (V. Batmanabane) and house a National Registry for Inherited Retinal Diseases. This is an important tool allowing affected individuals to stay connected with research opportunities.  

We train students of all levels from all over the world to ensure knowledge translation. Our ultimate goals are to develop approaches to allow genetic diagnosis and contribute to bringing novel therapeutic approaches to improve the visual outcome. We are invested in better understanding the patient perspective and work towards improving their quality of life.

The aim of NeuroVision is to study neuro-visual function from the retina to the most advanced stages of brain processing by using state-of-the-art techniques and research expertise. Currently, no other centre has the expertise and availability, under one roof, to use sophisticated electrophysiology, eye movement recordings, behavioral measures, and neuroimaging to study visual processing in children. The unique clinical environment at SickKids allows us to access a large number of children affected with common and rare eye diseases. Our integrated clinical-research approach ensures clinical questions guide our research directions, while new knowledge revolutionizes the assessment and treatment of visual and neurological disorders in children.  

We are actively investigating the neural mechanisms of amblyopia (lazy eye), strabismus (eye misalignment), and abnormal eye movements. We are also very active in determining sophisticated electrophysiological markers of drug toxicity on the retina and of the earliest signs of complications from diabetes. 

Retinopathy of prematurity (ROP) is a disease of the developing retina that occurs primarily in premature infants. The goals of this program are: (1) to improve functional and structural outcomes of patients treated for ROP; and (2) to increase access to ROP timely screening and treatment in remote underserved areas to reduce risk of blindness.   

We are actively studying efficacy and safety of new anti-VEGF drugs used for the treatment of ROP to ensure it compares to the high standards we already achieve with laser treatment. We have previously reported on our experience with regression of disease, visual, refractive and structural results with intravitreal bevacizumab injection. As well, we reported on neurodevelopmentaloutcomes at two years of age. Currently, our work is focused on investigating long-term outcomes and effects of these drugs on visual function and development of refractive errors. In addition, our multidisciplinary approach at SickKids is ongoing in evaluating systemic outcomes and aims to advance understanding of the safety of these medications on the premature infant’s health both early after treatment and later in childhood, including potential effects on lungs, heart, and kidneys. 

We also have a leading role in the use of telemedicine in Canada through our remote ROP screening program using live two-way audio-video connection in Ontario (ONTROP network), with SickKidsbeing the reading centre. Our work has shown ONTROP to be a clinically successful alternative solution to implementing ROP screening. Additionally, we have verified safety, decrease potential morbidity, and reduction in healthcare costs.  

The goal of this program is to promote technological innovations to preserve sight. We develop new techniques and adapt existing adult technologies for the paediatric population in ophthalmic diagnostic and surgery.  

Current projects include: (1) imaging of the corneal endothelial cell layer, which helps provide insight into the effect of surgery and disease on this layer; (2) corneal neurotization outcome studies and animal models, which study a unique procedure which was developed at SickKids; (3) outcomes of cataract surgery in children; (4) excimer laser refractive surgery project to perform refractive correction under general anesthetic to children with developmental delay and autism, and/or with amblyopia; and (5), outcomes of ocular surface disease which includes dry eye and Stevens-Johnson syndrome. 

The Department of Ophthalmology and Vision Sciences at SickKids offers educational observership opportunities for local and international learners. Observers are allowed to observe clinical interactions, procedures and participate in educational opportunities such as departmental rounds. 

How to apply 

If you are interested in applying for an Observership within the Department of Ophthalmology and Vision Sciences at SickKids, please email  ophthalmology.education@sickkids.ca. Your application will not be processed unless all of the information has been received. Observerships run for a maximum of two (2) week period only throughout the year. 

SickKids Ophthalmology Fellowship Programs are recognized among the best internationally, as we provide comprehensive training to ophthalmologists from all parts of the world.  

SickKids Ophthalmology offers Fellowships in Ocular Genetics, Retinoblastoma, Neuro-Ophthalmology and the only dedicated Pediatric Cornea and External Diseases fellowship in the world. 

Contact: Our Fellowship Director is Dr. Nasrin Tehrani, at nasrin.tehrani@sickkids.ca. 

How to apply

For information about becoming a fellow in our SickKids Ophthalmology and Vision Sciences Department, please visit the  University of Toronto's Department of Ophthalmology & Vision Sciences portal. 

Paediatric Ophthalmology and Strabismus Fellowship

SickKids offers four 1-year Paediatric Ophthalmology and Strabismus Fellowship positions throughout each academic year. 

This training experience is an intense and active fellowship set in the largest paediatric center in North American for clinical care and research; in conjunction with the Residency and Fellowship Training Program of the University of Toronto, Department of Ophthalmology. The fellowship is characterized by a broad exposure to clinical material and problem situations and can be tailored somewhat to fit special needs or interests of the trainee. It includes exposure to all subspecialties within paediatric ophthalmology and strabismus. 

The fellow, appointed for a one-year term, participates in all aspects of our department, and is responsible for patient care in the Eye Clinic, in-hospital consultations, academic conferences, participation in resident training, and in research. The fellows are also required to provide full clinic coverage on Friday afternoons as the residents have academic leave. 

Fellowship objectives

• To provide a complete fellowship training experience in paediatric ophthalmology with surgical and clinical exposure to all disciplines within the field including strabismus (including adults), cataract, glaucoma, cornea, anterior segment disorders,oculoplastics, retinopathy of prematurity, neuro-ophthalmology, retinoblastoma, and ocular genetics (including adults). 
• To expose training fellows to the wide range of paediatric systemic diseases with ocular manifestations. 
• To provide a paediatric ophthalmology research experience resulting in the publication of at least one manuscript. 
• To offer personal and professional development as a future academically oriented paediatric ophthalmologist who is active in the field, demonstrates exemplary doctor-patient/parent relationships, and ethical behavior. 

Deadlines

Fellowships run from July 1 to June 30 (3 spots) and January 1 to December 31 (1 spot). In person interviews are required. Deadline for applications is the second Friday in September of the year prior to beginning the Fellowship in July. For the January (1 position), we will be making selection in the Fall of the year prior (for example January 2025 position will be selected in the Fall of 2023). 

Application process

Please note the fellowship application requirements in this document: DOVS Fellowship Application Information (PDF)

Please contact the Fellowship Coordinator, Nerizza Matignas, for any further inquiries on the application process, at nerizza.matignas@sickkids.ca. 

License requirements

Foreign applicants may apply. Applicants must be fully fluent in the English language. The College of Physicians and Surgeons of Ontario (CPSO) will generally grant a full clinical educational license to applicants with recognized ophthalmology specialty certification in their home country. 

The CPSO designates the first 4–6 weeks of the fellowship to be an evaluation period during which the candidate's ability and language fluency will be assessed before a final educational license can be granted and the fellowship continued for the remainder of the designated 12-month period. Certificate of completion of the fellowship will be issued when the training time, research and other commitments are completed. 

SickKids Ophthalmology trains 12 to 16 Ophthalmology residents per year in Paediatric Ophthalmology through The University of Toronto. 

For information about The University of Toronto Residency Ophthalmology program, please visit the University of Toronto's Department of Ophthalmology and Vision Sciences page. 

If you are a resident and wish to do an elective in the Department of Ophthalmology and Vision Sciences, please send all requests to the Education AdministrativeCoordinator, at ophthalmology.education@sickkids.ca. 

SickKids Ophthalmology educates medical students (clerkship, visiting electives for international and Canadian medical students) in Paediatric Ophthalmology through the University of Toronto. 

Get more information about The University of Toronto Medical Education Ophthalmology Program.