For a young person who has received eye care since childhood, moving to an adult ophthalmology service can mean leaving behind a clinical team that knows their medical history, visual needs, and family circumstances. The next appointment may be with a new specialist, in a different setting, with different expectations about managing their own health.
That change can be particularly important for patients with childhood-onset conditions requiring ongoing monitoring or treatment. Yet research published in 2026 suggests that the evidence guiding these transitions in ophthalmology remains surprisingly limited.
When Pediatric Eye Care Ends, the Need for Care May Not
Moving from pediatric to adult eye care is not necessarily the end of treatment. Conditions such as childhood glaucoma, pediatric uveitis, inherited retinal disease, and some optic nerve disorders may require continuing surveillance or specialist management into adulthood.
The difficulty is that the organization of care changes as patients grow older. Parents or caregivers who previously coordinated appointments and treatment may become less involved, while young adults are expected to take greater responsibility for communicating with clinicians, understanding medications, and recognizing when follow-up is needed.
Transfer and transition are not the same thing. Transfer is the move between services. Transition includes the preparation, education, coordination, and follow-up that help make that move successful. For eye care teams, this distinction raises a question about how clinical knowledge and support can be preserved after pediatric follow-up ends.
What the 2026 Review Found
A scoping review by Kumar and colleagues, published in the European Journal of Ophthalmology in June 2026, examined published research on transition programs for young people moving from pediatric to adult eye care. The researchers searched Ovid MEDLINE, Ovid Embase, and the Cochrane Library, using a structured review methodology.
Of 339 publications identified, just five met the inclusion criteria. None specifically evaluated a transition program within ophthalmology. Two studies concerned transition programs for young people with type 1 diabetes, two involved rheumatological conditions, and one explored young people's views about transition in an eye or vision context.
The review therefore identified a gap in the published evidence rather than demonstrating the superiority of a particular approach. Experiences in other medical specialties may provide useful starting points, but their results cannot automatically be applied to ophthalmology.
This distinction matters for clinicians considering how to improve their own services. A structured transition process may be sensible, but more ophthalmology-specific research is needed to establish which elements improve attendance, clinical outcomes, and patient experience.
Why Continuity Matters for Childhood Eye Conditions
A young patient who feels well or notices no recent change in vision may not fully understand why ongoing monitoring remains necessary. Depending on the condition, the need for follow-up can continue even when symptoms are absent or vision appears stable.
For someone with childhood glaucoma, the adult clinician may need a detailed history of intraocular pressure measurements, treatment decisions, surgical procedures, and optic nerve findings. A patient with a history of pediatric uveitis may require clear documentation of inflammatory episodes, medications, treatment response, and complications.
Patients with inherited retinal conditions may have different needs, including previous imaging, genetic findings, counseling history, and access to low-vision or rehabilitation services. The appropriate transition plan should reflect the patient's diagnosis, clinical risks, and individual circumstances rather than follow a single template.
For the receiving team, continuity means more than knowing the diagnosis. Understanding how the condition has changed, what has already been tried, and which investigations are meaningful for future comparisons can reduce uncertainty during the first adult consultations.
Preparing Young Patients for Greater Independence
The transition process also involves helping adolescents develop confidence in managing their own eye health. That independence develops differently for every patient and should not be determined by age alone.
General healthcare transition guidance recommends assessing readiness, involving the young person in decisions, and gradually building self-management skills. In an eye care setting, that could include helping patients explain their diagnosis, recognize the purpose of medications, understand follow-up requirements, and know whom to contact when concerns arise.
An adolescent who previously relied on a parent to answer every question may benefit from opportunities to speak directly with the clinician. The goal is not to remove family support abruptly, but to give the young person a more active role while respecting their abilities, preferences, and support needs.
Clinics should also consider accessibility. Patients with low vision may need appointment information, medication instructions, and transition summaries in formats they can use independently. Those with additional disabilities or complex medical needs may require continuing caregiver involvement or coordination with other specialties.
A Practical Transition Process for Eye Care Clinics
Although the review found little ophthalmology-specific evidence, broader healthcare frameworks offer practical principles that eye care teams can adapt. The US-based Got Transition program describes a structured approach involving transition policies, tracking, readiness assessment, planning, transfer, and confirmation that adult care has been established. For ophthalmology practices, the following steps provide a practical planning framework rather than a protocol validated by the review.
Start the conversation before the final pediatric visit
Introduce the possibility of adult care while there is still time to prepare. Explain who may provide future care, what will change, and which aspects of monitoring or treatment will continue.
Assess readiness and support needs
Ask what the young person understands about their condition, appointments, medications, and warning signs. Identify barriers such as transportation, insurance changes, inaccessible information, or difficulty managing appointments without assistance.
Prepare a useful clinical summary
The receiving clinician may need more than a referral letter. Depending on the condition, an appropriate summary should bring together the essential information rather than leave it scattered across previous correspondence. Relevant items can include:
- Diagnosis and relevant medical history
- Current medications and treatment plans
- Previous surgeries and procedures
- Visual acuity and other relevant clinical findings over time
- Important imaging or investigation results
- Follow-up requirements and circumstances that warrant urgent review
- Accessibility, communication, and low-vision support needs
The aim is not to send every record indiscriminately. It is to provide enough reliable, relevant information for the adult team to understand the patient's history and continuing care needs.
Establish the next point of care
Where possible, identify a suitable adult clinician and arrange the initial appointment before pediatric follow-up ends. A coordinated handover, particularly for complex conditions, can help clarify responsibilities and reduce uncertainty for both the patient and receiving service.
Confirm that the transition was completed
Sending a referral does not establish that the patient attended an adult appointment. A practice may therefore benefit from a process for confirming whether care was established and identifying patients who need additional support after transfer.
These recommendations are adapted from broader healthcare transition principles, not from an ophthalmology-specific intervention validated by the 2026 review. Practices should adapt them to local resources, patient needs, and the requirements of the receiving service.
Supporting Patients With Low Vision or Complex Needs
For young people with visual impairment, transition extends beyond a change of specialist. Starting college, entering employment, living more independently, and adapting to new environments may all affect how a person manages their eye health.
A useful transition discussion can consider accessible appointment systems, preferred communication formats, assistive technology, and connections to rehabilitation or community support. It may also involve coordinating with education providers or other healthcare services when the patient wishes and appropriate information-sharing permissions are in place.
Young adults should have a meaningful voice in these decisions. At the same time, clinicians should avoid assuming that independence means managing every aspect of care without assistance.
The appropriate balance between autonomy and support will differ between individuals. A person-centered transition process makes room for those differences instead of treating them as exceptions.
What Research Still Needs to Establish
The 2026 review makes clear that ophthalmology needs stronger evidence about how transitions should be organized and evaluated. It remains uncertain whether particular models, such as joint pediatric-adult clinics, named coordinators, or standardized summaries, produce better ophthalmic outcomes than usual referral arrangements.
Future studies could measure whether young people attend their first adult appointment, remain engaged in follow-up, understand their condition, and report confidence managing their care. For some conditions, researchers could also examine relevant clinical outcomes, including disease activity or the consequences of delayed monitoring.
These outcomes should be considered alongside feasibility, staffing, accessibility, and patient experience. A transition process that works in a large specialist center may need adaptation for a smaller eye care practice.
For now, the practical opportunity is to look beyond the referral itself. Supporting a young person's move into adult eye care means preparing the patient, transferring the right information, and ensuring that continuing clinical responsibility is clear.
Sources
- 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. 2026.
- Ophthalmology Times Europe. Review highlights gaps in transition from paediatric to adult eye care. June 20, 2026.
- Got Transition. Six Core Elements of Health Care Transition.
- National Institute for Health and Care Excellence. Transition from children's to adults' services, NG43.
