Purpose: The introduction of paediatric ophthalmology as a distinct subspecialty began in North America in the mid-1900s. However, the literature frequently omits the important achievements of Canadians in this process. We examine how ophthalmologists at the Hospital for Sick Children (HSC) made pioneering contributions to the developing subspecialty since 1875. Study Design: Review of archives and the historic medical literature. Methods: Historical archives were comprehensively searched for items relating to HSC’s Department of Ophthalmology and Vision Science. Papers published by the Department’s ophthalmologists in the historic medical literature were extracted using PubMed. Results: Canada’s earliest paediatric ophthalmologists were influential politicians, military officers, benefactors and Olympic athletes who were inspired to care for children out of philanthropy. The first regular paediatric ophthalmology clinics began at HSC in 1898. The Wright Needle, invented at HSC in the early 1920s, was among the first instruments designed specifically for paediatric eye surgery. Surging demand for affordable paediatric eye care during the Great Depression led HSC to become a specialized paediatric ophthalmology consult service for Ontario in 1935, while the Department spearheaded a provincial campaign innovating the early treatment of strabismus and amblyopia. The 1930s saw the appointment at HSC of Canada’s first female pioneers in ophthalmology, Innis MacDonald and Mary Albertson, and later Lois Lloyd and Maria Arstikaitis. HSC’s Lloyd Morgan was the first ophthalmologist to limit his practice exclusively to children in 1941. He founded an inaugural research program in paediatrics in 1941 and introduced the first strabismology fellowship in North America in 1945. Morgan and Dr. John Crawford would pioneer numerous surgeries and instruments still used today. Crawford’s greatest contribution to the field was creating a new model of subspecialized, collaborative paediatric ophthalmology. This model led HSC’s ophthalmologists to delineate the natural histories of congenital cataract, congenital glaucoma, retinoblastoma, and a host of neuro-ophthalmologic and genetic conditions, while setting new precedents for postgraduate education in its Paediatric Ophthalmology and Strabismus Fellowship. Conclusions: This project is the first to celebrate the pacesetting achievements of Canadians that shaped paediatric ophthalmology as a developing subspecialty. These milestones contributed to the field’s culture of surgical innovation, research, education, and public outreach.

The emergence of paediatric ophthalmology: a Canadian story

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