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It took me an embarrassingly long time to realise that staff at London's Old Street underground station are not just being surprisingly helpful when they announce 'alight here for Moorfields Eye Hospital' - a level of information not offered at other stations. They are, of course, doing it because a significant proportion of the people wishing to get off at Old Street may be blind or partially sighted.

Once they have navigated their way through one of London's most confusing stations, followed by one of London's most confusing roundabouts, patients find themselves at a hospital that is second to none in clinical reputation, but with little to recommend it as a building. This is the building to which Penoyre & Prasad has made a special addition, reviewed by Alan Dunlop in our Building Study (see pages 23-35). It is a department used by children, the group most likely to be intimidated by depressing facilities, and nervous parents.

With the unpromising surroundings, the need to connect to existing operating theatres, a Byzantine procurement process, and pressures from planners, it is not surprising that the result is imperfect. Dunlop, while applauding the level of ambition and the vast improvement over anything that went before, wonders what might have happened if the architects had been less compliant. Further improvement? Loss of the job?

Or a delay which would have deprived hundreds of patients a year of the improved facilities? Was it a risk worth taking?

In a week that sees Herzog & de Meuron given another opportunity to show off what it can do, thanks to Portsmouth Football Club, we should not forget that there is another kind of heroism in architecture - accepting the constraints of public projects and doing the best that one can. It calls for a clarity of vision that, sadly, may not be shared by many of the patients who are benefiting from the new eye centre.

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