New Children’s Pathway can reduce waiting times for young patients

1 August 2019

The UK National Screening committee recommends that screening of children’s vision should be offered to all 4-5 year olds. This is usually delivered in school in the child’s first year.

Traditionally, children who fail the screening were referred into the hospital eye services, however LOCSU believe primary care optical practice is best placed to deliver this clinical work within the community. The benefits of this approach are that patients can be seen at a time and place convenient to them, removing the need to take time out of school and work. Waiting times can be significantly shorter compared with hospital clinics, and this approach also releases vital capacity within the clinics to deal with more complex cases.

The new Children’s Pathway is based on referral to a commissioned service delivered within primary care optical practices, appropriately utilising the skills of primary care practitioners (Optometrists and dispensing Opticians). The clinical work-up includes Cycloplegic Refraction, Orthoptic Assessment and a Fundus Assessment, in line with RCOphth recommendations.

Using optical practices rather than hospital clinics allows the clinical assessment and spectacle dispensing to be delivered at the same time, adding further convenience for patients. Children are fully managed or discharged, those who require further appointments are reviewed during their adaptation period and referred to hospital clinics if their sight fails to improve in this time.

Children's eyes


“The pathway supports the whole system – only small numbers require consultant or orthoptic intervention and even then, the first line treatment of amblyopia is spectacle correction. If the child ultimately requires hospital referral, they will attend their ophthalmology appointment wearing their spectacles and having partially adapted to them” says Zoe Richmond, LOCSU Interim Clinical Director.

Zoe continues “We shouldn’t underestimate the added value of introducing a young family to primary care optical practice. NHS Sight tests are provided for all children but many parents aren’t aware that if a child fails their vision screening there may be implications for other family members. Primary care can support the whole family by inviting siblings for a sight test ahead of screening, delivering targeted earlier intervention”

To access the Diagnostic Pathway following Child Screening diagram and clinical management guidelines, please login to the Members’ Area at the bottom of the page then click here.

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