Who is this service for?

Children in reception (or Year 1) are visited by an Orthoptist whilst at school for a vision screening.  If they fail the screening, the child is referred to an accredited practice unless they meet the following criteria:

1. Unable to perform crowded LogMAR test

2. Visual acuity <0.5 crowded LogMAR (<6/19) in one or both eyes

3. Manifest strabismus 

4. Ocular pathology 

In any of these cases, they are referred directly to the VEU (Herefordshire County Hospital) 

Who can perform these appointments?

Any qualified optometrist at the following practices:

What must be done at the appointment?

The Optometrist must do the following:

• Check monocular unaided vision with crowded LogMAR on each eye 

• Check stereoacuity

• Perform a cycloplegic refraction 25 minutes after installing Cyclopentolate 1% 

• Perform a fundus examination 

• Prescribe spectacles if appropriate 

If the vision is between 0.150 and 0.5 crowded LogMAR (6/7.5-2 and 6/19), spectacles should be prescribed and the patient reviewed in 6-weeks’ time. 

If the vision is <0.50 (<6/19) crowded LogMAR, the patient has a strabismus or other pathology, they must be referred to VEU and prescribed spectacles where required. 

6-week review (if required)

The Optometrist must do the following:

• Check the patient’s compliance with spectacles (and the fit)

• Re-check VA with glasses using crowded LogMAR 

• Discharge the patient to GOS with a 6-month review and inform Orthoptics (via Pharmaoutcomes) if the VA meets 0.150 (6/7.5-2) in each eye. 

If the VA does not meet 0.150 crowded LogMAR in each eye, review the patient again in another 6-weeks’ time. 

12-week review (if required)

This appointment is only required if the VA did not meet the required standard at the 6-week review. At this appointment, the optometrist must do the following: 

• Check the patient’s compliance with spectacles (and the fit)

• Re-check VA with glasses using crowded LogMAR 

• Discharge the patient to GOS with 6-month review and inform Orthoptics (via Pharmaoutcomes) if the VA meets 0.150 (6/7.5-2) in each eye. 

If the VA does not meet 0.150 crowded LogMAR in each eye, refer to the Orthoptics department via Pharmaoutcomes. 

What needs to be done after the appointment? 

After the first appointment, complete the “children’s eye care pathway” segment on Pharmaoutcomes. After the follow up appointment(s), complete the “children’s eye care pathway follow-up” segment on Pharmaoutcomes.  There will be the option to select whether the patient has been discharged or referred to Orthoptics on the “follow-up” segment. 

What happens if the patient doesn’t attend the appointment? 

If the patient doesn’t show up 2-3x for the review appointments, the patient needs to be referred to the Orthoptics department. Pharmaoutcomes should also be completed and the DNA option selected. 

If the patient has booked an initial appointment but then doesn’t show up on two separate occasions (or cannot be contacted to rebook), the Orthoptics department would still like to be informed via email (orthoptics.wvt@nhs.net).  

This is so that they can follow up with the school or inform safeguarding if needed.