The aim of the children's eye screening pathway is to ensure children are treated at the right time, in the right place as close to home as possible. The pathway will reduce unnecessary referrals to secondary care ophthalmology departments by allowing community optometrists to provide management and treatment to children who are found to have suspected amblyopia following school screening. Under the current pathway the majority of children who are identified as having a suspected eye defect at school vision screening are referred to secondary care for further investigation. The proposal is to refer children with suspected eye defects, identified at school screening, to community optometry, and then only refer into secondary care those children deemed to need secondary care attention according to the protocol.
If a child fails a school eye screening test, the parent/guardian will be given a letter asking them to book an appointment with a participating Optometrist from a list of participating practices. The letter will include a list of participating Optometrists and information for the Optometrist (appendix 1). The scheme is available for children registered with a Shropshire or Telford and Wrekin Clinical Commissioning Group GP. There will also be a referral form from the Orthoptist with additional clinical information (appendix 2). NB. When referral forms have been lost or mislaid, please contact Kay Phillips at the Royal Shrewsbury Hospital on 01743 261000 x 3324.
An NHS sight test will also be included in the check.
Accredited optometrists will receive referrals from the school screening standard referral form (Appendix 1).
If the practitioner is unable to provide an assessment and, where appropriate, the treatment of the child, the optometrist or other responsible person shall direct the child to an alternative provider of the services, by way of the list of contractors to the Services supplied by the CCG.
The optometrist shall seek written consent from the parent or guardian of the child to carry out the assessment and, where appropriate, treatment.
If onward referral is required, the ophthalmic practitioner will notify the school screening service and organise the referral via the GP.
The optometrist will measure unaided vision with crowded LogMAR using a patch on either eye, a cover test, measuring near and distant vision and stereopsis. Also included is a full cycloplegic refraction and a fundal examination. This will include a GOS sight test.
It may be necessary to prescribe glasses to correct refractive error if appropriate.
The child will then either be discharged, referred to the Hospital Eye Service or may need to return after 6 weeks for the optometrist to check progress or monitor changes.
The report form should be returned to :
referring orthoptist (by name),
School Vision Screening Services,
Royal Shrewsbury Hospital,
Mytton Oak Road,
Princess Royal Hospital,
whichever is your local hospital.
An 18 week review may also occur which will include a GOS sight test to check compliance with glasses and reassess acuity with crowded LogMAR test.
Participating Optometrists must be registered with the General Optical Council and on the CCG list of Providers for this service
Ophthalmic practitioners will be required to attend a session run by the CCG/LOC on delivering the service, but there are no more accreditation sessions planned for the time being. This may change in the future.