All children should have their eyes and vision checked regularly by an eye care professional. Children with learning disabilities are more at risk of having problems and may be less likely to be able to communicate them, so regular eye care is essential. It is recommended that all children who have a learning disability have a full eye examination (sight test) at least once a year.

As part of the Healthy Child Programme, children should be offered an eye check in the newborn period and in reception year (age four-five) at school. However, it is important to realise that these checks are designed to identify some but certainly not all problems that can affect eyes or vision, and that in some areas not all children are offered a school entry check.

It is not necessary for a child to be able to read or even speak in order for eye professionals to assess what a child can see or if they would benefit from glasses to make seeing easier.

 

Where to access eye care

Some areas have vision screening programmes in schools - often delivered by orthoptists - where vision is checked upon entry to school at age four-five and sometimes throughout school. The screening tests may vary from just a check on distance vision to also checking close vision and how the eyes work as a pair.  However, vision screening is not as detailed a check as a full sight test and some children may pass even if they have a problem with their eyes or vision.

All children under the age of 16, or 19 and in full time education, are entitled to a free NHS sight test carried out by an optometrist at a community opticians. You can arrange this yourself and don’t need to be referred. This test will include checking vision for far and near, how the eyes work as a pair, how the eyes are focused (to see if glasses are needed) and the health of the eyes inside and outside. Search using our database of optometrists to see optometrists in your area that make reasonable adjustments for children with learning disabilities.

If you see a paediatrician they may be able to help you access specialist children’s vision clinics set up at child development centres, health centres, or paediatric outpatients through hospital services.

Your GP can help with eye infections and refer you to the eye clinic at the hospital for serious concerns.

SeeAbility know that these services are not always consistent around the country, or easy for children with a learning disability to access. Our Children in Focus Campaign is all about campaigning for a national eye care programme to allow all children with learning disabilities to have their sight tested throughout their special education.

You can use our form to tell any eye care professional about your child and their eyes. This will help them to assess your child’s eyes appropriately and it is a good idea to get this form to them before the eye test so that they can be prepared.   

About your child and their eyes

We also recommend asking them to fill in our report to help you understand any problems with your child’s eyes and how you can help them to cope.  It may help to take a copy of the report to the eye test.

Eye test results report

If you are an eye care professional and you would like to use or adapt our forms, or want any help or advice in developing/improving eye care services for people with a learning disability, then please contact Laura Christie (National Manager – Children and Families) on 0161 748 6107 or email: [email protected]

 

A child's eye test

All children are entitled to and able to have a free (NHS) annual eye test. This is usually provided in the community by an optometrist (ophthalmic optician). Children who have learning or physical disabilities which make communicating or interacting difficult can still have an eye test as there are lots of ways of doing it. No one is too disabled to have an eye test.

To help, we have a video and an easy read factsheet for children who are Makaton users.

 

  Understanding your eye test - Makaton users

There are four main parts of the test:

  • Checking how well you can see - this can be done by using tests adapted for children such as a picture test rather than letters or by using tests which watch how the child responds to different visual stimuli
  • Checking how well the eyes focus (to see if glasses are needed) - this can be done just by looking at the eyes with a specialist instrument (a retinoscope) and you don’t need to be able to say when things look clearer
  • Checking how well the eyes move and work together to give 3D vision - this can be done with lights and toys and special picture tests (stereotests)
  • Checking the health of the inside and outside of the eyes - this can be done by shining a light into the eyes (an ophthalmoscope)

 

Reasonable adjustments

It’s possible to make reasonable adjustments to the sight test to make it accessible for children with learning disabilities. Many of these adjustments take place prior to the child arriving in the opticians or eye clinic. To have the best chance of a successful visit, it is helpful to highlight the child’s additional needs before the day of the appointment.

Examples of reasonable adjustments include:

  • Visiting the practice or hospital before the day of the eye test to aid familiarisation with the rooms
  • Arranging the appointment during a quieter time of day to minimise waiting time or at a time of day that is best for the child
  • Carrying out the tests from a wheelchair - you may need to check access and the size of rooms at high street practices before going
  • Using a range of tests to check vision e.g. Kay pictures, Cardiff cards or Keeler Cards
  • Conducting the tests over more than one visit if concentration is a problem or the child tires easily
  • Simply explaining to the child what will happen or demonstrating the test on parent/carer first for children who are anxious

If the child usually wears hearing aids, it is important to take these to the appointment so glasses can be fitted correctly around them.