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Children’s Eye Care – Reinforcing National Guidelines for Vision Screening in Schools for all 4-5 year olds

3 September 2015

The British and Irish Orthoptic Society (BIOS) supports the evidence-based national screening guidelines aimed at the early detection of vision defects in children, at the appropriate age, through clinical examinations by appropriately trained staff.

Detection of eye problems in the very young and pre-school child requires expert clinical examination. If a parent or carer has concern about their child’s vision or visual behaviour it is recommended that they consult their GP or Health Visitor as outlined in the Department of Health ‘Healthy Child programme 0 -5 years’. The GP and Health Visitor provide the link to local care pathways that ensure access to specialist eye care professionals.

BIOS endorses the UK National Screening Committee (NSC) recommendations, of universal vision screening for all children between the ages of 4-5 years in school by an orthoptic-led service. The recommendation was made following a review of research evidence and it included the importance of standardised delivery of screening provision. BIOS has developed evidence-based recommendations that support orthoptic-led delivery of the vision screening to provide the standardising approach required by the NSC.

BIOS is concerned with the situation that has developed regarding the commissioning process for Vision Screening in England. There is a lack of awareness of the NSC guidance on Vision Screening services, and a failure to incorporate for the onward care pathway for children who fail the vision screening and the quality assurance needed. BIOS is working to ensure that the specification and commissioning of Vision Screening contracts occur in a consistent way that deliver on NSC recommendations. Orthoptists are also working with the Governments in Scotland, Wales and Northern Ireland to achieve this standardisation. BIOS supports increasing parental awareness of the National Guidelines for a vision test in school at age 4 to 5 years and advocates that parents check that this is provided to their child.

BIOS commends the view of The Royal College of Ophthalmologists that a routine “sight test” is unnecessary in the absence of visual symptoms in children over 5 years of age. Visual problems such as short sightedness can develop in the older child. If a parent becomes concerned about their child’s vision, progress in school, or a child complains of headaches or tired eyes they can arrange to attend a local Optometrist for an eye examination or contact their GP.

There is no robust research to support any other vision screening in childhood.



Notes to editors:

The British and Irish Orthoptic Society (BIOS): BIOS is the professional body for
Orthoptists in the UK and Ireland. It supports members in continuous professional development and offers advice and guidance on professional conduct and standards, ensuring members working in the NHS and private practice achieve the best possible health outcomes for patients and service users.

BIOS has developed the following evidence-based guidance documents on Vision Screening:

  • BIOS Guidelines on Vision Screening in Children. British and Irish Orthoptic Society, 2014.
  • BIOS Statement on Orthoptic-led Vision Screening Services, April 2015
  • Guidelines on BIOS Vision Screening Training Programme for Vision
  • Screeners, April 2015
  • BIOS Information for Commissioners of Children’s Vision Screening Services,
  • May 2015
  • BIOS Vision Screening Care Pathway, August 2015
  • BIOS Vision Screening Key Performance Indicators, August 2015

National Screening Committee: The UK National Screening Committee recommends a systematic population screening programme for vision defects in children aged 4 to 5 by an orthoptic-led service-

For more information contact BIOS Vision Screening Special Interest Group Leads: Dr Helen Griffiths ( 0114 271 3818 or Dr Sarah Shea ( 01248 384023

For more information or an interview with one of our spokespeople please contact the BIOS office on +44(0)1353 66 55 41 or email