Reduced vision in children

Specialty: Ophthalmology
Age group: Children

Criteria for referral to public hospital service

• Reduced vision due to non-refractive error or other causes (e.g. cataract)
• Reduced vision with refractive error that has not responded to treatment (spectacles, contact lenses, patching, atropine eye drops or topical antibiotics).

Information to be included in the referral

Information that must be provided

• Child’s age
• Description of onset, severity and duration of symptoms
• Details of previous management including the course of treatment(s), assessment of adherence to current management plan and outcome of treatment(s)
• Comprehensive eye and vision assessment including cycloplegic refraction and dilated retinal examination (usually performed by an optometrist or ophthalmologist) with best corrected visual acuity (i.e. measured with spectacles or contact lenses) for both eyes or visual behaviour assessment if the child is pre-literate or non-verbal.

Provide if available

• Statement about the parent(s) or guardian’s interest in having surgical treatment if that is a possible intervention
• Ocular imaging (e.g. retinal photograph, optical coherence tomography (OCT) results)
• If the child is neurodiverse or has a disability
• If the child identifies as an Aboriginal and/or Torres Strait Islander
• If the child has a preferred language other than English and if they rely on cultural or linguistic support (e.g. Aboriginal cultural support, an interpreter)
• If the child lives in out-of-home care (foster care, kinship care, permanent care or residential care)
• If the child is aged 14-18 years, do they consent that their health information is shared with their parent, guardian or carer.

Additional comments

The Minimum information for referrals to non-admitted specialist services lists the information that should be included in a referral request.

Note there are also statewide referral criteria for Pupil abnormalities

Primary and secondary school children with low vision (permanent reduced visual acuity of 6/18 or worse) may be eligible to be reviewed at the Education Visual Assessment Clinic (EVAC) at the Royal Victorian Eye and Ear Hospital. EVAC does not accept referrals from a primary care providers, children must be referred by an ophthalmologist. Referrals for children with reduced vision are not accepted by Royal Victorian Eye and Ear Hospital.

Vision screening and eye examinations are best managed in primary care. Referrals for vision assessments will not be accepted.

People experiencing disadvantage or other barriers to accessing eyecare services may be eligible to receive services through the Victorian Eyecare Service.

Where appropriate and available the referral may be directed to an alternative specialist clinic or service.

Referral to a public hospital is not appropriate for

• Reduced vision with refractive error that has not been treated (spectacles, contact lenses, patching or atropine eye drops).