Cause for Concern Service

Patient Experience

  • Reference Number: HEY1146/2020
  • Departments: Ophthalmology Department, Orthoptic
  • Last Updated: 19 December 2023


This leaflet has been produced to give you general information. Most of your questions should be answered by this leaflet. It is not intended to replace the discussion between you and the healthcare team, but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.

What is the Cause for Concern Orthoptic Service?

This service provides access to a basic eye test for children between the ages of six months and six years. This may be where a parent/carer or a health professional (e.g. Health Visitor, doctor, Community Paediatrician etc.) are concerned about a child`s vision or the presence of a squint. Your child will be assessed by an Orthoptist who is an Allied Health Professional trained to assess vision and detect squints in young children.

The service is provided at local health centres and community hospitals

Can this impact vision and why do I need to attend appointments?

Children are not born with fully developed vision; in the same way they learn to speak they have to learn to see. Between 3% – 5% of children can develop an eye problem which may leave them at risk of amblyopia (lazy eye).

Can there be any complications or risks?

There are no complications or risks associated with the assessment. It is possible a child, who is suspected of having a problem and is then referred for a more detailed assessment, may later be found not to have a problem.

How do I prepare for the appointment?

It may be useful for you to write down any questions you may want to ask before you attend the appointment and bring them with you. Whether the Orthoptist will be able to complete a full assessment will be dependent on how much cooperation the Orthoptist is able to gain from your child for the tests. There is no guarantee the assessment with the Orthoptist will be able to be completed. In order to make the most of your appointment it would be useful to bring any photographs to show the Orthoptist where you believe your baby appears to have a squint.

What will happen at the appointment?

You will receive an appointment to see the Orthoptic Team. They will attempt to carry out a range of assessments. The appointment can take up to 20 minutes and you will receive the results on the day. You will have time to discuss the findings of the assessment and to also ask any questions.

What will happen afterwards?

You will be told the results of your child`s assessment at the end of the test. If there are no problems found you will be discharged from the service.

Your child will receive a routine eye test at school/nursery between the ages of four and five years. You do not need to book this test, the test is often carried out at school and you will be informed of the result in writing.

If your child requires a referral to the Hospital Eye Service, the Orthoptist will make this referral on your behalf. You will be offered the option to choose which hospital you would prefer to attend.

What should I do if I feel there is a problem in the future?

The visual system is continually and rapidly developing during the first few years of life. Squints can develop in children up until school age and sometimes in adults. If you feel your child is developing a squint or you have concerns about their vision, it is important that you seek a specialist opinion.  If you have any new concerns, please ask your Health Visitor, local Optometrist or doctor for onward referral.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Orthoptic Department on telephone: (01482) 816605

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