PAEDIATRIC REFERRAL REFINEMENT

PROTOCOL FOR COMMUNITY OPTOMETRY

1st PRR visit to Community Optometrists

  • Full NHS eye exam including:
  • Recheck unaided vision with crowded Keeler Logmar test
  • Cycloplegic refraction 30 minutes after instillation of G. Cyclopentolate 1%
  • Fundus examination – either BIO 20D or 90D or direct ophthalmoscope
  • Prescribe glasses if appropriate
  • Complete online report using unique patient identifier on SCH emailed referral

Possible outcomes of 1st PRR:

  1. VA meets required standard - discharge to GOS
  2. VA<0.5, strabismus or other pathology refer to secondary care using online reporting (issue spectacles where required prior to referral)
  3. VA between 6/7.5-3 and 6/19 (0.175 and 0.5) prescribe glasses and review at 8 weeks

2nd PRR visit at 8 weeks

  • Check compliance with spectacles and fit
  • Reassess acuity with spectacles using crowded Keeler Logmar test
  • Complete online report

Possible outcomes of 2nd PRR:

  1. VA meets required standard - discharge to GOS
  2. VA does not meet standard, but has improved or compliance has not been good review in further 10 weeks

3rd PRR visit at 18 weeks

  • Check compliance with glasses and fit
  • GOS examination (non cycloplegic)
  • Reassess acuity with spectacles using crowded Keeler Logmar test
  • Complete online report

Possible outcomes of 3rd PRR:

  1. VA meets required standard - discharge to GOS
  2. VA does not meet standard - refer to secondary care online

Required vision standard – VA ≥ 6/7.5-2 (0.150) in the best eye and ≥ 6/9.5 (0.2) in the poorest eye.

Referral to secondary care can be easily preformed by completing the on-line PRR combined Referral / Report on the first page of the system, this fulfils the PRR report and is a referral directly into SCH, so no further GOS 18 paperwork is required.

If the family wish to be referred to a trust other than SCH, then please complete a PRR in the usual way and outcome as Referral to hospital other than SCH, you will then need to complete a GOS 18 also.

Pathway updated for school year 2012 -2013