Key points
- This section provides guidance on examining children who are too young to have the capacity to consent. You must make the care of the child your first and continuing concern.
- You should gather key information about the child and carry out a range of tests including assessing: visual acuity, ocular muscle balance, binocular function, refractive error and the health of the child’s eyes.
- You must not refuse to see a patient based on their age alone. You should arrange a transfer of care or a referral if a specialist assessment is in the patient’s best interests.
- You should establish rapport with the child and communicate with them and their accompanying adult in an appropriate way.
- You should take steps to protect yourself against unfounded allegations of inappropriate conduct or assault. If you provide vision screening in schools you should make it clear that it is not a substitute for a full eye examination.
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This Guidance does not change what you must do under the law.
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You must not refuse to see a patient based on their age alone. You should arrange a transfer of care or a referral if a specialist assessment is in the patient’s best interests. You should make a reasonable attempt to include all appropriate tests. In exceptional circumstances, you may not be able to complete all the indicated tests for a very young child. In these situations, you should base your management on the findings you do have and act in the child's best interests. Records should reflect what was attempted and why it was not possible to complete an examination, and details of a referral made if required.
- England NHS England Avoidance of doubt letter, 2019 [Accessed 1 Nov 2023]
- Northern Ireland [Accessed 1 Nov 2023]
- Scotland [Accessed 1 Nov 2023]
- Wales [Accessed 1 Nov 2023]