Orthoptic visual processing difficulties clinic – information for patients and referrers

Read our guide below to help you understand how we can help in the assessment of children with visual processing difficulties (VPD).

You can also download a PDF version of this patient information by following the link on the right.

What is an orthoptic visual processing difficulties clinic?

It helps to diagnose and treat visual problems which may interfere with a child’s education. The clinic isn’t intended to replace the expertise of teachers, SENCOs, specialist teachers, or educational psychologists. We don’t give any diagnoses of dyslexia, specific learning difficulties or other educational problems.

We run orthoptic visual processing difficulties clinics at Wycombe, Amersham and Stoke Mandeville hospitals.

How we help

Our orthoptic expertise lies in visual processing difficulties such as ocular motility (eye movement) problems, visual stress/discomfort, problems in eye
tracking movements and visual perception difficulties.

Visual processing difficulties and specific learning issues don’t necessarily go hand in hand but some children may have characteristics of learning difficulties alongside an underlying visual problem.

Treating any area of visual difficulty will not resolve a learning issue, but it will help your child to manage their issue more effectively. It will also enable them to better access the information needed for learning.

Arranging a vision test for your child

This would especially useful for your child to visit an optometrist (optician) for a general vision test before the appointment. This will make
sure that your child doesn’t need glasses or to make sure their current glasses are up to date.

All eye services for children are free.

Bring your child’s glasses with you to our clinic and a copy of any glasses prescriptions if your child already wears glasses.

What happens during the clinic?

Your child will have a clinical assessment for visual processing difficulties. There are are 4 parts to the assessment.

We assess your child’s binocular vision and focusing

We assess the ability of your child to use their eyes together as a pair (binocular vision) and the focusing mechanisms of their eyes. For example, your child may have difficulties with their near sight (accommodative insufficiency).

This can be treated with exercises or glasses. Or your child may have a squint (turn in the eye) which is interfering with what they see.

We assess saccadic eye movements

These are very small movements needed for reading. A difficulty with your child’s voluntary saccades can lead to eye- tracking problems, for example, difficulties in following the words of a book.

Eye-tracking problems affect a child’s reading and comprehension. They may exhibit signs of ‘head bobbing’ when reading (the head is making the movements rather than the eyes), rubbing their eyes and feeling discomfort when reading, or fatigue with prolonged reading.

Eye-tracking problems can be treated with a series of exercises aimed at improving these eye movements.

We assess visual stress/discomfort

The striped effect of writing can cause visual stress (or pattern-related visual stress). It overstimulates the visual cortex in the brain and produces symptoms.

We may advise an an overlay with a tint unique to each child. The overlay can redistribute the wavelengths of light entering the eye to the brain and dampen down these symptoms of visual stress.

There’s no cure for visual stress but it can be treated and significantly improved.

We assess visual perception

This demonstrates how well a child can process different types of visual information. If we find a weakness we’ll recommend exercises.

How do I get a referral for a/my child?

If there’s a concern that your child can’t see before a referral at age 7, take them to an optometrist (optician) for an eye test for glasses.

You can get a referral for a children aged 7 and above from a GP, optometrist, or occupational therapist.

We do not accept self-referrals.

Contact us

Call the Orthoptic department on 01494 971720.

How can I help reduce healthcare associated infections?

Infection prevention and control is important to the wellbeing of our patients so we have procedures in place. Keeping your hands clean is an effective way of preventing the spread of infections.

You, and anyone visiting you, must use the hand sanitiser available at the entrance to every ward before coming in and after you leave. You may need to wash your hands at the sink using soap and water. Hand sanitisers are not suitable for dealing with patients who have symptoms of diarrhoea.

More help or advice

Contact our patient advice and liaison service (PALS) on 01296 316042 or bht.pals@nhs.net