In addition to condition specific guidelines please follow this advice


Absence red reflex/white reflex: - 

  • How to refer
    • Urgent clinic referral (1-2 weeks) – preferably David Jones


Lumps, abnormal  pupils

  • Refer to routine clinic


Epiphora/ persistent sticky eye

  • Management:
    • If child <1yr, advise lid cleaning and massage of mucocele – imperforate nasolacrimal duct may resolve within first year
  • When to refer:
    • >1yr old or dacryocystitis – refer routine clinic.
    • Refer urgently if dacryocystitis not responding to systemic antibiotics



  • Where to refer:
    • Refer to orthoptist for triage.
    • If covering visual axis and so risk of amblyopia refer to orthoptist urgently


Other child referrals (squint, reduced vision, amblyopia/blinking/aching eyes etc)

  • Where to refer
    • Refer to orthoptist – they will triage to optometrist +/- clinic as necessary

Date reviewed                     07/08/2019

Next review due                  07/08/2020

Sifter name                         Dr Rebecca Harling

Contributor                   Mr William Westlake



Version No. 2.10