Screen children in schools to find lazy eyes early, experts say

BBC News

20-06-2025

Children with a lazy eye are being increasingly missed for treatment, experts say, in areas where early screenings are not available in schools.Some councils are unable to offer the service due to capacity or budget constraints, according to the Local Government Association (LGA), which is calling for increased funding.The British and Irish Orthoptic Society (BIOS) says screening for amblyopia, the medical name for the lazy eye condition, should be provided in all schools in England, as it is in Wales, Scotland and Northern Ireland.The condition, where one eye is weaker than the other, is corrected using patching, but treatment works best before the age of seven.
Ellen and Robert Hopkins say they were devastated to find out their son Harry had a lazy eye when they brought him for his first test when he was six-and-a-half years old.Between two and five per cent of children like Harry are diagnosed with amblyopia every year.The UK National Screening Committee recommends vision screening for children aged four to five, but about 11% of local authorities do not offer it in schools.Harry has been wearing a patch for the past few months, but his progress has tapered off since he reached his seventh birthday."We'd definitely like to have known about it earlier," mum Ellen says."If we'd known about it when he was three or four, or perhaps at the start of school, then he would have had longer to work on it."Harry's dad Robert said it was a "fluke" they brought him for an eye test, after he thought he was looking past him when they were having a chat after dinner in their home in Derbyshire."When I was a child I was tested in school, I can't believe kids aren't tested because with conditions like this you have a limited amount of time to make an improvement or not," he added.Craig Murray, chair of BIOS, says it is a hard condition for parents to spot early, and that it is a "postcode lottery" for families on whether they are offered screening or not."We are finding more of those cases of older children who are coming in and they weren't screened, and now it's too late for them to have that amblyopia treated," he said.
Around 75,000 children now live in areas that do not offer school screening, according to a BIOS survey.In areas like Derbyshire, Lincolnshire and North Yorkshire, parents are instead given advice in their child's early development checks, or are signposted towards free NHS tests at their local optician.Others invite parents to complete a digital health screening questionnaire when children start school to highlight any concerns.Jenny Smedley, who carries out vision screening in Sheffield schools, says it is a good way to make sure most children are included.In groups of four, she takes the reception children at Marlcliffe Primary School out to the IT room to be tested.About 800 children have been referred on for further checks so far this year in the county."Parents often say to us, 'There is no way we would have known that there was a problem if screening wasn't there,'" she says."And if they weren't picked up, they wouldn't be able to access certain jobs later on in life, or even drive a car when they're older, so it's significantly important."
Marlcliffe Primary School's head teacher Clare Hayes agrees."It can be difficult for families with busy lives to make appointments at the opticians," she says. "And as parents and teachers, we may not always detect difficulties that children are having with their vision because the children have adapted and got used to that being their sight."Cllr David Fothergill, from the LGA, says he would like to see an increase in the public health grant which funds school-based screening, so that councils can commission and deliver the full range of services needed to improve child health.He says he believes the government's recent spending review overlooked public health funding.But the government said a £200m boost in funding, announced earlier this year, would help support local authorities to tackle the root causes of ill health, and build healthier communities nationwide.Experts say that parents should still bring their children for regular NHS-funded eye tests from the age of three or four every one to two years - even if they do live in areas that screen in schools.
Daniel Hardiman-McCartney, from the College of Optometrists, says school vision screening is a good safety net for children's vision, but it is not the same as an eye test at a local opticians - and both are important.Recent research by the college found many parents are confused about their children's eye health, and only take them for a test if they notice a problem.Harry's parents Ellen and Robert are encouraging everyone to make sure they get their child's eyes tested early, even if they are not able to read yet.The progress in Harry's right eye is being closely monitored to see if patching is still making a difference, and they say it is thankfully not stopping him from doing his favourite thing – reading.Visual journalism by Kady Wardell and Katherine Gaynor