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Management of children and young people with vision impairment: diagnosis, developmental challenges and outcomes
  1. Sue Keil1,
  2. Alistair Fielder2,
  3. Jenefer Sargent3
  1. 1Royal National Institute of Blind People, Birmingham, UK
  2. 2Division of Optometry & Visual Science, City University London, London, UK
  3. 3Wolfson Neurodisability Service, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
  1. Correspondence to Professor Alistair Fielder, Division of Optometry & Visual Science, City University, Northampton Square, London EC1V 0HB, UK; a.fielder{at}


Vision impairment (VI) has a significant impact on an individual's ability to engage with everyday tasks. Severe early-onset VI presents different challenges to adult onset visual loss since reduced visual input presents a major obstacle to the acquisition and development of fundamental developmental skills in early and later childhood. Early referral of the child with reduced vision is vital to ensure accurate diagnosis and prompt treatment of any modifiable aspects of the condition. Guidance to ensure optimisation of developmental opportunity through adaptation of play and care is vital from the earliest stages. Cognitive and social challenges occur throughout education and need to be understood and addressed through skilled support. Multiagency input, particularly from health and education, is vital to minimise the risk of adverse outcomes and promote successful transition to independent adulthood. VI may also arise in a variety of neurological disorders, and diagnosis and assessment to ensure appropriate adaptations are made is also crucial for this group of children. This review provides the paediatrician with information on diagnosis, assessment, long-term support needs and outcomes.

  • Neurodisability
  • Ophthalmology

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  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.