Eye Cancer Children Turned Away From Practices: ABDO’s Response

In response to the Childhood Eye Cancer Trust ‘s findings that almost half of optical practices approached by parents of children later diagnosed with eye cancer last year refused to see the children, the Association of British Dispensing Opticians (ABDO) President Fiona Anderson BSc(Hons) FBDO R SMC(Tech) FEAOO says, “We promote eyecare for babies, toddler and children. Children don’t need to be able to read to have an eye test. As Dispensing Opticians our members are a vital part of managing their journey in eyecare, with specialist competence in Paediatric Dispensing as a core function.”

Clive Marchant FBDO, Vice President, says, “Although these statistics are based on small numbers, they may be indicative of a wider problem. They demonstrate why the GOC need to change the way practitioners are listed on the register. Paediatric examination is a core competency for every optometrist and paediatric dispensing is a core competency for all Dispensing Opticians but clearly there are some practitioners who are more comfortable than others with small children and babies. The register should show practices and opticians, optometrists and Dispensing Opticians who are child friendly.” He continues, “I strongly believe that practices that have a Dispensing Optician front of house are more likely to recognise serious problems when patients are booking appointments. They are hence able to intervene to book an urgent appointment or refer.”

The Childhood Eye Cancer Trust (CHECT) reports that in 2017 11 practices across the UK were contacted by parents concerned about their child’s eyes, who was subsequently diagnosed with retinoblastoma, a rare form of eye cancer affecting babies and young children. Five of the practices refused to make appointments because of the child’s age.

Patrick Tonks, Chief Executive of the Childhood Eye Cancer Trust (CHECT), which released the figures today, said: “We understand that opticians do not usually see babies and very young children for routine eye examinations. However, it is important that frontline, non-optical staff are trained to recognised those red flag symptoms described by parents which could indicate a serious condition, and which require urgent examination by an optometrist or GP.”

To aid practices to do this, CHECT has developed an Opticians Protocol on Retinoblastoma. Endorsed by the College of Optometrists and the Royal College of Ophthalmologists, the Protocol is written in lay language and is aimed at all practice staff, including receptionists and dispensing opticians. It describes certain red flag symptoms which could indicate retinoblastoma, and informs staff of the appropriate action to take.

Tonks continues: “CHECT recommends that the Opticians Protocol is part of every practice’s in-house training programme for staff, and ask opticians to join us in working to prevent children with eye cancer having their diagnosis delayed.”

CHECT released the figures today to mark Rare Disease Day, which aims to raise awareness about rare diseases and their impact on patients’ lives. Retinoblastoma (Rb) is a rare form of aggressive eye cancer affecting babies and small children under the age of six, with around one child a week being diagnosed in the UK. Early diagnosis is essential in order to save a child’s eyes, sight and life. Sadly, more than 70% of children diagnosed with retinoblastoma will lose an eye to stop the cancer spreading.

The main presenting symptoms of children diagnosed with Rb in the UK between 2012 and 2017*, were:


  • Leukocoria – 64%
  • Squint – 33%
  • Change in colour of iris – 13%
  • Redness or swelling without infection – 7%
  • Roaming eyes / child not focusing – 7%
  • Loss of vision – 7%
  • Absence of red eye – 1%

The Opticians Referral Protocol for Suspected Retinoblastoma can be viewed at www.chect.org.uk/optician .