Strabismus or ocular motility disorder in paediatric patients

​​​​​​​​​​​​​​Emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergency medical advice via phone to on-call consultant/registrar:

  • abnormal red reflex or lack of visual response
  • sudden onset strabismus (squint) with diplopia
  • suspicion of nerve palsy with other cranial nerve and/or neurological signs

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.
  • Recent (up to 3 months in duration) or acute onset of strabismus (squint)
  • Aged < 1 year with constant strabismus
Category 2
Recommended to be seen within 90 calendar days.
  • Strabismus with systemic disease or developmental delay
  • Aged < 8 years with one or more of the following:
    • strabismus with visual asymmetry
    • reduced or loss of binocular vision
    • asymmetrical visual acuity
Category 3
Recommended to be seen within 365 calendar days.
  • Aged ​≥ 8 years with strabismus

Information to include within a referral

Required

  • Reason for referral
  • Details of the presenting condition including symptoms, type (constant or intermittent, unilateral or alternating) and duration (acute or longstanding onset)
  • Provisional diagnosis
  • Patient health summary (such as relevant medical history, relevant investigations,
    current medications and dosages, immunisations, allergies and/or adverse reactions)
  • Patient seen or not seen by another eye health professional (optometrist, orthoptist or ophthalmologist)

If available

  • Visual acuity or assessment of visual response
  • Direction of ocular misalignment (vertical or horizontal, convergent or divergent)
  • Corneal reflexes (e.g. Hirshberg test)
  • Optometrist, orthoptist or ophthalmologist report performed within last 3 months
  • Cover test
  • Ocular motility
  • Cycloplegic refraction
  • Head posture
  • Birth and pregnancy history​

Important information for referring health professionals​

If there is a change to a patient’s condition while waiting for their appointment, referring health professionals may further investigate and manage the situation, or send an updated referral to the outpatient service. Where there are significant concerns about a patient's condition, referring health professionals may check HealthPathways for urgent/same day advice or contact the relevant clinical team.​


 

Current as at: Monday 23 March 2026
Contact page owner: System Purchasing