The results of this clinical study show that the BVFB is a reliable tool for assessing the visual function in children with severe learning disability in whom other tests fail to elicit a response. The need for a tool which is quick to administer and portable has previously been highlighted. The BVFB offers an option for children for whom other formal tests are unsuccessful in eliciting a response.

The study demonstrates significant unmet need or undiagnosed visual impairment in a high-risk population. It also highlights the poor uptake of hospital eye care for children identified with significant visual needs and suggests the importance of providing in-school assessment and support, including refractive correction, to fully realise the benefits of a visual assessment programme.

Aim: To review the children's school vision screening service in order to investigate the uptake, referral pattern and follow-up attendance. Methods: The children were screened in school. The vision screening results of the children screened in the academic year 2011-2012 were reviewed for both uptake of screening and subsequent attendance for the follow-up assessment. Attendance outcomes from children referred to an optometrist of their choice and also those children referred to the Hospital Eye Service (HES) were reviewed. Results: Of the 5786 children eligible for vision screening in school 5409 were screened (96.7%). A total of 866 (16%) of children were referred for further investigation; 534 (9.87%) were referred to an optometrist of their choice and 332 (6%) were referred to the Hospital Eye Service (HES). 479 (55.3%) attended the first appointment sent. 114 (34.4%) failed to attend (FTA) the HES and 257 (48.13%) failed to attend their local optometrist. Recall appointments for the HES yielded a 10.54% increase in coverage and recall appointments sent to attend local optometrists yielded a 14.23% increase in coverage. Conclusions: Vision screening in school provides the opportunity for universal coverage. However, the failure to attend for follow-up both in the community and in the Hospital Eye Service (HES) suggests that a high proportion of children fail to benefit from appropriate treatment. Further research is required to provide an insight into the reasons for failing to attend that subsequently limit access.