Orthoptics – Visual Processing Difficulties Clinic

General introduction

The Orthoptic Visual Processing Difficulties (VPD) Clinic is a specialist service for children and young people who have problems with reading, tracking text, visual perception or visual comfort. These difficulties may be linked to the way their eyes work and process visual information.

The clinic can assess:

how the eyes work together, including eye alignment and convergence (the ability to turn the eyes inwards)
focusing ability, especially when reading or doing close-up tasks
eye movements, including how well the eyes follow and move between words and objects
visual perception skills, such as recognising, remembering and understanding visual information

The assessment helps identify whether visual, eye movement or visual perception difficulties may be affecting your child. If needed, we will provide advice, management strategies and recommendations to support them.

How to access this service

Before referring

The Visual Processing Difficulties (VPD) Clinic is not a first assessment for dyslexia, reading and writing difficulties, learning difficulties, or attention and behaviour concerns. Schools should first identify the child's educational needs and put suitable support and classroom adjustments in place.

Before making a referral, please make sure that:

the child is 8 years old or over
the child has had an eye test within the last 12 months
any prescribed glasses are worn regularly
appropriate educational support and classroom adjustments have been put in place and reviewed
any visual symptoms during reading have been identified and recorded - this should include whether classroom adjustments have improved the child's visual comfort
difficulties continue despite the support and adjustments already tried
the VPD Referral Tool has been completed in full

Coloured overlays

The Orthoptic Service does not routinely assess children solely for coloured overlays.

If a child already uses a coloured overlay, coloured background or another visual adjustment, schools should record whether it improves their visual comfort.

How to refer

We accept referrals from health care professionals from all areas and from teachers / staff in schools and colleges in Warrington and Halton boroughs.

Children who live or attend school outside Warrington and Halton can also be referred. Please see the 'Referrals from outside Warrington and Halton' section below.

Please download and read the:

VPD referral pathway and guidance for schools

Then complete the:

VPD referral tool

Please make sure all sections are completed before submitting the referral.

From 1 January 2027, referrals will be returned if they:

do not meet the pathway requirements
are incomplete
use a previous version of the referral tool

Referrals from outside Warrington and Halton

For children who do not live or attend school in Warrington or Halton, referrals must be made by the child's school.

The referral must also include confirmation from the child's GP that they are happy for the child to be assessed by a service outside their local NHS Trust.

About the team

The team consists of fully qualified orthoptists who are specialists in assessing children with visual processing difficulties. Each orthoptist has completed relevant post graduate training and has extensive experience in this area.

Kathryn Whitfield – highly specialist orthoptist and lead of the service
Lydia Bodell – specialist orthoptist
Jenny Shave – specialist orthoptist
Emma Rowett – highly specialist orthoptist
Aoife McCaughey – specialist orthoptist
Milly Bowen – specialist orthoptist

Useful information

Orthoptists, are trained to assess patients of all ages and abilities which enables us to be flexible with our approach and allows us to adapt our testing to suit individual needs. We are trained to help children with specific learning difficulties, such as dyspraxia and autism spectrum disorder (ASD). We work closely with school special educational needs coordinators (SENCO) and teachers to provide the holistic care for each child.