Estera is very active and smiley. She’s curious about everything and constantly on the move.

She was born with Angelman Syndrome, a genetic disorder which means that she’s non-verbal and hyperactive. Although only four-years-old, she has delayed development and movement, along with balance problems and regular seizures. This can be challenging for her mother Ana:

"Now Estera can walk I have to watch her all the time. I worry when I’m out with her as she tries to put everything in her mouth and has no sense of danger."

Unfamiliar environments can be distressing for children with disabilities like Estera. SeeAbility Optometrist Lisa Donaldson explains:

"It would be extremely challenging to give Estera an eye test in a regular optical practice. You don’t have the space to follow her around the room in most practices."

Children with profound and complex disabilities can’t always respond when an optometrist asks a question. Every child is entitled to free NHS eye tests, but for Estera to access her right to eye care, she needs an Optometrist who can adapt to her needs. 

A different approach

Lisa visited Estera at her special school and used her specialist skills and experience of working with children with complex needs to assess Estera as she moved around. By singing nursery rhymes to keep her interested, Lisa was able to shine a light in each eye to judge its health and also to check how her eyes focus to see if she needs glasses.

Lisa was also able to test using other methods:

"I watched Estera moving around and playing with little toys, which tells me her eye movement is good. It’s really hard to get responses from Estera - developmentally she’s probably about 10-months-old and her attention span is very short."

Lisa can test Estera’s use of both eyes with a binocular vision or stereovision test. She shows Estera 3D images and if Estera reaches out to touch, both her eyes are working well. The tests work well with children who are active, even if they don’t communicate verbally. 

"The moment I could assess her best, she was lying on her back on a sofa with someone massaging her legs. In a high street practice I’d be forced to get her mum to hold her still which would make Estera unhappy and more uncooperative."

It takes all Lisa’s patience, specialist expertise and constant adaptation throughout the session to ensure that Estera gets the same level of eye care that every child is entitled to.