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Safeguarding for children


Keeping a look out for child abuse may not be intuitive for an optometrist. However, do think twice as we are often one of the few professionals that come into contact with children. Our responsibility is to learn to recognize signs of abuse or neglect and know what to do next. We are NOT expected to diagnose or investigate the instances.

Four types of abuse:

1) Physical

2) Emotional

3) Neglect

4) Sexual

Physical abuse: Children are prone to accidents. If you are concerned you may ask the child or the parent how they got the injury. Signs that the injury not being accidental are:

- Delay or no medical help

- Very vague story about the event

- Site of injury inconsistent with story

- No explanation

- Parent not allowing child to tell the story

- Different injuries on repeat visits

- Fabricating symptoms of an illness in order to obtain treatment or therapy

- Ocular signs (ecchymoses, hemorrhages around and within the eye, subluxated lenses, cataract, atrophy of optic nerve, choroid or retinal scars that are related to abusive head trauma (AHT) aka shaken baby syndrome)

- Bruises (make sure it is not birth mark or moxibustion)

You should record in as much detail as possible about what you have been told and signs of injury. If medical attention is needed, call for help and report.

Emotional abuse: Maltreatment can cause adverse effects on the development of a child. It is less obvious to detect and requires great amount of observation. Some of the signs are:

- Child appears sad and withdrawn

- Witness inappropriate exchange between parent and child

- Parent appears uncaring about the child's basic need

Neglect: It is a failure to meet a child's physical or psychological needs. This however is different from differing parental standard. Signs of neglect includes:

- Undernourished and appears hungry

- Extremely poor hygiene

- Wearing inappropriate clothing

- Parent shows lack of interaction/ concern with child

- Missed appointments and failure to replace broken spectacles*

Important to note that poverty does not equal neglect hence it is important to ask the parent or child to understand better and offer necessary help.

Sexual abuse:This is something that is extremely hard to recognize and it may only be apparent after a long time of interaction with the child. Indication of sexual abuse are:

- Child telling you something that indicates abuse

- Child may act inappropriately toward you


If you suspect child abuse and the child's life could be in danger, call the police on 999 immediately.

If you are worried and needs help and support, call 1800-777-0000 or email to Ministry of Social and Family Development's Child Protective Service at

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