Passport Photo Rules for Blepharospasm, Tremors and Visual Impairments

If a medical condition means you cannot keep your eyes fully open, hold a still head position, or maintain a neutral expression for a passport photo, the standard advice — just relax, take a few attempts, try again — is not actually useful, because the issue is not effort or technique. It is the condition itself. This guide is for that situation specifically: conditions like blepharospasm, essential tremor, nystagmus, and other causes of involuntary movement or visual impairment that genuinely affect what a compliant photo looks like.

There is one official process that covers all of these situations, and it works the same way regardless of which specific condition is involved.

There is one process, not a separate rule for each condition

HM Passport Office does not publish separate protocols or different forms for blepharospasm, tremor, visual impairment, or any other specific condition. There is a single, general exception process that applies whenever a genuine disability or medical condition prevents someone meeting the standard photo requirements, and it works the same way no matter what the underlying condition is.

This is actually good news from a practical standpoint. You do not need to find condition-specific guidance that does not exist, or worry that your particular diagnosis is not covered. The process is genuinely general, and the job is simply to explain your specific situation clearly within that one process.

Blepharospasm and involuntary blinking

Blepharospasm causes involuntary, sustained contraction of the muscles around the eyes, which can range from frequent forceful blinking to the eyes being held closed for extended periods. The standard passport photo rule requires both eyes open and clearly visible — which for someone with blepharospasm is not simply a matter of holding still for a second longer.

In practice, this often means taking many more attempts than usual, ideally during a period when symptoms are milder, and accepting that the most representative photo achievable may still show eyes that are not fully or symmetrically open. If repeated genuine attempts do not produce a photo meeting the standard eyes-open requirement, this is exactly the situation the formal exception process exists for.

Essential tremor and involuntary movement

A tremor affecting the head or face can make two specific requirements difficult: a still, centred head position, and a genuinely neutral expression. Taking photos in short bursts, allowing brief rests between attempts, and trying at a time of day when tremor is typically less pronounced can help produce a usable shot. A second person taking the photo, rather than a self-timer, can also help by allowing more attempts in quicker succession without the applicant needing to reset their position each time.

Where a tremor genuinely prevents a compliant photo despite reasonable attempts, the same exception process applies, with the letter explaining specifically how the condition affects head position or expression.

Visual impairments and conditions affecting gaze

Conditions such as nystagmus, which causes involuntary, repetitive eye movement, can make the requirement to look directly at the camera genuinely difficult, since the eyes may not settle in a fixed forward position even briefly. The standard rule asks for eyes open and facing the camera because this is what a clear, identifiable image typically looks like. Where a genuine visual impairment changes how that image needs to be captured, the underlying purpose — an accurate likeness with the eyes clearly visible — is still being met even if the specific framing differs from the typical example.

The letter — what it actually needs to say

There is no official template, but the requirement is consistent and specific across HMPO's own guidance. The letter needs to cover three things:

The letter is most likely to be accepted without delay if it comes from a doctor or hospital consultant, on headed paper or otherwise clearly identifiable as genuine medical correspondence. Keep a copy of any letter used — the same condition is likely to be relevant again at the next renewal, and having the original makes producing an updated version considerably quicker.

Two related but different exceptions — the photo, and the identity interview

It is worth distinguishing these clearly, since they are easy to conflate but cover different parts of the application.

The photo exception covers the photo itself not meeting the standard rules. You explain the reason and attach a letter as described above. This applies if eyes-open, neutral expression, or head position cannot be met.

The identity interview exception is separate and covers a different stage of the process. Some applications, particularly first adult passports, require an in-person identity interview. If a mental or physical condition would prevent someone taking part in that interview, the same general mechanism applies — explain in section 8 or the online additional information section, and attach a letter from a doctor or consultant — and HMPO will arrange an alternative.

Online applications — how this works without a paper form

Section 8 specifically refers to the paper application form, but the large majority of UK passport applications are now made online. The same underlying process still applies. The online application includes its own additional information section where the explanation can be entered, and the supporting letter can be uploaded as part of the application or sent separately as instructed during the process.

The substance of what is required does not change between the two routes: an explanation of the condition and its effect on the photo, plus a letter from a doctor or consultant addressing whether the condition is permanent or temporary.