Pediatric Vision Screening

Abstract

1. Gary L. Rogers, MD 2. Catherine Olson Jordan, MD 1. Department of Ophthalmology, Nationwide Children’s Hospital, Columbus, OH. Although early detection of visual disorders can lead to therapy that will prevent permanent blindness, compliance with screening guidelines of the American Academy of Pediatrics is low. After completing this article, readers should be able to: 1. Be aware of common vision-threatening conditions that can be detected by using basic screening examinations. 2. Become familiar with techniques and findings used in vision screening examinations. 3. Understand the role of commercial screening tools. Early detection of ocular conditions can allow for assessment and treatment of a vision-threatening or life-threatening condition. Amblyopia, or “lazy eye,” can develop if a clear visual image is not projected onto the retina. Amblyopia can be caused by deprivation, strabismus, high refractive error (hyperopia, myopia, or astigmatism), or anisometropia (significant difference in the refractive error between eyes) and can be unilateral or bilateral. The prevalence of amblyopia is estimated to be 1% to 4%. (1) Many factors may prevent the achievement of universal vision screening, including lack of education of families; language, financial, and state legislative barriers; and a lack of available providers. (2) Primary care physicians are crucial providers for detecting and referring vision-threatening ocular conditions. From the newborn examination, through subsequent health supervision visits, and throughout a child’s life, the pediatrician and family physician can perform effective examinations to screen for common and uncommon conditions that may be vision-threatening or even potentially life-threatening. (3) However, vision screening in the primary care office should not take the place of a full eye examination. If a patient cannot be screened effectively after two attempts, a referral should be made to an eye care professional who is comfortable examining children. …