Vision Screening in Preschool Children: Should a child be admitted to the glaucoma screening?

Abstract

The global initiative of World Health Organization (WHO), Vision 2020, The Right to Sight, has set the goal of prevention of blindness and visual impairment. The data of WHO are in favor of the fact that more than 45% of blindness in children is preventable. The etiology of blindness and visual impairment in children varies from country to country. The screening programs of visual impairment in children under the age of five exist in many countries of high or midle socioeconomic status. The screening programs of visual impairment of children are heterogonous with the respect of their goal, instruments, profile of professionals and the level of health care system where the screenings are performed. The Ministry of Health of Republic of Croatia has brought the decision on the implementation of screening of visual impairment in children aged over three years, according to the world practice. In the planning of visual impairment screening, it is important to define which visual will be screened in certain population of children and how. The instruments and the methods of visual impairment screening, depending on age of children, their development, compliance and interaction with the screener are presented. Primary goal of visual impairment screening was detection of ambliopia in children. But the etiology of visual impairment in children is much broader. The special emphasis in this paper is placed on glaucoma in children because of its broad presentation from birth to the adolescence, in the sense of congenital glaucoma or as a part of systematic diseases. In the conclusion it could be said that the standardization of visual impairment screening should be done on several levels such as exacts definition of the goal of screening according to the child’s age, professionals involved in screening program and the standardization of level of health care system where the screening should be performed.