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Vol. 28 No. 2, February 2007
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Right arrow Disorders of the Eye

(Pediatrics in Review. 2007;28:54-61.)
© 2007 American Academy of Pediatrics

Vision Screening Essentials: Screening Today for Eye Disorders in the Pediatric Patient


Donald H. Tingley, MD*
* OcuSight Eye Care Center, Rochester, NY

The first 300 words of the full text of this article appear below.


    Learning Objectives
 
After completing this article, readers should be able to:

  1. Discuss the role of early intervention for vision-threatening problems.
  2. Explain how to screen patients for the most common vision problems.
  3. Recognize when to screen for vision problems.
  4. Describe who should be screened for vision problems.


    Introduction
 
Screening for eye disorders and vision problems is essential in preparing pediatric patients for the future. For this reason, regular vision evaluations are recommended by the American Academy of Pediatrics (AAP).

Significant problems affecting vision are common in children. Vision problems occur in 5% to 10% of all preschoolers and include refractive error, strabismus, and amblyopia. Strabismus is present in 4% of preschool-age children, and amblyopia affects up to 40% of those having strabismus. Major refractive errors requiring correction occur in 5% to 7% of preschool-age children. Cataracts in children are far less common (0.1% incidence), but vision can be affected seriously without early treatment. A simple screening can check effectively for such problems during a time when treatment is most critical without requiring all patients to have a "gold standard" complete eye evaluation at every age, saving both time and health-care resources.

Screening improves visual acuity. In a randomized, longitudinal study, intensive early screening led to a 60% decreased prevalence of amblyopia and improved visual acuity compared with a one-time screening at 37 months of age. (1) Amblyopia responds to therapy, and results are best when treatment is started early in life. The same study showed a 70% lower prevalence of residual amblyopia after treatment when therapy was initiated before age 3 years. The single most effective screening test for the presence of amblyopia is the determination of visual acuity via noninvasive screening.

The consequences of not finding vision-related problems can include adverse effects on school and social performance as well as adult . . . [Full Text of this Article]







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