Why screen children’s vision?

The development of a child’s sense of sight occurs over a period of years and is most sensitive to correction during the first seven to eight years of life.

Good vision is essential for proper physical development and educational progress in growing children. The visual system in the young child is not fully mature.

Equal input from both eyes is required for proper development of the visual centers in the brain. If a growing child’s eye does not provide a clear focused image to the developing brain, then permanent irreversible loss of vision may result.

Many vision problems in children go undetected by parents, teachers and the children themselves without a formal vision assessment.

Moreover children are often unaware that they are seeing “less” than they should and often do not complain of visual difficulties. Identifying children who may have issues with vision “appears to have substantial benefits in simpler, more effective, and less costly treatment, improvement of developmental outcomes, and enhancement of quality of life”.

An understanding of the importance of vision screening by administrators, teachers, school nurses, other school personnel and parents is critical to the outcome of a child’s academic success. Vision deficits are a common problem in the preschool and school age population.

Early detection and treatment of these deficits will lessen the possibility of any damaging long-term effects and may have a direct impact on each child’s academic performance.

Untreated vision problems can lead to:

  • Permanent loss of vision
  • Difficulty learning
  • Delayed sensory and social-emotional development

Eye examination and vision assessment are vital for the detection of conditions that result in blindness, signify serious systemic disease, lead to problems with school performance, or at worst, and threaten the child’s life.

Through careful evaluation of the ocular system, retinal abnormalities, cataracts, glaucoma, retinoblastoma, strabismus, and neurological disorders can be identified, and prompt treatment of these conditions can save a child’s vision or even life. Children at risk for eye problems (e.g., prematurity, family history of congenital cataracts, retinoblastoma, metabolic or genetic diseases,) demonstrate a much higher incidence of vision defects. It is important that this population be included in vision screening programs so learning problems are not compounded. Color vision problems are usually hereditary. The early detection of color vision problems is important because many toddler, preschool and elementary school games, activities, educational supplies and tasks are color oriented. Color vision problems are not a disease and are not treatable. However, it is important to provide information on color discrimination problems to parents and teachers.

Vision problems generally are not the direct cause of learning disorders; however, they can interfere with children’s abilities to perform to their potential.

Because children do not complain of visual difficulties, visual acuity measurement (vision screening) plays an important role in identifying potential vision problems and in promoting eye health as early as possible.

If a problem is detected, the child’s parent or guardian is notified and the child is referred for further evaluation and treatment if necessary. A well-developed vision screening program may help identify children ages 3 and older who may require additional follow-up with an eye care professional for a professional examination.

DIFFERENCE BETWEEN A VISION SCREENING AND AN COMPREHENSIVE EYE EXAMINATION? 

The visual screening do not involve examination of eye structures (such as the retina) to determine eye disease. There are several important differences between vision screening and a comprehensive vision examination:

SCREENING

    1. Identify children at high risk for visual problems or in need of a professional eye examination
    2. May detect signs of disorders in early, treatable stages
    3. Educate bout eye care parents and teachers with valuable information

 COMPREHENSIVE EYE EXAMINATION

    1. Identify risk factors for ocular disease
    2. Identify eye disorders and disease
    3. Determine the health status of the eye and related structures, visual system, and assess refractive errors
    4. Initiate an appropriate management plan: treatment, counselling, further tests, referral, follow up, …

Vision screening is not diagnostic. Children who fail the initial screening test and the rescreening test must be referred to an eye specialist for a diagnostic examination.

Screening will not identify every child who needs eye care, nor will every child who is referred require treatment.

The criteria for referral have been set to keep both the over-referrals (those with no problem on examination) and the under-referrals (those who are missed) at a minimum.

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