As children get ready to head back to school, we reflect on the importance of vision for learning. This month Colorado Governor John Hickenlooper released a proclamation recognizing the prevalence of undiagnosed and untreated vision disorders. In his proclamation, Gov. Hickenlooper states that as many as one in four school-age children has vision problems. Indeed, vision problems are the most common disorders among children. He calls on all Coloradoans to recognize the importance of education in children’s lives. He says, “Parents are encouraged to have their children evaluated for vision problems to maximize their potential in the classroom.”
Usually, most children do not need a complete eye examination; however, all children should have serial screenings. Objective, device-based vision screening or photoscreening is an excellent way to accomplish screening in young children. With the right referral criteria in place, screenings in preschoolers can help to identify risk factors for amblyopia. Therefore, children’s screening should be performed yearly.
Recently the American Association for Pediatric Ophthalmology and Strabismus added the option of photoscreening for children ages 12 months to 36 months to its recommendations. If a child fails the screening, it is then referred to an eye care provider for a complete eye examination with dilation.1 Not all children who have a refractive error will need to wear glasses; the treatment will depend on their individual situation and factors such as age and the level of risk for developing amblyopia.
Therefore, it is crucial that there is a follow through when a child is referred with a “Refer” screening result for a complete exam. Communication is key throughout this process, starting with the person who performs the vision screening.
In January 2016, the American Academy of Pediatrics updated its vision screening policy for pediatricians. The policy statement recommends that instrument-based screening in the office setting be first attempted between 12 months and 3 years of age and at annual well-child visits thereafter until acuity can be tested directly.
Read how the updated vision screening statement spurs change in a pediatrician’s practice in our today’s blogpost by Denise Brown, MD.
Photoscreening is an efficient and effective method of identifying kids at risk for amblyopia.
The Kodiak Area Native Association (KANA) serves a 12,000-member community located on a large, mostly uninhabited island in Alaska. I am a Developmental Specialist with the KANA Infant Learning Program. This is a part of the Alaska Early Intervention system that works with young children, who are experiencing developmental delays, or are at risk of developing such delays, and their families.
KANA collaborates with Alaska Blind Child Discovery (ABCD), a cooperative, charitable research project to conduct vision screening on every preschooler in Alaska. ABCD is the brain child of pediatric ophthalmologist Robert Arnold, MD. During his pediatric fellowship at Indiana University, Dr. Arnold became intrigued with detecting small-angle strabismus using the Brückner Test. After starting practice in Anchorage with Ophthalmic Associates in 1989, he began publishing clinical research around modifying the test. As his interest in photoscreening advanced, Dr. Arnold began working with public health nurses, and later various charities to launch screening clinics in urban and remote villages.
“Working to educate the community about the value of early childhood vision screening with the platform that Miss Colorado has provided me has been a very rewarding experience. By sharing my story, I hope I convince more people to support and participate in screening programs.”
“Really? Now we should photoscreen all kids over the age of 1 year? What else can they put on us.” That was my first thought when the American Academy of Pediatrics, the American Academy of Ophthalmology, and the American Optometric Association updated their screening policy statements in 2015 to include recommending photoscreening for children ages 1 to 3.
After our group of five independent pediatricians calmed down and thought about the idea, however, we realized that this new technology was probably far superior to the old methods we employed to screen vision. We researched the available products, seeking the tool that would accomplish screening with the highest specificity and sensitivity. The tools varied in cost and sophistication from cell phone apps to more expensive screening devices. We collected data on the options and presented it to the optometrists and pediatric ophthalmology groups to whom we refer. We asked them, which of these products would you want us to use on your child? They understand that over- and under-referrals are real issues in our community, and they want to prevent them as much as we do. They all picked Plusoptix. Continue reading “VISION SCREENING IN PRIMARY CARE – It is time to get onboard”
Robert “Bob” Fitzgerald manages the KidSight program in his chapter in Louisiana. He had undetected ambylopia as a child and became blind in his left eye. Today, in his KidSight program, 4,000 kids are screened per year with 3 devices of their own. Nevertheless, he has never conducted a screening himself, because he thought he was not able to. But when a friend experienced that his grandchild had a problem with its vision, and was asking Bob for help, he was right there on the spot.
Welcome to the Plusoptix Amblyopia Screening monthly blog where readers can learn more about the importance of amblyopia screenings and follow-up eye exams in early childhood as well as other key topics related to kids’ eye health.
Vision screening that requires a child to respond to an eye chart has been shown to have poor predictive value, especially in the first 3 to 4 years of life.(1) Instrument-based vision screening, however, can detect abnormalities that could lead to permanent vision loss. Plusoptix, founded in 2001, is dedicated to the development of binocular handheld photorefractors for babies, children, and uncooperative patients. Plusoptix vision devices screen for hyperopia, myopia, astigmatism, anisometropia, anisocoria, and strabismus. A number of these conditions are considered risk factors for amblyopia, which can cause partial or full blindness if not treated. The goal of amblyopia screening is to detect vision disorders in the first few years of life and to and treat early when therapy has the best chance of being successful. Continue reading “Welcome!”
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